Measurement of free drug and clinical end-point by high-performance liquid chromatography-mass spectrometry: Applications and implications for pharmacokinetic and pharmacodynamic studies

Free drug measurement and pharmacodymanic markers provide the opportunity for a better understanding of drug efficacy and toxicity. High-performance liquid chromatography (HPLC)-mass spectrometry (MS) is a powerful analytical technique that could facilitate the measurement of free drug and these markers. Currently, there are very few published methods for the determination of free drug concentrations by HPLC-MS. The development of atmospheric pressure ionisation sources, together with on-line microdialysis or on-line equilibrium dialysis and column switching techniques have reduced sample run times and increased assay efficiency. The availability of such methods will aid in drug development and the clinical use of certain drugs, including anti-convulsants, anti-arrhythmics, immunosuppressants, local anaesthetics, anti-fungals and protease inhibitors. The history of free drug measurement and an overview of the current HPLC-MS applications for these drugs are discussed. Immunosuppressant drugs are used as an example for the application of HPLC-MS in the measurement of drug pharmacodynamics. Potential biomarkers of immunosuppression that could be measured by HPLC-MS include purine nucleoside/nucleotides, drug-protein complexes and phosphorylated peptides. At the proteomic level, two-dimensional gel electrophoresis combined with matrix-assisted laser desorption/ionisation time-of-flight (TOF) MS is a powerful tool for identifying proteins involved in the response to inflammatory mediators. (C) 2003 Elsevier Science B.V. All rights reserved.

Effects of phytase supplementation of phosphorus-adequate, lysine-deficient, wheat-based diets on growth performance of weaner pigs

The effects of microbial phytase supplementation of phosphorus-adequate, wheat-based diets with available lysine : energy density ratios ranging from 0.75 to 0.90 g available lysine/MJ DE on growth performance of weaner pigs were investigated in 3 studies. In the first study, increasing levels of dietary phytate depressed growth rates (P<0.08) and efficiency of feed conversion (P<0.01) and phytase supplementation enhanced growth rates (P<0.05) and tended to improve feed efficiency (P<0.15). There were no significant interactions between dietary phytate and phytase inclusion to support the hypothesis that dietary substrate levels of phytate govern responses to phytase. However, in this and other studies, percentage increases in efficiency of feed conversion generated by phytase were positively correlated to dietary phytate concentrations to a significant extent (P<0.005), so it is possible that dietary substrate levels are of importance to the magnitude of responses following phytase supplementation. Diets with 3 levels of protein, expressed as 0.80, 0.85, and 0.90 g available lysine/MJ DE, were offered to pigs without and with phytase in the second study. Protein/amino acid levels or lysine : energy density ratios did not influence growth performance, which was not expected. However, phytase tended to increase growth rates (P<0.08) and improved feed efficiency (P<0.01). Although it is believed that phytase may have a positive influence on protein utilisation, this was not demonstrated in this experiment. In the third study, the simultaneous inclusion of phytase and xylanase feed enzymes in wheat-based weaner diets did not increase growth performance responses in comparison with phytase alone. Individually, phytase improved feed efficiency (P<0.05) and numerically increased growth rates (P<0.25). Although responses in growth performance of weaner pigs following phytase supplementation lacked consistency, they were generally positive and indicative of anti-nutritive properties of phytate that are unrelated to P availability. That these positive responses were observed in diets with suboptimal available lysine : energy density ratios is consistent with the possibility that phytate has a negative influence on protein utilisation, which is ameliorated by phytase. However, these antinutritive effects and their underlying mechanisms need to be better defined if full advantage of the potential protein-sparing effects of microbial phytase is to be taken.

Assessment of P availability in heavily fertilized soils using the diffusive gradient in thin films (DGT) technique

Phosphorus-availability tests typically provide an indication of quantity of P available (Colwell bicarbonate-extractable P), or of the intensity of supply (0.01 M CaCl2-extractable P). The soil's capacity to buffer P is more difficult to assess, and is generally estimated using a P-adsorption curve. The diffusive gradient in thin films (DGT) approach may provide a simpler means of assessing a soil's ability to maintain soil solution P. Optimal extraction conditions were found to be 24 h exposure of DGT samplers to saturated soil. The DGT approach was evaluated on a range of 24 soils, some of which had high Colwell- (>100 mu g g(-1)) and Bray 1- (>30 mu g g(-1)) extractable P content, but showed a tomato (Lycopersicon esculentum Mill.) yield response to the addition of P fertilizer. The DGT approach provided an excellent separation of soils on which tomato showed a yield response, from those where fertilizer P did not increase dry-matter yield. Phosphorus accumulation was strongly correlated with soil solution P concentration and anion exchange resin-extractable P, but showed poor correlation with Colwell- or Bray 1-extractable P. The DGT P accumulation rate of 3.62 x 10(-7) to 4.79 x 10(-5) mol s(-1) m(-3) for the soils tested was comparable to the uptake rate of roots of tomato plants that were adequately supplied with P (2.25 x 10(-5) mol s(-1) m(-3)).

Palm kernel meal in broiler diets: effect on chicken performance and health

An increase in the production of palm kernel meal (PKM) coupled with the concern for continued availability of conventional feedstuffs in some parts of the world has led to research to establish the maximum inclusion level of palm kernel meal in broiler diets. The results suggested that palm kernel meal has no anti-nutritional properties and thus its inclusion is safe up to at least 40% in the diet, provided the diet is balanced in amino acids and metabolisable energy. Although feed digestibility is decreased due to high dietary fibre when PKM is included in the diet, the feed intake is increased. This makes total digestible nutrient intake relatively high. beta-mannan is the main component of palm kernel meal non-starch polysaccharide (NSP). Both mannose and manno-oligosaccharides have been reported to act as prebiotics. The inclusion of palm kernel meal in the diet improves the immune system of birds and reduces pathogenic bacteria and increases the population of nonpathogenic bacteria in the intestine. These two benefits should be considered as strong recommendations for using palm kernel meal in broiler diets, particularly in palm kernel meal producing countries, not only for increasing bird productivity but also to improve chicken health. Selective enzyme addition increases feed efficiency and digestibility as well as decreasing the moisture content of faeces.

Benchmarking of performance of Mexican states with effective coverage

Benchmarking of the performance of states, provinces, or districts in a decentralised health system is important for fostering of accountability, monitoring of progress, identification of determinants of success and failure, and creation of a culture of evidence. The Mexican Ministry of Health has, since 2001, used a benchmarking approach based on the World Health Organization (WHO) concept of effective coverage of an intervention, which is defined as the proportion of potential health gain that could be delivered by the health system to that which is actually delivered. Using data collection systems, including state representative examination surveys, vital registration, and hospital discharge registries, we have monitored the delivery of 14 interventions for 2005-06. Overall effective coverage ranges from 54.0% in Chiapas, a poor state, to 65.1% in the Federal District. Effective coverage for maternal and child health interventions is substantially higher than that for interventions that target other health problems. Effective coverage for the lowest wealth quintile is 52% compared with 61% for the highest quintile. Effective coverage is closely related to public-health spending per head across states; this relation is stronger for interventions that are not related to maternal and child health than those for maternal and child health. Considerable variation also exists in effective coverage at similar amounts of spending. We discuss the implications of these issues for the further development of the Mexican health-information system. Benchmarking of performance by measuring effective coverage encourages decision-makers to focus on quality service provision, not only service availability. The effective coverage calculation is an important device for health-system stewardship. In adopting this approach, other countries should select interventions to be measured on the basis of the criteria of affordability, effect on population health, effect on health inequalities, and capacity to measure the effects of the intervention. The national institutions undertaking this benchmarking must have the mandate, skills, resources, and independence to succeed.