Teicoplanin A3-1

In this study, a novel and high-throughput liquid chromatography-tandem mass spectrometric (LC-MS-MS) assay was developed and validated for simultaneous determination of two glycopeptides (vancomycin, teicoplanin) and two small molecule compounds (meropenem, voriconazole) in human plasma. Only 50 μL of human plasma is used to quantify these four drugs simultaneously at clinical concentration levels. After a relative simple protein precipitation, the supernatant was then diluted with mobile phase acetonitrile: 0.1% formic acid (5:95, v/v) to avoid solvent effect and reduce the matrix effect. Then, the target compounds were separated on an Agilent Zorbax SB-C18 column (4.6 × 50 mm, 2.7 μm). All the target compounds were detected by positive ion mode. The teicoplanin concentration was determined as the sum of six components (A2-1, A2-2, A2-3, A2-4, A2-5 and A3-1). The method was linear in the concentration range 0.3-30 μg/mL for meropenem; 1-100 μg/mL for teicoplanin and vancomycin; 0.3-10 μg/mL for voriconazole. The lower limit of quantitation (LLOQ) of meropenem and voriconazole were 0.30 μg/mL; and the LLOQ of teicoplanin and vancomycin were 1.0 μg/mL. The intra- and inter-day accuracies were<9.67% and 13.0%, and the precisions were <14.5% at all tested concentrations. The entire analysis time for the four drugs was only 5 min for each sample. The currently developed assay was successfully applied for the therapeutic drug monitoring of 85 patients administered with standard drug treatments, demonstrating its high-throughput clinical usage for the therapeutic drug monitoring.

Teicoplanin, a lipoglycopeptide antibiotic, consists of five major components (A2-1 through A2-5), one hydrolysis component (A3-1), and four minor components (RS-1 through RS-4). All the major components contain an N-acyl-beta-D-glucosamine, but they differ in the lengths and branchings of their acyl-aliphatic chains. Previous studies with radiolabeled teicoplanin in rats and humans have shown that the drug is eliminated by the renal route and that metabolic transformation is very minor, about 5%. A possible metabolic transformation of teicoplanin into A3-1 was also suggested. In the present study in humans, two metabolites (metabolites 1 and 2; 2 to 3% of total teicoplanin) were isolated after intravenous administration of radiolabeled teicoplanin. After purification, their structures were determined by fast atom bombardment mass spectroscopy and 1H nuclear magnetic resonance spectroscopy on the basis of the well-known correlations established in this field, and they were found to be new teicoplaninlike molecules, bearing 8-hydroxydecanoic and 9-hydroxydecanoic acyl moieties. This metabolic transformation is likely due to hydroxylation in the omega-2 and omega-1 positions for metabolites 1 and 2, respectively, of the C-10 linear side chain of component A2-3. This might explain the low extent of metabolism of teicoplanin if we consider that only component A2-3 has a linear chain that is susceptible to such oxidation.

Total and unbound concentrations of six teicoplanin components in human plasma were determined by high-performance liquid chromatography with a coextractive cleanup technique. Unbound concentrations of teicoplanin components were estimated after ultrafiltration of plasma. For determination of each component in plasma, plasma was deproteinized with acetonitrile and the supernatant was shaken for 60 s with chloroform under acidic conditions. The recoveries of A3-1, A2-1, A2-2, A2-3, A2-4 and A2-5 were greater than 88%. The within-day and between-day coefficients of variation were 1.3-8.8% and 2.8-11.9%, respectively. The limits of detection in ultrafiltered plasma for each component were 0.82, 2.87, 4.23, 3.36, 7.33 and 4.93 nM, respectively. A good correlation was observed between the FPIA and HPLC methods when total concentrations of each teicoplanin component in patient plasma were determined. The analytical methods established in this study are suitable for determining the total and unbound concentrations of six components of teicoplanin in human plasma and for studying the pharmacokinetics of teicoplanin components in patients.