R eseaRch a Rticle
Tuberculosis, a pervasive and infectious disease
of the respiratory system, is one of the most
lethal worldwide health threats [1] . Prothiona-
mide (PTA; 2-propyl-4-pyridinecabothio-
amide) is a thioamide antibiotic, used in the
treatment of mycobacterial infections caused
by Mycobacterium tuberculosis, Mycobacterium
leprae and Mycobacterium avium complex infec-
tions [2] . PTA along with ethionamide (ETA)
belongs to the thioamide class and these are
considered second-line drugs for the treatment
of multidrug-resistant tuberculosis. They are
mainly used during resistance to first-line treat-
ment with isoniazid and rifampin, and leprosy
[3] . They are commonly used in conjunction
with other antimycobacterial chemotherapeu-
tics. PTA has a bacteriostatic effect and the
mode of action is assumed to be similar to that
of ETA due to structural similarity. Based on
cell activation method, Wang et al. have shown
definitive evidence that PTA and ETA form
covalent adducts with nicotinamide adenine
dinucleotide, which acts as an inhibitor of an
M. tuberculosis and M. leprae InhA gene product
(a gene encoding a target for PTA and ETA in
tuberculosis) [4] . Like ETA, PTA is a prodrug
and gets metabolized by mycobacterial enzymes
to its active form, prothionamide sulfoxide
(PTA-SO), which is then metabolized further to
the nicotinamide and nicotinic acid forms, with
no antibacterial activity [5] . The bioavailability
of PTA is almost 90% after oral administra-
tion. It has negligible plasma protein binding
and the peak plasma concentration (1–5 μg/ml)
is achieved in approximately 1 h [6,101] .
Very few reports describe methods for the
analysis of PTA and its metabolite PTA-SO in
biological fluids [6–10] . Jenner et al . compared
the blood levels and rates of urinary excretion
of PTA and ETA and their sulfoxide metabo-
lites in humans by HPLC–UV [6] . The analytes
were determined in plasma, urine and fecal sam-
ples. A quantitative thin-layer chromatographic
determination of PTA and PTA-SO has been
described in human plasma and urine [8] . The
linearity was established from 0.75 to 25 μg/ml
for both the analytes. Another method based on
normal-phase HPLC–UV has been presented
for simultaneous determination of PTA and
ETA and was used for a PK study in humans
[9] . The samples were prepared by liquid–liquid
extraction (LLE) in diethyl ether employing
3 ml plasma/serum and urine. A simple, rapid
and sensitive HPLC method has been proposed
for determination of PTA in human serum [10] .
The LLOQ for 300 μl serum was 27 μg/l and
the chromatographic run time was 8 min. A
comparative summary of reported procedures
for PTA and/or PTA-SO in biological samples
is shown in Table 1.
Ex vivo conversion of prodrug prothionamide
to its metabolite prothionamide sulfoxide with
different extraction techniques and their
estimation in human plasma by LC–MS/MS
Background: The present work reports an ex vivo conversion study of prothionamide to its active metabolite
prothionamide sulfoxide in human plasma during sample preparation by three conventional extraction techniques.
Results: The chromatography was done on a Hypersil™ Gold C18 (50 × 2.1 mm, 3.0 µm) column using 0.1%
acetic acid and acetonitrile (20:80, v/v) as the mobile phase. Quantitation of the analytes was done by MS/MS in
the positive ionization mode. The method was validated over a wide concentration range of 30 to 6000 ng/ml for
prothionamide and 50 to 10,000 ng/ml for prothionamide sulfoxide. The recovery for both the analytes was
greater than 89%. Stability was extensively validated under different storage conditions. Conclusion: The extraction
protocol was optimized using acetonitrile as protein precipitant for their simultaneous determination in human
plasma by LC–MS/MS. The method was applied to a bioequivalence study of 250 mg prothionamide tablet formulation
in 14 healthy Indian subjects.
Vikas Trivedi
1
, Vivek
Upadhyay
1
, Gaurang
Shah
1
, Manish Yadav
2
,
Pranav S Shrivastav*
2
& Mallika Sanyal
1,3
1
Chemistry Department, Kadi Sarva
Vishwavidyalaya, Sarva Vidyalaya
Campus, Sector 15/23, Gandhinagar
382015, India
2
Department of Chemistry, School
of Sciences, Gujarat University,
Navrangpura, Ahmedabad 380009,
India
3
Chemistry Department, St Xavier’s
College, Navrangpura, Ahmedabad
380009, India
*Author for correspondence:
Tel.: +91 79 2630 0969
Fax: +91 79 2630 8545
Email: pranav_shrivastav@
yahoo.com
185 ISSN 1757-6180 10.4155/BIO.12.301 © 2013 Future Science Ltd
Bioanalysis (2013) 5(2), 185–200
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