Abstract Introduction: Mutations of the isocitrate dehydrogenase (IDH)-1/2 genes frequently occur in certain malignancies, including gliomas. Mutant IDH-1/2 proteins gain a new ability to produce oncometabolite 2-hydroxiglutarate (2HG), which results in a different clinical impact on gliomas in comparison to those with a wild-type IDH. The status of IDH mutations has been determined by immunohistochemistry (IHC) using the IDH1-R132H antibody or through the DNA sequencing of IDH1-R132C/R132S; however, its practical applications are still under discussion, and the significance of the oncometabolite 2HG evaluation is not clear. In this study, we analyzed the serum and tissue levels of 2HG in clinical gliomas using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and the matrix assisted laser desorption and ionization mass spectrometry imaging (MALDI-MSI) system. Method: Glioma samples (n = 78, matched pairs of serum and flash frozen tissue) were obtained between October 2007 to January 2015 at the National Cancer Center Hospital, Japan. High performance liquid chromatography (Nexera X2, Shimadzu) and triple quad mass spectrometry (QTRAP4500, AB SCIEX) were used for LC-MS/MS analysis. The two MALDI-MSI systems, quadrupole ion trap time-to-flight mass spectrometry imaging (iMScope, Shimadzu), and high-resolution atmospheric pressure mass spectrometry imaging (AP-SMALDI, TransMIT; Q-Exactive, Thermo Fisher Scientific) were used for analyzing the 2HG tissue distribution after coating with 9-aminoacridine or 2,5-dihydroxybenzoic acid. The IDH mutation was determined by direct sequencing and IHC. Results: The median 2HG concentration in serum was 21.43 ng/mL (range: 9.58 to 62.51) in this study, and no significant correlation was observed between the IDH mutation and the wild type status (mutation, n = 28, median 20.2 ng/mL, range 9.58 to 62.51 vs. wild type, n = 50, median 22.88 ng/mL, range 11.51 to 40.32; Wilcoxon test p = 0.1597). The median of the 2HG tissue concentration in the entire group was 0.16 ng/μg, and a significant difference was seen between the IDH mutant and wild type groups (mutation, median 4.86 ng/μg, range 0.51 to 49.86 vs. wild type, median 0.09 ng/μg, range 0.02 to 0.45; Wilcoxon test p = <0.0001). In the MALDI-MSI analysis, the average 2HG ion intensities were 381.62/mm2 in the IDH mutation and 8.25/mm2 in the wild-type IDH tissues (Wilcoxon test p = 0.016), which showed a positive correlation with the 2HG tissue concentration by LC-MSMS analyses (Spearman ρ = 0.87, p = 0.0003). The MSI results indicate a possible link between the 2HG tissue distributions and the histology of IDH mutant sections. Conclusion: Tissue 2HG measurement using mass spectrometric analyses may be a useful alternative in determining IDH mutations. Further research may provide a biological perspective and help gain some insights on the clinical significance of 2HG. Citation Format: Mitsuhiro Hayashi, Hiroaki Aikawa, Makoto Ohno, Koichi Ichimura, Yuko Matsushita, Mayu Ohuchi, Mariko Mizui, Akihiko Yoshida, Yoshitaka Narita, Akinobu Hamada. Mass spectrometric analysis of oncometabolite 2-hydroxyglutarate in clinical gliomas with the isocitrate dehydrogenase-1 mutation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4647. doi:10.1158/1538-7445.AM2017-4647
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