Endogenous serum concentrations of ANG I and ANG II were measured by ultra-performance liquid chromatography with tandem mass spectrometry detection, capable of measuring angiotensin peptide levels as low as 10 pg/mL (inVentiv Health Clinique, Quebec City, Quebec, Canada). Following rapid thawing of the serum, samples were stabilized with a combination of aliskiren, pepstatin A, and o-phenanthroline in acidified dimethyl sulfoxide combined with a mixture of EDTA and 4-(hydroxymercury) benzoic acid in phosphate-buffered saline. All samples were spiked with stable-isotope-labeled internal standards for ANG I and ANG II at a concentration of 50 pg/mL. Following protein precipitation using acetonitrile with 1% formic acid and solid-phase extraction (
Oasis MCX; Waters Corporation, Milford, MA, USA) of the supernatant, samples underwent liquid chromatography-tandem mass spectrometry analysis using a reverse-phase analytical column (
Acquity CSH C18; Waters Corporation) operating in line with an
XEVO TQ-S triple quadrupole mass spectrometer (Waters Corporation) in multiple reaction monitoring. The sum of the signal from three different mass transitions per peptide was measured, and angiotensin concentrations were calculated by relating the ratio of peptide signal to internal standard signal.
Bellomo R., Wunderink R.G., Szerlip H., English S.W., Busse L.W., Deane A.M., Khanna A.K., McCurdy M.T., Ostermann M., Young P.J., Handisides D.R., Chawla L.S., Tidmarsh G.F, & Albertson T.E. (2020). Angiotensin I and angiotensin II concentrations and their ratio in catecholamine-resistant vasodilatory shock. Critical Care, 24, 43.