The mechanism of insulin dysregulation in children with hyperinsulinism associated with inactivating mutations of short-chain 3-hydroxyacyl-CoA dehydrogenase (SCHAD) was examined in mice with a knock-out of the hadh gene (hadh ؊/؊ ). Congenital hyperinsulinism is the most common cause of persistent hypoglycemia in infants and children (1). Six genetic loci have been associated with the disorder. The most common of these disorders are due to inactivating mutations of the sulfonylurea receptor 1 (SUR1) 2 and Kir6.2 subunits of the ␤-cell ATP-dependent potassium (K ATP ) channel or to activating mutations of glutamate dehydrogenase (GDH) and glucokinase. Recently, several children have been described with a recessively inherited form of hyperinsulinism that is associated with deficiency of a mitochondrial fatty acid ␤-oxidation enzyme, short-chain 3-hydroxyacyl-CoA dehydrogenase (SCHAD) encoded by the HADH gene on 4q (2-4). SCHAD catalyzes the third step in the ␤-oxidation cycle for medium and short-chain 3-hydroxy fatty acyl-CoAs. Children afflicted with SCHAD deficiency have recurrent episodes of hypoglycemia that can be prevented by treatment with diazoxide (2, 3) and also have characteristic accumulations of fatty acid metabolites, including plasma 3-hydroxybutyrylcarnitine and urinary 3-hydroxyglutaric acid (2, 3). This form of abnormal insulin regulation is unique, because other genetic disorders of mitochondrial fatty acid oxidation do not cause hyperinsulinism (5). In addition, the genetic defect in SCHAD deficiency is expected to impair, rather than increase, the production of ATP, which normally serves as the triggering signal for insulin release. An important clue to the mechanism of insulin dysregulation in SCHAD deficiency has been recently provided by the report * This work was supported, in whole or in part, by National Institutes of Health Grants DK53012 (to C. A. S.), DK22122 (to F. M. M.), DK 53761 (to I. N.), HL075421 (to A. W. S.). This work was also supported by a fellowship award from Society for Inherited Metabolic Disorders (to A. P.

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Matrix assisted ionization vacuum (MAIV) rapidly generates gas-phase analyte ions from subliming solid-phase matrix:analyte crystals for analysis by mass spectrometry (MS). Ionization from the solid-phase allows the use of a variety of surfaces for introducing matrix:analyte samples to the vacuum of a mass spectrometer, including common laboratory materials, such as disposable pipet tips, filter paper, tooth picks, and nylon mesh. MAIV is shown here to be capable of analyses as fast as 3 s per sample with achievable sensitivities in the low femtomole range. MAIV-MS coupled with ion mobility spectrometry (IMS)-MS and tandem mass spectrometry (MS/MS) is shown to be especially powerful for analysis and characterization of a wide range of molecules ranging from small molecules such as drugs and metabolites (∼300 Da) to intact proteins (25.6 kDa). Automated sample introduction is demonstrated on two different commercial mass spectrometers using a programmable XYZ stage. A MAIV high-throughput nontargeted MS(E) approach is also demonstrated utilizing IMS for rapid characterization of small molecules and peptides from standard solutions, as well as drug spiked human urine.

Matrix-assisted ionization (MAI) mass spectrometry (MS) is a simple and sensitive method for analysis of low- and high-mass compounds, requiring only that the analyte in a suitable matrix be exposed to the inlet aperture of an atmospheric pressure ionization mass spectrometer. Here, we evaluate the reproducibility of MAI and its potential for quantification using six drug standards. Factors influencing reproducibility include the matrix compound used, temperature, and the method of sample introduction. The relative standard deviation (RSD) using MAI for a mixture of morphine, codeine, oxymorphone, oxycodone, clozapine, and buspirone and their deuterated internal standards using the matrix 3-nitrobenzonitrile is less than 10% with either a Waters SYNAPT G2 or a Thermo LTQ Velos mass spectrometer. The RSD values obtained using MAI are comparable to those using ESI or MALDI on these instruments. The day-to-day reproducibility of MAI determined for five consecutive days with internal standards was better than 20% using manual sample introduction. The reproducibility improved to better than 5% using a mechanically assisted sample introduction method. Hydrocodone, present in a sample of undiluted infant urine, was quantified with MAI using the standard addition method.