Determination of purine compounds in carotid artery plaque by liquid chromatography electrospray ionization tandem mass spectrometry † In recent years, the oxidation theory of atherogenesis has been attracted considerable attention. 1 -4 This theory envisages oxidation of low-density lipoprotein (LDL) as a key and early event responsible for the lipid loading into atherosclerotic foam cells and for progression of atherosclerotic disease: however, in carotid artery plaque, oxidative stress has never been directly correlated with the presence of other compounds except ox-LDL.It is well known that some purine compounds, such as hypoxanthine, xanthine, uric acid and allantoin, in the presence of situations such as experimental tumors, oxidative stress and hypoxia, change their plasmatic or urinary levels owing to the occurrence of nucleic acid turnover alterations. 5 -7 In a recent publication, 8 using high-performance liquid chromatography (HPLC) and capillary zone electrophoresis (CZE) techniques, the presence of the four reported compounds in carotid artery plaques was already described to demonstrate, through the presence of hypoxanthine, xanthine, uric acid and allantoin, the occurrence of oxidative stress in the arterial wall. Owing to the complexity of the substrate under investigation, in order to achieve good specificity a careful sample preparation procedure proved to be essential.Liquid chromatography/mass spectrometry (LC/MS) with application of multiple reaction monitoring (MRM) experiments has been widely demonstrated to be a good choice in qualitative and quantitative complex mixture analysis: 9 the higher specificity and sensitivity achievable by monitoring the occurrence of a selected molecule fragmentation often allow the application of simpler and less time-consuming sample preparation procedures. For this reason, we decided to apply this kind of approach to the qualitative determination of the four already reported purine bases in carotid plaque with the aim of developing a more rapid and selective analytical assay.We have previously used off-line liquid chromatography/electron ionization tandem mass spectrometry to examine purine bases in urine extracts from both healthy and colo-rectal cancer patients, but some difficulties were encountered in the structural assignment of a number of observed ions and in some isomers differentiation for the absence of an on-line chromatographic separation. 10 Ten carotid artery plaque samples (¾50 mg each) obtained from patients (eight males and two females, mean age 74 years) who had undergone carotid endoarterectomy were frozen with liquid nitrogen, pulverized, suspended in 500 µl of water and centrifuged at 12 000 g for 10 min. The supernatant, filtered through 0.45 µm PTFE, was injected directly into the HPLC/MS system. Samples 1 and 9 were treated in parallel following the 'classical' sample preparation method, 8 i.e. adding to the supernatant obtained after a first centrifugation 0.1 ml of 4 N perchloric acid (for protein precipitation) and centrifuging...