DE102023110285B3 - NMR MEASUREMENT OF GLYCOPROTEINS - Google Patents
NMR MEASUREMENT OF GLYCOPROTEINS Download PDFInfo
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- G—PHYSICS
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- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
- G01N33/6803—General methods of protein analysis not limited to specific proteins or families of proteins
- G01N33/6848—Methods of protein analysis involving mass spectrometry
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N24/00—Investigating or analyzing materials by the use of nuclear magnetic resonance, electron paramagnetic resonance or other spin effects
- G01N24/08—Investigating or analyzing materials by the use of nuclear magnetic resonance, electron paramagnetic resonance or other spin effects by using nuclear magnetic resonance
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Abstract
Die Erfindung betrifft ein Verfahren zur Messung der Beiträge einzelner Glykoproteine und/oder Glykoylierungsmuster als Biomarker, abgeleitet aus einer Analyse von NMR-Spektren von Blutserum und/oder Blutplasma, umfassend die Schritte:i. Selektion von Glykoporoteinen aus einer Probe von Blutserum anhand ihrer spezifischen Diffusions- und/oder Relaxationseigenschaften und/oder Frequenzen und/oder J-Kopplungenii. Bestimmung der Glykan, GlycA- und GlycB-Signalgruppen in einem NMR-Spektrum wobei die GlyA-Signalgruppe von Methylgruppen von Neu5Ac gebildet ist und wobei die GlycB-Signalgruppe von Methylgruppen von GlcNAc-Einheiten gebildet ist und wobei die Glykan-Signalgruppe zwischen 3,5 und 5,5 ppm und die Neu5Ac-H3eq-Signalgruppe zwischen 2,6 und 2,9 ppm und die Neu5Ac-H3ax-Signalgruppe zwischen 1,6 und 1,88 ppm und die GycA-Signalgruppe zwischen 2,0 und 2,07 ppm und die GlycB-Signalgruppe zwischen 2,07 und 2,2 ppm liegt und wobei eine Zuordnung der Signale anhand des aus Abbildung 1 zu entnehmenden Schemas erfolgtiii. Anpassung von charakteristischen Frequenzmatrizen für einzelne oder zuvor zu Klassen zusammengestellte Glykoproteine an die bestimmten Signalgruppen mittels mathematischer Methodeniv. Ermittlung der Beiträge einzelner Glykoprotein-Biomarker durch Dekonvolution des Spektrums unter Verwendung der in Schritt iii angepassten Frequenzmatrizen und Addition einer zuvor zugeordneten Anzahl von mathematischen Funktionen.Ferner betrifft die Erfindung ein Computerprogrammprodukt und eine Verwendung.The invention relates to a method for measuring the contributions of individual glycoproteins and/or glycoylation patterns as biomarkers derived from an analysis of NMR spectra of blood serum and/or blood plasma, comprising the steps:i. Selection of glycoproteins from a sample of blood serum based on their specific diffusion and/or relaxation properties and/or frequencies and/or J-couplingsii. Determination of the glycan, GlycA and GlycB signal groups in an NMR spectrum, where the GlyA signal group is formed by methyl groups of Neu5Ac and where the GlycB signal group is formed by methyl groups of GlcNAc units and where the glycan signal group is between 3.5 and 5.5 ppm and the Neu5Ac-H3eq signal group is between 2.6 and 2.9 ppm and the Neu5Ac-H3ax signal group is between 1.6 and 1.88 ppm and the GycA signal group is between 2.0 and 2.07 ppm and the GlycB signal group is between 2.07 and 2.2 ppm and where the signals are assigned using the scheme shown in Figure 1iii. Adaptation of characteristic frequency matrices for individual glycoproteins or glycoproteins previously grouped into classes to the determined signal groups using mathematical methodsiv. Determining the contributions of individual glycoprotein biomarkers by deconvolution of the spectrum using the frequency matrices adjusted in step iii and adding a previously assigned number of mathematical functions.The invention further relates to a computer program product and a use.
Description
Die vorliegende Erfindung betrifft die NMR-Analyse von Proteinsignalen in Blutserum- oder Plasmaproben.The present invention relates to the NMR analysis of protein signals in blood serum or plasma samples.
Die Kernmagnetische Resonanz Spektroskopie wird zunehmend zur Bestimmung von Biomarkern eingesetzt, insbesondere von Lipoprotein-Biomarkern, die mit Cholesterin in Verbindung stehen. Siehe
Gruppen EG, Riphagen IJ, Connelly MA, Otvos JD, Bakker SJL, Dullaart RPF (2015) GlycA, a Pro-Inflammatory Glycoprotein Biomarker, and Incident Cardiovascular Disease: Relationship with C-Reactive Protein and renal Function. PLoS ONE 10 (9) schlagen GlycA als neuen NMRspektroskopischen Biomarker zur Erkennung von Entzündungen und kardiovaskulären Erkrankungen vor.Gruppen EG, Riphagen IJ, Connelly MA, Otvos JD, Bakker SJL, Dullaart RPF (2015) GlycA, a Pro-Inflammatory Glycoprotein Biomarker, and Incident Cardiovascular Disease: Relationship with C-Reactive Protein and renal Function. PLoS ONE 10 (9) propose GlycA as a new NMR spectroscopic biomarker for the detection of inflammation and cardiovascular disease.
NMR-Methoden, die zur Ableitung medizinischer Marker für die medizinische Risikobewertung Signale von Glykoproteinen (GlycA und GlycB) nutzen, sind aus der
Die Signale von GlycA und GlyB stammen von einer Reihe von Proteinen, die oft als Akut-Phase-Proteine bezeichnet werden und sich dadurch auszeichnen, dass sie stark auf Entzündungen reagieren, die zu einem erheblichen Anstieg oder Abfall im Blut führen. Zu den Akute-Phase-Proteinen gehören unter anderem CRP, Serum-Amyloid A, Haptoglobin, Fibrinogen, α-1-saures Glykoprotein, Haptoglobin, Serotransferrin, α-1-Antitrypsin und α-1-Antichymotrypsin. Es ist bekannt, dass sich die Konzentration von Akute-Phase-Proteinen nicht nur als Reaktion auf Entzündungsereignisse, sondern auch hinsichtlich ihres Glykosylierungsmusters krankheitsspezifisch verändert. Die GlycA und GlycB Signale in NMR Spektren beruhen auf Methylgruppen spezifischer Glykanreste, die Teil dieser Akut-Phase-Proteine sind und welche hervorragende Biomarker darstellen.The GlycA and GlyB signals originate from a group of proteins, often referred to as acute phase proteins, which are characterized by their strong response to inflammation, leading to a significant increase or decrease in blood levels. Acute phase proteins include CRP, serum amyloid A, haptoglobin, fibrinogen, α-1-acid glycoprotein, haptoglobin, serotransferrin, α-1-antitrypsin, and α-1-antichymotrypsin, among others. It is known that the concentration of acute phase proteins changes in a disease-specific manner not only in response to inflammatory events, but also in terms of their glycosylation pattern. The GlycA and GlycB signals in NMR spectra are based on methyl groups of specific glycan residues that are part of these acute phase proteins and which represent excellent biomarkers.
Die GlycA und GlycB NMR-Signale wurden Berichten zufolge mit klinisch-pathologischen Zuständen in Verbindung gebracht, wie z. B. einem erhöhten Sterberisiko [
Die von GlycA und GlycB abgeleiteten Ergebnisse sind allerdings bisweilen unspezifisch was die Natur der Proteine und der Art der Glykane betrifft. Es wäre eine detailliertere Analyse dieser und anderer Proteinsignale erforderlich, um den Beitrag spezifischer Akut-Phase-Proteine oder zumindest Gruppen von Proteinen zu ermitteln.However, the results derived from GlycA and GlycB are sometimes nonspecific with regard to the nature of the proteins and the type of glycans. A more detailed analysis of these and other protein signals would be required to determine the contribution of specific acute phase proteins or at least groups of proteins.
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Daher ist es Aufgabe der Erfindung ein Verfahren zur Messung der Beiträge einzelner Glykoproteine und/oder Glykoylierungsmuster als Biomarker, abgeleitet aus einer Analyse von NMR-Spektren von Blutserum und/oder Blutplasma zur Verfügung zu stellen.Therefore, it is an object of the invention to provide a method for measuring the contributions of individual glycoproteins and/or glycation patterns as biomarkers, derived from an analysis of NMR spectra of blood serum and/or blood plasma.
Die Aufgabe der Erfindung wird gelöst durch ein Verfahren zur Messung der Beiträge einzelner Glykoproteine und/oder Glykoylierungsmuster als Biomarker, abgeleitet aus einer Analyse von NMR-Spektren von Blutserum, umfassend die Schritte:
- Verfahren zur Messung der Beiträge einzelner Glykoproteine als Biomarker, abgeleitet aus einer Analyse von NMR-Spektren von Blutserum und/oder Blutplasma, umfassend die Schritte:
- i. Selektion von Glykoporoteinen in NMR Spektren aus einer Probe von Blutserum und/oder Blutplvasma anhand ihrer spezifischen Diffusions und/oder Relaxationseigenschaften und/oder ihrer spezifischen Frequenz und/oder Kopplungskonstanten im NMR Spektrum.
- ii. Bestimmung der Glykan, GlycA- und GlycB-Signalgruppen in einem NMR-Spektrum wobei die GlycA-Signalgruppe von Methylgruppen von Neu5Ac (5-AcetylNeuraminsäure) gebildet ist und wobei die GlycB-Signalgruppe von Methylgruppen von GlcNAc-Einheiten gebildet ist und wobei die Glykan-Signalgruppe zwischen 3,4 und 5,5 ppm und die Neu5Ac-H3eq-Signalgruppe zwischen 2,6 und 2,9 ppm und die Neu5Ac-H3ax-Signalgruppe zwischen 1,6 und 1,88 ppm und die GycA-Signalgruppe zwischen 2,0 und 2,07 ppm und die GlycB-Signalgruppe zwischen 2,07 und 2,2 ppm liegen und wobei eine Zuordnung der Signale anhand des aus
- iii. Anpassung von charakteristischen Frequenzmatrizen für einzelne oder zuvor zu Klassen zusammengestellten Glykoproteinen an die bestimmten Signalgruppen mittels mathematischer Methoden
- iv. Ermittlung der Beiträge einzelner Glykoprotein-Biomarker durch Dekonvolution des Spektrums unter Verwendung der in Schritt iii angepassten Frequenzmatrizen und Addition einer zuvor zugeordneten Anzahl von mathematischen Funktionen.
- A method for measuring the contributions of individual glycoproteins as biomarkers derived from an analysis of NMR spectra of blood serum and/or blood plasma, comprising the steps:
- i. Selection of glycoporoteins in NMR spectra from a sample of blood serum and/or blood plasma based on their specific diffusion and/or relaxation properties and/or their specific frequency and/or coupling constants in the NMR spectrum.
- ii. Determination of the glycan, GlycA and GlycB signal groups in an NMR spectrum, wherein the GlycA signal group is formed by methyl groups of Neu5Ac (5-acetyl neuraminic acid) and wherein the GlycB signal group is formed by methyl groups of GlcNAc units and wherein the glycan signal group is between 3.4 and 5.5 ppm and the Neu5Ac-H3eq signal group is between 2.6 and 2.9 ppm and the Neu5Ac-H3ax signal group is between 1.6 and 1.88 ppm and the GycA signal group is between 2.0 and 2.07 ppm and the GlycB signal group is between 2.07 and 2.2 ppm and wherein an assignment of the signals is made based on the
- iii. Adaptation of characteristic frequency matrices for individual or previously classified glycoproteins to the specific signal groups using mathematical methods
- iv. Determine the contributions of individual glycoprotein biomarkers by deconvolution of the spectrum using the frequency matrices fitted in step iii and adding a pre-assigned number of mathematical functions.
In einer bevorzugten Ausführungsform der Erfindung erfolgt die Selektion von Glykoporoteinen aus einer Probe von Blutserum und/oder Blutplasma anhand ihrer spezifischen Diffusions- und/oder Relaxationseigenschaften (Schritt i) mittels der Diffusionsdifferenzspektroskopie (DDS), wobei Differenzen von Diffusionsspektren mit unterschiedlichen Diffusionsparametern zur Selektion von Proteinen unterschiedlicher Größe und Diffusionseigenschaften verwendet werden.In a preferred embodiment of the invention, the selection of glycoporoteins from a sample of blood serum and/or blood plasma based on their specific diffusion and/or relaxation properties (step i) is carried out by means of diffusion difference spectroscopy (DDS), whereby differences of diffusion spectra with different diffusion parameters are used to select proteins of different sizes and diffusion properties.
In einer weiteren bevorzugten Ausführungsform der Erfindung erfolgt die Ermittlung der Beiträge einzelner Glykoprotein-Biomarker unter Verwendung von Differenzen der Beiträge einzelner Frequenzmatrix-Komponenten.In a further preferred embodiment of the invention, the contributions of individual glycoprotein biomarkers are determined using differences in the contributions of individual frequency matrix components.
In einer weiteren bevorzugten Ausführungsform erfolgt eine Multiplikation mit einem durch eine Referenzmessung ermittelten Skalierungsfaktor zur Angabe von Konzentrationen in mg/ml, wobei die Multiplikation vor der Dekonvolution der Spektren oder nach Schritt iv erfolgen kann.In a further preferred embodiment, a multiplication by a scaling factor determined by a reference measurement is carried out to indicate concentrations in mg/ml, wherein the multiplication can be carried out before the deconvolution of the spectra or after step iv.
In einem weiteren Aspekt wird die Aufgabe der Erfindung durch ein Computerprogrammprodukt zum Evaluieren von biologischen in-vitro-Blutplasma- oder-Serumproben enthaltend ein nichtflüchtiges computerlesbares Speichermedium mit computerlesbarem Programmcode, der in dem Speichermedium verkörpert ist, wobei der computerlesbare Programmcode folgendes beinhaltet: computerlesbaren Programmcode, der ein NMR-Spektrum einer Anpassungsregion einer Blutplasma- oder Serumprobe eines Individuums entfaltet, wobei der computerlesbare Programmcode das zusammengesetzte NMR-Spektrum unter Verwendung einer charakteristischen Frequenzmatrix, welche Entfaltungsmodelle für verschiedene Proteine beinhaltet, auf Signale mit Komponenten von (a) GlycA, (b) GlycB, (c) Glykan-Protonen und (d) Methyl-gruppen-Protonen angewendet und wobei der Programmcode eine Definition der Frequenzbereiche zur Ermittlung der Glykan, GlycA- und GlycB-Signalgruppen, wobei Glykan-Signalgruppe zwischen 3,4 und 5,5 ppm und die Neu5Ac-H3eq-Signalgruppe zwischen 2,6 und 2,9 ppm und die Neu5Ac-H3ax-Signalgruppe zwischen 1,6 und 1,88 ppm und die GycA-Signalgruppe zwischen 2,0 und 2,07 ppm und die GlycB-Signalgruppe zwischen 2,07 und 2,2 pm liegen und ein Schema zur Zuordnung der Signale entsprechend
Die Selektion von Glykoporoteinen aus einer Probe von Blutserum anhand ihrer spezifischen Diffusions- und/oder Relaxationseigenschaften (Schritt i) erfolgt durch Editierung des NMR-Spektrums. Erfindungsgemäß werden zur Editierung des NMR-Spektrums J-, T2-Relaxation- und Diffusions-Editierte-Spektren oder deren Differenz verwendet, was hier als Diffusionsdifferenzspektroskopie bezeichnet wird (DDS).The selection of glycoporoteins from a sample of blood serum based on their specific diffusion and/or relaxation properties (step i) is carried out by editing the NMR spectrum. According to the invention, J-, T 2 -relaxation and diffusion-edited spectra or their difference are used to edit the NMR spectrum, which is referred to here as diffusion difference spectroscopy (DDS).
Die Editierung nach Methode der T2-Relaxation kann von dem Fachmann aus [
Es kann ebenfalls die dem Fachmann aus [
Ebenfalls möglich ist die Editierung der NMR-Spektren entsprechend des DIRE-Ansatzes, der auf der Vereinfachung von 1 H-NMR-Spektren durch die Nutzung von Unterschieden in den Moleküldiffusionskoeffizienten allein und Kombinationen von Relaxations- und Diffusionsparametern beruht und dem Fachmann aus [
Die Diffusionsdifferenzspektroskopie (DDS) wird hier definiert als die Verwendung einer NMR-Pulssequenz, die ein Element der Diffusionsbearbeitung enthält, von Fachleuten als DOSY (Diffusion Editing Spectroscopy) [
Die DDS ermöglicht eine Editierung von NMR Spektren zur Selektion von Proteinen unterschiedlicher Diffusionseigenschaften, die sich zum Beispiel aus der Proteingröße ergeben. Mittels DDS können zusätzlich die Signale von kleinen Molekülen (<1000 Da) und von Lipoproteinen in NMR-Spektren unterdrückt werden.DDS enables editing of NMR spectra to select proteins with different diffusion properties, which result, for example, from protein size. DDS can also be used to suppress the signals of small molecules (<1000 Da) and lipoproteins in NMR spectra.
Alternativ können im Schritt i auch NMR-Verfahren eingesetzt werden, welche bestimmte Frequenzen selektieren und mittels, dem Fachmann als TOCSY (Total Correlation SpectroscopY) bekannten Verfahren, aus der initialen Selektion auf andere Frequenzbereiche übertragen. Auf diese Weise können Glycan und/oder GlycA und/oder GlycB Signale selektiert werden. [TOCSY: Kapitel 6 in J. Cavanagh, W. J. Fairbrother, A. G. Palmer .III, M. Rance and N. J. Skelton, Protein NMR Spectroscopy (2nd edition, Academic Press, 2007)].Alternatively, NMR methods can be used in step i, which select certain frequencies and transfer them from the initial selection to other frequency ranges using methods known to those skilled in the art as TOCSY (Total Correlation SpectroscopY). In this way, glycan and/or GlycA and/or GlycB signals can be selected. [TOCSY: Chapter 6 in J. Cavanagh, W. J. Fairbrother, A. G. Palmer .III, M. Rance and N. J. Skelton, Protein NMR Spectroscopy (2nd edition, Academic Press, 2007)].
Im Folgenden wird der erfindungsgemäße Schritt iii, die Anpassung von charakteristischen Frequenzmatrizen für einzelne oder zuvor zu Klassen zusammengestellten Glykoproteinen an die bestimmten Signalgruppen mittels mathematischer Methoden eingehender erläutert, ohne dabei die Allgemeinheit der Lehre einzuschränken.In the following, step iii according to the invention, the adaptation of characteristic frequency matrices for individual glycoproteins or glycoproteins previously grouped into classes to the specific signal groups by means of mathematical methods, is explained in more detail without restricting the generality of the teaching.
Die Auswertung der Impulsfolgen für die Analyse von Glykoproteinen folgt [
In
Im Folgenden wird exemplarisch die Analyse von Proben gesunder Kontrollen im Vergleich zu Proben von Patienten mit kardiogenem Schock und COVID-19 im Vergleich zu konventionell ermittelten Werten gezeigt.The following shows an example of the analysis of samples from healthy controls compared to samples from patients with cardiogenic shock and COVID-19 in comparison to conventionally determined values.
Es wird in
Das erfindungsgemäße Verfahren geht über bisherige Analysen von Glykoproteinen hinaus, indem die Beiträge einzelner Glykoproteine oder Proteinklassen (z. B. im Fall von IgG) oder Glykoylierungsmuster detailliert aufzeigt werden können. Dies wird durch die Bestimmung einer charakteristischen Frequenzmatrix für jedes Glykoprotein erreicht, welche dann an die Spektren von Blutserum oder -plasma angepasst wird. Die Erfindung hat erkannt, dass auch der Glykanbereich von NMR-Spektren als weiteres Merkmal des Glykoproteintyps und der Glykanstruktur verwendet werden sollte.The method according to the invention goes beyond previous analyses of glycoproteins in that the contributions of individual glycoproteins or protein classes (e.g. in the case of IgG) or glycoylation patterns can be shown in detail. This is achieved by determining a characteristic frequency matrix for each glycoprotein, which is then adapted to the spectra of blood serum or plasma. The invention has recognized that the glycan range of NMR spectra should also be used as a further feature of the glycoprotein type and glycan structure.
Erfindungsgemäß werden 1H-NMR-NMR-Spektren von Blutserum oder-plasma verwendet, um Biomarker für die Risikobewertung oder klinische Diagnose von Krankheiten abzuleiten. Spezifische Proteine oder Klassen von Proteinen, die im Blut sehr häufig vorkommen und als Akute-Phase-Proteine bezeichnet werden, werden anhand einer Matrix von für jedes Protein charakteristischen chemischen Verschiebungen identifiziert und/oder quantifiziert. Die Biomarker werden durch elektronische Entfaltung charakteristischer Proteinsignale unter Verwendung einer Matrix charakteristischer chemischer Verschiebungen für einzelne Signalkomponenten abgeleitet. Die Signalkomponenten stellen einzelne Akutphasenproteine oder Klassen von glykosylierten Akutphasenproteinen dar. Die Messungen von Akute-Phase-Proteinen können als klinische Biomarker für klinische Krankheitszustände verwendet werden.According to the invention, 1H NMR spectra of blood serum or plasma are used to derive biomarkers for risk assessment or clinical diagnosis of disease. Specific proteins or classes of proteins that are highly abundant in blood, referred to as acute phase proteins, are identified and/or quantified using a matrix of chemical shifts characteristic of each protein. The biomarkers are derived by electronic deconvolution of characteristic protein signals using a matrix of characteristic chemical shifts for individual signal components. The signal components represent individual acute phase proteins or classes of glycosylated acute phase proteins. The measurements of acute phase proteins can be used as clinical biomarkers for clinical disease states.
Die Analyse kann für medizinische Diagnosezwecke eingesetzt werden, wie in beispielhaften Fällen mit Proben von gesunden Kontrollen, kardiogenem Schock und COVID-19-Patienten gezeigt wurde. Die detaillierteren Glykoproteinparameter können die medizinische Diagnose oder die Differenzierung zwischen Patienten unterstützen.The analysis can be used for medical diagnostic purposes, as demonstrated in exemplary cases with samples from healthy controls, cardiogenic shock and COVID-19 patients. The more detailed glycoprotein parameters can support medical diagnosis or differentiation between patients.
Im Folgenden wird die Allgemeinheit der Lehre nicht einschränkend das Vorgehen bei der Durchführung des erfindungsgemäßen Verfahrens aufgezeigt.In the following, the generality of the teaching is shown in a non-limiting manner and the procedure for carrying out the method according to the invention is shown.
Zur Präparation der Blutproben wurde Serum oder Plasma nach in der Klinik etablierten Methoden präpariert, für Serum durch Zentrifugation nach einer Periode der Blutgerinnung und anschließender Zentrifugation, bei Plasma (EDTA oder Heparin-Plasma) Zentrifugation der Proben, nach Protokollen in klinischen Laboren.For the preparation of blood samples, serum or plasma was prepared according to methods established in the clinic, for serum by centrifugation after a period of blood coagulation and subsequent centrifugation, for plasma (EDTA or heparin plasma) by centrifugation of the samples, according to protocols in clinical laboratories.
Die gefrorenen Serum oder Plasma Proben wurde aufgetaut und anschließend 1/1 mit einem 75mM Phosphatpuffer versetzt, dann für eine Minute geschüttelt. 600µL Probe wurde dann in ein 5 mm NMR-Röhrchen transferiert. Die NMR Analyse wurde anschließend mit einem 600 MHz NMR Spektrometer (Bruker Avance III HD Spektrometer mit einem Raum-Temperatur für 1H optimierten Probenkopf) gemessen. Das Spektrometer wurde für diese Untersuchungen kalibiriert wie in Dona et al beschrieben.Frozen serum or plasma samples were thawed and then mixed 1/1 with a 75 mM phosphate buffer and shaken for one minute. 600 µL of sample was then transferred to a 5 mm NMR tube. NMR analysis was then performed using a 600 MHz NMR spectrometer (Bruker Avance III HD spectrometer with a room temperature probe head optimized for 1H). The spectrometer was calibrated for these studies as described in Dona et al.
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