Clinical role of polyamine analysis: problem and promise

Polyamines are ubiquitous cell components for growth. They play an important role in cell proliferation, cell growth and synthesis of protein and nucleic acids. Cells that are stimulated to reproduce demonstrated early increases in biosynthetic enzymes involved in polyamine synthesis and subsequent elevations in polyamine levels. Extracellular fluid polyamine concentrations that reflect the intracellular events may be useful as rapid indicators of therapy in disorders which involve altered cell growth. More complex analytical approaches are required to isolate, identify and quantitate these polyamines. Most of the methods require an extraction procedure to remove interfering amino acid derivatives. Daily monitoring of plasma and urine polyamine levels in many pathological states may provide a non-invasive biochemical marker of the existing disease activity or response to therapy or to screen for drug efficacy. Automated high-performance liquid chromatography, with post or pre-column derivatization and fluorescence or electrochemical detection is frequently used for the simultaneous quantitation of picomolar quantities of polyamines. Recently, a new immuno-cytochemical model system incorporating an enzyme-linked immunosorbent assay for specific polyamines has been developed. The increasing momentum of basic science information in the polyamine discipline may lead clinicians to regard polyamines, their metabolites and antimetabolites as sources of effective treatment.