S-Adenosylmethionine (SAM) and S-Adenosylhomocysteine (SAH) Monitoring Using Analytical Methods in Clinical...

Area of Science:

• Biochemistry
• Analytical Chemistry
• Clinical Diagnostics

Background:

• S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) are vital one-carbon metabolism intermediates.
• Their levels and ratio are key indicators in metabolic, cardiovascular, neurological, and cancer research.

Purpose of the Study:

• To review validated analytical methods for quantifying SAM and SAH.
• To focus on liquid chromatography-tandem mass spectrometry (LC-MS/MS) as the gold standard.
• To discuss challenges and preanalytical variables for accurate biomarker measurement.

Main Methods:

• Comprehensive literature search for method development, validation, and clinical use studies.
• Focus on liquid chromatography-tandem mass spectrometry (LC-MS/MS) techniques.
• Comparison of LC-MS/MS with alternative methods like immunoassays.

Main Results:

• LC-MS/MS is the preferred method due to its sensitivity and specificity.
• Analytical challenges include high polarity, structural similarity, endogenous presence, and limited stability of SAM and SAH.
• Preanalytical factors like matrix, handling, and storage significantly impact results.

Conclusions:

• Harmonized analytical protocols and matrix-specific validation are essential for reliable SAM and SAH biomarker interpretation.
• Accurate measurement of SAM and SAH is critical for understanding cellular methylation capacity in disease.
• Standardization efforts are needed to enable consistent clinical application of these biomarkers.