Bacillus anthracis, the etiological agent of anthrax, is a Gram-positive, rod-shaped bacterium that forms spores that are highly resistant to
heat, ultraviolet light, radiation, pressure, and chemical agents. The durability of these spores make this bacterium a potential
bioweapon (1).

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Immediate treatment of anthrax infection with antibiotics is very effective. There is a limited period of time in which an
infected patient, who might only exhibit mild flu-like symptoms, can be saved with antibiotic therapy. Toxins released by
anthrax cause a patient to succumb to infection well after antibiotics have killed the anthrax bacteria. The major virulence
factor of anthrax infection is Lethal Factor (LF), a zinc-dependent metalloprotease toxin. LF disrupts MAP kinase signaling
pathways, resulting in cytotoxicity. MAP kinase signaling pathways regulate proinflammatory cytokines. Overproduction of these
cytokines is associated with septic shock, respiratory distress, and multiorgan failure leading to death (1–6). Injection
of the lethal toxin alone into mammals results in death. Research has demonstrated that inhibiting the activity of LF can
reduce tissue damage associated with anthrax infection (7).
 Figure 1
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LFI ((2R)-2-{[(4-fluoro-3-methyl-phenyl)sulfonyl]amino}-N-hydroxy-2-(tetrahydro-2H-pyran-4-yl)acetamide; Figure 1) previously
was shown to be a specific anthrax LF inhibitor (7). A high performance liquid chromatography tandem mass spectrometry (HPLC–MS-MS)
method for the determination of LFI in human plasma was developed and validated. HPLC–MS-MS was evaluated as the analytical
method. HPLC–MS-MS has become the gold standard for highly selective biological quantitative assays (8,9). LFI and internal
standard (ISTD) were extracted from 100 μL of plasma using an automated 96-well liquid–liquid extraction. A C8 HPLC column
with a mobile phase consisting of 0.1% acetic acid in water-acetonitrile (80:20, v/v) exhibited superior peak symmetry and
retention characteristics for both the LFI and ISTD. The highly aqueous mobile phase was necessary for adequate retention.
Both LFI and ISTD were detected using MS-MS with electrospray ionization in the positive mode. The calibration range was 5–1500
ng/mL when 100 μL of plasma was processed. This article describes the method development and performance characteristics of
the validated LFI assay and evaluates stability in human plasma.
ExperimentalMaterials: LFI and the isotopically labeled ISTD (Figure 1) were provided by the Medicinal Chemistry Department (Merck Research Laboratories,
West Point, Pennsylvania) and the Labeled Compound Synthesis group in the Drug Metabolism and Pharmacokinetics Department
(Merck Research Laboratories, Rahway, New Jersey), respectively. All solvents and reagents were of HPLC or analytical reagent
grade and were purchased from Fisher Scientific (Fair Lawn, New Jersey). The drug-free heparinized human plasma was obtained
from Biological Specialties (Colmar, Pennsylvania).
Instrumentation: The HPLC–MS-MS system consisted of an Applied Biosystems/MDS Sciex (Foster City, California) API 4000 tandem mass spectrometer
equipped with an electrospray ionization interface, a Perkin-Elmer (Norwalk, Connecticut) Series 200 quaternary pump, and
a Varian (Palo Alto, California) Pro Star Model 430 autosampler. Data were processed on a Dell Pentium 4 computer using Analyst
1.4 software (Sciex). A Tomtec Quadra 96 (Hamden, Connecticut) liquid-handling robot was used for sample preparation.
HPLC–MS-MS conditions: HPLC separation was performed on a 50 mm ×2.1 mm, 3.5-μm dp Symmetry C8 column (Waters, Milford, Massachusetts) at ambient temperature. The mobile phase was a mixture of 0.1% acetic
acid in water–acetonitrile (80:20, v/v) and was delivered at a flow rate of 0.300 mL/min. The retention time was 2.25 min.