Tracing the Human Metabolism of Stable Isotope-Labelled Drugs by ex vivo NM R Spectroscopy A Revision of S-Carboxymethyl-ʟ-cysteine Biotransformation

A direct structural identification, and quantitative assessment below the 50 nmol/ml level, of the full pattern of renally excreted metabolites is made possible by 13C NMR measurements of untreated urine samples when stable isotope-labelled (13C) drug analogues are administered to humans. The full potential of the new ex vivo NMR approach is exemplified by a study, for a group of volunteers, of S-carboxymethyl-L-cysteine metabolism. The metabolic sulphoxidation pathway of S-carboxymethyl-L-cysteine in man, accepted so far, needs to be profoundly revised on the basis of the 13C NMR results.