Stable isotope tracers used in human studies are generally considered to be safe, with no reported adverse biological or physiological effects at the applied concentrations25,35. However, since the stable isotope tracer needs to be orally administered, it is essential that the tracer dose conforms to food safety standards. This can be achieved by demanding that suppliers and manufacturers of stable isotope-labeled vitamin A carry out food safety tests on the supplied isotopes7,20,24. Likewise, it is imperative that isotope preparation and storage are only carried out in dedicated areas for food preparation. Furthermore, all equipment used for preparing stable isotopes must be dedicated to isotope preparation only and kept in areas for food preparation.
Retinyl acetate labelled isotopes have previously been dissolved using ethanol, then dried under nitrogen gas before being dissolved into vegetable oil36. Here, we present a method that allows the dissolution of the isotope-labeled tracer into vegetable oil using a combination of sonication and heat. Although this method is easier to perform in a food preparative area, care must be taken when applying heat to dissolve the tracer in vegetable oil. All-trans-retinol is isomerized to 13-cis-retinol during heat treatment, which accelerates with higher temperatures37. Isomerization of retinol further increases through exposure to light32. Moreover, the stability of retinol is influenced by the lipid oxidation property of the vegetable oil32,38. Since α-tocopherol content in vegetable oil has a positive impact on vitamin A retention32, and sunflower oil has one of the highest contents of α-tocopherol33, we opted to use sunflower oil in preparing the tracer doses. The decision to apply up to 50°C heat to dissolve the tracer was based on the application of heat to dissolve retinol crystals in cosmetic products without significant loss39. Although we have not seen significant degradation of retinyl acetate under the described protocol, it is vital to check for cis isomerization of the tracer dose right after the heat treatment (Figure 2). We further recommend that the stability of the tracer dose should be monitored throughout the study to confirm the applied tracer dose concentration.
The tracer must be prepared at a concentration well within the volumetric limits of the delivery system used to administer the required dose. Since the RID relies on accurate delivery of stable isotope-labeled tracers, it is recommended to use a positive displacement pipette for dose application. Although dose sizes of up to 1 mL have been applied in the past to adults16,20,40, it is easier to apply volumes between 100 - 250 µL, as these volumes have been shown to be well tolerated by infants and children1. Alternatively, doses can also be administered in capsule form17, but it is essential to select capsules specifically designed to prevent oil leakage and to ensure acceptability within the study population. Finally, applied dose levels depend on the age group of the target population29, the ability of the applied analytical platform to detect low levels3 and the total body stores of the target population, with a lower plasma fraction of dose at higher total body stores1.
As indicated in the example above, [13C10]retinyl acetate at a concentration of 2.58 µg/µL in sunflower oil will provide a dose of 0.4 mg RE tracer in 155 µL of sunflower oil, which can be delivered accurately using a 250 µL positive displacement pipette. To obtain concentrations that are within the volumetric limits of the delivery system, it is critical that the vegetable oil chosen to solubilize the tracer is accurately weighed using an analytical balance (accurate to 0.1 g) into the bottle containing the stable isotope tracer. For example, if a total of 63 mg [13C10]retinyl acetate is to be prepared at a concentration of 3.04 mg/mL in sunflower oil, and the specific gravity of sunflower oil is 0.92 g/mL at 25 ◦C, then 19.0 g (20.7 mL x 0.92 g/mL) of oil needs to be weighed into the bottle containing the tracer. Although the final concentration of the stable isotope tracer will be confirmed using a spectrophotometer reading, accurate weighing of the isotope tracer and the applied oil will guarantee that the obtained concentrations are close to the chosen delivery volume for each dose.
It is advisable to aliquot oil preparations based on the anticipated daily requirement to ensure that all doses in a vial are used within 2 weeks after opening the vial. It is best to keep the oil preparations on ice packs in the field during use and refreeze them as soon as possible after the dosing is completed. Although the oil preparations are not affected by repeated freeze and thaw cycles, they need to always be protected from light and frozen when not in use.
In summary, this protocol details the precise preparation and quality control of tracer doses for the RID method, ensuring accurate dosing, stability, and safety. The method calculates tracer requirements, optimizes solubilization in vegetable oil, and verifies purity and concentration using spectrophotometry and HPLC. Rigorous handling and storage guidelines guarantee reliable tracer integrity for accurate isotope-based assessments.