Wenchao Qu

18F Stilbenes and Styrylpyridines for PET Imaging of Aβ Plaques in Alzheimer’s Disease: A Miniperspective

Alzheimer’s disease (AD) is a neurodegenerative disease of the brain, characterized by a slowly progressive dementia. This insidious disease is growing in importance because it affects millions of older patients. Clinical symptoms of AD include cognitive decline, irreversible memory loss, disorientation and language impairment. Major neuropathology observations of postmortem AD brain include the presence of senile plaques containing β-amyloid (Aβ) aggregates and neurofibrillary tangles containing highly phosphorylated tau proteins (Figure 1A).1,2 Several genomic factors have been linked to AD. Familial AD (or early onset AD) has been reported to have mutations in genes encoding β-amyloid precursor protein (APP), presenilin 1, presenilin 2 and Apolipoprotein E (APOE).3 The exact mechanisms of these mutations, which lead to the development of AD, are not fully understood; however, formation of plaques comprised of Aβ peptide in the brain is a pivotal event in the pathology of Alzheimer’s disease. Significant evidence suggests that accumulation and aggregation of Aβ peptides may play a major causative role in AD pathogenesis.2,4 The excessive burden of Aβ, produced by various mechanisms, may represent the starting point of neurodegenerative events, and may initiate a cascade of events (β-amyloid cascade, Figure 1B) that includes gliosis, inflammatory changes, neuritic/synaptic change, tangles and transmitter loss.2 Currently, there is no definitive method to diagnose AD, except by postmortem evaluation and staining of the brain tissue, which demonstrates the existence of Aβ plaques. Figure 1 A. Processes (β-amyloid cascade) participating in AD pathogenesis. Aβ peptides produced by neurons aggregate into a variety of assemblies, some of which may impair synapses and neuronal dendrites. Build-up of pathogenic Aβ aggregates ... Recent reports have suggested that β-amyloid aggregates in the brain play a key role in a cascade of events leading to AD.2,5 Thus, the development of diagnostic imaging agents targeting Aβ aggregates is very important in the diagnosis and treatment of AD. Novel PET imaging agents specifically targeting the Aβ plaques may lead to early detection of AD pathology, differential diagnosis of patients with dementia, and for monitoring patients who are undergoing drug treatment designed to reverse the Aβ buildup in the brain. Indeed, diagnosis and treatment of AD have been hampered by the absence of reliable non-invasive markers for the underlying pathology. Diagnosis based on consensus criteria is approximately 81% sensitive and 70% specific by comparison to the gold standard of pathology at autopsy.6 In addition to errors of misdiagnosis in patients with AD, there is significant under diagnosis; approximately 10% of community dwelling elderly still have undiagnosed dementia, and community physicians may fail to diagnose up to 33% of mild dementia cases.7 Thus, there is a need for a biomarker that can be applied in the community setting and can help physicians separate those patients who do not have AD from those who have pathological signs and should be evaluated further. Additionally, there are a large number of patients who, upon comprehensive diagnostic testing, are found to have cognitive impairment but are not demented and thus, do not meet diagnostic criteria for AD (e.g., patients with mild cognitive impairment, MCI). Some, but not all of these patients will go on to develop AD within 3-5 years. A reliable biomarker might aid prognostic evaluation by documenting the presence or absence of AD related pathology. Based on the definitions of AD endorsed by the American Academy of Neurology, American Psychiatric Association (DSM-IV) and others, patients without abnormal amyloid plaque levels do not meet currently accepted neuropathological criteria for AD. This definition of AD, which includes amyloid plaques as a required feature, is supported by more than 100 years of autopsy data. Therefore, based on this widely-endorsed definition of AD, the use of a test for ruling-out the presence of amyloid plaque pathology in subjects with clinical signs and symptoms of cognitive impairment will, effectively, rule-out the diagnosis of AD, and lead to more careful evaluation and appropriate treatment for alternative causes of cognitive deficits. Moreover, the use of a test for ruling-in the presence of abnormal levels of Aβ plaques in the brain of subjects with signs and symptoms of cognitive impairment will lead to the selection of patients who warrant more detailed work-up for the possible diagnosis of AD or MCI. The differential diagnosis for AD includes a large number of other diseases. At early stages of disease (e.g. MCI), frequent confounds include cognitive impairment as a result of underlying depression, effects of CNS active medications, inadequately treated or end stage medical conditions affecting other organ systems, and even normal age-related changes. At later stages of disease, more common confounds include vascular dementia, frontal temporal lobar dementia (FTLD) complex, dementia with Lewy bodies (DLB) as well as rarer neurodegenerative diseases such as Creutzfeld Jacob Disease (CJD). Importantly, AD subjects will always have Aβ plaques, whereas amyloid is seen not at all, or only sporadically in most of these other diseases. In each case, appropriate prognosis and treatment requires accurate diagnostic assessment.

PET Imaging of Glutaminolysis in Tumors by 18F-(2S,4R)4-Fluoroglutamine

Changes in gene expression, metabolism, and energy requirements are hallmarks of cancer growth and self-sufficiency. Upregulation of the PI3K/Akt/mTor pathway in tumor cells has been shown to stimulate aerobic glycolysis, which has enabled 18F-FDG PET tumor imaging. However, of the millions of 18F-FDG PET scans conducted per year, a significant number of malignant tumors are 18F-FDG PET–negative. Recent studies suggest that several tumors may use glutamine as the key nutrient for survival. As an alternative metabolic tracer for tumors, 18F-(2S,4R)4-fluoroglutamine was developed as a PET tracer for mapping glutaminolytic tumors. Methods: A series of in vitro cell uptake and in vivo animal studies were performed to demonstrate tumor cell addiction to glutamine. Cell uptake studies of this tracer were performed in SF188 and 9L glioblastoma tumor cells. Dynamic small-animal PET studies of 18F-(2S,4R)4-fluoroglutamine were conducted in 2 animal models: xenografts produced in F344 rats by subcutaneous injection of 9L tumor cells and transgenic mice with M/tomND spontaneous mammary gland tumors. Results: In vitro studies showed that both transformed 9L and SF188 tumor cells displayed a high rate of glutamine uptake (maximum uptake, ≈16% dose/100 μg of protein). The cell uptake of 18F-(2S,4R)4-fluoroglutamine by SF188 cells is comparable to that of 3H-l-glutamine but higher than that of 18F-FDG. The tumor cell uptake can be selectively blocked. Biodistribution and PET studies showed that 18F-(2S,4R)4-fluoroglutamine localized in tumors with a higher uptake than in surrounding muscle and liver tissues. Data suggest that certain tumor cells may use glutamine for energy production. Conclusion: The results support that 18F-(2S,4R)4-fluoroglutamine is selectively taken up and trapped by tumor cells. It may be useful as a novel metabolic tracer for tumor imaging.

Preparation and Characterization of l-[5-11C]-Glutamine for Metabolic Imaging of Tumors

Recently, there has been a renewed interest in the study of tumor metabolism above and beyond the Warburg effect. Studies on cancer cell metabolism have provided evidence that tumor-specific activation of signaling pathways, such as the upregulation of the oncogene myc, can regulate glutamine uptake and its metabolism through glutaminolysis to provide the cancer cell with a replacement of energy source. Methods: We report a convenient procedure to prepare l-[5-11C]-glutamine. The tracer was evaluated in 9L and SF188 tumor cells (glioma and astrocytoma cell lines). The biodistribution of l-[5-11C]-glutamine in rodent tumor models was investigated by dissection and PET. Results: By reacting 11C-cyanide ion with protected 4-iodo-2-amino-butanoic ester, the key intermediate was obtained in good yield. After hydrolysis with trifluoroacetic and sulfonic acids, the desired optically pure l-[5-11C]-glutamine was obtained (radiochemical yield, 5% at the end of synthesis; radiochemical purity, >95%). Tumor cell uptake studies showed maximum uptake of l-[5-11C]-glutamine reached 17.9% and 22.5% per 100 μg of protein, respectively, at 60 min in 9L and SF188 tumor cells. At 30 min after incubation, more than 30% of the activity appeared to be incorporated into cellular protein. Biodistribution in normal mice showed that l-[5-11C]-glutamine had significant pancreas uptake (7.37 percentage injected dose per gram at 15 min), most likely due to the exocrine function and high protein turnover within the pancreas. Heart uptake was rapid, and there was 3.34 percentage injected dose per gram remaining at 60 min after injection. Dynamic small-animal PET studies in rats bearing xenografted 9L tumors and in transgenic mice bearing spontaneous mammary gland tumors showed a prominent tumor uptake and retention. Conclusion: The data demonstrated that this tracer was favorably taken up in the tumor models. The results suggest that l-[5-11C]-glutamine might be useful for probing in vivo tumor metabolism in glutaminolytic tumors.

Comparative Evaluation of 18F-Labeled Glutamic Acid and Glutamine as Tumor Metabolic Imaging Agents

18F-labeled (2S,4R)-4-fluoro-l-glutamine (4F-GLN) has demonstrated high uptake in tumor cells that undergo high growth and proliferation. Similar tumor targeting properties have also been observed for 18F-labeled (2S,4R)-4-fluoro-l-glutamate (4F-GLU), suggesting that both are useful imaging agents. A new labeling procedure facilitates the preparation of 18F-(2S,4R)4F-GLN and 18F-(2S,4R)4F-GLU with confirmed radiochemical and enantiomeric purity. Here, we report the preparation and comparative evaluation of 18F-(2S,4R)4F-GLN and 18F-(2S,4R)4F-GLU as tumor metabolic imaging agents. Methods: Uptake of enantiomerically pure 18F-(2S,4R)4F-GLN and 18F-(2S,4R)4F-GLU was determined in 3 tumor cell lines (9L, SF188, and PC-3) at selected time points. The in vitro cell uptake mechanism was evaluated by inhibition studies in 9L cells. In vivo biodistribution and PET studies were performed on male F344 rats bearing 9L tumor xenografts. Results: In vitro cell uptake studies showed that 18F-(2S,4R)4F-GLN displayed higher uptake than 18F-(2S,4R)4F-GLU. Amino acid transport system ASC (alanine-serine-cysteine–preferring; in particular, its subtype ASCT2 [SLC1A5 gene]) and system Xc− (SLC7A11 gene) played an important role in transporting 18F-(2S,4R)4F-GLN and 18F-(2S,4R)4F-GLU, respectively, across the membrane. After being transported into cells, a large percentage of 18F-(2S,4R)4F-GLN was incorporated into protein, whereas 18F-(2S,4R)4F-GLU mainly remained as the free amino acid in its original form. In vivo studies of 18F-(2S,4R)4F-GLN in the 9L tumor model showed a higher tumor uptake than 18F-(2S,4R)4F-GLU, whereas 18F-(2S,4R)4F-GLU had a slightly higher tumor-to-background ratio than 18F-(2S,4R)4F-GLN. Imaging studies showed that both tracers had fast accumulation in 9L tumors. Compared with 18F-(2S,4R)4F-GLU, 18F-(2S,4R)4F-GLN exhibited prolonged tumor retention reflecting its incorporation into intracellular macromolecules. Conclusion: Differences in uptake and metabolism in tumor cells were found between 18F-(2S,4R)4F-GLN and 18F-(2S,4R)4F-GLU. Both agents are potentially useful as metabolic tracers for tumor imaging.

Novel Styrylpyridines as Probes for SPECT Imaging of Amyloid Plaques

We report a series of radioiodinated styrylpyridines as single photon emission computed tomography probes for imaging Abeta plaques in the brain of patients with Alzheimers disease (AD). In vitro binding showed that all of the styrylpyridines displayed very good binding affinities in postmortem AD brain homogenates (Ki = 3.6 to 15.5 nM). No-carrier-added samples of 13a, 13b, 16a, 16b, and 16e (radioiodinated with 125I) were successfully prepared. The in vivo biodistribution in normal mice, at 2 min after injection, showed excellent initial brain penetrations (4.03, 6.22, 5.43, and 8.04% dose/g for [125I]13a, 13b, 16a, and 16b, respectively). Furthermore, in vitro autoradiography of AD brain sections showed that the high binding signal was specifically due to the presence of Abeta plaques. Taken together, these results strongly suggest that these styrylpyridines are useful for imaging Abeta plaques in the living human brain.

Multidentate 18F-Polypegylated Styrylpyridines As Imaging Agents for Aβ Plaques in Cerebral Amyloid Angiopathy (CAA)

β-Amyloid plaques (Aβ plaques) in the brain are associated with cerebral amyloid angiopathy (CAA). Imaging agents that could target the Aβ plaques in the living human brain would be potentially valuable as biomarkers in patients with CAA. A new series of (18)F styrylpyridine derivatives with high molecular weights for selectively targeting Aβ plaques in the blood vessels of the brain but excluded from the brain parenchyma is reported. The styrylpyridine derivatives, 8a-c, display high binding affinities and specificity to Aβ plaques (K(i) = 2.87, 3.24, and 7.71 nM, respectively). In vitro autoradiography of [(18)F]8a shows labeling of β-amyloid plaques associated with blood vessel walls in human brain sections of subjects with CAA and also in the tissue of AD brain sections. The results suggest that [(18)F]8a may be a useful PET imaging agent for selectively detecting Aβ plaques associated with cerebral vessels in the living human brain.

Synthesis and evaluation of 18F labeled alanine derivatives as potential tumor imaging agents

INTRODUCTION This paper reports the synthesis and labeling of (18)F alanine derivatives. We also investigate their biological characteristics as potential tumor imaging agents mediated by alanine-serine-cysteine preferring (ASC) transporter system. METHODS Three new (18)F alanine derivatives were prepared from corresponding tosylate-precursors through a two-step labeling reaction. In vitro uptake studies to evaluate and to compare these three analogs were carried out in 9L glioma and PC-3 prostate cancer cell lines. Potential transport mechanisms, protein incorporation and stability of 3-(1-[(18)F]fluoromethyl)-L-alanine (L-[(18)F]FMA) were investigated in 9L glioma cells. Its biodistribution was determined in a rat-bearing 9L tumor model. PET imaging studies were performed on rat bearing 9L glioma tumors and transgenic mouse carrying spontaneous generated M/tomND tumor (mammary gland adenocarcinoma). RESULTS New (18)F alanine derivatives were prepared with 7%-34% uncorrected radiochemical yields, excellent enantiomeric purity (>99%) and good radiochemical purity (>99%). In vitro uptake of the L-[(18)F]FMA in 9L glioma and PC-3 prostate cancer cells was higher than that observed for the other two alanine derivatives and [(18)F]FDG in the first 1h. Inhibition of cell uptake studies suggested that L-[(18)F]FMA uptake in 9L glioma was predominantly via transport system ASC. After entering into cells, L-[(18)F]FMA remained stable and was not incorporated into protein within 2h. In vivo biodistribution studies demonstrated that L-[(18)F]FMA had relatively high uptake in liver and kidney. Tumor uptake was fast, reaching a maximum within 30 min. The tumor-to-muscle, tumor-to-blood and tumor-to-brain ratios at 60 min post injection were 2.2, 1.9 and 3.0, respectively. In PET imaging studies, tumors were visualized with L-[(18)F]FMA in both 9L rat and transgenic mouse. CONCLUSION L-[(18)F]FMA showed promising properties as a PET imaging agent for up-regulated ASC transporter associated with tumor proliferation.

Synthesis, uptake mechanism characterization and biological evaluation of 18F labeled fluoroalkyl phenylalanine analogs as potential PET imaging agents

INTRODUCTION Amino acids based tracers represent a promising class of tumor metabolic imaging agents with successful clinical applications. Two new phenylalanine derivatives, p-(2-[(18)F]fluoroethyl)-L-phenylalanine (FEP, [(18)F]2) and p-(3-[(18)F]fluoropropyl)-L-phenylalanine (FPP, [(18)F]3) were synthesized and evaluated in comparison to clinically utilized O-(2-[(18)F]fluoroethyl)-L-tyrosine (FET, [(18)F]1). METHODS FEP ([(18)F]2) and FPP ([(18)F]3) were successfully synthesized by a rapid and efficient two-step nucleophilic fluorination of tosylate precursors and deprotection reaction. In vitro cell uptake studies were carried out in 9L glioma cells. In vivo studies, 9L tumor xenografts were implanted in Fisher 344 rats. RESULTS FEP ([(18)F]2) and FPP ([(18)F]3) could be efficiently labeled within 90 min with good enantiomeric purity (>95%), good yield (11-37%) and high specific activity (21-69 GBq/μmol). Cell uptake studies showed FEP had higher uptake than FPP as well as reference ligand FET ([(18)F]1). Uptake mechanism studies suggested that FEP is a selective substrate for system L and prefers its subtype LAT1. In vivo biodistribution studies demonstrated FEP had specific accumulation in tumor cells and tumor to background ratio reached 1.45 at 60 min. Small animal positron emission tomography (PET) imaging studies showed FEP was comparable to FET for imaging rats bearing 9L tumor model. FEP had high uptake in 9L tumor compared to surrounding tissue and was quickly excreted through urinary tract. CONCLUSION Biological evaluations indicate that FEP ([(18)F]2) is a potential useful tracer for tumor imaging with PET.

Synthesis and comparative biological evaluation of l- and d-isomers of 18F-labeled fluoroalkyl phenylalanine derivatives as tumor imaging agents

INTRODUCTION L-amino acid-based tracers have established their important role as tumor metabolic imaging agents. Recently, a number of studies demonstrated that D-amino acids may have improved imaging properties than their corresponding L-isomers. We synthesized and evaluated the D-isomer of a new phenylalanine derivative, p-(2-[(18)F]fluoroethyl)-phenylalanine ([(18)F]FEP), in comparison to its L-isomer and previously reported the L- and D-isomers of O-(2-[(18)F]fluoroethyl)-tyrosine ([(18)F]FET). METHODS L- and D-Isomers of [(18)F]FET and [(18)F]FEP were successfully synthesized via a rapid and efficient two-step nucleophilic fluorination and deprotection reaction. In vitro studies were carried out in 9L glioma cells. In in vivo studies, Fisher 344 rats bearing the 9L tumor model were used. RESULTS L- and D-Isomers of (18)F-fluoroalkyl tyrosine and phenylalanine derivatives were efficiently labeled with high enantiomeric purity (>95%), good yield (11-45%) and high specific activity (21-75 GBq/μmol). D-[(18)F]FEP showed a similar linear time-dependent uptake as D-[(18)F]FET, while their corresponding L-isomers had much faster and higher uptake (4.3- to 16.0-fold at maximum uptake). The maximum uptake of the new compounds, L- and D-[(18)F]FEP, was 1.4- and 5.2-fold of that reported for L- and D-[(18)F]FET, respectively. Transport characterization studies indicated that both L- and D-[(18)F]FEP were selective substrates for system L. While L-[(18)F]FEP exhibited preference towards one subtype of system L, LAT1, D-[(18)F]FEP did not exhibit the same preference. Small animal PET imaging studies showed that both L- and D-[(18)F]FEP had higher uptake in 9L tumor compared to surrounding tissues, but D-isomer had lower tumor-to-muscle ratio in comparison with its L-isomer. CONCLUSION Both L- and D-[(18)F]FEP are substrates for system L amino acid transporter with different preference toward its subtypes. Small animal imaging studies of 9L tumor showed that D-[(18)F]FEP did not show better imaging properties than their corresponding L-isomer.

Synthesis and in vitro evaluation of 18F labeled tyrosine derivatives as potential positron emission tomography (PET) imaging agents

Three new 18F labeled fluoroalkyl tyrosine derivatives, O-(2-[18F]fluoroethyl)-alpha-methyltyrosine (FEMT, [18F]2), O-(2-[18F]fluoroethyl)-2-L-azatyrosine (FEAT, [18F]3), O-(2-[18F]fluoroethyl)-L-tyrosineamide (FETA, [18F]4) have been synthesized and radiofluorinated with 5-34% decay-corrected yield. In vitro studies were carried out in U-138 MG human glioblastoma. Cellular uptake of new tracers was compared to clinically utilized imaging agent O-(2-[18F]fluoroethyl)-L-tyrosine (FET, [18F]1). The uptake of tracers followed the order of FET ([18F]1) > FEAT([18F]3) > FEMT ([18F]2) approximately FETA ([18F]4).