1
|
Jain S, Singh M, Sarhan M, Damiba N, Singh A, Villabona-Rueda A, Meza ON, Chen X, Ordonez A, D'Alessio F, Aboagye E, Carroll L. Proapoptotic Bcl-2 inhibitor as host directed therapy for pulmonary tuberculosis. RESEARCH SQUARE 2024:rs.3.rs-4926508. [PMID: 39281866 PMCID: PMC11398574 DOI: 10.21203/rs.3.rs-4926508/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
Mycobacterium tuberculosis establishes within host cells by inducing anti-apoptotic Bcl-2 family proteins, triggering necrosis, inflammation, and fibrosis. Here, we demonstrate that navitoclax, an orally bioavailable, small-molecule Bcl-2 inhibitor, significantly improves pulmonary tuberculosis (TB) treatments as a host-directed therapy. Addition of navitoclax to standard TB treatments at human equipotent dosing in mouse models of TB, inhibits Bcl-2 expression, leading to improved bacterial clearance, reduced tissue damage / fibrosis and decreased extrapulmonary bacterial dissemination. Using immunohistochemistry and flow cytometry, we show that navitoclax induces apoptosis in several immune cells, including CD68 + and CD11b + cells. Finally, positron emission tomography (PET) in live animals using novel, clinically translatable biomarkers for apoptosis ( 18 F-ICMT-11) and fibrosis ( 18 F-FAPI-74) demonstrates that navitoclax significantly increases apoptosis and reduces fibrosis in pulmonary tissues, which are confirmed using post-mortem studies. Our studies suggest that proapoptotic drugs such as navitoclax can improve pulmonary TB treatments, and should be evaluated in clinical trials.
Collapse
|
2
|
Chen X, Arun B, Nino-Meza OJ, Sarhan MO, Singh M, Jeon B, Mane K, Shah M, Tucker EW, Carroll LS, Freundlich JS, Peloquin CA, Ivaturi VD, Jain SK. Dynamic PET reveals compartmentalized brain and lung tissue antibiotic exposures of tuberculosis drugs. Nat Commun 2024; 15:6657. [PMID: 39143055 PMCID: PMC11324906 DOI: 10.1038/s41467-024-50989-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 07/26/2024] [Indexed: 08/16/2024] Open
Abstract
Tuberculosis (TB) remains a leading cause of death, but antibiotic treatments for tuberculous meningitis, the deadliest form of TB, are based on those developed for pulmonary TB and not optimized for brain penetration. Here, we perform first-in-human dynamic 18F-pretomanid positron emission tomography (PET) in eight human subjects to visualize 18F-pretomanid biodistribution as concentration-time exposures in multiple compartments (NCT05609552), demonstrating preferential brain versus lung tissue partitioning. Preferential, antibiotic-specific partitioning into brain or lung tissues of several antibiotics, active against multidrug resistant (MDR) Mycobacterium tuberculosis strains, are confirmed in experimentally-infected mice and rabbits, using dynamic PET with chemically identical antibiotic radioanalogs, and postmortem mass spectrometry measurements. PET-facilitated pharmacokinetic modeling predicts human dosing necessary to attain therapeutic brain exposures. These data are used to design optimized, pretomanid-based regimens which are evaluated at human equipotent dosing in a mouse model of TB meningitis, demonstrating excellent bactericidal activity without an increase in intracerebral inflammation or brain injury. Importantly, several antibiotic regimens demonstrate discordant activities in brain and lung tissues in the same animal, correlating with tissue antibiotic exposures. These data provide a mechanistic basis for the compartmentalized activities of antibiotic regimens, with important implications for developing treatments for meningitis and other infections in compartments with unique antibiotic penetration.
Collapse
Affiliation(s)
- Xueyi Chen
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bhavatharini Arun
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Oscar J Nino-Meza
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mona O Sarhan
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Medha Singh
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Byeonghoon Jeon
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kishor Mane
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Maunank Shah
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth W Tucker
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laurence S Carroll
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joel S Freundlich
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Charles A Peloquin
- Infectious Disease Pharmacokinetics Laboratory, Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Vijay D Ivaturi
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD, USA
- Centre for Pharmacometrics, Manipal University, Manipal, Karnataka, India
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
3
|
Khan RMN, Ahn YM, Marriner GA, Via LE, D'Hooge F, Seo Lee S, Yang N, Basuli F, White AG, Tomko JA, Frye LJ, Scanga CA, Weiner DM, Sutphen ML, Schimel DM, Dayao E, Piazza MK, Gomez F, Dieckmann W, Herscovitch P, Mason NS, Swenson R, Kiesewetter DO, Backus KM, Geng Y, Raj R, Anthony DC, Flynn JL, Barry CE, Davis BG. Distributable, metabolic PET reporting of tuberculosis. Nat Commun 2024; 15:5239. [PMID: 38937448 PMCID: PMC11211441 DOI: 10.1038/s41467-024-48691-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/09/2024] [Indexed: 06/29/2024] Open
Abstract
Tuberculosis remains a large global disease burden for which treatment regimens are protracted and monitoring of disease activity difficult. Existing detection methods rely almost exclusively on bacterial culture from sputum which limits sampling to organisms on the pulmonary surface. Advances in monitoring tuberculous lesions have utilized the common glucoside [18F]FDG, yet lack specificity to the causative pathogen Mycobacterium tuberculosis (Mtb) and so do not directly correlate with pathogen viability. Here we show that a close mimic that is also positron-emitting of the non-mammalian Mtb disaccharide trehalose - 2-[18F]fluoro-2-deoxytrehalose ([18F]FDT) - is a mechanism-based reporter of Mycobacteria-selective enzyme activity in vivo. Use of [18F]FDT in the imaging of Mtb in diverse models of disease, including non-human primates, successfully co-opts Mtb-mediated processing of trehalose to allow the specific imaging of TB-associated lesions and to monitor the effects of treatment. A pyrogen-free, direct enzyme-catalyzed process for its radiochemical synthesis allows the ready production of [18F]FDT from the most globally-abundant organic 18F-containing molecule, [18F]FDG. The full, pre-clinical validation of both production method and [18F]FDT now creates a new, bacterium-selective candidate for clinical evaluation. We anticipate that this distributable technology to generate clinical-grade [18F]FDT directly from the widely-available clinical reagent [18F]FDG, without need for either custom-made radioisotope generation or specialist chemical methods and/or facilities, could now usher in global, democratized access to a TB-specific PET tracer.
Collapse
Affiliation(s)
- R M Naseer Khan
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
- Clinical Pharmacology Lab, Clinical Center, NIHBC, NIH, Bethesda, MD, USA
| | - Yong-Mo Ahn
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Gwendolyn A Marriner
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Laura E Via
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
- Tuberculosis Imaging Program, DIR, NIAID, NIH, Bethesda, MD, USA
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Francois D'Hooge
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
| | - Seung Seo Lee
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
- School of Chemistry, University of Southampton, Southampton, UK
| | - Nan Yang
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
- The Rosalind Franklin Institute, Oxfordshire, UK
| | - Falguni Basuli
- Chemistry and Synthesis Center, NHLBI, NIH, Bethesda, MD, USA
| | - Alexander G White
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, USA
| | - Jaime A Tomko
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, USA
| | - L James Frye
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, USA
| | - Charles A Scanga
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, USA
| | - Danielle M Weiner
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Michelle L Sutphen
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Daniel M Schimel
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Emmanuel Dayao
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | | | - Felipe Gomez
- Tuberculosis Imaging Program, DIR, NIAID, NIH, Bethesda, MD, USA
| | - William Dieckmann
- Positron Emission Tomography Department, Clinical Center, NIH, Bethesda, MD, USA
| | - Peter Herscovitch
- Positron Emission Tomography Department, Clinical Center, NIH, Bethesda, MD, USA
| | - N Scott Mason
- Department of Radiology, University of Pittsburgh, Pittsburgh, USA
| | - Rolf Swenson
- Chemistry and Synthesis Center, NHLBI, NIH, Bethesda, MD, USA
| | - Dale O Kiesewetter
- Molecular Tracer and Imaging Core Facility, National Institute of Biomedical Imaging and Bioengineering, NIH, Bethesda, MD, USA
| | - Keriann M Backus
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
- Biological Chemistry Department, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Yiqun Geng
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
| | - Ritu Raj
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
| | | | - JoAnne L Flynn
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, USA
| | - Clifton E Barry
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA.
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
| | - Benjamin G Davis
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK.
- The Rosalind Franklin Institute, Oxfordshire, UK.
- Department of Pharmacology, University of Oxford, Oxford, UK.
| |
Collapse
|
4
|
Jain S, Chen X, Arun B, Meza ON, Sarhan M, Singh M, Jeon B, Mane K, Shah M, Tucker E, Carroll L, Freundlich J, Peloquin C, Ivaturi V. Dynamic PET Reveals Compartmentalized Brain and Lung Tissue Antibiotic Exposures. RESEARCH SQUARE 2024:rs.3.rs-4096014. [PMID: 38562706 PMCID: PMC10984015 DOI: 10.21203/rs.3.rs-4096014/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Tuberculosis (TB) remains a leading cause of death, but antibiotic treatments for tuberculous meningitis, the deadliest form of TB, are based on those developed for pulmonary TB and not optimized for brain penetration. Here, we performed first-in-human dynamic 18F-pretomanid positron emission tomography (PET) studies in eight human subjects for three-dimensional, multi-compartmental in situ visualization of antibiotic concentration-time exposures (area under the curve - AUC), demonstrating preferential brain (AUCtissue/plasma 2.25) versus lung (AUCtissue/plasma 0.97) tissue partitioning. Preferential, antibiotic-specific partitioning into brain or lung tissues of antibiotics active against MDR strains were confirmed in experimentally-infected mice and rabbits, using dynamic PET with chemically identical antibiotic radioanalogs, and postmortem mass spectrometry measurements. PET-facilitated pharmacokinetic modeling predicted human dosing necessary to attain therapeutic brain exposures in human subjects. These data were used to design optimized, pretomanid-based regimens which were evaluated at human equipotent dosing in a mouse model of TB meningitis, demonstrating excellent bactericidal activity without an increase in intracerebral inflammation or brain injury. Importantly, several antibiotic regimens demonstrated discordant activities in brain and lung tissues in the same animal, correlating with the compartmentalized tissue exposures of the component antibiotics. These data provide a mechanistic basis for the compartmentalized activities of antibiotic regimens, with important implications for the development of antimicrobial regimens for meningitis and other infections in compartments with unique antibiotic penetration.
Collapse
Affiliation(s)
| | - Xueyi Chen
- Johns Hopkins University School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Naseer Khan R, Ahn YM, Marriner GA, Via LE, D’Hooge F, Lee SS, Yang N, Basuli F, White AG, Tomko JA, Frye LJ, Scanga CA, Weiner DM, Sutphen ML, Schimel DM, Dayao E, Piazza MK, Gomez F, Dieckmann W, Herscovitch P, Mason NS, Swenson R, Kiesewetter DO, Backus KM, Geng Y, Raj R, Anthony DC, Flynn JL, Barry CE, Davis BG. Distributable, Metabolic PET Reporting of Tuberculosis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.03.535218. [PMID: 37333343 PMCID: PMC10274857 DOI: 10.1101/2023.04.03.535218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Tuberculosis remains a large global disease burden for which treatment regimens are protracted and monitoring of disease activity difficult. Existing detection methods rely almost exclusively on bacterial culture from sputum which limits sampling to organisms on the pulmonary surface. Advances in monitoring tuberculous lesions have utilized the common glucoside [18F]FDG, yet lack specificity to the causative pathogen Mycobacterium tuberculosis (Mtb) and so do not directly correlate with pathogen viability. Here we show that a close mimic that is also positron-emitting of the non-mammalian Mtb disaccharide trehalose - 2-[18F]fluoro-2-deoxytrehalose ([18F]FDT) - can act as a mechanism-based enzyme reporter in vivo. Use of [18F]FDT in the imaging of Mtb in diverse models of disease, including non-human primates, successfully co-opts Mtb-specific processing of trehalose to allow the specific imaging of TB-associated lesions and to monitor the effects of treatment. A pyrogen-free, direct enzyme-catalyzed process for its radiochemical synthesis allows the ready production of [18F]FDT from the most globally-abundant organic 18F-containing molecule, [18F]FDG. The full, pre-clinical validation of both production method and [18F]FDT now creates a new, bacterium-specific, clinical diagnostic candidate. We anticipate that this distributable technology to generate clinical-grade [18F]FDT directly from the widely-available clinical reagent [18F]FDG, without need for either bespoke radioisotope generation or specialist chemical methods and/or facilities, could now usher in global, democratized access to a TB-specific PET tracer.
Collapse
Affiliation(s)
- R.M. Naseer Khan
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
| | - Yong-Mo Ahn
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD USA
| | - Gwendolyn A. Marriner
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD USA
| | - Laura E. Via
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD USA
- Tuberculosis Imaging Program, DIR, NIAID, NIH, Bethesda, MD 20892
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Francois D’Hooge
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
| | - Seung Seo Lee
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
- School of Chemistry, University of Southampton, Southampton, UK
| | - Nan Yang
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
- The Rosalind Franklin Institute, Oxfordshire, OX11 0FA, UK
| | - Falguni Basuli
- Chemistry and Synthesis Center, NHLBI, NIH, Bethesda, MD USA
| | - Alexander G. White
- Department of Microbiology and Molecular Genetics, University of Pittsburgh
| | - Jaime A. Tomko
- Department of Microbiology and Molecular Genetics, University of Pittsburgh
| | - L. James Frye
- Department of Microbiology and Molecular Genetics, University of Pittsburgh
| | - Charles A. Scanga
- Department of Microbiology and Molecular Genetics, University of Pittsburgh
| | - Danielle M. Weiner
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD USA
| | - Michelle L. Sutphen
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD USA
| | - Daniel M. Schimel
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD USA
| | - Emmanuel Dayao
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD USA
| | | | - Felipe Gomez
- Tuberculosis Imaging Program, DIR, NIAID, NIH, Bethesda, MD 20892
| | - William Dieckmann
- Positron Emission Tomography Department, Clinical Center, NIH, Bethesda, MD USA 20892
| | - Peter Herscovitch
- Positron Emission Tomography Department, Clinical Center, NIH, Bethesda, MD USA 20892
| | | | - Rolf Swenson
- Chemistry and Synthesis Center, NHLBI, NIH, Bethesda, MD USA
| | - Dale O. Kiesewetter
- Molecular Tracer and Imaging Core Facility, National Institute of Biomedical Imaging and Bioengineering, NIH, Bethesda, MD 20892
| | - Keriann M. Backus
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
| | - Yiqun Geng
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
| | - Ritu Raj
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
| | - Daniel C. Anthony
- Laboratory of Experimental Neuropathology, Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK
| | - JoAnne L. Flynn
- Department of Microbiology and Molecular Genetics, University of Pittsburgh
| | - Clifton E. Barry
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD USA
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Benjamin G. Davis
- Department of Chemistry, University of Oxford, Chemistry Research Laboratory, Oxford, UK
- The Rosalind Franklin Institute, Oxfordshire, OX11 0FA, UK
| |
Collapse
|
6
|
Akter A, Lyons O, Mehra V, Isenman H, Abbate V. Radiometal chelators for infection diagnostics. FRONTIERS IN NUCLEAR MEDICINE (LAUSANNE, SWITZERLAND) 2023; 2:1058388. [PMID: 37388440 PMCID: PMC7614707 DOI: 10.3389/fnume.2022.1058388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Infection of native tissues or implanted devices is common, but clinical diagnosis is frequently difficult and currently available noninvasive tests perform poorly. Immunocompromised individuals (for example transplant recipients, or those with cancer) are at increased risk. No imaging test in clinical use can specifically identify infection, or accurately differentiate bacterial from fungal infections. Commonly used [18F]fluorodeoxyglucose (18FDG) positron emission computed tomography (PET/CT) is sensitive for infection, but limited by poor specificity because increased glucose uptake may also indicate inflammation or malignancy. Furthermore, this tracer provides no indication of the type of infective agent (bacterial, fungal, or parasitic). Imaging tools that directly and specifically target microbial pathogens are highly desirable to improve noninvasive infection diagnosis and localization. A growing field of research is exploring the utility of radiometals and their chelators (siderophores), which are small molecules that bind radiometals and form a stable complex allowing sequestration by microbes. This radiometal-chelator complex can be directed to a specific microbial target in vivo, facilitating anatomical localization by PET or single photon emission computed tomography. Additionally, bifunctional chelators can further conjugate therapeutic molecules (e.g., peptides, antibiotics, antibodies) while still bound to desired radiometals, combining specific imaging with highly targeted antimicrobial therapy. These novel therapeutics may prove a useful complement to the armamentarium in the global fight against antimicrobial resistance. This review will highlight current state of infection imaging diagnostics and their limitations, strategies to develop infection-specific diagnostics, recent advances in radiometal-based chelators for microbial infection imaging, challenges, and future directions to improve targeted diagnostics and/or therapeutics.
Collapse
Affiliation(s)
- Asma Akter
- Department of Analytical, Environmental and Forensic Sciences, King’s College London, London, United Kingdom
| | - Oliver Lyons
- Vascular Endovascular and Transplant Surgery, Christchurch Public Hospital, Christchurch, New Zealand
- Department of Surgery, University of Otago, Christchurch, New Zealand
| | - Varun Mehra
- Department of Hematology, King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Heather Isenman
- Department of Infectious Diseases, General Medicine, Christchurch Hospital, Christchurch, New Zealand
| | - Vincenzo Abbate
- Department of Analytical, Environmental and Forensic Sciences, King’s College London, London, United Kingdom
| |
Collapse
|
7
|
Lawal IO, Abubakar S, Ankrah AO, Sathekge MM. Molecular Imaging of Tuberculosis. Semin Nucl Med 2023; 53:37-56. [PMID: 35882621 DOI: 10.1053/j.semnuclmed.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/05/2022] [Indexed: 01/28/2023]
Abstract
Despite the introduction of many novel diagnostic techniques and newer treatment agents, tuberculosis (TB) remains a major cause of death from an infectious disease worldwide. With about a quarter of humanity harboring Mycobacterium tuberculosis, the causative agent of TB, the current efforts geared towards reducing the scourge due to TB must be sustained. At the same time, newer alternative modalities for diagnosis and treatment response assessment are considered. Molecular imaging entails the use of radioactive probes that exploit molecular targets expressed by microbes or human cells for imaging using hybrid scanners that provide both anatomic and functional features of the disease being imaged. Fluorine-18 fluorodeoxyglucose (FDG) is the most investigated radioactive probe for TB imaging in research and clinical practice. When imaged with positron emission tomography interphase with computed tomography (PET/CT), FDG PET/CT performs better than sputum conversion for predicting treatment outcome. At the end of treatment, FDG PET/CT has demonstrated the unique ability to identify a subset of patients declared cured based on the current standard of care but who still harbor live bacilli capable of causing disease relapse after therapy discontinuation. Our understanding of the pathogenesis and evolution of TB has improved significantly in the last decade, owing to the introduction of FDG PET/CT in TB research. FDG is a non-specific probe as it targets the host inflammatory response to Mycobacterium tuberculosis, which is not specifically different in TB compared with other infectious conditions. Ongoing efforts are geared towards evaluating the utility of newer probes targeting different components of the TB granuloma, the hallmark of TB lesions, including hypoxia, neovascularization, and fibrosis, in TB management. The most exciting category of non-FDG PET probes developed for molecular imaging of TB appears to be radiolabeled anti-tuberculous drugs for use in studying the pharmacokinetic characteristics of the drugs. This allows for the non-invasive study of drug kinetics in different body compartments concurrently, providing an insight into the spatial heterogeneity of drug exposure in different TB lesions. The ability to repeat molecular imaging using radiolabeled anti-tuberculous agents also offers an opportunity to study the temporal changes in drug kinetics within the different lesions during treatment.
Collapse
Affiliation(s)
- Ismaheel O Lawal
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA; Department of Nuclear Medicine, University of Pretoria, Pretoria, Gauteng, South Africa.
| | - Sofiullah Abubakar
- Department of Radiology and Nuclear Medicine, Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman
| | - Alfred O Ankrah
- Department of Nuclear Medicine, University of Pretoria, Pretoria, Gauteng, South Africa; National Center for Radiotherapy Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana; Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Mike M Sathekge
- Department of Nuclear Medicine, University of Pretoria, Pretoria, Gauteng, South Africa; Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
| |
Collapse
|
8
|
Mota F, Ruiz-Bedoya CA, Tucker EW, Holt DP, De Jesus P, Lodge MA, Erice C, Chen X, Bahr M, Flavahan K, Kim J, Brosnan MK, Ordonez AA, Peloquin CA, Dannals RF, Jain SK. Dynamic 18F-Pretomanid PET imaging in animal models of TB meningitis and human studies. Nat Commun 2022; 13:7974. [PMID: 36581633 PMCID: PMC9800570 DOI: 10.1038/s41467-022-35730-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022] Open
Abstract
Pretomanid is a nitroimidazole antimicrobial active against drug-resistant Mycobacterium tuberculosis and approved in combination with bedaquiline and linezolid (BPaL) to treat multidrug-resistant (MDR) pulmonary tuberculosis (TB). However, the penetration of these antibiotics into the central nervous system (CNS), and the efficacy of the BPaL regimen for TB meningitis, are not well established. Importantly, there is a lack of efficacious treatments for TB meningitis due to MDR strains, resulting in high mortality. We have developed new methods to synthesize 18F-pretomanid (chemically identical to the antibiotic) and performed cross-species positron emission tomography (PET) imaging to noninvasively measure pretomanid concentration-time profiles. Dynamic PET in mouse and rabbit models of TB meningitis demonstrates excellent CNS penetration of pretomanid but cerebrospinal fluid (CSF) levels does not correlate with those in the brain parenchyma. The bactericidal activity of the BPaL regimen in the mouse model of TB meningitis is substantially inferior to the standard TB regimen, likely due to restricted penetration of bedaquiline and linezolid into the brain parenchyma. Finally, first-in-human dynamic 18F-pretomanid PET in six healthy volunteers demonstrates excellent CNS penetration of pretomanid, with significantly higher levels in the brain parenchyma than in CSF. These data have important implications for developing new antibiotic treatments for TB meningitis.
Collapse
Affiliation(s)
- Filipa Mota
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Camilo A. Ruiz-Bedoya
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Elizabeth W. Tucker
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Daniel P. Holt
- grid.21107.350000 0001 2171 9311Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Patricia De Jesus
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Martin A. Lodge
- grid.21107.350000 0001 2171 9311Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Clara Erice
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Xueyi Chen
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Melissa Bahr
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Kelly Flavahan
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - John Kim
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Mary Katherine Brosnan
- grid.21107.350000 0001 2171 9311Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Alvaro A. Ordonez
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Charles A. Peloquin
- grid.15276.370000 0004 1936 8091Infectious Disease Pharmacokinetics Laboratory, Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL 32610 USA
| | - Robert F. Dannals
- grid.21107.350000 0001 2171 9311Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Sanjay K. Jain
- grid.21107.350000 0001 2171 9311Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| |
Collapse
|
9
|
Gouws AC, Kruger HG, Gheysens O, Zeevaart JR, Govender T, Naicker T, Ebenhan T. Antibiotic-Derived Radiotracers for Positron Emission Tomography: Nuclear or "Unclear" Infection Imaging? Angew Chem Int Ed Engl 2022; 61:e202204955. [PMID: 35834311 PMCID: PMC9826354 DOI: 10.1002/anie.202204955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Indexed: 01/11/2023]
Abstract
The excellent features of non-invasive molecular imaging, its progressive technology (real-time, whole-body imaging and quantification), and global impact by a growing infrastructure for positron emission tomography (PET) scanners are encouraging prospects to investigate new concepts, which could transform clinical care of complex infectious diseases. Researchers are aiming towards the extension beyond the routinely available radiopharmaceuticals and are looking for more effective tools that interact directly with causative pathogens. We reviewed and critically evaluated (challenges or pitfalls) antibiotic-derived PET radiopharmaceutical development efforts aimed at infection imaging. We considered both radiotracer development for infection imaging and radio-antibiotic PET imaging supplementing other tools for pharmacologic drug characterization; overall, a total of 20 original PET radiotracers derived from eleven approved antibiotics.
Collapse
Affiliation(s)
- Arno Christiaan Gouws
- Catalysis and Peptide Research UnitUniversity of KwaZulu-NatalDurban4000South Africa
| | | | - Olivier Gheysens
- Department of Nuclear MedicineCliniques Universitaires Saint-Luc, and Institute of Clinical and Experimental ResearchUniversité Catholique de LouvainBrusselsBelgium
| | - Jan Rijn Zeevaart
- Nuclear Medicine Research Infrastructure NPCPretoria0001South Africa
- RadiochemistryThe South African Nuclear Energy CorporationBrits0420South Africa
- Preclinical Drug Development PlatformNorth West UniversityPotchefstroom2520South Africa
| | | | - Tricia Naicker
- Catalysis and Peptide Research UnitUniversity of KwaZulu-NatalDurban4000South Africa
| | - Thomas Ebenhan
- Nuclear Medicine Research Infrastructure NPCPretoria0001South Africa
- Preclinical Drug Development PlatformNorth West UniversityPotchefstroom2520South Africa
- Department of Nuclear MedicineUniversity of PretoriaPretoria0001South Africa
| |
Collapse
|
10
|
Gouws AC, Kruger HG, Gheysens O, Zeevaart JR, Govender T, Naiker T, Ebenhan T. Antibiotic‐Derived Radiotracers for Positron Emission Tomography: Nuclear or ‘Unclear’ Infection Imaging? Angew Chem Int Ed Engl 2022. [DOI: 10.1002/ange.202204955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Arno Christiaan Gouws
- University of KwaZulu-Natal School of Health Sciences Catalysis and Peptide Research Unit SOUTH AFRICA
| | - Hendrik Gerhardus Kruger
- University of KwaZulu-Natal School of Health Sciences Catalysis and Peptide Research Unit SOUTH AFRICA
| | - Olivier Gheysens
- Cliniques Universitaires Saint-Luc Department of Nuclear Medicine BELGIUM
| | - Jan Rijn Zeevaart
- North-West University Potchefstroom Campus: North-West University Preclinical Drug Development Platform SOUTH AFRICA
| | | | - Tricia Naiker
- University of KwaZulu-Natal School of Health Sciences Catalysis and Peptide Research Unit SOUTH AFRICA
| | - Thomas Ebenhan
- University of Pretoria Nuclear Medicine Steve Biko and Malherbe St 0001 Pretoria SOUTH AFRICA
| |
Collapse
|
11
|
Woong Yoo S, Young Kwon S, Kang SR, Min JJ. Molecular imaging approaches to facilitate bacteria-mediated cancer therapy. Adv Drug Deliv Rev 2022; 187:114366. [PMID: 35654213 DOI: 10.1016/j.addr.2022.114366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/06/2022] [Accepted: 05/25/2022] [Indexed: 12/14/2022]
Abstract
Bacteria-mediated cancer therapy is a potential therapeutic strategy for cancer that has unique properties, including broad tumor-targeting ability, various administration routes, the flexibility of delivery, and facilitating the host's immune responses. The molecular imaging of bacteria-mediated cancer therapy allows the therapeutically injected bacteria to be visualized and confirms the accurate delivery of the therapeutic bacteria to the target lesion. Several hurdles make bacteria-specific imaging challenging, including the need to discriminate therapeutic bacterial infection from inflammation or other pathologic lesions. To realize the full potential of bacteria-specific imaging, it is necessary to develop bacteria-specific targets that can be associated with an imaging assay. This review describes the current status of bacterial imaging techniques together with the advantages and disadvantages of several imaging modalities. Also, we describe potential targets for bacterial-specific imaging and related applications.
Collapse
Affiliation(s)
- Su Woong Yoo
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeonnam, Korea
| | - Seong Young Kwon
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeonnam, Korea; Department of Nuclear Medicine, Chonnam National University Medical School, Hwasun, Jeonnam, Korea
| | - Sae-Ryung Kang
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeonnam, Korea
| | - Jung-Joon Min
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeonnam, Korea; Department of Nuclear Medicine, Chonnam National University Medical School, Hwasun, Jeonnam, Korea.
| |
Collapse
|
12
|
Kahlaoui N, Naninck T, Le Grand R, Chapon C. Impact of a PMMA tube on performances of a Vereos PET/CT system adapted for BSL-3 environment according to the NEMA NU2-2012 standard. EJNMMI Phys 2022; 9:22. [PMID: 35316846 PMCID: PMC8938744 DOI: 10.1186/s40658-022-00450-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/02/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction A Vereos PET/CT device was adapted to be compatible with the experimentation in large animals within BSL-3 environment. The aim of this study was to investigate the impact of this modification on the performance according to NEMA NU2-2012 standard. Methods Spatial resolution, sensitivity, count rate performance, accuracies of corrections and image quality were assessed using the NEMA NU2-2012 standards before and after installation of a transparent poly-methyl methacrylate tube of 8 mm thickness, 680 mm diameter and 2800 mm long inside the tunnel of the system. In addition, CT performance tests were performed according to manufacturer standard procedure. Results Although the presence of the tube led to a slight decrease in sensitivity, performance measurements were in accordance with manufacturer preconisation ranges and comparable to previous performance published data. Conclusion Modifications of Vereos PET/CT system allowing its use in BSL-3 conditions did not affect significantly its performance according to NEMA NU2-2012 standard.
Key points Question. Does a BSL-3 compatible modification alter Philips Vereos PET/CT performances according to NEMA NU2-2012 standards? Pertinent findings. Our Vereos PET/CT system was modified by a wall separating BSL-1 and BSL-3 sides and an 8 mm thickness PMMA tube inserted into the bore of the camera in order to extend the BSL-3 containment along the bed movement. The performances of our modified system according to NEMA NU2-2012 standards were not significantly impacted by the modifications and were in accordance with the values prescribed by the manufacturer. Implications for patients care. Our clinical PET/CT device was modified for human infectious diseases studies in Non-Human Primates. This unusual set up may then provide truly transposable data from preclinical studies into clinical application in infected patients.
Collapse
Affiliation(s)
- Nidhal Kahlaoui
- Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Université Paris-Saclay, Paris, France
| | - Thibaut Naninck
- Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Université Paris-Saclay, Paris, France
| | - Roger Le Grand
- Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Université Paris-Saclay, Paris, France
| | - Catherine Chapon
- Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Université Paris-Saclay, Paris, France.
| |
Collapse
|
13
|
Signore A, Conserva M, Varani M, Galli F, Lauri C, Velikyan I, Roivainen A. PET imaging of bacteria. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00077-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
14
|
More S, Marakalala MJ, Sathekge M. Tuberculosis: Role of Nuclear Medicine and Molecular Imaging With Potential Impact of Neutrophil-Specific Tracers. Front Med (Lausanne) 2021; 8:758636. [PMID: 34957144 PMCID: PMC8703031 DOI: 10.3389/fmed.2021.758636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/03/2021] [Indexed: 01/02/2023] Open
Abstract
With Tuberculosis (TB) affecting millions of people worldwide, novel imaging modalities and tools, particularly nuclear medicine and molecular imaging, have grown with greater interest to assess the biology of the tuberculous granuloma and evolution thereof. Much early work has been performed at the pre-clinical level using gamma single photon emission computed tomography (SPECT) agents exploiting certain characteristics of Mycobacterium tuberculosis (MTb). Both antituberculous SPECT and positron emission tomography (PET) agents have been utilised to characterise MTb. Other PET tracers have been utilised to help to characterise the biology of MTb (including Gallium-68-labelled radiopharmaceuticals). Of all the tracers, 2-[18F]FDG has been studied extensively over the last two decades in many aspects of the treatment paradigm of TB: at diagnosis, staging, response assessment, restaging, and in potentially predicting the outcome of patients with latent TB infection. Its lower specificity in being able to distinguish different inflammatory cell types in the granuloma has garnered interest in reviewing more specific agents that can portend prognostic implications in the management of MTb. With the neutrophil being a cell type that portends this poorer prognosis, imaging this cell type may be able to answer more accurately questions relating to the tuberculous granuloma transmissivity and may help in characterising patients who may be at risk of developing active TB. The formyl peptide receptor 1(FPR1) expressed by neutrophils is a key marker in this process and is a potential target to characterise these areas. The pre-clinical work regarding the role of radiolabelled N-cinnamoyl –F-(D) L – F – (D) –L F (cFLFLF) (which is an antagonist for FPR1) using Technetium 99m-labelled conjugates and more recently radiolabelled with Gallium-68 and Copper 64 is discussed. It is the hope that further work with this tracer may accelerate its potential to be utilised in responding to many of the current diagnostic dilemmas and challenges in TB management, thereby making the tracer a translatable option in routine clinical care.
Collapse
Affiliation(s)
- Stuart More
- Division of Nuclear Medicine, Department of Radiation Medicine, University of Cape Town, Cape Town, South Africa
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
- Nuclear Medicine Research Infrastructure, Steve Biko Academic Hospital, Pretoria, South Africa
- *Correspondence: Stuart More
| | - Mohlopheni J. Marakalala
- Africa Health Research Institute, Durban, South Africa
- Division of Infection and Immunity, University College London, London, United Kingdom
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Michael Sathekge
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
- Nuclear Medicine Research Infrastructure, Steve Biko Academic Hospital, Pretoria, South Africa
| |
Collapse
|
15
|
Kuzma BA, Pence IJ, Greenfield DA, Ho A, Evans CL. Visualizing and quantifying antimicrobial drug distribution in tissue. Adv Drug Deliv Rev 2021; 177:113942. [PMID: 34437983 DOI: 10.1016/j.addr.2021.113942] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022]
Abstract
The biodistribution and pharmacokinetics of drugs are vital to the mechanistic understanding of their efficacy. Measuring antimicrobial drug efficacy has been challenging as plasma drug concentration is used as a surrogate for tissue drug concentration, yet typically does not reflect that at the intended site(s) of action. Utilizing an image-guided approach, it is feasible to accurately quantify the biodistribution and pharmacokinetics within the desired site(s) of action. We outline imaging modalities used in visualizing drug distribution with examples ranging from in vitro cellular drug uptake to clinical treatment of microbial infections. The imaging modalities of interest are: radio-labeling, magnetic resonance, mass spectrometry imaging, computed tomography, fluorescence, and Raman spectroscopy. We outline the progress, limitations, and future outlook for each methodology. Further advances in these optical approaches would benefit patients and researchers alike, as non-invasive imaging could yield more profound insights with a lower clinical burden than invasive measurement approaches used today.
Collapse
Affiliation(s)
- Benjamin A Kuzma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
| | - Isaac J Pence
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
| | - Daniel A Greenfield
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
| | - Alexander Ho
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
| | - Conor L Evans
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
| |
Collapse
|
16
|
Ordonez AA, Abhishek S, Singh AK, Klunk MH, Azad BB, Aboagye EO, Carroll L, Jain SK. Caspase-Based PET for Evaluating Pro-Apoptotic Treatments in a Tuberculosis Mouse Model. Mol Imaging Biol 2021; 22:1489-1494. [PMID: 32232626 DOI: 10.1007/s11307-020-01494-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE Despite recent advances in antimicrobial treatments, tuberculosis (TB) remains a major global health threat. Mycobacterium tuberculosis proliferates in macrophages, preventing apoptosis by inducing anti-apoptotic proteins leading to necrosis of the infected cells. Necrosis then leads to increased tissue destruction, reducing the penetration of antimicrobials and immune cells to the areas where they are needed most. Pro-apoptotic drugs could be used as host-directed therapies in TB to improve antimicrobial treatments and patient outcomes. PROCEDURE We evaluated [18F]-ICMT-11, a caspase-3/7-specific positron emission tomography (PET) radiotracer, in macrophage cell cultures and in an animal model of pulmonary TB that closely resembles human disease. RESULTS Cells infected with M. tuberculosis and treated with cisplatin accumulated [18F]-ICMT-11 at significantly higher levels compared with that of controls, which correlated with levels of caspase-3/7 activity. Infected mice treated with cisplatin with increased caspase-3/7 activity also had a higher [18F]-ICMT-11 PET signal compared with that of untreated infected animals. CONCLUSIONS [18F]-ICMT-11 PET could be used as a noninvasive approach to measure intralesional pro-apoptotic responses in situ in pulmonary TB models and support the development of pro-apoptotic host-directed therapies for TB.
Collapse
Affiliation(s)
- Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sudhanshu Abhishek
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alok K Singh
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Amity Institute of Biotechnology, Amity University, Noida, Uttar Pradesh, India
| | - Mariah H Klunk
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Babak Benham Azad
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eric O Aboagye
- Comprehensive Cancer Imaging Centre, Department of Surgery & Cancer Hammersmith Campus, Imperial College, London, UK
| | - Laurence Carroll
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
17
|
Yang HJ, Wang D, Wen X, Weiner DM, Via LE. One Size Fits All? Not in In Vivo Modeling of Tuberculosis Chemotherapeutics. Front Cell Infect Microbiol 2021; 11:613149. [PMID: 33796474 PMCID: PMC8008060 DOI: 10.3389/fcimb.2021.613149] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/08/2021] [Indexed: 12/11/2022] Open
Abstract
Tuberculosis (TB) remains a global health problem despite almost universal efforts to provide patients with highly effective chemotherapy, in part, because many infected individuals are not diagnosed and treated, others do not complete treatment, and a small proportion harbor Mycobacterium tuberculosis (Mtb) strains that have become resistant to drugs in the standard regimen. Development and approval of new drugs for TB have accelerated in the last 10 years, but more drugs are needed due to both Mtb's development of resistance and the desire to shorten therapy to 4 months or less. The drug development process needs predictive animal models that recapitulate the complex pathology and bacterial burden distribution of human disease. The human host response to pulmonary infection with Mtb is granulomatous inflammation usually resulting in contained lesions and limited bacterial replication. In those who develop progressive or active disease, regions of necrosis and cavitation can develop leading to lasting lung damage and possible death. This review describes the major vertebrate animal models used in evaluating compound activity against Mtb and the disease presentation that develops. Each of the models, including the zebrafish, various mice, guinea pigs, rabbits, and non-human primates provides data on number of Mtb bacteria and pathology resolution. The models where individual lesions can be dissected from the tissue or sampled can also provide data on lesion-specific bacterial loads and lesion-specific drug concentrations. With the inclusion of medical imaging, a compound's effect on resolution of pathology within individual lesions and animals can also be determined over time. Incorporation of measurement of drug exposure and drug distribution within animals and their tissues is important for choosing the best compounds to push toward the clinic and to the development of better regimens. We review the practical aspects of each model and the advantages and limitations of each in order to promote choosing a rational combination of them for a compound's development.
Collapse
Affiliation(s)
- Hee-Jeong Yang
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Decheng Wang
- Medical College, China Three Gorges University, Yichang, China.,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China
| | - Xin Wen
- Medical College, China Three Gorges University, Yichang, China.,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China
| | - Danielle M Weiner
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States.,Tuberculosis Imaging Program, DIR, NIAID, NIH, Bethesda, MD, United States
| | - Laura E Via
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research (DIR), National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States.,Tuberculosis Imaging Program, DIR, NIAID, NIH, Bethesda, MD, United States.,Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
18
|
Ordonez AA, Tucker EW, Anderson CJ, Carter CL, Ganatra S, Kaushal D, Kramnik I, Lin PL, Madigan CA, Mendez S, Rao J, Savic RM, Tobin DM, Walzl G, Wilkinson RJ, Lacourciere KA, Via LE, Jain SK. Visualizing the dynamics of tuberculosis pathology using molecular imaging. J Clin Invest 2021; 131:145107. [PMID: 33645551 PMCID: PMC7919721 DOI: 10.1172/jci145107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Nearly 140 years after Robert Koch discovered Mycobacterium tuberculosis, tuberculosis (TB) remains a global threat and a deadly human pathogen. M. tuberculosis is notable for complex host-pathogen interactions that lead to poorly understood disease states ranging from latent infection to active disease. Additionally, multiple pathologies with a distinct local milieu (bacterial burden, antibiotic exposure, and host response) can coexist simultaneously within the same subject and change independently over time. Current tools cannot optimally measure these distinct pathologies or the spatiotemporal changes. Next-generation molecular imaging affords unparalleled opportunities to visualize infection by providing holistic, 3D spatial characterization and noninvasive, temporal monitoring within the same subject. This rapidly evolving technology could powerfully augment TB research by advancing fundamental knowledge and accelerating the development of novel diagnostics, biomarkers, and therapeutics.
Collapse
Affiliation(s)
- Alvaro A. Ordonez
- Center for Infection and Inflammation Imaging Research
- Center for Tuberculosis Research
- Department of Pediatrics, and
| | - Elizabeth W. Tucker
- Center for Infection and Inflammation Imaging Research
- Center for Tuberculosis Research
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Claire L. Carter
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | - Shashank Ganatra
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Deepak Kaushal
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Igor Kramnik
- Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, Massachusets, USA
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA
| | - Philana L. Lin
- Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Cressida A. Madigan
- Department of Biological Sciences, UCSD, San Diego, La Jolla, California, USA
| | - Susana Mendez
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Rockville, Maryland, USA
| | - Jianghong Rao
- Molecular Imaging Program at Stanford, Department of Radiology and Chemistry, Stanford University, Stanford, California, USA
| | - Rada M. Savic
- Department of Bioengineering and Therapeutic Sciences, School of Pharmacy and Medicine, UCSF, San Francisco, California, USA
| | - David M. Tobin
- Department of Molecular Genetics and Microbiology, Duke University, Durham, North Carolina, USA
| | - Gerhard Walzl
- SAMRC Centre for Tuberculosis Research, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robert J. Wilkinson
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
- Wellcome Centre for Infectious Diseases Research in Africa and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- The Francis Crick Institute, London, United Kingdom
| | - Karen A. Lacourciere
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Rockville, Maryland, USA
| | - Laura E. Via
- Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, and Tuberculosis Imaging Program, Division of Intramural Research, NIAID, NIH, Bethesda, Maryland, USA
| | - Sanjay K. Jain
- Center for Infection and Inflammation Imaging Research
- Center for Tuberculosis Research
- Department of Pediatrics, and
| |
Collapse
|
19
|
Ordoñez AA, Jain SK. Imaging of Bacterial Infections. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00089-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
20
|
Henrich TJ, Jones T, Beckford-Vera D, Price PM, VanBrocklin HF. Total-Body PET Imaging in Infectious Diseases. PET Clin 2020; 16:89-97. [PMID: 33160926 DOI: 10.1016/j.cpet.2020.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Total-body PET enables high-sensitivity imaging with dramatically improved signal-to-noise ratio. These enhanced performance characteristics allow for decreased PET scanning times acquiring data "total-body wide" and can be leveraged to decrease the amount of radiotracer required, thereby permitting more frequent imaging or longer imaging periods during radiotracer decay. Novel approaches to PET imaging of infectious diseases are emerging, including those that directly visualize pathogens in vivo and characterize concomitant immune responses and inflammation. Efforts to develop these imaging approaches are hampered by challenges of traditional imaging platforms, which may be overcome by novel total-body PET strategies.
Collapse
Affiliation(s)
- Timothy J Henrich
- Division of Experimental Medicine, University of California San Francisco, 1001 Potrero Avenue, Building 3, Room 525A, San Francisco, CA 94110, USA.
| | - Terry Jones
- Department of Radiology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Denis Beckford-Vera
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | | | - Henry F VanBrocklin
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
21
|
Jain SK, Andronikou S, Goussard P, Antani S, Gomez-Pastrana D, Delacourt C, Starke JR, Ordonez AA, Jean-Philippe P, Browning RS, Perez-Velez CM. Advanced imaging tools for childhood tuberculosis: potential applications and research needs. THE LANCET. INFECTIOUS DISEASES 2020; 20:e289-e297. [PMID: 32589869 DOI: 10.1016/s1473-3099(20)30177-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/01/2020] [Accepted: 03/04/2020] [Indexed: 12/15/2022]
Abstract
Tuberculosis is the leading cause of death globally that is due to a single pathogen, and up to a fifth of patients with tuberculosis in high-incidence countries are children younger than 16 years. Unfortunately, the diagnosis of childhood tuberculosis is challenging because the disease is often paucibacillary and it is difficult to obtain suitable specimens, causing poor sensitivity of currently available pathogen-based tests. Chest radiography is important for diagnostic evaluations because it detects abnormalities consistent with childhood tuberculosis, but several limitations exist in the interpretation of such results. Therefore, other imaging methods need to be systematically evaluated in children with tuberculosis, although current data suggest that when available, cross-sectional imaging, such as CT, should be considered in the diagnostic evaluation for tuberculosis in a symptomatic child. Additionally, much of the understanding of childhood tuberculosis stems from clinical specimens that might not accurately represent the lesional biology at infection sites. By providing non-invasive measures of lesional biology, advanced imaging tools could enhance the understanding of basic biology and improve on the poor sensitivity of current pathogen detection systems. Finally, there are key knowledge gaps regarding the use of imaging tools for childhood tuberculosis that we outlined in this Personal View, in conjunction with a proposed roadmap for future research.
Collapse
Affiliation(s)
- Sanjay K Jain
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Savvas Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
| | - Pierre Goussard
- Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - Sameer Antani
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
| | - David Gomez-Pastrana
- Unidad de Neumología Infantil, Hospital Universitario Materno-Infantil de Jerez, Jerez de la Frontera, Spain; Departamento de Pediatría, Universidad de Cádiz, Cádiz, Spain
| | - Christophe Delacourt
- Service de Pneumologie et Allergologie Pédiatriques, AP-HP, Hôpital Necker-Enfants-Malades, Paris, France; Université Paris Descartes, Université de Paris, Paris, France
| | - Jeffrey R Starke
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Alvaro A Ordonez
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patrick Jean-Philippe
- Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Renee S Browning
- Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Carlos M Perez-Velez
- Tuberculosis Clinic, Pima County Health Department, Tucson, AZ, USA; Division of Infectious Diseases, University of Arizona College of Medicine, Tucson, AZ, USA
| |
Collapse
|
22
|
Mota F, Jadhav R, Ruiz-Bedoya CA, Ordonez AA, Klunk MH, Freundlich JS, Jain SK. Radiosynthesis and Biodistribution of 18F-Linezolid in Mycobacterium tuberculosis-Infected Mice Using Positron Emission Tomography. ACS Infect Dis 2020; 6:916-921. [PMID: 32243132 DOI: 10.1021/acsinfecdis.9b00473] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Oxazolidinones are a novel class of antibacterials with excellent activity against resistant Gram-positive bacteria including strains causing multidrug-resistant tuberculosis (TB). Despite their excellent efficacy, optimal dosing strategies to limit their toxicities are still under development. Here, we developed a novel synthetic strategy for fluorine-18-radiolabeled oxazolidinones. As proof-of-concept, we performed whole-body 18F-linezolid positron emission tomography (PET) in a mouse model of pulmonary TB for noninvasive in situ measurements of time-activity curves in multiple compartments with subsequent confirmation by ex vivo tissue gamma counting. After intravenous injection, 18F-linezolid rapidly distributed to all organs with excellent penetration into Mycobacterium tuberculosis-infected lungs. Drug biodistribution studies with PET can provide unbiased, in situ drug measurements, which could boost efforts to optimize antibiotic dosing strategies.
Collapse
Affiliation(s)
| | - Ravindra Jadhav
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers University−New Jersey Medical School, Newark, New Jersey 07103, United States
| | | | | | | | - Joel S. Freundlich
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers University−New Jersey Medical School, Newark, New Jersey 07103, United States
| | | |
Collapse
|
23
|
Foss CA, Kulik L, Ordonez AA, Jain SK, Michael Holers V, Thurman JM, Pomper MG. SPECT/CT Imaging of Mycobacterium tuberculosis Infection with [ 125I]anti-C3d mAb. Mol Imaging Biol 2020; 21:473-481. [PMID: 29998399 DOI: 10.1007/s11307-018-1228-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Diagnosis and therapeutic monitoring of chronic bacterial infection requires methods to detect and localize sites of infection accurately. Complement C3 activation fragments are generated and covalently bound to selective bacterial pathogens during the immune response and can serve as biomarkers of ongoing bacterial infection. We have developed several probes for detecting tissue-bound C3 deposits, including a monoclonal antibody (mAb 3d29) that recognizes the tissue-bound terminal processing fragments iC3b and C3d but does not recognize native circulating C3 or tissue-bound C3b. PROCEDURES To determine whether mAb 3d29 could be used to detect chronic Mycobacterium tuberculosis infection non-invasively, aerosol-infected female C3HeB/FeJ mice were injected with [125I]3d29 mAb and either imaged using single-photon emission computed tomography (SPECT)/X-ray computed tomography (CT) imaging at 24 and 48 h after radiotracer injection or being subjected to biodistribution analysis. RESULTS Discrete lesions were detected by SPECT/CT imaging in the lungs and spleens of infected mice, consistent with the location of granulomas in the infected animals as detected by CT. Low-level signal was seen in the spleens of uninfected mice and no signal was seen in the lungs of healthy mice. Immunofluorescence microscopy revealed that 3d29 in the lungs of infected mice co-localized with aggregates of macrophages (detected with anti-CD68 antibodies). 3d29 was detected in the cytoplasm of macrophages, consistent with the location of internalized M. tuberculosis. 3d29 was also present within alveolar epithelial cells, indicating that it detected M. tuberculosis phagocytosed by other CD68-positive cells. Healthy controls showed very little retention of fluorescent or radiolabeled antibody across tissues. Radiolabeled 3d29 compared with radiolabeled isotype control showed a 3.5:1 ratio of increased uptake in infected lungs, indicating specific uptake by 3d29. CONCLUSION 3d29 can be used to detect and localize areas of infection with M. tuberculosis non-invasively by 24 h after radiotracer injection and with high contrast.
Collapse
Affiliation(s)
- Catherine A Foss
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, 1550 Orleans St. CRB2 493, Baltimore, MD, 21228, USA. .,Center for Infection and Inflammation Imaging Research, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, 21228, USA.
| | - Liudmila Kulik
- Department of Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, 21228, USA
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, 21228, USA
| | - V Michael Holers
- Department of Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Joshua M Thurman
- Department of Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Martin G Pomper
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, 1550 Orleans St. CRB2 493, Baltimore, MD, 21228, USA.,Center for Infection and Inflammation Imaging Research, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, 21228, USA
| |
Collapse
|
24
|
Mota F, Ordonez AA, Firth G, Ruiz-Bedoya CA, Ma MT, Jain SK. Radiotracer Development for Bacterial Imaging. J Med Chem 2020; 63:1964-1977. [PMID: 32048838 DOI: 10.1021/acs.jmedchem.9b01623] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Bacterial infections remain a major threat to humanity and are a leading cause of death and disability. Antimicrobial resistance has been declared as one of the top ten threats to human health by the World Health Organization, and new technologies are urgently needed for the early diagnosis and monitoring of deep-seated and complicated infections in hospitalized patients. This review summarizes the radiotracers as applied to imaging of bacterial infections. We summarize the recent progress in the development of pathogen-specific imaging and the application of radiotracers in understanding drug pharmacokinetics as well as the local biology at the infection sites. We also highlight the opportunities for medicinal chemists in radiotracer development for bacterial infections, with an emphasis on target selection and radiosynthetic approaches. Imaging of infections is an emerging field. Beyond clinical applications, these technologies could provide unique insights into disease pathogenesis and expedite bench-to-bedside translation of new therapeutics.
Collapse
Affiliation(s)
- Filipa Mota
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
| | - Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
| | - George Firth
- School of Biomedical Engineering and Imaging Sciences, St. Thomas' Hospital, King's College London, London SE1 7EH, United Kingdom
| | - Camilo A Ruiz-Bedoya
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
| | - Michelle T Ma
- School of Biomedical Engineering and Imaging Sciences, St. Thomas' Hospital, King's College London, London SE1 7EH, United Kingdom
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
| |
Collapse
|
25
|
Ordonez AA, Carroll LS, Abhishek S, Mota F, Ruiz-Bedoya CA, Klunk MH, Singh AK, Freundlich JS, Mease RC, Jain SK. Radiosynthesis and PET Bioimaging of 76Br-Bedaquiline in a Murine Model of Tuberculosis. ACS Infect Dis 2019; 5:1996-2002. [PMID: 31345032 PMCID: PMC6911007 DOI: 10.1021/acsinfecdis.9b00207] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Bedaquiline is a promising drug against tuberculosis (TB), but limited data are available on its intralesional pharmacokinetics. Moreover, current techniques rely on invasive tissue resection, which is difficult in humans and generally limited even in animals. In this study, we developed a novel radiosynthesis for 76Br-bedaquiline and performed noninvasive, longitudinal whole-body positron emission tomography (PET) in live, Mycobacterium tuberculosis-infected mice over 48 h. After the intravenous injection, 76Br-bedaquiline distributed to all organs and selectively localized to adipose tissue and liver, with excellent penetration into infected lung lesions (86%) and measurable penetration into the brain parenchyma (15%). Ex vivo high resolution, two-dimensional autoradiography, and same section hematoxylin/eosin and immunofluorescence provided detailed intralesional drug biodistribution. PET bioimaging and high-resolution autoradiography are novel techniques that can provide detailed, multicompartment, and intralesional pharmacokinetics of new and existing TB drugs. These technologies can significantly advance efforts to optimize drug dosing.
Collapse
Affiliation(s)
- Alvaro A. Ordonez
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland,
USA
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine,
Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Laurence S. Carroll
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of
Medicine, Baltimore, Maryland, USA
| | - Sudhanshu Abhishek
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland,
USA
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine,
Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Filipa Mota
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland,
USA
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine,
Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Camilo A. Ruiz-Bedoya
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland,
USA
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine,
Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mariah H. Klunk
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland,
USA
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine,
Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alok K. Singh
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland,
USA
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine,
Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joel S. Freundlich
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers University - New Jersey Medical School,
Newark, NJ, USA
| | - Ronnie C. Mease
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of
Medicine, Baltimore, Maryland, USA
| | - Sanjay K. Jain
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland,
USA
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine,
Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of
Medicine, Baltimore, Maryland, USA
| |
Collapse
|
26
|
Abstract
Molecular imaging is an emerging technology that enables the noninvasive visualization, characterization, and quantification of molecular events within living subjects. Positron emission tomography (PET) is a clinically available molecular imaging tool with significant potential to study pathogenesis of infections in humans. Molecular imaging is an emerging technology that enables the noninvasive visualization, characterization, and quantification of molecular events within living subjects. Positron emission tomography (PET) is a clinically available molecular imaging tool with significant potential to study pathogenesis of infections in humans. PET enables dynamic assessment of infectious processes within the same subject with high temporal and spatial resolution and obviates the need for invasive tissue sampling, which is difficult in patients and generally limited to a single time point, even in animal models. This review presents current state-of-the-art concepts on the application of molecular imaging for infectious diseases and details how PET imaging can facilitate novel insights into infectious processes, ongoing development of pathogen-specific imaging, and simultaneous in situ measurements of intralesional antimicrobial pharmacokinetics in multiple compartments, including privileged sites. Finally, the potential clinical applications of this promising technology are also discussed.
Collapse
|
27
|
Tucker EW, Guglieri-Lopez B, Ordonez AA, Ritchie B, Klunk MH, Sharma R, Chang YS, Sanchez-Bautista J, Frey S, Lodge MA, Rowe SP, Holt DP, Gobburu JVS, Peloquin CA, Mathews WB, Dannals RF, Pardo CA, Kannan S, Ivaturi VD, Jain SK. Noninvasive 11C-rifampin positron emission tomography reveals drug biodistribution in tuberculous meningitis. Sci Transl Med 2019; 10:10/470/eaau0965. [PMID: 30518610 DOI: 10.1126/scitranslmed.aau0965] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/01/2018] [Accepted: 11/02/2018] [Indexed: 12/14/2022]
Abstract
Tuberculous meningitis (TBM) is a devastating form of tuberculosis (TB), and key TB antimicrobials, including rifampin, have restricted brain penetration. A lack of reliable data on intralesional drug biodistribution in infected tissues has limited pharmacokinetic (PK) modeling efforts to optimize TBM treatments. Current methods to measure intralesional drug distribution rely on tissue resection, which is difficult in humans and generally limited to a single time point even in animals. In this study, we developed a multidrug treatment model in rabbits with experimentally induced TBM and performed serial noninvasive dynamic 11C-rifampin positron emission tomography (PET) over 6 weeks. Area under the curve brain/plasma ratios were calculated using PET and correlated with postmortem mass spectrometry. We demonstrate that rifampin penetration into infected brain lesions is limited, spatially heterogeneous, and decreases rapidly as early as 2 weeks into treatment. Moreover, rifampin concentrations in the cerebrospinal fluid did not correlate well with those in the brain lesions. First-in-human 11C-rifampin PET performed in a patient with TBM confirmed these findings. PK modeling predicted that rifampin doses (≥30 mg/kg) were required to achieve adequate intralesional concentrations in young children with TBM. These data demonstrate the proof of concept of PET as a clinically translatable tool to noninvasively measure intralesional antimicrobial distribution in infected tissues.
Collapse
Affiliation(s)
- Elizabeth W Tucker
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Division of Pediatric Critical Care, Johns Hopkins All Children's Hospital, St. Petersburg, FL 33701, USA
| | - Beatriz Guglieri-Lopez
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
| | - Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Brittaney Ritchie
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Mariah H Klunk
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Richa Sharma
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Yong S Chang
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Julian Sanchez-Bautista
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Sarah Frey
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Martin A Lodge
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Steven P Rowe
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Daniel P Holt
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jogarao V S Gobburu
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
| | - Charles A Peloquin
- Infectious Disease Pharmacokinetics Laboratory, Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville, FL 32610, USA
| | - William B Mathews
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Robert F Dannals
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Carlos A Pardo
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Sujatha Kannan
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Vijay D Ivaturi
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA.
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. .,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| |
Collapse
|
28
|
Lawal IO, Fourie BP, Mathebula M, Moagi I, Lengana T, Moeketsi N, Nchabeleng M, Hatherill M, Sathekge MM. 18F-FDG PET/CT as a Noninvasive Biomarker for Assessing Adequacy of Treatment and Predicting Relapse in Patients Treated for Pulmonary Tuberculosis. J Nucl Med 2019; 61:412-417. [PMID: 31451489 DOI: 10.2967/jnumed.119.233783] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/05/2019] [Indexed: 12/16/2022] Open
Abstract
Microbial culture is the gold standard for determining the effectiveness of tuberculosis treatment. End-of-treatment (EOT) 18F-FDG PET/CT findings are variable among patients with negative microbial culture results after completing a standard regimen of antituberculous treatment (ATT), with some patients having a complete metabolic response to treatment whereas others have residual metabolic activity (RMA). We herein determine the impact of findings on EOT 18F-FDG PET/CT on tuberculosis relapse in patients treated with a standard regimen of ATT for drug-sensitive pulmonary tuberculosis (DS-PTB). Methods: Patients who completed a standard regimen of ATT for DS-PTB and were declared cured based on a negative clinical and bacteriologic examination were prospectively recruited to undergo EOT 18F-FDG PET/CT. Images were assessed for the presence of RMA. Patients were subsequently followed up for 6 mo looking for symptoms of tuberculosis relapse. When new symptoms developed, relapse was confirmed with bacteriologic testing. Repeat 18F-FDG PET/CT was done in patients who relapsed. Results: Fifty-three patients were included (mean age, 37.81 ± 11.29 y), with 62% being male and 75% HIV-infected. RMA was demonstrated in 33 patients (RMA group), whereas 20 patients had a complete metabolic response to ATT (non-RMA group). There was a higher prevalence of lung cavitation in the RMA group (P = 0.035). The groups did not significantly differ in age, sex, presence of HIV infection, body mass index, or hemoglobin level (P > 0.05). On follow-up, no patients in the non-RMA group developed tuberculosis relapse. Three patients in the RMA group developed relapse. All patients who developed tuberculosis relapse had bilateral disease with lung cavitation. Conclusion: A negative EOT 18F-FDG PET/CT result is protective against tuberculosis relapse. Nine percent of patients with RMA after ATT may experience tuberculosis relapse within 6 mo of completing ATT. Bilateral disease with lung cavitation is prevalent among patients with tuberculosis relapse.
Collapse
Affiliation(s)
- Ismaheel O Lawal
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Bernard P Fourie
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
| | - Matsontso Mathebula
- Department of Medical Microbiology and MeCRU, Sefako Makgatho University of Medical Science, Pretoria, South Africa; and
| | - Ingrid Moagi
- Department of Medical Microbiology and MeCRU, Sefako Makgatho University of Medical Science, Pretoria, South Africa; and
| | - Thabo Lengana
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Nontando Moeketsi
- Department of Medical Microbiology and MeCRU, Sefako Makgatho University of Medical Science, Pretoria, South Africa; and
| | - Maphoshane Nchabeleng
- Department of Medical Microbiology and MeCRU, Sefako Makgatho University of Medical Science, Pretoria, South Africa; and
| | - Mark Hatherill
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Mike M Sathekge
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| |
Collapse
|
29
|
PET Radiopharmaceuticals for Specific Bacteria Imaging: A Systematic Review. J Clin Med 2019; 8:jcm8020197. [PMID: 30736324 PMCID: PMC6406348 DOI: 10.3390/jcm8020197] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 01/30/2019] [Accepted: 02/04/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Bacterial infections are still one of the main factors associated with mortality worldwide. Many radiopharmaceuticals were developed for bacterial imaging, both with single photon emission computed tomography (SPECT) and positron emission tomography (PET) isotopes. This review focuses on PET radiopharmaceuticals, performing a systematic literature review of published studies between 2005 and 2018. Methods: A systematic review of published studies between 2005 and 2018 was performed. A team of reviewers independently screened for eligible studies. Because of differences between studies, we pooled the data where possible, otherwise, we described separately. Quality of evidence was assessed by Quality Assessment of Diagnostic Accuracy Studies (QUADAS) approach. Results: Eligible papers included 35 published studies. Because of the heterogeneity of animal models and bacterial strains, we classified studies in relation to the type of bacterium: Gram-positive, Gram-negative, Gram-positive and negative, others. Conclusions: Results highlighted the availability of many promising PET radiopharmaceuticals for bacterial imaging, despite some bias related to animal selection and index test, but few have been translated to human subjects. Results showed a lack of standardized infection models and experimental settings.
Collapse
|
30
|
Malherbe ST, Kleynhans L, Walzl G. The potential of imaging tools as correlates of infection and disease for new TB vaccine development. Semin Immunol 2018; 39:73-80. [PMID: 29914653 DOI: 10.1016/j.smim.2018.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 06/07/2018] [Indexed: 12/17/2022]
Abstract
The development of an improved vaccine to stimulate an effective response against Mycobacterium tuberculosis (MTB) infection and disease will be a major breakthrough in the fight against TB. A lack of tools to adequately track the progression or resolution of events in TB pathogenesis that occur at bacterial loads below the threshold for culture in human samples seriously hampers vaccine development and evaluation. In this review we discuss recent studies that use new imaging applications, modalities and analysis techniques to provide insight into the dynamic processes of MTB infection and disease that are challenging to monitor. These include early infection, the spectrum of latency and subclinical disease, the paucibacillary state induced by treatment, and events leading to recurrence, including relapse.
Collapse
Affiliation(s)
- Stephanus T Malherbe
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Léanie Kleynhans
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Gerhard Walzl
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| |
Collapse
|
31
|
Ordonez AA, Jain SK. Pathogen-Specific Bacterial Imaging in Nuclear Medicine. Semin Nucl Med 2018. [DOI: 10.1053/j.semnuclmed.2017.11.003
expr 890398765 + 809902709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
|
32
|
Abstract
When serious infections are suspected, patients are often treated empirically with broad-spectrum antibiotics while awaiting results that provide information on the bacterial class and species causing the infection, as well as drug susceptibilities. For deep-seated infections, these traditional diagnostic techniques often rely on tissue biopsies to obtain clinical samples which can be expensive, dangerous, and has the potential of sampling bias. Moreover, these procedures and results can take several days and may not always provide reliable information. This combination of time and effort required for proper antibiotic selection has become a barrier leading to indiscriminate broad-spectrum antibiotic use. Exposure to nosocomial infections and indiscriminate use of broad-spectrum antibiotics are responsible for promoting bacterial drug-resistance leading to substantial morbidity and mortality, especially in hospitalized and immunosuppressed patients. Therefore, early diagnosis of infection and targeted antibiotic treatments are urgently needed to reduce morbidity and mortality caused by bacterial infections worldwide. Reliable pathogen-specific bacterial imaging techniques have the potential to provide early diagnosis and guide antibiotic treatments.
Collapse
Affiliation(s)
- Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
| |
Collapse
|
33
|
Abstract
Infectious diseases are a major threat to humanity, and it is imperative that we develop imaging tools that aid in their study, facilitate diagnosis, and guide treatment. The alarming rise of highly virulent and multi-drug-resistant pathogens, their rapid spread leading to frequent global pandemics, fears of bioterrorism, and continued life-threatening nosocomial infections in hospitals remain as major challenges to health care in the USA and worldwide. Early diagnosis and rapid monitoring are essential for appropriate management and control of infections. Tomographic molecular imaging enables rapid, noninvasive visualization, localization, and monitoring of molecular processes deep within the body and offers several advantages over traditional tools used for the study of infectious diseases. Noninvasive, longitudinal assessments could streamline animal studies, allow unique insights into disease pathogenesis, and expedite clinical translation of new therapeutics. Since molecular imaging is already in common use in the clinic, it could also become a valuable tool for clinical studies, for patient care, for public health, and for enabling precision medicine for infectious diseases.
Collapse
|
34
|
Guillon A, Sécher T, Dailey LA, Vecellio L, de Monte M, Si-Tahar M, Diot P, Page CP, Heuzé-Vourc'h N. Insights on animal models to investigate inhalation therapy: Relevance for biotherapeutics. Int J Pharm 2017; 536:116-126. [PMID: 29180257 DOI: 10.1016/j.ijpharm.2017.11.049] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 12/20/2022]
Abstract
Acute and chronic respiratory diseases account for major causes of illness and deaths worldwide. Recent developments of biotherapeutics opened a new era in the treatment and management of patients with respiratory diseases. When considering the delivery of therapeutics, the inhaled route offers great promises with a direct, non-invasive access to the diseased organ and has already proven efficient for several molecules. To assist in the future development of inhaled biotherapeutics, experimental models are crucial to assess lung deposition, pharmacokinetics, pharmacodynamics and safety. This review describes the animal models used in pulmonary research for aerosol drug delivery, highlighting their advantages and limitations for inhaled biologics. Overall, non-clinical species must be selected with relevant scientific arguments while taking into account their complexities and interspecies differences, to help in the development of inhaled medicines and ensure their successful transposition in the clinics.
Collapse
Affiliation(s)
- A Guillon
- INSERM, Centre d'Etude des Pathologies Respiratoires, U1100, F-37032, Tours, France; Université François Rabelais de Tours, F-37032, Tours, France; CHRU de Tours, Service de Médecine Intensive - Réanimation, F-37000, Tours, France
| | - T Sécher
- INSERM, Centre d'Etude des Pathologies Respiratoires, U1100, F-37032, Tours, France; Université François Rabelais de Tours, F-37032, Tours, France
| | - L A Dailey
- Institute of Pharmacy, Martin-Luther-University Halle-Wittenberg, Wolfgang-Langenbeck Str. 4, 06122, Halle (Saale), Germany
| | - L Vecellio
- INSERM, Centre d'Etude des Pathologies Respiratoires, U1100, F-37032, Tours, France; Aerodrug, Université François Rabelais - Faculté de Médecine, Tours, France
| | - M de Monte
- Plateforme Scientifique et Technique (PST) Animaleries, Université F. Rabelais, F-37000, Tours, France
| | - M Si-Tahar
- INSERM, Centre d'Etude des Pathologies Respiratoires, U1100, F-37032, Tours, France; Université François Rabelais de Tours, F-37032, Tours, France
| | - P Diot
- INSERM, Centre d'Etude des Pathologies Respiratoires, U1100, F-37032, Tours, France; Université François Rabelais de Tours, F-37032, Tours, France; CHRU de Tours, Service de Pneumologie, F-37000, Tours, France
| | - C P Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London, SE1 9NH, UK
| | - N Heuzé-Vourc'h
- INSERM, Centre d'Etude des Pathologies Respiratoires, U1100, F-37032, Tours, France; Université François Rabelais de Tours, F-37032, Tours, France.
| |
Collapse
|
35
|
Siitonen R, Pietikäinen A, Liljenbäck H, Käkelä M, Söderström M, Jalkanen S, Hytönen J, Roivainen A. Targeting of vascular adhesion protein-1 by positron emission tomography visualizes sites of inflammation in Borrelia burgdorferi-infected mice. Arthritis Res Ther 2017; 19:254. [PMID: 29166944 PMCID: PMC5700622 DOI: 10.1186/s13075-017-1460-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/26/2017] [Indexed: 12/13/2022] Open
Abstract
Background In the present study, we sought to evaluate the feasibility of targeting vascular adhesion protein-1 (VAP-1) by positron emission tomography (PET) for the longitudinal quantitative assessment of Borrelia burgdorferi infection-induced inflammation in mice. Methods Mice with B. burgdorferi infection-induced arthritis were studied. During a 7-week follow-up period, the progression of arthritis was monitored weekly with 68Ga-DOTA-Siglec-9 PET/computed tomography (CT) and measurement of tibiotarsal joint swellings. A subgroup of infected mice was treated with ceftriaxone. Finally, histopathological assessment of joint inflammation was performed and VAP-1 expression in joints were determined. Results Explicit joint swelling and 68Ga-DOTA-Siglec-9 uptake could be demonstrated in the affected joints from B. burgdorferi-infected mice. By contrast, no obvious accumulation of 68Ga-DOTA-Siglec-9 was detected in joints of uninfected mice. The maximum swelling and highest uptake in the affected joints were observed 4 weeks after the infection. 68Ga-DOTA-Siglec-9 uptake in joints correlated with joint swelling (P < 0.0001) and histopathological scoring of inflammation (P = 0.020). Despite short-term antibiotic treatment, the arthritis persisted, and the PET signal remained as high as in nontreated mice. Immunohistochemistry revealed strong-to-moderate expression of VAP-1 in the synovium of B. burgdorferi-infected mice, while only weak expression of VAP-1 was detected in uninfected mice. Conclusions The present study showed that 68Ga-DOTA-Siglec-9 can detect B. burgdorferi infection-induced arthritis in mice. Furthermore, longitudinal PET/CT imaging allowed monitoring of arthritis development over time.
Collapse
Affiliation(s)
- Riikka Siitonen
- Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland
| | - Annukka Pietikäinen
- Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland.,Turku Doctoral Programme for Molecular Medicine, Turku, Finland
| | - Heidi Liljenbäck
- Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland.,Turku Center for Disease Modeling, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland
| | - Meeri Käkelä
- Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland
| | - Mirva Söderström
- Department of Pathology, Turku University Hospital, Kiinamyllynkatu 10, FI-20520, Turku, Finland
| | - Sirpa Jalkanen
- Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland.,MediCity Research Laboratory, University of Turku, Tykistönkatu 6, FI-20520, Turku, Finland
| | - Jukka Hytönen
- Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland.,Microbiology and Genetics Department, Turku University Hospital, Kiinamyllynkatu 10, FI-20520, Turku, Finland
| | - Anne Roivainen
- Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland. .,Turku Center for Disease Modeling, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland. .,Turku PET Centre, Turku University Hospital, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland.
| |
Collapse
|
36
|
Pietikäinen A, Siitonen R, Liljenbäck H, Eskola O, Söderström M, Roivainen A, Hytönen J. In vivo imaging of Lyme arthritis in mice by [ 18F]fluorodeoxyglucose positron emission tomography/computed tomography. Scand J Rheumatol 2017. [PMID: 28649922 DOI: 10.1080/03009742.2017.1287306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Lyme borreliosis (LB) is a tick-borne infectious disease caused by Borrelia burgdorferi spirochaetes, which are able to disseminate from the tick-bite site to distant organs. Mouse models are widely used to study LB and especially Lyme arthritis (LA), but only a few whole-animal in vivo imaging studies on the pathogenesis of B. burgdorferi infection in mice have been published so far. The existing imaging techniques have their drawbacks and, therefore, novel tools to complement the array of available LB imaging methodologies are needed. METHOD The applicability of positron emission tomography combined with computed tomography (PET/CT) imaging was evaluated as a method to monitor LB and especially LA in the C3H/HeN mouse model infected with wild-type B. burgdorferi N40 bacteria. The imaging results were compared with the traditional LA analysis methods, such as tibiotarsal joint swelling and histopathological assessment of joint inflammation. RESULTS PET/CT imaging provided high-resolution images with quantitative information on the spatial and temporal distribution of the [18F]fluorodeoxyglucose ([18F]FDG) tracer in B. burgdorferi-infected mice. The [18F]FDG accumulated in the affected joints and activated lymph nodes of infected mice, while the tracer signal could not be visualized in these organs in uninfected control animals. Importantly, in vivo PET/CT imaging data were in agreement with the histopathological scoring of inflammation of mouse joints. CONCLUSION PET/CT imaging with [18F]FDG is a reliable method to longitudinally monitor the development and progression of B. burgdorferi infection-induced inflammation in vivo in mouse joints.
Collapse
Affiliation(s)
- A Pietikäinen
- a Department of Medical Microbiology and Immunology , University of Turku , Turku , Finland.,b Turku Doctoral Programme for Molecular Medicine , University of Turku , Turku , Finland
| | - R Siitonen
- c Turku PET Centre , Turku University Hospital and University of Turku , Turku , Finland
| | - H Liljenbäck
- c Turku PET Centre , Turku University Hospital and University of Turku , Turku , Finland.,d Turku Center for Disease Modeling , University of Turku , Turku , Finland
| | - O Eskola
- c Turku PET Centre , Turku University Hospital and University of Turku , Turku , Finland
| | - M Söderström
- e Department of Pathology and Forensic Medicine , Turku University Hospital and University of Turku , Turku , Finland
| | - A Roivainen
- c Turku PET Centre , Turku University Hospital and University of Turku , Turku , Finland.,d Turku Center for Disease Modeling , University of Turku , Turku , Finland
| | - J Hytönen
- a Department of Medical Microbiology and Immunology , University of Turku , Turku , Finland.,f Department of Clinical Microbiology and Immunology , Turku University Hospital , Turku , Finland
| |
Collapse
|
37
|
Dutta J, Naicker T, Ebenhan T, Kruger HG, Arvidsson PI, Govender T. Synthetic approaches to radiochemical probes for imaging of bacterial infections. Eur J Med Chem 2017; 133:287-308. [DOI: 10.1016/j.ejmech.2017.03.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 02/08/2023]
|
38
|
Subcellular Partitioning and Intramacrophage Selectivity of Antimicrobial Compounds against Mycobacterium tuberculosis. Antimicrob Agents Chemother 2017; 61:AAC.01639-16. [PMID: 28052847 DOI: 10.1128/aac.01639-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 12/30/2016] [Indexed: 12/14/2022] Open
Abstract
The efficacy of antimicrobial drugs against Mycobacterium tuberculosis, an intracellular bacterial pathogen, is generally first established by testing compounds against bacteria in axenic culture. However, inside infected macrophages, bacteria encounter an environment which differs substantially from broth culture and are subject to important host-dependent pharmacokinetic phenomena which modulate drug activity. Here, we describe how pH-dependent partitioning drives asymmetric antimicrobial drug distribution in M. tuberculosis-infected macrophages. Specifically, weak bases with moderate activity against M. tuberculosis (fluoxetine, sertraline, and dibucaine) were shown to accumulate intracellularly due to differential permeability and relative abundance of their ionized and nonionized forms. Nonprotonatable analogs of the test compounds did not show this effect. Neutralization of acidic organelles directly with ammonium chloride or indirectly with bafilomycin A1 partially abrogated the growth restriction of these drugs. Using high-performance liquid chromatography, we quantified the degree of accumulation and reversibility upon acidic compartment neutralization in macrophages and observed that accumulation was greater in infected than in uninfected macrophages. We further demonstrate that the efficacy of a clinically used compound, clofazimine, is augmented by pH-based partitioning in a macrophage infection model. Because the parameters which govern this effect are well understood and are amenable to chemical modification, this knowledge may enable the rational development of more effective antibiotics against tuberculosis.
Collapse
|
39
|
Zhang Z, Ordonez AA, Smith-Jones P, Wang H, Gogarty KR, Daryaee F, Bambarger LE, Chang YS, Jain SK, Tonge PJ. The biodistribution of 5-[18F]fluoropyrazinamide in Mycobacterium tuberculosis-infected mice determined by positron emission tomography. PLoS One 2017; 12:e0170871. [PMID: 28151985 PMCID: PMC5289470 DOI: 10.1371/journal.pone.0170871] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/11/2017] [Indexed: 02/03/2023] Open
Abstract
5-[18F]F-pyrazinamide (5-[18F]F-PZA), a radiotracer analog of the first-line tuberculosis drug pyrazinamide (PZA), was employed to determine the biodistribution of PZA using PET imaging and ex vivo analysis. 5-[18F]F-PZA was synthesized in 60 min using a halide exchange reaction. The overall decay-corrected yield of the reaction was 25% and average specific activity was 2.6 × 106 kBq (70 mCi)/μmol. The biodistribution of 5-[18F]F-PZA was examined in a pulmonary Mycobacterium tuberculosis mouse model, where rapid distribution of the tracer to the lung, heart, liver, kidney, muscle, and brain was observed. The concentration of 5-[18F]F-PZA was not significantly different between infected and uninfected lung tissue. Biochemical and microbiological studies revealed substantial differences between 5-F-PZA and PZA. 5-F-PZA was not a substrate for pyrazinamidase, the bacterial enzyme that activates PZA, and the minimum inhibitory concentration for 5-F-PZA against M. tuberculosis was more than 100-fold higher than that for PZA.
Collapse
Affiliation(s)
- Zhuo Zhang
- Institute for Chemical Biology & Drug Discovery, Department of Chemistry and Department of Radiology, Stony Brook University, Stony Brook, New York, United States of America
| | - Alvaro A. Ordonez
- Center for Infection and Inflammation Imaging Research, Center for Tuberculosis Research and Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Peter Smith-Jones
- The Facility for Experimental Radiopharmaceutical Manufacturing, Department of Psychiatry, Stony Brook University, Stony Brook, New York, United States of America
| | - Hui Wang
- Institute for Chemical Biology & Drug Discovery, Department of Chemistry and Department of Radiology, Stony Brook University, Stony Brook, New York, United States of America
| | - Kayla R. Gogarty
- Institute for Chemical Biology & Drug Discovery, Department of Chemistry and Department of Radiology, Stony Brook University, Stony Brook, New York, United States of America
| | - Fereidoon Daryaee
- Institute for Chemical Biology & Drug Discovery, Department of Chemistry and Department of Radiology, Stony Brook University, Stony Brook, New York, United States of America
| | - Lauren E. Bambarger
- Center for Infection and Inflammation Imaging Research, Center for Tuberculosis Research and Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Yong S. Chang
- Center for Infection and Inflammation Imaging Research, Center for Tuberculosis Research and Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Sanjay K. Jain
- Center for Infection and Inflammation Imaging Research, Center for Tuberculosis Research and Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail: (SKJ); (PJT)
| | - Peter J. Tonge
- Institute for Chemical Biology & Drug Discovery, Department of Chemistry and Department of Radiology, Stony Brook University, Stony Brook, New York, United States of America
- * E-mail: (SKJ); (PJT)
| |
Collapse
|
40
|
Abel zur Wiesch P, Clarelli F, Cohen T. Using Chemical Reaction Kinetics to Predict Optimal Antibiotic Treatment Strategies. PLoS Comput Biol 2017; 13:e1005321. [PMID: 28060813 PMCID: PMC5257006 DOI: 10.1371/journal.pcbi.1005321] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 01/23/2017] [Accepted: 12/19/2016] [Indexed: 11/19/2022] Open
Abstract
Identifying optimal dosing of antibiotics has proven challenging-some antibiotics are most effective when they are administered periodically at high doses, while others work best when minimizing concentration fluctuations. Mechanistic explanations for why antibiotics differ in their optimal dosing are lacking, limiting our ability to predict optimal therapy and leading to long and costly experiments. We use mathematical models that describe both bacterial growth and intracellular antibiotic-target binding to investigate the effects of fluctuating antibiotic concentrations on individual bacterial cells and bacterial populations. We show that physicochemical parameters, e.g. the rate of drug transmembrane diffusion and the antibiotic-target complex half-life are sufficient to explain which treatment strategy is most effective. If the drug-target complex dissociates rapidly, the antibiotic must be kept constantly at a concentration that prevents bacterial replication. If antibiotics cross bacterial cell envelopes slowly to reach their target, there is a delay in the onset of action that may be reduced by increasing initial antibiotic concentration. Finally, slow drug-target dissociation and slow diffusion out of cells act to prolong antibiotic effects, thereby allowing for less frequent dosing. Our model can be used as a tool in the rational design of treatment for bacterial infections. It is easily adaptable to other biological systems, e.g. HIV, malaria and cancer, where the effects of physiological fluctuations of drug concentration are also poorly understood.
Collapse
Affiliation(s)
- Pia Abel zur Wiesch
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Centre for Molecular Medicine Norway, Nordic EMBL Partnership, Oslo, Norway
- Department of Pharmacy, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Fabrizio Clarelli
- Department of Pharmacy, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Ted Cohen
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| |
Collapse
|
41
|
Jain SK. Introduction. IMAGING INFECTIONS 2017. [PMCID: PMC7122386 DOI: 10.1007/978-3-319-54592-9_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Infectious diseases are a major cause of morbidity and mortality worldwide and in the USA. Overall costs and morbidity are expected to continue to rise due to increasing rates of drug-resistant pathogens, use of invasive techniques such as implants, as well as immunosuppressive and cancer therapies. Tomographic molecular imaging techniques enable rapid visualization and monitoring of molecular processes noninvasively and promise unparalleled opportunities for field of infectious diseases. These technologies are an emerging field of research, overcome several fundamental limitations of current tools, and could have a broad impact on both basic research and patient care. Beyond diagnosis and monitoring disease, these technologies could also provide a uniform cross-species platform for animal studies, allow unique insights into understanding disease pathogenesis, and expedite bench-to-bedside translation of new therapeutics. Finally, since molecular imaging is readily available for humans, validated tracers could also become valuable tools for clinical applications and for enabling personalized medicine for infectious diseases.
Collapse
Affiliation(s)
- Sanjay K. Jain
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland USA
| |
Collapse
|
42
|
Rundell SR, Wagar ZL, Meints LM, Olson CD, O'Neill MK, Piligian BF, Poston AW, Hood RJ, Woodruff PJ, Swarts BM. Deoxyfluoro-d-trehalose (FDTre) analogues as potential PET probes for imaging mycobacterial infection. Org Biomol Chem 2016; 14:8598-609. [PMID: 27560008 DOI: 10.1039/c6ob01734g] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Mycobacterium tuberculosis, the etiological agent of human tuberculosis, requires the non-mammalian disaccharide trehalose for growth and virulence. Recently, detectable trehalose analogues have gained attention as probes for studying trehalose metabolism and as potential diagnostic imaging agents for mycobacterial infections. Of particular interest are deoxy-[(18)F]fluoro-d-trehalose ((18)F-FDTre) analogues, which have been suggested as possible positron emission tomography (PET) probes for in vivo imaging of M. tuberculosis infection. Here, we report progress toward this objective, including the synthesis and conformational analysis of four non-radioactive deoxy-[(19)F]fluoro-d-trehalose ((19)F-FDTre) analogues, as well as evaluation of their uptake by M. smegmatis. The rapid synthesis and purification of several (19)F-FDTre analogues was accomplished in high yield using a one-step chemoenzymatic method. Conformational analysis of the (19)F-FDTre analogues using NMR and molecular modeling methods showed that fluorine substitution had a negligible effect on the conformation of the native disaccharide, suggesting that fluorinated analogues may be successfully recognized and processed by trehalose metabolic machinery in mycobacteria. To test this hypothesis and to evaluate a possible route for delivery of FDTre probes specifically to mycobacteria, we showed that (19)F-FDTre analogues are actively imported into M. smegmatis via the trehalose-specific transporter SugABC-LpqY. Finally, to demonstrate the applicability of these results to the efficient preparation and use of short-lived (18)F-FDTre PET radiotracers, we carried out (19)F-FDTre synthesis, purification, and administration to M. smegmatis in 1 hour.
Collapse
Affiliation(s)
- Sarah R Rundell
- Department of Chemistry and Biochemistry, Central Michigan University, Mount Pleasant, MI 48859, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Dooley KE, Phillips PPJ, Nahid P, Hoelscher M. Challenges in the clinical assessment of novel tuberculosis drugs. Adv Drug Deliv Rev 2016; 102:116-22. [PMID: 26827911 DOI: 10.1016/j.addr.2016.01.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/29/2015] [Accepted: 01/21/2016] [Indexed: 11/18/2022]
Abstract
To tackle the global TB epidemic effectively, novel treatment strategies are critically needed to shorten the duration of TB therapy and treat drug-resistant TB. Drug development for TB, stymied for decades, has enjoyed a renaissance over the past several years. However, the development of new TB regimens is hindered by the limitations in our understanding and use of preclinical models; the paucity of accurate, early surrogate markers of cure, and challenges in untangling the individual contributions of drugs to multidrug regimens in a complex, multi-compartment disease. Lack of profit motive, advocacy, and imagination has contributed mightily to the dearth of drugs we have on the shelf to treat this ancient disease. Areas that will speed the development of new regimens for TB include novel murine and in vitro pharmacodynamics models, clinical endpoints that are not culture-based, innovative clinical trial designs, and an infusion of much-needed funding.
Collapse
Affiliation(s)
- Kelly E Dooley
- Divisions of Clinical Pharmacology & Infectious Diseases, Center for Tuberculosis Research, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Osler 527, Baltimore, MD, 2187, USA.
| | - Patrick P J Phillips
- MRC Clinical Trials Unit at UCL, Aviation House, 125 Kingsway, London WC1B 6NH, UK.
| | - Payam Nahid
- Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, at San Francisco General Hospital, 1001 Potrero Ave., 5K1, San Francisco, CA, USA.
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), Leopoldstrasse 5, 80802 Munich, Germany; German Centre for Infection Research (DZIF), Leopoldstrasse 5, 80802 Munich, Germany; German Centre for Infection Research, Leopoldstrasse 5, 80802 Munich, Germany.
| |
Collapse
|
44
|
Ordonez AA, DeMarco VP, Klunk MH, Pokkali S, Jain SK. Imaging Chronic Tuberculous Lesions Using Sodium [(18)F]Fluoride Positron Emission Tomography in Mice. Mol Imaging Biol 2016; 17:609-14. [PMID: 25750032 DOI: 10.1007/s11307-015-0836-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE Calcification is a hallmark of chronic tuberculosis (TB) in humans, often noted years to decades (after the initial infection) on chest radiography, but not visualized well with traditional positron emission tomography (PET). We hypothesized that sodium [(18)F]fluoride (Na[(18)F]F) PET could be used to detect microcalcifications in a chronically Mycobacterium tuberculosis-infected murine model. PROCEDURES C3HeB/FeJ mice, which develop necrotic and hypoxic TB lesions, were aerosol-infected with M. tuberculosis and imaged with Na[(18)F]F PET. RESULTS Pulmonary TB lesions from chronically infected mice demonstrated significantly higher Na[(18)F]F uptake compared with acutely infected or uninfected animals (P < 0.01), while no differences were noted in the blood or bone compartments (P > 0.08). Ex vivo biodistribution studies confirmed the imaging findings, and tissue histology demonstrated microcalcifications in TB lesions from chronically infected mice, which has not been demonstrated previously in a murine model. CONCLUSION Na[(18)F]F PET can be used for the detection of chronic TB lesions and could prove to be a useful noninvasive biomarker for TB studies.
Collapse
Affiliation(s)
- Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Vincent P DeMarco
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Mariah H Klunk
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Supriya Pokkali
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, USA
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University, 1550 Orleans Street, CRB-II, Rm 1.09, Baltimore, MD, USA.
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD, USA.
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA.
| |
Collapse
|
45
|
Levin VA, Tonge PJ, Gallo JM, Birtwistle MR, Dar AC, Iavarone A, Paddison PJ, Heffron TP, Elmquist WF, Lachowicz JE, Johnson TW, White FM, Sul J, Smith QR, Shen W, Sarkaria JN, Samala R, Wen PY, Berry DA, Petter RC. CNS Anticancer Drug Discovery and Development Conference White Paper. Neuro Oncol 2016; 17 Suppl 6:vi1-26. [PMID: 26403167 DOI: 10.1093/neuonc/nov169] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Following the first CNS Anticancer Drug Discovery and Development Conference, the speakers from the first 4 sessions and organizers of the conference created this White Paper hoping to stimulate more and better CNS anticancer drug discovery and development. The first part of the White Paper reviews, comments, and, in some cases, expands on the 4 session areas critical to new drug development: pharmacological challenges, recent drug approaches, drug targets and discovery, and clinical paths. Following this concise review of the science and clinical aspects of new CNS anticancer drug discovery and development, we discuss, under the rubric "Accelerating Drug Discovery and Development for Brain Tumors," further reasons why the pharmaceutical industry and academia have failed to develop new anticancer drugs for CNS malignancies and what it will take to change the current status quo and develop the drugs so desperately needed by our patients with malignant CNS tumors. While this White Paper is not a formal roadmap to that end, it should be an educational guide to clinicians and scientists to help move a stagnant field forward.
Collapse
Affiliation(s)
- Victor A Levin
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Peter J Tonge
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - James M Gallo
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Marc R Birtwistle
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Arvin C Dar
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Antonio Iavarone
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Patrick J Paddison
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Timothy P Heffron
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - William F Elmquist
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Jean E Lachowicz
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Ted W Johnson
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Forest M White
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Joohee Sul
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Quentin R Smith
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Wang Shen
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Jann N Sarkaria
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Ramakrishna Samala
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Patrick Y Wen
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Donald A Berry
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| | - Russell C Petter
- Kaiser Permanente, Redwood City, California, USA (V.A.L.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (V.A.L.); University of California, San Francisco, CA, USA (V.A.L.); SUNY Stony Brook University, Stony Brook, NY, USA (P.J.T.); Icahn School of Medicine at Mount Sinai, New York, NY, USA (J.M.G., M.R.B., A.C.D.); Columbia University Institute for Cancer Genetics, New York, NY, USA (A.I.); Fred Hutchinson Cancer Research Center, Seattle, WA, USA (P.J.P.); Genentech, Inc., South San Francisco, CA, USA (T.P.H.); University of Minnesota School of Pharmacy, Minneapolis, MN, USA (W.F.E.); Angiochem, Inc., Montreal, Quebec, Canada (J.E.L.); Pfizer Oncology, San Diego, CA, USA (T.W.J.); Massachusetts Institute of Technology, Cambridge, MA, USA (F.M.W.); US Food and Drug Administration, Silver Spring, MD, USA (J.S.); Texas Tech University School of Pharmacy, Amarillo, TX, USA (Q.R.S., R.S.); NewGen Therapeutics, Inc., Menlo Park, CA, USA (W.S.); Mayo Clinic, Rochester, MN, USA (J.N.S.); Dana-Farber Cancer Institute, Boston, MA, USA (P.Y.W.); University of Texas MD Anderson Cancer Center, Houston, TX, USA (D.A.B.); Celgene Avilomics Research, Bedford, MA, USA (R.C.P.)
| |
Collapse
|
46
|
Ordonez AA, Tasneen R, Pokkali S, Xu Z, Converse PJ, Klunk MH, Mollura DJ, Nuermberger EL, Jain SK. Mouse model of pulmonary cavitary tuberculosis and expression of matrix metalloproteinase-9. Dis Model Mech 2016; 9:779-88. [PMID: 27482816 PMCID: PMC4958312 DOI: 10.1242/dmm.025643] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/20/2016] [Indexed: 01/12/2023] Open
Abstract
Cavitation is a key pathological feature of human tuberculosis (TB), and is a well-recognized risk factor for transmission of infection, relapse after treatment and the emergence of drug resistance. Despite intense interest in the mechanisms underlying cavitation and its negative impact on treatment outcomes, there has been limited study of this phenomenon, owing in large part to the limitations of existing animal models. Although cavitation does not occur in conventional mouse strains after infection with Mycobacterium tuberculosis, cavitary lung lesions have occasionally been observed in C3HeB/FeJ mice. However, to date, there has been no demonstration that cavitation can be produced consistently enough to support C3HeB/FeJ mice as a new and useful model of cavitary TB. We utilized serial computed tomography (CT) imaging to detect pulmonary cavitation in C3HeB/FeJ mice after aerosol infection with M. tuberculosis Post-mortem analyses were performed to characterize lung lesions and to localize matrix metalloproteinases (MMPs) previously implicated in cavitary TB in situ A total of 47-61% of infected mice developed cavities during primary disease or relapse after non-curative treatments. Key pathological features of human TB, including simultaneous presence of multiple pathologies, were noted in lung tissues. Optical imaging demonstrated increased MMP activity in TB lesions and MMP-9 was significantly expressed in cavitary lesions. Tissue MMP-9 activity could be abrogated by specific inhibitors. In situ, three-dimensional analyses of cavitary lesions demonstrated that 22.06% of CD11b+ signal colocalized with MMP-9. C3HeB/FeJ mice represent a reliable, economical and tractable model of cavitary TB, with key similarities to human TB. This model should provide an excellent tool to better understand the pathogenesis of cavitation and its effects on TB treatments.
Collapse
Affiliation(s)
- Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Rokeya Tasneen
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Supriya Pokkali
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Ziyue Xu
- Center for Infectious Disease Imaging, National Institutes of Health, Bethesda, MD 20892, USA
| | - Paul J Converse
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Mariah H Klunk
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Daniel J Mollura
- Center for Infectious Disease Imaging, National Institutes of Health, Bethesda, MD 20892, USA
| | - Eric L Nuermberger
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| |
Collapse
|
47
|
Bocan TM, Panchal RG, Bavari S. Applications of in vivo imaging in the evaluation of the pathophysiology of viral and bacterial infections and in development of countermeasures to BSL3/4 pathogens. Mol Imaging Biol 2015; 17:4-17. [PMID: 25008802 PMCID: PMC4544652 DOI: 10.1007/s11307-014-0759-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
While preclinical and clinical imaging have been applied to drug discovery/development and characterization of disease pathology, few examples exist where imaging has been used to evaluate infectious agents or countermeasures to biosafety level (BSL)3/4 threat agents. Viruses engineered with reporter constructs, i.e., enzymes and receptors, which are amenable to detection by positron emission tomography (PET), single photon emission tomography (SPECT), or magnetic resonance imaging (MRI) have been used to evaluate the biodistribution of viruses containing specific therapeutic or gene transfer payloads. Bioluminescence and nuclear approaches involving engineered reporters, direct labeling of bacteria with radiotracers, or tracking bacteria through their constitutively expressed thymidine kinase have been utilized to characterize viral and bacterial pathogens post-infection. Most PET, SPECT, CT, or MRI approaches have focused on evaluating host responses to the pathogens such as inflammation, brain neurochemistry, and structural changes and on assessing the biodistribution of radiolabeled drugs. Imaging has the potential when applied preclinically to the development of countermeasures against BSL3/4 threat agents to address the following: (1) presence, biodistribution, and time course of infection in the presence or absence of drug; (2) binding of the therapeutic to the target; and (3) expression of a pharmacologic effect either related to drug mechanism, efficacy, or safety. Preclinical imaging could potentially provide real-time dynamic tools to characterize the pathogen and animal model and for developing countermeasures under the U.S. FDA Animal Rule provision with high confidence of success and clinical benefit.
Collapse
Affiliation(s)
- Thomas M Bocan
- Molecular and Translational Sciences, US Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Ft. Detrick, MD, 21702, USA,
| | | | | |
Collapse
|
48
|
Wang H, Liu L, Lu Y, Pan P, Hooker JM, Fowler JS, Tonge PJ. Radiolabelling and positron emission tomography of PT70, a time-dependent inhibitor of InhA, the Mycobacterium tuberculosis enoyl-ACP reductase. Bioorg Med Chem Lett 2015; 25:4782-4786. [PMID: 26227776 DOI: 10.1016/j.bmcl.2015.07.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/06/2015] [Accepted: 07/07/2015] [Indexed: 11/26/2022]
Abstract
PT70 is a diaryl ether inhibitor of InhA, the enoyl-ACP reductase in the Mycobacterium tuberculosis fatty acid biosynthesis pathway. It has a residence time of 24 min on the target, and also shows antibacterial activity in a mouse model of tuberculosis infection. Due to the interest in studying target tissue pharmacokinetics of PT70, we developed a method to radiolabel PT70 with carbon-11 and have studied its pharmacokinetics in mice and baboons using positron emission tomography.
Collapse
Affiliation(s)
- Hui Wang
- Institute for Chemical Biology and Drug Discovery, Department of Chemistry, Stony Brook University, Stony Brook, NY 11794-3400, United States
| | - Li Liu
- Institute for Chemical Biology and Drug Discovery, Department of Chemistry, Stony Brook University, Stony Brook, NY 11794-3400, United States
| | - Yang Lu
- Institute for Chemical Biology and Drug Discovery, Department of Chemistry, Stony Brook University, Stony Brook, NY 11794-3400, United States
| | - Pan Pan
- Institute for Chemical Biology and Drug Discovery, Department of Chemistry, Stony Brook University, Stony Brook, NY 11794-3400, United States
| | - Jacob M Hooker
- Biological, Environmental and Climate Sciences Department, Brookhaven National Laboratory, Upton, NY 11973, United States
| | - Joanna S Fowler
- Biological, Environmental and Climate Sciences Department, Brookhaven National Laboratory, Upton, NY 11973, United States
| | - Peter J Tonge
- Institute for Chemical Biology and Drug Discovery, Department of Chemistry, Stony Brook University, Stony Brook, NY 11794-3400, United States.
| |
Collapse
|
49
|
Determination of [11C]rifampin pharmacokinetics within Mycobacterium tuberculosis-infected mice by using dynamic positron emission tomography bioimaging. Antimicrob Agents Chemother 2015; 59:5768-74. [PMID: 26169396 DOI: 10.1128/aac.01146-15] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/05/2015] [Indexed: 12/14/2022] Open
Abstract
Information about intralesional pharmacokinetics (PK) and spatial distribution of tuberculosis (TB) drugs is limited and has not been used to optimize dosing recommendations for new or existing drugs. While new techniques can detect drugs and their metabolites within TB granulomas, they are invasive, rely on accurate resection of tissues, and do not capture dynamic drug distribution in the tissues of interest. In this study, we assessed the in situ distribution of (11)C-labeled rifampin in live, Mycobacterium tuberculosis-infected mice that develop necrotic lesions akin to human disease. Dynamic positron emission tomography (PET) imaging was performed over 60 min after injection of [(11)C]rifampin as a microdose, standardized uptake values (SUV) were calculated, and noncompartmental analysis was used to estimate PK parameters in compartments of interest. [(11)C]rifampin was rapidly distributed to all parts of the body and quickly localized to the liver. Areas under the concentration-time curve for the first 60 min (AUC0-60) in infected and uninfected mice were similar for liver, blood, and brain compartments (P > 0.53) and were uniformly low in brain (10 to 20% of blood values). However, lower concentrations were noted in necrotic lung tissues of infected mice than in healthy lungs (P = 0.03). Ex vivo two-dimensional matrix-assisted laser desorption ionization (MALDI) imaging confirmed restricted penetration of rifampin into necrotic lung lesions. Noninvasive bioimaging can be used to assess the distribution of drugs into compartments of interest, with potential applications for TB drug regimen development.
Collapse
|
50
|
Rajeshkumar NV, Dutta P, Yabuuchi S, de Wilde RF, Martinez GV, Le A, Kamphorst JJ, Rabinowitz JD, Jain SK, Hidalgo M, Dang CV, Gillies RJ, Maitra A. Therapeutic Targeting of the Warburg Effect in Pancreatic Cancer Relies on an Absence of p53 Function. Cancer Res 2015; 75:3355-64. [PMID: 26113084 DOI: 10.1158/0008-5472.can-15-0108] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 05/27/2015] [Indexed: 12/21/2022]
Abstract
The "Warburg effect" describes a peculiar metabolic feature of many solid tumors, namely their increased glucose uptake and high glycolytic rates, which allow cancer cells to accumulate building blocks for the biosynthesis of macromolecules. During aerobic glycolysis, pyruvate is preferentially metabolized to lactate by the enzyme lactate dehydrogenase-A (LDH-A), suggesting a possible vulnerability at this target for small-molecule inhibition in cancer cells. In this study, we used FX11, a small-molecule inhibitor of LDH-A, to investigate this possible vulnerability in a panel of 15 patient-derived mouse xenograft (PDX) models of pancreatic cancer. Unexpectedly, the p53 status of the PDX tumor determined the response to FX11. Tumors harboring wild-type (WT) TP53 were resistant to FX11. In contrast, tumors harboring mutant TP53 exhibited increased apoptosis, reduced proliferation indices, and attenuated tumor growth when exposed to FX11. [18F]-FDG PET-CT scans revealed a relative increase in glucose uptake in mutant TP53 versus WT TP53 tumors, with FX11 administration downregulating metabolic activity only in mutant TP53 tumors. Through a noninvasive quantitative assessment of lactate production, as determined by 13C magnetic resonance spectroscopy (MRS) of hyperpolarized pyruvate, we confirmed that FX11 administration inhibited pyruvate-to-lactate conversion only in mutant TP53 tumors, a feature associated with reduced expression of the TP53 target gene TIGAR, which is known to regulate glycolysis. Taken together, our findings highlight p53 status in pancreatic cancer as a biomarker to predict sensitivity to LDH-A inhibition, with regard to both real-time noninvasive imaging by 13C MRS as well as therapeutic response.
Collapse
Affiliation(s)
- N V Rajeshkumar
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Prasanta Dutta
- Department of Cancer Imaging and Metabolism, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Shinichi Yabuuchi
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Roeland F de Wilde
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gary V Martinez
- Department of Cancer Imaging and Metabolism, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Anne Le
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jurre J Kamphorst
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey
| | - Joshua D Rabinowitz
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Manuel Hidalgo
- Spanish National Cancer Research Center (CNIO), Melchor Fernandez Almagro 3, Madrid, Spain
| | - Chi V Dang
- Abramson Cancer Center, Abramson Family Cancer Research Institute, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Robert J Gillies
- Department of Cancer Imaging and Metabolism, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Anirban Maitra
- Department of Pathology and Translational Molecular Pathology, Sheikh Ahmad Center for Pancreatic Cancer Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| |
Collapse
|