Preclinical Models for Cryptococcosis of the CNS and Their Characterization Using In Vivo Imaging Techniques

Infections caused by Cryptococcus neoformans and Cryptococcus gattii remain a challenge to our healthcare systems as they are still difficult to treat. In order to improve treatment success, in particular for infections that have disseminated to the central nervous system, a better understanding of the disease is needed, addressing questions like how it evolves from a pulmonary to a brain disease and how novel treatment approaches can be developed and validated. This requires not only clinical research and research on the microorganisms in a laboratory environment but also preclinical models in order to study cryptococci in the host. We provide an overview of available preclinical models, with particular emphasis on models of cryptococcosis in rodents. In order to further improve the characterization of rodent models, in particular the dynamic aspects of disease manifestation, development, and ultimate treatment, preclinical in vivo imaging methods are increasingly used, mainly in research for oncological, neurological, and cardiac diseases. In vivo imaging applications for fungal infections are rather sparse. A second aspect of this review is how research on models of cryptococcosis can benefit from in vivo imaging methods that not only provide information on morphology and tissue structure but also on function, metabolism, and cellular properties in a non-invasive way.

In vivo Cell Tracking Using Non-invasive Imaging of Iron Oxide-Based Particles with Particular Relevance for Stem Cell-Based Treatments of Neurological and Cardiac Disease

Stem cell-based therapeutics is a rapidly developing field associated with a number of clinical challenges. One such challenge lies in the implementation of methods to track stem cells and stem cell-derived cells in experimental animal models and in the living patient. Here, we provide an overview of cell tracking in the context of cardiac and neurological disease, focusing on the use of iron oxide-based particles (IOPs) visualized in vivo using magnetic resonance imaging (MRI). We discuss the types of IOPs available for such tracking, their advantages and limitations, approaches for labeling cells with IOPs, biological interactions and effects of IOPs at the molecular and cellular levels, and MRI-based and associated approaches for in vivo and histological visualization. We conclude with reviews of the literature on IOP-based cell tracking in cardiac and neurological disease, covering both preclinical and clinical studies.

Molecular Imaging with MRI: Potential Application in Pancreatic Cancer

Despite the variety of approaches that have been improved to achieve a good understanding of pancreatic cancer (PC), the prognosis of PC remains poor, and the survival rates are dismal. The lack of early detection and effective interventions is the main reason. Therefore, considerable ongoing efforts aimed at identifying early PC are currently being pursued using a variety of methods. In recent years, the development of molecular imaging has made the specific targeting of PC in the early stage possible. Molecular imaging seeks to directly visualize, characterize, and measure biological processes at the molecular and cellular levels. Among different imaging technologies, the magnetic resonance (MR) molecular imaging has potential in this regard because it facilitates noninvasive, target-specific imaging of PC. This topic is reviewed in terms of the contrast agents for MR molecular imaging, the biomarkers related to PC, targeted molecular probes for MRI, and the application of MRI in the diagnosis of PC.

PET imaging in ischemic cerebrovascular disease: current status and future directions

Cerebrovascular diseases are caused by interruption or significant impairment of the blood supply to the brain, which leads to a cascade of metabolic and molecular alterations resulting in functional disturbance and morphological damage. These pathophysiological changes can be assessed by positron emission tomography (PET), which permits the regional measurement of physiological parameters and imaging of the distribution of molecular markers. PET has broadened our understanding of the flow and metabolic thresholds critical for the maintenance of brain function and morphology: in this application, PET has been essential in the transfer of the concept of the penumbra (tissue with perfusion below the functional threshold but above the threshold for the preservation of morphology) to clinical stroke and thereby has had great impact on developing treatment strategies. Radioligands for receptors can be used as early markers of irreversible neuronal damage and thereby can predict the size of the final infarcts; this is also important for decisions concerning invasive therapy in large ("malignant") infarctions. With PET investigations, the reserve capacity of blood supply to the brain can be tested in obstructive arteriosclerosis of the supplying arteries, and this again is essential for planning interventions. The effect of a stroke on the surrounding and contralateral primarily unaffected tissue can be investigated, and these results help to understand the symptoms caused by disturbances in functional networks. Chronic cerebrovascular disease causes vascular cognitive disorders, including vascular dementia. PET permits the detection of the metabolic disturbances responsible for cognitive impairment and dementia, and can differentiate vascular dementia from degenerative diseases. It may also help to understand the importance of neuroinflammation after stroke and its interaction with amyloid deposition in the development of dementia. Although the clinical application of PET investigations is limited, this technology had and still has a great impact on research into cerebrovascular diseases.

Chitosan-triphosphate nanoparticles for encapsulation of super-paramagnetic iron oxide as an MRI contrast agent

Super-paramagnetic iron oxide nanoparticles (SPIONPs) were encapsulated at various concentrations within chitosan-triphosphate (SPIONPs-CS) nanoparticles using an ionotropic gelation method. The encapsulation of SPIONPs within CS nanoparticles enhanced their dispersion ability in aqueous solution, with all particles being lower than 130 nm in size and having highly positive surface charge. The SPIONPs-CS nanoparticles exhibited crystalline structure and super-paramagnetic behavior, as seen in non-encapsulated SPIONPs. The morphology of SPIONPs-CS nanoparticles showed that they almost spherical in shape. The effect of phantom environments (culture medium and 3% agar solution) on either T1 or T2 weighted MRI was investigated using a clinical 1.5T MRI scanner. The results revealed that 3% agar solution showed relaxation values higher than the culture medium, leading to a significant decrease in the MR image intensity. Our results demonstrated that the SPIONPs-CS nanoparticles can be applied as tissue-specific MRI contrast agents.

Current challenges for the advancement of neural stem cell biology and transplantation research

Transplantation of neural stem cells (NSC) is hoped to become a promising primary or secondary therapy for the treatment of various neurodegenerative disorders of the central nervous system (CNS), as demonstrated by multiple pre-clinical animal studies in which functional recovery has already been demonstrated. However, for NSC therapy to be successful, the first challenge will be to define a transplantable cell population. In the first part of this review, we will briefly discuss the main features of ex vivo culture and characterisation of NSC. Next, NSC grafting itself may not only result in the regeneration of lost tissue, but more importantly has the potential to improve functional outcome through many bystander mechanisms. In the second part of this review, we will briefly discuss several pre-clinical studies that contributed to a better understanding of the therapeutic potential of NSC grafts in vivo. However, while many pre-clinical animal studies mainly report on the clinical benefit of NSC grafting, little is known about the actual in vivo fate of grafted NSC. Therefore, the third part of this review will focus on non-invasive imaging techniques for monitoring cellular grafts in the brain under in vivo conditions. Finally, as NSC transplantation research has evolved during the past decade, it has become clear that the host micro-environment itself, either in healthy or injured condition, is an important player in defining success of NSC grafting. The final part of this review will focus on the host environmental influence on survival, migration and differentiation of grafted NSC.

Polyelectrolyte coating of iron oxide nanoparticles for MRI-based cell tracking

Iron oxide-based magnetic nanoparticles (MNPs) offer unique properties for cell tracking by magnetic resonance imaging (MRI) in cellular immunotherapy. In this study, we investigated the uptake of chemically engineered NPs into antigen-presenting dendritic cells (DCs). DCs are expected to perceive MNPs as foreign antigens, thus exhibiting the capability to immunologically sense MNP surface chemistry. To systematically evaluate cellular uptake and T2/T2(⁎) MR imaging properties of MNPs, we synthesized polymer-based MNPs by employing layer-by-layer (LbL) technology. Thereby, we achieved modification of particle shell parameters, such as size, surface charge, and chemistry. We found that subcellular packaging of MNPs rather than MNP content in DCs influences MR imaging quality. Increased local intracellular electron density as inferred from transmission electron microscopy (TEM) strongly correlated with enhanced contrast in MRI. Thus, LbL-tailoring of MNP shells using polyelectrolytes that impact on uptake and subcellular localization can be used for modulating MR imaging properties.

FROM THE CLINICAL EDITOR

In this study, layer-by-layer tailoring of magnetic NP shells was performed using polyelectrolytes to improve uptake by dendritic cells for cell-specific MR imaging. The authors conclude that polyelectrolyte modified NP-s can be used for modulating improving MR imaging quality by increasing subcellular localization.

Potential targets for molecular imaging of apoptosis resistance in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the most common cancers, which is mainly a concern in Southeast Asia. Apoptosis resistance in HCC is one of the significant factors for hepatocarcinogenesis and tumour progression. Recent advances of apoptosis resistance mechanisms in HCC could serve as potential targets for molecular imaging, which would be of considerable value to explore the molecular processes involved in HCC progression and to evaluate responses of certain anti-HCC therapies. Disruptions in the balance of anti-apoptotic and pro-apoptotic processes have been found to be involved in apoptosis resistance in HCC. Loss of response to death receptors, transformation of growth factor-β induced apoptosis, upregulation of anti-apoptotic Bcl-2 subgroup, as well as downregulation of pro-apoptotic Bax subgroup and BH3-only subgroup, are associated with apoptosis resistance in HCC. Mutation of p53 gene, dysregulation of NF-κB and survivin are also of interest because of their contribution to HCC development. In this review, the aim is to identify potential targets for molecular imaging of apoptosis resistance in HCC.

Neuroimaging in rabies

Rabies remains a virtually incurable disease once symptoms develop. Neuroimaging studies demonstrate lesions in the different parts of the neuroaxis, even before brain symptoms are evident. These abnormalities have been detailed in both rabies virus-infected humans and dogs with magnetic resonance imaging (MRI). MRI disturbances were similar in both forms (furious or paralytic) in human rabies; however, they were more pronounced in paralytic than in furious rabies virus-infected dogs in which examination was done early in the disease course. Abnormalities were not confined only to neuronal structures of hippocampus, hypothalamus, basal ganglia, and brain stem but also extended to white matter. The blood-brain barrier (BBB) has been clearly shown to be intact during the time rabies virus-infected patients and dogs remained conscious, whereas leakage was demonstrated as soon as they became comatose. Although the location of MRI abnormalities can help diagnosing rabies, the intensities of signals are usually not very distinct and sometimes not recognizable. Newer techniques and protocols have been developed and utilized, such as diffusion-weighted imaging and diffusion tensor imaging, and the latter provides both qualitative and quantitative data. These techniques have been applied to normal and rabies virus-infected dogs to construct fractional anisotropy and mean diffusivity maps. Results showed clear-cut evidence of BBB intactness with absence of vasogenic brain edema and preservation of most neuronal structures and tracts except at the level of brainstem in paralytic rabies-infected dogs. Neuroimaging is one of the most useful tools for the in vivo study of central nervous system infections.

MR-based molecular imaging of the brain: the next frontier

In the foreseeable future, the MI field could greatly assist neuroradiologists. Reporter molecules provide information on specific molecular or cellular events that could not only aid diagnosis but potentially differentiate stages of disorders and treatments. To accomplish this, reporter molecules literally need to pass a barrier, the BBB, which is designed to repel nonessential molecules from the brain. Although this is not a trivial task, several transport systems could be tricked into guiding molecules into the brain. The noninvasive nature in conjunction with a wide availability makes MR imaging particularly suitable for longitudinal neurologic imaging studies. This review explains the principles of MR imaging contrast, delineates different types of reporter molecules, and describes strategies to transport reporters into the brain. It also discusses recent advances in MR imaging hardware, pulse sequences, the development of targeted reporter probes, and future directions of the MR neuroimaging field.

Switching on the lights for real-time multimodality tumor neuroimaging: The integrated positron-emission tomography/MR imaging system

A recent report of the feasibility of simultaneous PET/MR imaging of the healthy human brain has sparked excitement in the field of neuroimaging because of its potential influence and utility in clinical neuroscience research. The aim of this communication is to discuss the benefits and current drawbacks of the hybrid imaging system and to highlight some perspectives of the new technique for brain neoplasms.

Nanotechnology for treatment of stroke and spinal cord injury

The use of nanotechnology in cell therapy and tissue engineering offers promising future perspectives for brain and spinal cord injury treatment. Stem cells have been shown to selectively target injured brain and spinal cord tissue and improve functional recovery. To allow cell detection, superparamagnetic iron-oxide nanoparticles can be used to label transplanted cells. MRI is then a suitable method for the in vivo tracking of grafted cells in the host organism. CNS, and particularly spinal cord, injury is accompanied by tissue damage and the formation of physical and biochemical barriers that prevent axons from regenerating. One aspect of nanomedicine is the development of biologically compatible nanofiber scaffolds that mimic the structure of the extracellular matrix and can serve as a permissive bridge for axonal regeneration or as a drug-delivery system. The incorporation of biologically active epitopes and/or the utilization of these scaffolds as stem cell carriers may further enhance their therapeutic efficacy.

The use of microgel iron oxide nanoparticles in studies of magnetic resonance relaxation and endothelial progenitor cell labelling

In vivo tracking of stem cells after transplantation is crucial for understanding cell-fate and therapeutic efficacy. By labelling stem cells with magnetic particles, they can be tracked by Magnetic Resonance Imaging (MRI). We previously demonstrated that microgel iron oxide nanoparticle (MGIO) provide superior tracking sensitivity over commercially available particles. Here, we describe the synthesis of MGIO and report on their morphology, hydrodynamic diameters (87-766 nm), iron oxide weight content (up to 82%) and magnetization characteristics (M(s)=52.9 Am(2)/kg, M(R)=0.061 Am(2)/kg and H(c)=0.672 A/m). Their MR relaxation characteristics are comparable to those of theoretical models and represent the first such correlation between model and real particles of varying diameters. A labelling study of primary endothelial progenitor cells also confirms that MGIO is an efficient label regardless of cell type. The facile synthesis of MGIO makes it a useful tool for the studying of relaxation induced by magnetic particles and cellular tracking by MRI.

An integrated MR/PET system: prospective applications

Radiology is strongly depending on medical imaging technology and consequently directing technological progress. A novel technology can only be established, however, if improved diagnostic accuracy influence on therapeutic management and/or overall reduced cost can be evidenced. It has been demonstrated recently that Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) can technologically be integrated into one single hybrid system. Some scientific arguments on the benefits are obvious, e.g., that simultaneous imaging of morphological and functional information will improve tissue characterization. However, crossfire of questions still remains: What unmet radiological needs are addressed by the novel system? What level of hardware integration is reasonable, or would software-based image co-registration be sufficient? Will MR/PET achieve higher diagnostic accuracy compared to separate imaging? What is the added value compared to other hybrid imaging modalities like PET/CT? And finally, is the system economically reasonable and has the potential to reduce overall costs for therapy planning and monitoring? This article tries to highlight some perspectives of applying an integrated MR/PET system for simultaneous morphologic and functional imaging.

The potential of PET/MR for brain imaging

INTRODUCTION

The completion of an integrated PET/MR prototype system for brain imaging is the latest step in the evolution of positron emission tomography. Early images with this new imaging system demonstrate that high-resolution multiparametric studies can be combined without significant loss of performance of either imaging modality.

OBJECTIVE

This new technology will make fusion of morphological and biological information much easier, yield real-time assessment of complementary variables and will provide dynamic information for kinetic modelling. Simultaneous acquisition of various metabolic and functional parameters may open new insights into the organization of the brain and its changes in disease.

DISCUSSION

A new field may open up for molecular and cellular imaging, where new targets--e.g. angiogenesis, gene transfer, function and migration of transplanted cells--can be imaged in the morphological context and within a functional environment. This application might have a special impact on the translation of treatment concepts from experimental models into clinical application. If the added value of the hybrid system for diagnosis and treatment monitoring is established, a cost-effective PET/MR combination might attain wider clinical application.

Cell labeling and tracking for experimental models using magnetic resonance imaging

Magnetic Resonance Imaging (MRI), as one of the most powerful methods in clinical diagnosis, has emerged as an additional method in the field of molecular and cellular imaging. Compared to established molecular imaging methods, MRI provides in vivo images with high resolution. In particularly in the field of cell-based therapy, non-invasively acquired information on temporal changes of cell location linked to high-resolution anatomical information is of great interest. Relatively new approaches like responsive contrast agents or MR imaging reporter gene expression are MRI applications beyond temporal and spatial information on labeled cells towards investigations on functional changes of cells in vivo. MRI-based cell monitoring and tracking studies require prior labeling of the cells under investigation for excellent contrast against the background of host tissue. Here, an overview is provided on contrast generation strategies for MRI of cells. This includes MR contrast agents, various approaches of cell labeling and MRI as well as MR spectroscopic methods used for cell tracking in vivo. Advantages and disadvantages of the particular labeling approaches and methods are discussed. In addition to description of the methods, the emphasis is on the potential but also challenges and shortcomings of this imaging technique for applications that aim to visualize cellular processes in vivo.