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Li Z, Hasson A, Daggumati L, Zhang H, Thorek DLJ. Molecular Imaging of ACE2 Expression in Infectious Disease and Cancer. Viruses 2023; 15:1982. [PMID: 37896761 PMCID: PMC10610869 DOI: 10.3390/v15101982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Angiotensin-converting enzyme 2 (ACE2) is a cell-surface receptor that plays a critical role in the pathogenesis of SARS-CoV-2 infection. Through the use of ligands engineered for the receptor, ACE2 imaging has emerged as a valuable tool for preclinical and clinical research. These can be used to visualize the expression and distribution of ACE2 in tissues and cells. A variety of techniques including optical, magnetic resonance, and nuclear medicine contrast agents have been developed and employed in the preclinical setting. Positron-emitting radiotracers for highly sensitive and quantitative tomography have also been translated in the context of SARS-CoV-2-infected and control patients. Together this information can be used to better understand the mechanisms of SARS-CoV-2 infection, the potential roles of ACE2 in homeostasis and disease, and to identify potential therapeutic modulators in infectious disease and cancer. This review summarizes the tools and techniques to detect and delineate ACE2 in this rapidly expanding field.
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Affiliation(s)
- Zhiyao Li
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA; (Z.L.); (A.H.); (H.Z.)
- Program in Quantitative Molecular Therapeutics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA;
| | - Abbie Hasson
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA; (Z.L.); (A.H.); (H.Z.)
- Program in Quantitative Molecular Therapeutics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA;
- Department of Biomedical Engineering, Washington University, St. Louis, MO 63110, USA
| | - Lasya Daggumati
- Program in Quantitative Molecular Therapeutics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA;
- School of Medicine Missouri, University of Missouri-Kansas City, Kansas, MO 64108, USA
| | - Hanwen Zhang
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA; (Z.L.); (A.H.); (H.Z.)
- Program in Quantitative Molecular Therapeutics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA;
- Siteman Cancer Center, St. Louis, MO 63110, USA
| | - Daniel L. J. Thorek
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA; (Z.L.); (A.H.); (H.Z.)
- Program in Quantitative Molecular Therapeutics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA;
- Department of Biomedical Engineering, Washington University, St. Louis, MO 63110, USA
- Siteman Cancer Center, St. Louis, MO 63110, USA
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Ren F, Jiang H, Shi L, Zhang L, Li X, Lu Q, Li Q. 68Ga-cyc-DX600 PET/CT in ACE2-targeted tumor imaging. Eur J Nucl Med Mol Imaging 2023; 50:2056-2067. [PMID: 36847824 PMCID: PMC9969023 DOI: 10.1007/s00259-023-06159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE For the tumor-specific ACE2 expression, this research aimed to establish and verify ACE2-targeted PET imaging in differentiating tumors with distinct ACE2 expression. METHODS 68Ga-cyc-DX600 was synthesized as tracer of ACE2 PET. NOD-SCID mice were used to prepare the subcutaneous tumor models with HEK-293 or HEK-293T/hACE2 cells to verify ACE2 specificity, with other kinds of tumor cells to evaluate the diagnostic efficiency for ACE2 expression, additionally, immunohistochemical analysis and western blot were used to certify the findings on ACE2 PET, which was then performed on four cancer patients and compared with FDG PET. RESULTS The metabolic clearance of 68Ga-cyc-DX600 was initially completed in 60 min, realizing an ACE2-dependent and organ-specific background of ACE2 PET; meanwhile, tracer uptake of subcutaneous tumor models was of a definite dependence on ACE2 expression (r = 0.903, p < 0.05), and the latter served as the primary factor when ACE2 PET was used for the differential diagnosis of ACE2-related tumors. In pre-clinical practice, a comparable tumor-to-background ratio was acquired in ACE2 PET of a lung cancer patient at 50 and 80 min post injection; the quantitative values of ACE2 PET and FDG PET were negatively correlated (r = - 0.971 for SUVmax, p = 0.006; r = - 0.994 for SUVmean, p = 0.001) in an esophageal cancer patient, no matter the primary lesion or metastasis. CONCLUSIONS 68Ga-cyc-DX600 PET was an ACE2-specific imaging for the differential diagnosis of tumors and added complementary value to conventional nuclear medicine diagnosis, such as FDG PET on glycometabolism.
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Affiliation(s)
- Fangyuan Ren
- Cancer Center, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Zhejiang, 310014, Hangzhou, China
| | - Hongyang Jiang
- Cancer Center, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Zhejiang, 310014, Hangzhou, China
| | - Lin Shi
- Cancer Center, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Zhejiang, 310014, Hangzhou, China
| | - Lan Zhang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, 201800, China
| | - Xiao Li
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, 201800, China.
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 200032, China.
| | - Qinkang Lu
- Department of Radiology, The Affiliated People's Hospital of Ningbo University, Zhejiang, 315040, Ningbo, China.
| | - Qiang Li
- Department of Radiology, The Affiliated People's Hospital of Ningbo University, Zhejiang, 315040, Ningbo, China.
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Li X, Li J, Zhou P, Li D, Wang M, Tong Q, Chen J, Zuo C, Zhang L, Li R. The functional views on response of host rabbit post coronavirus vaccination via ACE2 PET. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2023; 13:43-50. [PMID: 36923599 PMCID: PMC10009468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023]
Abstract
Molecular imaging can dynamically and quantitatively record the biochemical changes in a systemic view. In this research, SARS-CoV-2 pseudovirus was intramuscularly injected to simulate the vaccination with inactivated virus. New Zealand white rabbits were evaluated with 18F-FDG PET for inflammation and 68Ga-cyc-DX600 PET for ACE2 fluctuation, which were performed before and at 3, 7 and 14 days post injection (d P.I.); furthermore, one rabbit was vaccinated with two cycles with interval of 14 days for a longer period evaluation. Different with the vaccination-induced inflammatory response that was random and individual, ACE2 regulation was systemic and organ-specific: the liver and spleen were of a moderate decrease post injection but rebound at 14 d P.I., while there were a downward trend in heart, testis and bone marrow; besides, similar pattern of ACE2 regulation were recorded after the second injection with a relatively greater volatility. In conclusion, ACE2 PET gave a more comprehensive view on host response post vaccination, hold substantial promise in continuous monitoring of coronavirus vaccine administration and effectiveness.
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Affiliation(s)
- Xiao Li
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences Shanghai 201800, China.,University of Chinese Academy of Sciences Beijing 100049, China.,Department of Nuclear Medicine, Shanghai Changhai Hospital Shanghai 200433, China
| | - Jie Li
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences Shanghai 201800, China.,University of Chinese Academy of Sciences Beijing 100049, China
| | - Pan Zhou
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences Shanghai 201800, China
| | - Danni Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital Shanghai 200433, China
| | - Mingxin Wang
- Department of Nuclear Medicine, Shanghai Changhai Hospital Shanghai 200433, China
| | - Qianqian Tong
- Department of Nuclear Medicine, Shanghai Changhai Hospital Shanghai 200433, China
| | - Jian Chen
- Department of Radiology, Shanghai Jiangong Hospital Shanghai 200083, China
| | - Changjing Zuo
- Department of Nuclear Medicine, Shanghai Changhai Hospital Shanghai 200433, China
| | - Lan Zhang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences Shanghai 201800, China
| | - Rou Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital Shanghai 200433, China
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Abstract
Human monkeypox is a zoonotic orthopoxvirus with presentation similar to smallpox. Monkeypox is transmitted incidentally to humans when they encounter infected animals. Reports have shown that the virus can also be transmitted through direct contact (sexual or skin-to-skin), respiratory droplets, and via fomites such as towels and bedding. Multiple medical countermeasures are stockpiled for orthopoxviruses such as monkeypox. Two vaccines are currently available, JYNNEOSTM (live, replication incompetent vaccinia virus) and ACAM2000® (live, replication competent vaccinia virus). While most cases of monkeypox will have mild and self-limited disease, with supportive care being typically sufficient, antivirals (e.g. tecovirimat, brincidofovir, cidofovir) and vaccinia immune globulin intravenous (VIGIV) are available as treatments. Antivirals can be considered in severe disease, immunocompromised patients, pediatrics, pregnant and breastfeeding women, complicated lesions, and when lesions appear near the mouth, eyes, and genitals. The purpose of this short review is to describe each of these countermeasures.
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Affiliation(s)
- John G Rizk
- Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, School of Pharmacy, 220 Arch Street, 12th Floor, Room 01-409-E, Baltimore, MD, 21201, USA.
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Brandon M Henry
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Donald N Forthal
- Division of Infectious Diseases, Department of Medicine, University of California, Irvine, School of Medicine, Irvine, CA, USA
- Department of Molecular Biology and Biochemistry, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Youssef Rizk
- Division of Family Medicine, Department of Internal Medicine, Lebanese American University School of Medicine, Beirut, Lebanon
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