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Song C, Hu P, Peng R, Li F, Fang Z, Xu Y. Bioenergetic dysfunction in the pathogenesis of intervertebral disc degeneration. Pharmacol Res 2024; 202:107119. [PMID: 38417775 DOI: 10.1016/j.phrs.2024.107119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/16/2024] [Accepted: 02/24/2024] [Indexed: 03/01/2024]
Abstract
Intervertebral disc (IVD) degeneration is a frequent cause of low back pain and is the most common cause of disability. Treatments for symptomatic IVD degeneration, including conservative treatments such as analgesics, physical therapy, anti-inflammatories and surgeries, are aimed at alleviating neurological symptoms. However, there are no effective treatments to prevent or delay IVD degeneration. Previous studies have identified risk factors for IVD degeneration such as aging, inflammation, genetic factors, mechanical overload, nutrient deprivation and smoking, but metabolic dysfunction has not been highlighted. IVDs are the largest avascular structures in the human body and determine the hypoxic and glycolytic features of nucleus pulposus (NP) cells. Accumulating evidence has demonstrated that intracellular metabolic dysfunction is associated with IVD degeneration, but a comprehensive review is lacking. Here, by reviewing the physiological features of IVDs, pathological processes and metabolic changes associated with IVD degeneration and the functions of metabolic genes in IVDs, we highlight that glycolytic pathway and intact mitochondrial function are essential for IVD homeostasis. In degenerated NPs, glycolysis and mitochondrial function are downregulated. Boosting glycolysis such as HIF1α overexpression protects against IVD degeneration. Moreover, the correlations between metabolic diseases such as diabetes, obesity and IVD degeneration and their underlying molecular mechanisms are discussed. Hyperglycemia in diabetic diseases leads to cell senescence, the senescence-associated phenotype (SASP), apoptosis and catabolism of extracellualr matrix in IVDs. Correcting the global metabolic disorders such as insulin or GLP-1 receptor agonist administration is beneficial for diabetes associated IVD degeneration. Overall, we summarized the recent progress of investigations on metabolic contributions to IVD degeneration and provide a new perspective that correcting metabolic dysfunction may be beneficial for treating IVD degeneration.
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Affiliation(s)
- Chao Song
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Peixuan Hu
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Renpeng Peng
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Feng Li
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
| | - Zhong Fang
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
| | - Yong Xu
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
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2
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Lorentzian-Corrected Apparent Exchange-Dependent Relaxation (LAREX) Ω-Plot Analysis-An Adaptation for qCEST in a Multi-Pool System: Comprehensive In Silico, In Situ, and In Vivo Studies. Int J Mol Sci 2022; 23:ijms23136920. [PMID: 35805925 PMCID: PMC9266897 DOI: 10.3390/ijms23136920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/05/2022] [Accepted: 06/20/2022] [Indexed: 12/14/2022] Open
Abstract
Based on in silico, in situ, and in vivo studies, this study aims to develop a new method for the quantitative chemical exchange saturation transfer (qCEST) technique considering multi-pool systems. To this end, we extended the state-of-the-art apparent exchange-dependent relaxation (AREX) method with a Lorentzian correction (LAREX). We then validated this new method with in situ and in vivo experiments on human intervertebral discs (IVDs) using the Kendall-Tau correlation coefficient. In the in silico experiments, we observed significant deviations of the AREX method as a function of the underlying exchange rate (kba) and fractional concentration (fb) compared to the ground truth due to the influence of other exchange pools. In comparison to AREX, the LAREX-based Ω-plot approach yielded a substantial improvement. In the subsequent in situ and in vivo experiments on human IVDs, no correlation to the histological reference standard or Pfirrmann classification could be found for the fb (in situ: τ = −0.17 p = 0.51; in vivo: τ = 0.13 p = 0.30) and kba (in situ: τ = 0.042 p = 0.87; in vivo: τ = −0.26 p = 0.04) of Glycosaminoglycan (GAG) with AREX. In contrast, the influence of interfering pools could be corrected by LAREX, and a moderate to strong correlation was observed for the fractional concentration of GAG for both in situ (τ = −0.71 p = 0.005) and in vivo (τ = −0.49 p < 0.001) experiments. The study presented here is the first to introduce a new qCEST method that enables qCEST imaging in systems with multiple proton pools.
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3
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Pelled G, Salas MM, Han P, Gill HE, Lautenschlager KA, Lai TT, Shawver CM, Hoch MB, Goff BJ, Betts AM, Zhou Z, Lynch C, Schroeder G, Bez M, Maya MM, Bresee C, Gazit Z, McCallin JP, Gazit D, Li D. Intradiscal quantitative chemical exchange saturation transfer MRI signal correlates with discogenic pain in human patients. Sci Rep 2021; 11:19195. [PMID: 34584114 PMCID: PMC8478892 DOI: 10.1038/s41598-021-97672-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/22/2021] [Indexed: 12/13/2022] Open
Abstract
Low back pain (LBP) is often a result of a degenerative process in the intervertebral disc. The precise origin of discogenic pain is diagnosed by the invasive procedure of provocative discography (PD). Previously, we developed quantitative chemical exchange saturation transfer (qCEST) magnetic resonance imaging (MRI) to detect pH as a biomarker for discogenic pain. Based on these findings we initiated a clinical study with the goal to evaluate the correlation between qCEST values and PD results in LBP patients. Twenty five volunteers with chronic low back pain were subjected to T2-weighted (T2w) and qCEST MRI scans followed by PD. A total of 72 discs were analyzed. The average qCEST signal value of painful discs was significantly higher than non-painful discs (p = 0.012). The ratio between qCEST and normalized T2w was found to be significantly higher in painful discs compared to non-painful discs (p = 0.0022). A receiver operating characteristics (ROC) analysis indicated that qCEST/T2w ratio could be used to differentiate between painful and non-painful discs with 78% sensitivity and 81% specificity. The results of the study suggest that qCEST could be used for the diagnosis of discogenic pain, in conjunction with the commonly used T2w scan.
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Affiliation(s)
- Gadi Pelled
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
| | - Margaux M Salas
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- 59th Medical Wing Air Force, San Antonio, TX, 78236, USA
| | - Pei Han
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Biomedical Research Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Howard E Gill
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Karl A Lautenschlager
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Tristan T Lai
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Cameron M Shawver
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Matthew B Hoch
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Brandon J Goff
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Aaron M Betts
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Zhengwei Zhou
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Biomedical Research Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Cody Lynch
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Biomedical Research Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Grant Schroeder
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Maxim Bez
- Medical Corps, Israel Defense Forces, Tel HaShomer, Israel
| | - Marcel M Maya
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Catherine Bresee
- Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Zulma Gazit
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - John P McCallin
- Division of Pain Management, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, 78234, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Dan Gazit
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Faculty of Dental Medicine, Hebrew University, 91120, Jerusalem, Israel
| | - Debiao Li
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Biomedical Research Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, 90095, USA
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4
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Lee NN, Salzer E, Bach FC, Bonilla AF, Cook JL, Gazit Z, Grad S, Ito K, Smith LJ, Vernengo A, Wilke H, Engiles JB, Tryfonidou MA. A comprehensive tool box for large animal studies of intervertebral disc degeneration. JOR Spine 2021; 4:e1162. [PMID: 34337336 PMCID: PMC8313180 DOI: 10.1002/jsp2.1162] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 12/12/2022] Open
Abstract
Preclinical studies involving large animal models aim to recapitulate the clinical situation as much as possible and bridge the gap from benchtop to bedside. To date, studies investigating intervertebral disc (IVD) degeneration and regeneration in large animal models have utilized a wide spectrum of methodologies for outcome evaluation. This paper aims to consolidate available knowledge, expertise, and experience in large animal preclinical models of IVD degeneration to create a comprehensive tool box of anatomical and functional outcomes. Herein, we present a Large Animal IVD Scoring Algorithm based on three scales: macroscopic (gross morphology, imaging, and biomechanics), microscopic (histological, biochemical, and biomolecular analyses), and clinical (neurologic state, mobility, and pain). The proposed algorithm encompasses a stepwise evaluation on all three scales, including spinal pain assessment, and relevant structural and functional components of IVD health and disease. This comprehensive tool box was designed for four commonly used preclinical large animal models (dog, pig, goat, and sheep) in order to facilitate standardization and applicability. Furthermore, it is intended to facilitate comparison across studies while discerning relevant differences between species within the context of outcomes with the goal to enhance veterinary clinical relevance as well. Current major challenges in pre-clinical large animal models for IVD regeneration are highlighted and insights into future directions that may improve the understanding of the underlying pathologies are discussed. As such, the IVD research community can deepen its exploration of the molecular, cellular, structural, and biomechanical changes that occur with IVD degeneration and regeneration, paving the path for clinically relevant therapeutic strategies.
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Affiliation(s)
- Naomi N. Lee
- Thompson Laboratory for Regenerative OrthopaedicsUniversity of MissouriColumbiaMissouriUSA
| | - Elias Salzer
- Orthopaedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - Frances C. Bach
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Andres F. Bonilla
- Preclinical Surgical Research Laboratory, Department of Clinical SciencesColorado State UniversityColoradoUSA
| | - James L. Cook
- Thompson Laboratory for Regenerative OrthopaedicsUniversity of MissouriColumbiaMissouriUSA
| | - Zulma Gazit
- Department of SurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | | | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
| | - Lachlan J. Smith
- Departments of Neurosurgery and Orthopaedic SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Andrea Vernengo
- AO Research Institute DavosDavosSwitzerland
- Department of Chemical EngineeringRowan UniversityGlassboroNew JerseyUSA
| | - Hans‐Joachim Wilke
- Institute of Orthopaedic Research and BiomechanicsUniversity Hospital UlmUlmGermany
| | - Julie B. Engiles
- Department of Pathobiology, New Bolton Center, School of Veterinary MedicineUniversity of PennsylvaniaKennett SquarePennsylvaniaUSA
| | - Marianna A. Tryfonidou
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
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5
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Autissier R, Mazuel L, Maubert E, Bonny JM, Auzeloux P, Schmitt S, Traoré A, Peyrode C, Miot-Noirault E, Pagés G. Simultaneous proteoglycans and hypoxia mapping of chondrosarcoma environment by frequency selective CEST MRI. Magn Reson Med 2021; 86:1008-1018. [PMID: 33772858 DOI: 10.1002/mrm.28781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE To evaluate the relevance of CEST frequency selectivity in simultaneous in vivo imaging of both of chondrosarcoma's phenotypic features, that are, its high proteoglycan concentration and its hypoxic core. METHODS Swarm rat chondrosarcomas were implanted subcutaneously in NMRI nude mice. When tumors were measurable (12-16 days postoperative), mice were submitted to GAG, guanidyl, and APT CEST imaging. Proteoglycans and hypoxia were assessed in parallel by nuclear imaging exploiting 99m Tc-NTP 15-5 and 18 F-FMISO, respectively. Data were completed by ex vivo analysis of proteoglycans (histology and biochemical assay) and hypoxia (immunofluorescence). RESULTS Quantitative analysis of GAG CEST evidenced a significantly higher signal for tumor tissues than for muscles. These results were in agreement with nuclear imaging and ex vivo data. For imaging tumoral pH in vivo, the CEST ratio of APT/guanidyl was studied. This highlighted an important heterogeneity inside the tumor. The hypoxic status was confirmed by 18 F-FMISO PET imaging and ex vivo immunofluorescence. CONCLUSION CEST MRI simultaneously imaged both chondrosarcoma properties during a single experimental run and without the injection of any contrast agent. Both MR and nuclear imaging as well as ex vivo data were in agreement and showed that this chondrosarcoma animal model was rich in proteoglycans. However, even if tumors were lightly hypoxic at the stage studied, acidic areas were highlighted and mapped inside the tumor.
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Affiliation(s)
- Roxane Autissier
- INRAE, UR QuaPA, Saint-Genès-Champanelle, France.,Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France.,INRAE, ISC AgroResonance, Saint-Genès-Champanelle, France
| | - Leslie Mazuel
- INRAE, UR QuaPA, Saint-Genès-Champanelle, France.,Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France.,INRAE, ISC AgroResonance, Saint-Genès-Champanelle, France
| | - Elise Maubert
- Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Jean-Marie Bonny
- INRAE, UR QuaPA, Saint-Genès-Champanelle, France.,INRAE, ISC AgroResonance, Saint-Genès-Champanelle, France
| | - Philippe Auzeloux
- Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Sébastien Schmitt
- Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Amidou Traoré
- INRAE, UR QuaPA, Saint-Genès-Champanelle, France.,INRAE, ISC AgroResonance, Saint-Genès-Champanelle, France
| | - Caroline Peyrode
- Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Elisabeth Miot-Noirault
- Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France
| | - Guilhem Pagés
- INRAE, UR QuaPA, Saint-Genès-Champanelle, France.,INRAE, ISC AgroResonance, Saint-Genès-Champanelle, France
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6
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Li L, Zhou Z, Xiong W, Fang J, Scotti A, Shaghaghi M, Zhu W, Cai K. Characterization of microenvironmental changes in the intervertebral discs of patients with chronic low back pain using multiparametric MRI contrasts extracted from Z-spectrum. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1063-1071. [PMID: 33475842 DOI: 10.1007/s00586-021-06733-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/02/2021] [Accepted: 01/11/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Z-spectral MRI data were analyzed to produce multiparametric metabolic and microenvironmental contrasts for identifying intervertebral discs with/without pain symptom and sore pain. METHODS Z-spectra data were collected from the lumbar discs of 26 patients with non-specific chronic low bck pain (CLBP) and 21 asymptomatic controls (AC) with a chemical exchange saturation transfer (CEST). Data were fitted to quantify the CEST effects from glycosaminoglycan, amide proton transfer (APT), nuclear Overhauser enhancement (NOE), semi-solid magnetization transfer contrast effects, and the direct saturation of water. Multiparametric maps were computed from the fitted peak amplitudes, and the average values were calculated from all five lumber discs. Those parameters were compared between the CLBP and AC groups and between the subgroups with and without (Nsore) sore pain. RESULTS The discs in symptomatic patients have lower water content, collagen-bound water and collagen than the discs in AC (P < 0.05). Additionally, Z-sepctral MRI indicated that the discs in the sore subgroup had less water, collagen-bound water and collagen, and likely lower pH compared to the Nsore subgroup (P < 0.05). Lower pH as measured with reduced APT and NOE effects may be an important pathological factor causing sore pain of the back. CONCLUSION Z-spectral MRI with its multiparametric metabolic and microenvironmental contrasts has been demonstrated to identify discs with and without pain symptom or sore pain, providing more important information of CLBP.
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Affiliation(s)
- Li Li
- Radiological Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, 430030, Hubei, People's Republic of China.,Departments of Radiology, Department of Bioengineering, and the Center for MR Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Zhiguo Zhou
- Department of Orthopedics, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, HUST, Wuhan, 430030, Hubei, People's Republic of China
| | - Wei Xiong
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, HUST, Wuhan, 430030, Hubei, People's Republic of China
| | - Jicheng Fang
- Radiological Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, 430030, Hubei, People's Republic of China
| | - Alessandro Scotti
- Departments of Radiology, Department of Bioengineering, and the Center for MR Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Mehran Shaghaghi
- Departments of Radiology, Department of Bioengineering, and the Center for MR Research, University of Illinois at Chicago, Chicago, IL, USA
| | - WenZhen Zhu
- Radiological Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, 430030, Hubei, People's Republic of China.
| | - Kejia Cai
- Departments of Radiology, Department of Bioengineering, and the Center for MR Research, University of Illinois at Chicago, Chicago, IL, USA
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7
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Einarsson E, Peterson P, Önnerfjord P, Gottschalk M, Xu X, Knutsson L, Dahlberg LE, Struglics A, Svensson J. The role of cartilage glycosaminoglycan structure in gagCEST. NMR IN BIOMEDICINE 2020; 33:e4259. [PMID: 31999387 DOI: 10.1002/nbm.4259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Abstract
Glycosaminoglycan (GAG) chemical exchange saturation transfer (gagCEST) is a potential method for cartilage quality assessment. The aim of this study was to investigate how the gagCEST effect depends on the types and molecular organization of GAG typically found in articular cartilage. gagCEST was performed on different concentrations of GAG in various forms: free chains of chondroitin sulfate (CS) of different types (-A and -C) and GAG bound to protein in aggregated and nonaggregated aggrecan extracted from calf articular cartilage. The measured magnetization transfer ratio asymmetry (MTRasym ) was compared with known GAG concentrations or GAG concentrations determined through biochemical analysis. The gagCEST effect was assessed through the linear regression coefficient with 95% confidence interval of MTRasym per GAG concentration. We observed a lower gagCEST effect in phantoms containing a mixture of CS-A and CS-C compared with phantoms containing mainly CS-A. The difference in response corresponds well to the difference in CS-A concentration. GAG bound in aggrecan from calf articular cartilage, where CS-A is assumed to be the major type of GAG, produed a similar gagCEST effect as that observed for free CS-A. The effect was also similar for aggregated (ie, bound to hyaluronic acid) and nonaggregated aggrecan. In conclusion, our results indicate that the aggrecan structure in itself does not impact the gagCEST effect, but that the effect is strongly dependent on GAG type. In phantoms, the current implementation of gagCEST is sensitive to CS-A while for CS-C, the main GAG component in mature human articular cartilage, the sensitivity is limited. This difference in gagCEST sensitivity between GAG types detected in phantoms is a strong motivation to also explore the possibility of a similar effect in vivo.
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Affiliation(s)
- Emma Einarsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Pernilla Peterson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
- Radiation Physics, Department of Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Patrik Önnerfjord
- Rheumatology and Molecular Skeletal Biology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Xiang Xu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
| | - Linda Knutsson
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Medical Radiation Physics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Leif E Dahlberg
- Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - André Struglics
- Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Jonas Svensson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
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8
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Zhou X, Zhang F, Wang D, Wang J, Wang C, Xia K, Ying L, Huang X, Tao Y, Chen S, Xue D, Hua J, Liang C, Chen Q, Li F. Micro Fragmented Adipose Tissue Promotes the Matrix Synthesis Function of Nucleus Pulposus Cells and Regenerates Degenerated Intervertebral Disc in a Pig Model. Cell Transplant 2020; 29:963689720905798. [PMID: 32030997 PMCID: PMC7444234 DOI: 10.1177/0963689720905798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Intervertebral disc (IVD) degeneration and consequent lower back pain is a common
disease. Micro fragmented adipose tissue (MFAT) is promising for a wide range of
applications in regenerative medicine. In this study, MFAT was isolated by a
nonenzymatic method and co-cultured with nucleus pulposus cells (NPCs) using an
indirect co-culture system in vitro. A pig disc degeneration
model was used to investigate the regenerative effect of MFAT on degenerated
IVDs in vivo. The mRNA expression of Sox9,
Acan, and Col2 in NPCs was significantly
increased, while no significant increase was observed in the mRNA expression of
proinflammatory cytokine genes after the NPCs were co-cultured with MFAT.
Nucleus pulposus (NP)-specific markers were increased in MFAT cells after
co-culture with NPCs. After injection of MFAT, the disc height, water content,
extracellular matrix, and structure of the degenerated NP were significantly
improved. MFAT promoted the matrix synthesis function of NPCs, and NPCs
stimulated the NP-like differentiation of MFAT cells. In addition, MFAT also
partly regenerated degenerated IVDs in the pig model.
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Affiliation(s)
- Xiaopeng Zhou
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.,These authors contributed equally to this article
| | - Feng Zhang
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.,These authors contributed equally to this article
| | - Dawei Wang
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,These authors contributed equally to this article
| | - Jingkai Wang
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.,These authors contributed equally to this article
| | - Chenggui Wang
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Kaishun Xia
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Liwei Ying
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Xianpeng Huang
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Yiqing Tao
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Shouyong Chen
- Department of Orthopedics Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, People's Republic of China
| | - Deting Xue
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Jianming Hua
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China
| | - Chengzhen Liang
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Qixin Chen
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Fangcai Li
- Department of Orthopedics Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.,Department of Orthopedics Research Institute of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
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9
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Sheyn D, Ben-David S, Tawackoli W, Zhou Z, Salehi K, Bez M, De Mel S, Chan V, Roth J, Avalos P, Giaconi JC, Yameen H, Hazanov L, Seliktar D, Li D, Gazit D, Gazit Z. Human iPSCs can be differentiated into notochordal cells that reduce intervertebral disc degeneration in a porcine model. Theranostics 2019; 9:7506-7524. [PMID: 31695783 PMCID: PMC6831475 DOI: 10.7150/thno.34898] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction: As many as 80% of the adult population experience back pain at some point in their lifetimes. Previous studies have indicated a link between back pain and intervertebral disc (IVD) degeneration. Despite decades of research, there is an urgent need for robust stem cell therapy targeting underlying causes rather than symptoms. It has been proposed that notochordal cells (NCs) appear to be the ideal cell type to regenerate the IVD: these cells disappear in humans as they mature, are replaced by nucleus pulposus (NP) cells, and their disappearance correlates with the initiation of degeneration of the disc. Human NCs are in short supply, thus here aimed for generation of notochordal-like cells from induced pluripotent cells (iPSCs). Methods: Human iPSCs were generated from normal dermal fibroblasts by transfecting plasmids encoding for six factors: OCT4, SOX2, KLF4, L-MYC, LIN28, and p53 shRNA. Then the iPSCs were treated with GSK3i to induce differentiation towards Primitive Streak Mesoderm (PSM). The differentiation was confirmed by qRT-PCR and immunofluorescence. PSM cells were transfected with Brachyury (Br)-encoding plasmid and the cells were encapsulated in Tetronic-tetraacrylate-fibrinogen (TF) hydrogel that mimics the NP environment (G'=1kPa), cultured in hypoxic conditions (2% O2) and with specifically defined growth media. The cells were also tested in vivo in a large animal model. IVD degeneration was induced after an annular puncture in pigs, 4 weeks later the cells were injected and IVDs were analyzed at 12 weeks after the injury using MRI, gene expression analysis and histology. Results: After short-term exposure of iPSCs to GSK3i there was a significant change in cell morphology, Primitive Streak Mesoderm (PSM) markers (Brachyury, MIXL1, FOXF1) were upregulated and markers of pluripotency (Nanog, Oct4, Sox2) were downregulated, both compared to the control group. PSM cells nucleofected with Br (PSM-Br) cultured in TF hydrogels retained the NC phenotype consistently for up to 8 weeks, as seen in the gene expression analysis. PSM-Br cells were co-cultured with bone marrow (BM)-derived mesenchymal stem cells (MSCs) which, with time, expressed the NC markers in higher levels, however the levels of expression in BM-MSCs alone did not change. Higher expression of NC and NP marker genes in human BM-MSCs was found to be induced by iNC-condition media (iNC-CM) than porcine NC-CM. The annular puncture induced IVD degeneration as early as 2 weeks after the procedure. The injected iNCs were detected in the degenerated discs after 8 weeks in vivo. The iNC-treated discs were found protected from degeneration. This was evident in histological analysis and changes in the pH levels, indicative of degeneration state of the discs, observed using qCEST MRI. Immunofluorescence stains show that their phenotype was consistent with the in vitro study, namely they still expressed the notochordal markers Keratin 18, Keratin 19, Noto and Brachyury. Conclusion: In the present study, we report a stepwise differentiation method to generate notochordal cells from human iPSCs. These cells not only demonstrate a sustainable notochordal cell phenotype in vitro and in vivo, but also show the functionality of notochordal cells and have protective effect in case of induced disc degeneration and prevent the change in the pH level of the injected IVDs. The mechanism of this effect could be suggested via the paracrine effect on resident cells, as it was shown in the in vitro studies with MSCs.
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Affiliation(s)
- Dmitriy Sheyn
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Shiran Ben-David
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Wafa Tawackoli
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Biomedical Research Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Zhengwei Zhou
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Biomedical Research Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Khosrawdad Salehi
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Maxim Bez
- Skeletal Biotech Laboratory, Hebrew University of Jerusalem, 91120, Israel
| | - Sandra De Mel
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Virginia Chan
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Joseph Roth
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Pablo Avalos
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Joseph C Giaconi
- Biomedical Research Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Haneen Yameen
- Faculty of Biomedical Engineering, Technion, Haifa, 32003, Israel
| | - Lena Hazanov
- Faculty of Biomedical Engineering, Technion, Haifa, 32003, Israel
| | - Dror Seliktar
- Faculty of Biomedical Engineering, Technion, Haifa, 32003, Israel
| | - Debiao Li
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Biomedical Research Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
| | - Dan Gazit
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Skeletal Biotech Laboratory, Hebrew University of Jerusalem, 91120, Israel
| | - Zulma Gazit
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, 90048, CA
- Skeletal Biotech Laboratory, Hebrew University of Jerusalem, 91120, Israel
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10
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Fujii K, Yamazaki M, Kang JD, Risbud MV, Cho SK, Qureshi SA, Hecht AC, Iatridis JC. Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment. JBMR Plus 2019; 3:e10180. [PMID: 31131347 PMCID: PMC6524679 DOI: 10.1002/jbm4.10180] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 10/21/2018] [Accepted: 01/30/2019] [Indexed: 12/11/2022] Open
Abstract
Discogenic back pain is multifactorial; hence, physicians often struggle to identify the underlying source of the pain. As a result, discogenic back pain is often hard to treat—even more so when clinical treatment strategies are of questionable efficacy. Based on a broad literature review, our aim was to define discogenic back pain into a series of more specific and interacting pathologies, and to highlight the need to develop novel approaches and treatment strategies for this challenging and unmet clinical need. Discogenic pain involves degenerative changes of the intervertebral disc, including structural defects that result in biomechanical instability and inflammation. These degenerative changes in intervertebral discs closely intersect with the peripheral and central nervous systems to cause nerve sensitization and ingrowth; eventually central sensitization results in a chronic pain condition. Existing imaging modalities are nonspecific to pain symptoms, whereas discography methods that are more specific have known comorbidities based on intervertebral disc puncture and injection. As a result, alternative noninvasive and specific diagnostic methods are needed to better diagnose and identify specific conditions and sources of pain that can be more directly treated. Currently, there are many treatments/interventions for discogenic back pain. Nevertheless, many surgical approaches for discogenic pain have limited efficacy, thus accentuating the need for the development of novel treatments. Regenerative therapies, such as biologics, cell‐based therapy, intervertebral disc repair, and gene‐based therapy, offer the most promise and have many advantages over current therapies. © 2019 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research
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Affiliation(s)
- Kengo Fujii
- Leni & Peter W. May Department of Orthopaedics Icahn School of Medicine at Mount Sinai New York NY USA.,Department of Orthopaedic Surgery University of Tsukuba Tsukuba Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery University of Tsukuba Tsukuba Japan
| | - James D Kang
- Department of Orthopaedic Surgery Brigham and Women's Hospital Harvard Medical School Boston MA USA
| | - Makarand V Risbud
- Department of Orthopaedic Surgery Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA
| | - Samuel K Cho
- Leni & Peter W. May Department of Orthopaedics Icahn School of Medicine at Mount Sinai New York NY USA
| | - Sheeraz A Qureshi
- Department of Orthopaedic Surgery Hospital for Special Surgery New York NY USA
| | - Andrew C Hecht
- Leni & Peter W. May Department of Orthopaedics Icahn School of Medicine at Mount Sinai New York NY USA
| | - James C Iatridis
- Leni & Peter W. May Department of Orthopaedics Icahn School of Medicine at Mount Sinai New York NY USA
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11
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Han Z, Liu G. Sugar-based biopolymers as novel imaging agents for molecular magnetic resonance imaging. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2019; 11:e1551. [PMID: 30666829 DOI: 10.1002/wnan.1551] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/21/2018] [Accepted: 12/10/2018] [Indexed: 12/11/2022]
Abstract
Sugar-based biopolymers have been recognized as attractive materials to develop macromolecule- and nanoparticle-based cancer imaging and therapy. However, traditional biopolymer-based imaging approaches rely on the use of synthetic or isotopic labeling, and because of it, clinical translation often is hindered. Recently, a novel magnetic resonance imaging (MRI) technology, chemical exchange saturation transfer (CEST), has emerged, which allows the exploitation of sugar-based biopolymers as MRI agents by their hydroxyl protons-rich nature. In the study, we reviewed recent studies on the topic of CEST MRI detection of sugar-based biopolymers. The CEST MRI property of each biopolymer was briefly introduced, followed by the pre-clinical and clinical applications. The findings of these preliminary studies imply the enormous potential of CEST detectable sugar-based biopolymers in developing highly sensitive and translatable molecular imaging agents and constructing image-guided biopolymer-based drug delivery systems. This article is categorized under: Diagnostic Tools > in vivo Nanodiagnostics and Imaging Therapeutic Approaches and Drug Discovery > Emerging Technologies.
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Affiliation(s)
- Zheng Han
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Guanshu Liu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
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12
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Molecular pain markers correlate with pH-sensitive MRI signal in a pig model of disc degeneration. Sci Rep 2018; 8:17363. [PMID: 30478330 PMCID: PMC6255799 DOI: 10.1038/s41598-018-34582-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 10/01/2018] [Indexed: 12/28/2022] Open
Abstract
Intervertebral disc (IVD) degeneration is a leading cause of chronic low back pain that affects millions of people every year. Yet identification of the specific IVD causing this pain is based on qualitative visual interpretation rather than objective findings. One possible approach to diagnosing pain-associated IVD could be to identify acidic IVDs, as decreased pH within an IVD has been postulated to mediate discogenic pain. We hypothesized that quantitative chemical exchange saturation transfer (qCEST) MRI could detect pH changes in IVDs, and thence be used to diagnose pathologically painful IVDs objectively and noninvasively. To test this hypothesis, a surgical model of IVD degeneration in Yucatan minipigs was used. Direct measurement of pH inside the degenerated IVDs revealed a significant drop in pH after degeneration, which correlated with a significant increase in the qCEST signal. Gene analysis of harvested degenerated IVDs revealed significant upregulation of pain-, nerve- and inflammatory-related markers after IVD degeneration. A strong positive correlation was observed between the expression of pain markers and the increase in the qCEST signal. Collectively, these findings suggest that this approach might be used to identify which IVD is causing low back pain, thereby providing valuable guidance for pain and surgical management.
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13
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Zhou Z, Han P, Zhou B, Christodoulou AG, Shaw JL, Deng Z, Li D. Chemical exchange saturation transfer fingerprinting for exchange rate quantification. Magn Reson Med 2018; 80:1352-1363. [PMID: 29845651 PMCID: PMC6592698 DOI: 10.1002/mrm.27363] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/17/2018] [Accepted: 04/24/2018] [Indexed: 01/18/2023]
Abstract
PURPOSE There is an increased interest to determine the exchange rate using CEST to provide pH information. However, current CEST quantification methods require lengthy scan times and do not address magnetization transfer effects. The purpose of this work was to apply the magnetic resonance fingerprinting (MRF) concept to CEST to achieve more efficient and accurate exchange rate quantification. METHODS The proposed CEST fingerprinting method used varying saturation powers and saturation times to create unique signal evolutions for different exchange rates. The acquired signal was matched to a predefined dictionary to determine the exchange rate. The magnetization transfer effects were also addressed in the framework of CEST fingerprinting: The simulated dictionary could predict the signal curves without magnetization transfer effects, and comparing the dictionary to the acquired signals allowed the correction of the magnetization transfer effects. The CEST fingerprinting method was compared with the conventional pulsed quantitative CEST method using omega plots in the creatine phantom study. RESULTS The CEST fingerprinting method has a significantly reduced scan time (10 minutes versus 50 minutes) while providing more accurate exchange rate quantification using literature values as the reference. CONCLUSION In this study, we demonstrate that CEST fingerprinting is more efficient (5 times faster) compared with pulsed quantitative CEST. It is also shown that the results of the proposed CEST fingerprinting technique are much closer to the literature values than pulsed quantitative CEST at 3 T.
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Affiliation(s)
- Zhengwei Zhou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California
| | - Pei Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Bill Zhou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
- University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | | | - Jaime L. Shaw
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California
| | - Zixin Deng
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California
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14
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Lindeman LR, Randtke EA, High RA, Jones KM, Howison CM, Pagel MD. A comparison of exogenous and endogenous CEST MRI methods for evaluating in vivo pH. Magn Reson Med 2018; 79:2766-2772. [PMID: 29024066 PMCID: PMC5821269 DOI: 10.1002/mrm.26924] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 08/24/2017] [Accepted: 08/27/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE Extracellular pH (pHe) is an important biomarker for cancer cell metabolism. Acido-chemical exchange saturation transfer (CEST) MRI uses the contrast agent iopamidol to create spatial maps of pHe. Measurements of amide proton transfer exchange rates (kex ) from endogenous CEST MRI were compared to pHe measurements by exogenous acido-CEST MRI to determine whether endogenous kex could be used as a proxy for pHe measurements. METHODS Spatial maps of pHe and kex were obtained using exogenous acidoCEST MRI and an endogenous CEST MRI analyzed with the omega plot method, respectively, to evaluate mouse kidney, a flank tumor model, and a spontaneous lung tumor model. The pHe and kex results were evaluated using pixelwise comparisons. RESULTS The kex values obtained from endogenous CEST measurements did not correlate with the pHe results from exogenous CEST measurements. The kex measurements were limited to fewer pixels and had a limited dynamic range relative to pHe measurements. CONCLUSION Measurements of kex with endogenous CEST MRI cannot substitute for pHe measurements with acidoCEST MRI. Whereas endogenous CEST MRI may still have good utility for evaluating some specific pathologies, exogenous acido-CEST MRI is more appropriate when evaluating pathologies based on pHe values. Magn Reson Med 79:2766-2772, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Leila R. Lindeman
- Cancer Biology Graduate Interdisciplinary Program, University of Arizona Cancer Center, Tucson, AZ, USA
| | - Edward A. Randtke
- Department of Medical Imaging, University of Arizona, Tucson, AZ, USA
| | - Rachel A. High
- Cancer Biology Graduate Interdisciplinary Program, University of Arizona Cancer Center, Tucson, AZ, USA
| | - Kyle M. Jones
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | | | - Mark D. Pagel
- Cancer Biology Graduate Interdisciplinary Program, University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Medical Imaging, University of Arizona, Tucson, AZ, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
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15
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Stabinska J, Cronenberg T, Wittsack HJ, Lanzman RS, Müller-Lutz A. Quantitative pulsed CEST-MRI at a clinical 3T MRI system. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 30:505-516. [PMID: 28569374 DOI: 10.1007/s10334-017-0625-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/28/2017] [Accepted: 05/12/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The goal of this study was to quantify CEST related parameters such as chemical exchange rate and fractional concentration of exchanging protons at a clinical 3T scanner. For this purpose, two CEST quantification approaches-the AREX metric (for 'apparent exchange dependent relaxation'), and the AREX-based Ω-plot method were used. In addition, two different pulsed RF irradiation schemes, using Gaussian-shaped and spin-lock pulses, were compared. MATERIALS AND METHODS Numerical simulations as well as MRI measurements in phantoms were performed. For simulations, the Bloch-McConnell equations were solved using a two-pool exchange model. MR experiments were performed on a clinical 3T MRI scanner using a cylindrical phantom filled with creatine solution at different pH values and different concentrations. RESULTS The validity of the Ω-plot method and the AREX approach using spin-lock preparation for determination of the quantitative CEST parameters was demonstrated. Especially promising results were achieved for the Ω-plot method when the spin-lock preparation was employed. CONCLUSION Pulsed CEST at 3T could be used to quantify parameters such as exchange rate constants and concentrations of protons exchanging with free water. In the future this technique might be used to estimate the exchange rates and concentrations of biochemical substances in human tissues in vivo.
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Affiliation(s)
- Julia Stabinska
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Tom Cronenberg
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Rotem Shlomo Lanzman
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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