Direct observation of resolved resonances from intra- and extracellular sodium-23 ions in NMR studies of intact cells and tissues using dysprosium(III)tripolyphosphate as paramagnetic shift reagent

23 Na-MRI as a Noninvasive Biomarker for Cancer Diagnosis and Prognosis

The influx of sodium (Na⁺) ions into a resting cell is regulated by Na⁺ channels and by Na⁺/H⁺ and Na⁺/Ca²⁺ exchangers, whereas Na⁺ ion efflux is mediated by the activity of Na⁺/K⁺‐ATPase to maintain a high transmembrane Na⁺ ion gradient. Dysfunction of this system leads to changes in the intracellular sodium concentration that promotes cancer metastasis by mediating invasion and migration. In addition, the accumulation of extracellular Na⁺ ions in cancer due to inflammation contributes to tumor immunogenicity. Thus, alterations in the Na⁺ ion concentration may potentially be used as a biomarker for malignant tumor diagnosis and prognosis. However, current limitations in detection technology and a complex tumor microenvironment present significant challenges for the in vivo assessment of Na⁺ concentration in tumor. ²³Na‐magnetic resonance imaging (²³Na‐MRI) offers a unique opportunity to study the effects of Na⁺ ion concentration changes in cancer. Although challenged by a low signal‐to‐noise ratio, the development of ultrahigh magnetic field scanners and specialized sodium acquisition sequences has significantly advanced ²³Na‐MRI. ²³Na‐MRI provides biochemical information that reflects cell viability, structural integrity, and energy metabolism, and has been shown to reveal rapid treatment response at the molecular level before morphological changes occur. Here we review the basis of ²³Na‐MRI technology and discuss its potential as a direct noninvasive in vivo diagnostic and prognostic biomarker for cancer therapy, particularly in cancer immunotherapy. We propose that ²³Na‐MRI is a promising method with a wide range of applications in the tumor immuno‐microenvironment research field and in cancer immunotherapy monitoring.

Level of Evidence

2

Technical Efficacy

Stage 2

Crystallographic Characterization and Non-Innocent Redox Activity of the Glycine Modified DOTA Scaffold and Its Impact on EuIII Electrochemistry

EuDOTA-glycine derivatives have been explored as alternatives to typical gadolinium-containing complexes for MRI agents used in diagnostic imaging. Different imaging modalities can be accessed (T 1 or PARACEST) dependent on the oxidation state of the europium ion. Throughout the past 30 years, there have been significant manipulations and additions made to the DOTA scaffold; yet, characterizations related to electrochemistry and structure determined through XRD analysis have not been fully analyzed. In this work, electrochemical analysis using cyclic voltammetry was carried out on EuDOTA derivatives, including the free ligand DOTAGly4 (4) and the complexes. Effects of glycinate substitution on the DOTA scaffold, specifically, ligand interactions with the glassy carbon electrode were observed. A range of electrochemical investigations were carried out to show that increased glycinate substitution led to increased interaction with the electrode surface, thus implicating a new factor to consider when evaluating the electrochemistry of glycinate substituted ligands. In addition, the solid-state structure of EuDOTAGly4 (Eu4) was determined by X-ray diffraction and a brief analysis is presented compared to known Ln3+ structures found within literature. The Eu4 complex crystalizes in a rare polymer type arrangement via bridging side-arms between adjacent complexes.

Triple-quantum-filtered sodium imaging at 9.4 Tesla

PURPOSE

Efficient acquisition of triple-quantum-filtered (TQF) sodium images at ultra-high field (UHF) strength.

METHODS

A three-pulse preparation and a stack of double-spirals were used for the acquisition of TQF images at 9.4 Tesla. The flip angles of the TQ preparation were smoothly reduced toward the edge of k-space along the partition-encoding direction. In doing so, the specific absorption rate could be reduced while preserving the maximal signal intensity for the partitions most relevant for image contrast in the center of k-space. Simulations, phantom and in vivo measurements were used to demonstrate the usefulness of the proposed method.

RESULTS

A higher sensitivity (∼ 20%) was achieved compared to the standard acquisition without flip angle apodization. Signals from free sodium ions were successfully suppressed irrespective of the amount of apodization used. B0 corrected TQF images with a nominal resolution of 5 × 5 × 5 mm(3) and an acceptable signal-to-noise ratio could be acquired in vivo within 21 min.

CONCLUSION

Conventional TQF in combination with flip angle apodization permits to exploit more efficiently the increased sensitivity available at 9.4T.

30 Years of sodium/X-nuclei magnetic resonance imaging

In principle, all nuclei with nonzero spin can be employed for magnetic resonance imaging (MRI). Special scanner hardware and MR sequences are required to select the nucleus-specific frequency and to enable imaging with "sufficient" signal-to-noise ratio. This Special Issue starts with an overview of different nuclei that can be used for MRI today, followed by a review article about techniques required for imaging of quadrupolar nuclei with short relaxation times. Sequence developments to improve image quality and applications on different organs and diseases are presented for different nuclei ((23)Na, (35)Cl, (17)O, and (19)F), with a focus on imaging at natural abundance.

Measurement techniques for magnetic resonance imaging of fast relaxing nuclei

In this review article, techniques for sodium ((23)Na) magnetic resonance imaging (MRI) are presented. These techniques can also be used to image other nuclei with short relaxation times (e.g., (39)K, (35)Cl, (17)O). Twisted projection imaging, density-adapted 3D projection reconstruction, and 3D cones are preferred because of uniform k-space sampling and ultra-short echo times. Sampling density weighted apodization can be applied if intrinsic filtering is desired. This approach leads to an increased signal-to-noise ratio compared to postfiltered acquisition in cases of short readout durations relative to T 2 (*) relaxation time. Different MR approaches for anisotropic resolution are presented, which are important for imaging of thin structures such as myocardium, cartilage, and skin. The third part of this review article describes different methods to put more weighting either on the intracellular or the extracellular sodium signal by means of contrast agents, relaxation-weighted imaging, or multiple-quantum filtering.

Measurements of intracellular volumes by 59Co and 2H/1H NMR and their physiological applications

Determination of the intracellular water volumes using NMR spectroscopy was performed using the NMR-visible nuclei: 59Co and 2H or 1H. Accurate measurement of intracellular water in cell suspensions and perfused organs is an important physiological parameter in the context of electrolyte homeostasis and energy metabolism, in particular when these parameters are monitored by non-invasive NMR spectroscopy. Furthermore, repeated or continuous monitoring of intracellular water provided significant insights into the physiology of cardiac muscle and sarcolemmal membrane permeability and integrity.

23Na NMR microimaging: a tool for non-invasive monitoring of sodium distribution in living plants

Detailed knowledge of the sodium (Na) distribution within the tissues of highly salt-tolerant Australian native species could help in understanding the physiological adaptations of salt-tolerance or salt-sensitive plants. ²³Na nuclear magnetic resonance (NMR) microimaging is presented as a tool to achieve this goal. Maps of the Na distribution in stem tissue were obtained with an in-plane resolution of approximately125 µm and a slice thickness of 4 mm. Simultaneously recorded high resolution ¹H NMR images showing water distribution in the same slice with 31 µm in-plane resolution and 1 mm slice thickness, were used as an anatomical reference together with optical micrographs that were taken immediately after the NMR experiments were completed. To quantify the Na concentration, reference capillaries with known NaCl concentrations were located in the NMR probe together with the plant sample. Average concentration values calculated from signal intensities in the tissue and the capillaries were compared with concentration values obtained from atomic emission photometry and optical microscopy performed on digested stem sections harvested immediately after NMR experiments. Results showed that ²³Na NMR microimaging has great potential for physiological studies of salt stress at the macroscopic level, and may become a unique tool for diagnosing salt tolerance and sensitivity.

23Na NMR shift reagents enhance cardiac staircase effect in isolated perfused rat hearts

The effects of the currently used (23)Na NMR shift reagents, dysprosium bis-triphosphate [Dy(PPP)(2)], dysprosium triethylenetriamine hexaacetate [Dy(TTHA)] and thulium 1,4,7, 10-tetraazacyclododecane-N,N',N",N"'-tetra(methylenephosphonate) [Tm(DOTP)] were studied in the rat heart cardiac staircase model. Rat hearts were perfused with low or normal extracellular free calcium ([Ca(o)](f)). At low [Ca(o)](f) (0.34 +/- 0.05 mM), hearts were perfused with Dy(PPP)(2) (group I), Dy(TTHA) (group II) or no shift reagent (group III), while at normal [Ca(o)](f) (1.25 +/- 0.15 mM), hearts were perfused with Tm(DOTP) (group IV), Dy(TTHA) (group V) or no shift reagent (group VI). Left ventricular developed pressure (LVDP) values in group I were significantly higher than in groups II and III (p < 0.01), while no significant differences were found between groups II and III. LVDP values in group IV were significantly higher than in groups V and VI (p < 0.05), while the LVDP values in groups V and VI were almost identical. Also, a positive correlation between pacing rate and intracellular sodium ([Na(i)]) was evident. The [Na(i)] values at high [Ca(o)](f) were significantly lower than at low [Ca(o)](f) at each pacing level (p <0.01), indicating a negative correlation between [Na(i)] and [Ca(o)](f). No statistical differences were found in [Na(i)] between groups I vs II and IV vs V, showing that determination of [Na(i)] is not affected by any of these shift reagents. Thus the different LVDP responses in groups I vs II and IV vs V were not mirrored in [Na(i)] changes. We hypothesize that a direct, sarcolemmal Ca-Dy(PPP)(2)-, or Ca-Tm(DOTP)-induced positive inotropic effect could be responsible for these Na(i)-independent LVDP increases in groups I and IV.

Spectroscopic studies of PhTX facilitated cation movement across membranes

Philanthotoxins, noncompetitive inhibitors of the nicotinic acetylcholine receptor and various glutamate receptors, were found to be capable of mediating cation transport across lipid bilayers. With respect to the relatively weak binding constants of these amphiphilic polyamines to neuronal receptor proteins, this finding implies that their interaction with cell membranes might have to be considered in addition to that with protein receptors to fully understand the molecular mechanism of these neurotoxins.

31P NMR and triple quantum filtered 23Na NMR studies of the effects of inhibition of Na+/H+ exchange on intracellular sodium and pH in working and ischemic hearts

The triple quantum filtered 23Na NMR method is applied here to measure the effects of EIPA, a specific inhibitor of the Na+/H+ antiporter, on relative intracellular sodium concentrations in isolated working hearts at baseline, during ischemia, and at subsequent reperfusion. In analogy to the spectrophotometric isosbestic point, an approach is developed that defines a value of tau at which the effect of the relaxation times on the TQF signal intensities is minimized, and the signals are proportional to the sodium concentration for both ischemic and working hearts. EIPA at 1.5 microM significantly inhibited (P < 0.01) the influx of intracellular Na+ during 20 min of ischemia at 36.2 degrees C in this rat heart model. In parallel 31P NMR studies, EIPA had no effect on either the development of acidosis during ischemia or on the recovery of pHi during reperfusion despite its profound effect on intracellular Na+ influx. Thus, under our conditions the Na+/H+ antiporter did not play a critical role in the maintenance of intracellular pH. EIPA treatment resulted in improved recovery (P < 0.005) of mechanical function after 20 min of ischemia. [ATP] was higher in treated hearts during ischemia and reperfusion.

Study on the erythrocytes from myotonic dystrophy with multi-nuclear NMR

We have studied the water permeability through membranes, the function of the Na pump, and glucose metabolism of erythrocytes of patients with myotonic muscular dystrophy (MyD) using 1H--, 23Na, and 13C-NMR techniques. A significant decrease in water permeability was recognized in the MyD erythrocyte membrane, and impaired Na pumping was suspected to be correlated with the former biochemical abnormalities in band III protein of MyD erythrocyte membrane. Significant acceleration of glycolysis in the erythrocyte for the first 160 minutes was also recognized in MyD; however, the production of lactate showed no difference between MyD and controls. The increased glucose uptake in MyD may be compensatory to the diminished pumping mechanism, but further information, such as inorganic phosphate permeability and the activity of the rate-limiting enzyme of erythrocyte glycolysis, is needed.

Variable NMR visibility of intracellular sodium induced by Na(+)-substrate cotransport in dog cortical tubules

The intracellular sodium concentration [( Na+]i) of dog kidney cortical tubules was monitored by flame photometry and 23Na NMR using dysprosium tripolyphosphate as shift reagent. Upon addition of substrates cotransported with sodium, flame photometry showed an increase in [Na+]i while no change (glutamine, glucose) or even a decrease (lactate) in the Na+i NMR signal was observed. This discrepancy could not be explained by a lack of ATP prior to the addition of substrates or by a decrease of NMR visibility of Nai+ induced by binding of substrate to membrane transporters (and pump). We propose that a variation of the "apparent visibility" of Nai+ may occur, arising from either a compartmentation of Nai+ in dog cortical tubules or an inhomogeneous extracellular distribution of the shift reagent.

Nuclear magnetic resonance studies of sodium/calcium exchange in frog perfused, beating hearts

This study explores the effect of extracellular Ca2+ concentration ([Ca2+]o), on the intracellular Na+ concentration ([Na+]i), in frog intact hearts using nuclear magnetic resonance spectroscopy, which allows for the measurement of [Na+]i in perfused, beating hearts. Decreases in [Ca2+]o yielded marked increases in [Na+]i. A similar effect was seen during inhibition of the Na+/K+ pump and was fully reversible. This sensitivity of [Na+]i to [Ca2+]o, previously observed using microelectrodes, supports a crucial physiological role for Na+/Ca2+ exchange in frog intact, beating hearts.

Na+ and K+ fluxes stimulated by Na+-coupled glucose transport: evidence for a Ba2+-insensitive K+ efflux pathway in rabbit proximal tubules

Addition of glucose or the nonmetabolizable analogue alpha-methyl-D-glucoside to rabbit proximal tubules suspended in a glucose- and alanine-free buffer caused a sustained increase in intracellular Na+ content (+43 +/- 7 nmol.(mg protein)-1) and a concomitant but larger decrease in K+ content (-72 +/- 11 nmol.(mg protein)-1). A component of the net K+ efflux was Ba2+ insensitive, and was inhibited by high (1 mM) but not low (10 microM) concentrations of the diuretics furosemide and bumetanide. The increase in intracellular Na+ content is consistent with the view that the increased rates of Na+ and water transport seen in the proximal tubule in the presence of glucose can be attributed (at least in part) to a stimulation of basolateral pump activity by an increased [Na+]i.

Ion transport by lasalocid A across red-blood-cell membranes. A multinuclear NMR study

Na+ and K+ fluxes mediated by lasalocid A across erythrocyte membranes have been determined from 23Na-NMR peak areas and chemical shifts, respectively. In similar experiments, Cl- transport has been monitored by NMR signal intensities. Taking into account the external pH variations, the results are readily explainable in terms of charge-balance conservation. The effect of disodium 4,4'-diisothiocyanostilbene-2,2'-disulfonate, an anion-exchange inhibitor, has also been studied.

31P NMR analysis of intracellular pH of Swiss Mouse 3T3 cells: effects of extracellular Na+ and K+ and mitogenic stimulation

Swiss mouse 3T3 cells grown on microcarrier beads were superfused with electrolyte solution during continuous NMR analysis. Conventional 31P and 19F probes of intracellular pH (pHc) were found to be impracticable. Cells were therefore superfused with 1 to 4 mM 2-deoxyglucose, producing a large intracellular, pH-sensitive signal of 2-deoxyglucose phosphate (2DGP). The intracellular incorporation of 2DGP inhibited the Embden-Meyerhof pathway. However, intracellular ATP was at least in part retained and the cellular responsivity to changes in extracellular ionic composition and to the application of growth factors proved intact. Transient replacement of external Na+ with choline or K+ reversibly acidified the intracellular fluids. Quiescent cells and mitogenically stimulated cells displayed the same dependence of shifts in pHc on external Na+ concentration (CoNa). PHc also depended on intracellular Na+ concentration (CcNa). Increasing ccNa by withdrawing external K+ (thereby inhibiting the Na,K-pump) caused reversible intracellular acidification; subsequently reducing CoNa produced a larger acid shift in pHc than with external K+ present. Comparison of separate preparations indicated that pHc was higher in stimulated than in quiescent cells. Transient administration of mitogens also reversibly alkalinized quiescent cells studied continuously. This study documents the feasibility of monitoring pHc of Swiss mouse 3T3 cells using 31P NMR analysis of 2DGP. The results support the concept of a Na/H antiport operative in these cells, both in quiescence and after mitogenic stimulation. The data document by an independent technique that cytoplasmic alkalinization is an early event in mitogenesis, and that full activity of the Embden-Meyerhof pathway is not required for the expression of this event.