Photoreceptor processes in visual adaptation

[68Ga]Ga-FAPI PET for the evaluation of digestive system tumors: systematic review and meta-analysis

PURPOSE

Digestive system tumors are a group of tumors with high incidence in the world nowadays. The assessment of digestive system tumor metastasis by conventional imaging seems to be unsatisfactory. [⁶⁸Ga]Ga-FAPI, which has emerged in recent years, seems to be able to evaluate digestive system tumor metastasis. We aimed to summarize the current evidence of [⁶⁸Ga]Ga-FAPI PET/CT or PET/MR for the assessment of primary tumors, lymph node metastases, and distant metastases in digestive system tumors. Besides, we also aimed to perform a meta-analysis of the sensitivity of [⁶⁸Ga]Ga-FAPI PET diagnosis to discriminate between digestive system tumors, primary lesions, and non-primary lesions (lymph node metastases and distant metastases).

MATERIALS AND METHODS

PubMed, MEDLINE and Cochrane Library databases were searched from the beginning of the database build to August 12, 2022. All studies undergoing [⁶⁸Ga]Ga-FAPI PET for the evaluation of digestive tumors were included in the screening and review. Screening and full text review was performed by 3 investigators and data extraction was performed by 2 investigators. Risk of bias was examined with the QUADAS-2 criteria. Diagnostic test meta-analysis was performed with a random-effects model.

RESULTS

A total of 541 studies were retrieved. Finally, 22 studies were selected for the systematic review and 18 studies were included in the meta-analysis. In the 18 publications, a total of 524 patients with digestive system tumors, 459 primary tumor lesions of digestive system tumors, and 1921 metastatic lesions of digestive system tumors were included in the meta-analysis. Based on patients, the sensitivity of [⁶⁸Ga]Ga-FAPI PET for the diagnosis of digestive system tumors was 0.98 (95% CI: 0.94-0.99). Based on lesions, the sensitivity of [⁶⁸Ga]Ga-FAPI PET for the diagnostic evaluation of primary tumor lesions of the digestive system was 0.97 (95% CI: 0.93-0.99); the sensitivity of [⁶⁸Ga]Ga-FAPI PET for the diagnostic evaluation of non-primary lesions (lymph node metastases and distant metastases) of the digestive system tumors was 0.94 (95% CI: 0.79-0.99).

CONCLUSION

[⁶⁸Ga]Ga-FAPI PET has high accuracy and its sensitivity is at a high level for the diagnostic evaluation of digestive system tumors. Clinicians, nuclear medicine physicians, and radiologists may consider using [⁶⁸Ga]Ga-FAPI PET/CT or PET/MR in the evaluation of primary tumors, lymph node metastases, and distant metastases in digestive system tumors.

Alkylated hydroxylamine derivatives eliminate peripheral retinylidene Schiff bases but cannot enter the retinal binding pocket of light-activated rhodopsin

Besides Lys-296 in the binding pocket of opsin, all-trans-retinal forms adducts with peripheral lysine residues and phospholipids, thereby mimicking the spectral and chemical properties of metarhodopsin species. These pseudophotoproducts composed of nonspecific retinylidene Schiff bases have long plagued the investigation of rhodopsin deactivation and identification of decay products. We discovered that, while hydroxylamine can enter the retinal binding pocket of light-activated rhodopsin, the modified hydroxylamine compounds o-methylhydroxylamine (mHA), o-ethylhydroxylamine (eHA), o-tert-butylhydroxylamine (t-bHA), and o-(carboxymethyl)hydroxylamine (cmHA) are excluded. However, the alkylated hydroxylamines react quickly and efficiently with exposed retinylidene Schiff bases to form their respective retinal oximes. We further investigated how t-bHA affects light-activated rhodopsin and its interaction with binding partners. We found that both metarhodopsin II (Meta II) and Meta III are resistant to t-bHA, and neither arrestin nor transducin binding is affected by t-bHA. This discovery suggests that the hypothetical solvent channel that opens in light-activated rhodopsin is extremely stringent with regard to size and/or polarity. We believe that alkylated hydroxylamines will prove to be extremely useful reagents for the investigation of rhodopsin activation and decay mechanisms. Furthermore, the use of alkylated hydroxylamines should not be limited to in vitro studies and could help elucidate visual signal transduction mechanisms in the living cells of the retina.

Intrinsic cone adaptation modulates feedback efficiency from horizontal cells to cones

Processing of visual stimuli by the retina changes strongly during light/dark adaptation. These changes are due to both local photoreceptor-based processes and to changes in the retinal network. The feedback pathway from horizontal cells to cones is known to be one of the pathways that is modulated strongly during adaptation. Although this phenomenon is well described, the mechanism for this change is poorly characterized. The aim of this paper is to describe the mechanism for the increase in efficiency of the feedback synapse from horizontal cells to cones. We show that a train of flashes can increase the feedback response from the horizontal cells, as measured in the cones, up to threefold. This process has a time constant of approximately 3 s and can be attributed to processes intrinsic to the cones. It does not require dopamine, is not the result of changes in the kinetics of the cone light response and is not due to changes in horizontal cells themselves. During a flash train, cones adapt to the mean light intensity, resulting in a slight (4 mV) depolarization of the cones. The time constant of this depolarization is approximately 3 s. We will show that at this depolarized membrane potential, a light-induced change of the cone membrane potential induces a larger change in the calcium current than in the unadapted condition. Furthermore, we will show that negative feedback from horizontal cells to cones can modulate the calcium current more efficiently at this depolarized cone membrane potential. The change in horizontal cell response properties during the train of flashes can be fully attributed to these changes in the synaptic efficiency. Since feedback has major consequences for the dynamic, spatial, and spectral processing, the described mechanism might be very important to optimize the retina for ambient light conditions.

Relief of opsin desensitization and prolonged excitation of rod photoreceptors by 9-desmethylretinal

The 9-methyl group of 11-cis-retinal plays a crucial role in photoexcitation of the visual pigment rhodopsin. A hydrogen-substituted analogue, 11-cis-9-desmethylretinal, combines with opsin to form a pigment that produces abnormal photoproducts and diminished activation of the GTP-binding protein transducin in vitro. We have measured the formation of this analogue pigment in bleached salamander rods and determined the size and shape of its quantal response. In addition, we have characterized the influence of opsin and newly formed analogue pigment on the quantal response to native porphyropsin. We find that, as 11-cis-9-desmethylretinal combines with opsin in bleached rods, the amplitude of the quantal response from residual native pigment is elevated by approximately 7.5-fold to 0.15 +/- 0.09 pA, a value close to the amplitude of the quantal response before bleach (0.31 +/- 0.10 pA). When activated by light, the new analogue pigment produces a quantal response that is approximately 30-fold smaller and decays approximately 5 times more slowly than that of native pigment in unbleached cells. We conclude that the 9-methyl group of retinal is not critical for conversion of opsin to its nondesensitizing state but that it is critical for the normal processes of activation and deactivation of metarhodopsin that give rise to the quantal response.

Sensitization of bleached rod photoreceptors by 11-cis-locked analogues of retinal

Photoactivation of rhodopsin initiates both excitation and adaptation in vertebrate rod photoreceptors. Bleaching of rhodopsin to free opsin and all-trans-retinal in isolated rods produces a stable desensitization (bleaching adaptation) that is much larger than expected from pigment depletion alone. In our experiments, a 93% bleach produced a 500-fold increase in the light intensity required for saturation of the light response. This component of adaptation was 32-fold larger than the 16-fold increase expected from pigment depletion alone. 11-cis-Retinal, when delivered to isolated rods from liposomes, combines with free opsin to form a bleachable photopigment that fully restores sensitivity. 11-cis-Locked analogues of retinal combine with opsin to form unbleachable pigments in isolated bleached rods from the tiger salamander. They restore sensitivity to a substantial (16- to 25-fold) but incomplete extent. The analogues apparently relieve a stable component of adaptation when they interact with opsin. Because these analogues do not detectably excite rods, the structural requirements of both retinal and opsin for the relief of adaptation are different from those of excitation. The biochemical basis of light adaptation resulting from pigment bleaching and the minimum structural requirements of retinal for its relief remain to be determined.