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Hart XM, Spangemacher M, Defert J, Uchida H, Gründer G. Update Lessons from PET Imaging Part II: A Systematic Critical Review on Therapeutic Plasma Concentrations of Antidepressants. Ther Drug Monit 2024; 46:155-169. [PMID: 38287888 DOI: 10.1097/ftd.0000000000001142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 07/29/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Compared with antipsychotics, the relationship between antidepressant blood (plasma or serum) concentrations and target engagement is less well-established. METHODS We have discussed the literature on the relationship between plasma concentrations of antidepressant drugs and their target occupancy. Antidepressants reviewed in this work are citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine, duloxetine, milnacipran, tricyclic antidepressants (amitriptyline, nortriptyline, and clomipramine), bupropion, tranylcypromine, moclobemide, and vortioxetine. Four electronic databases were systematically searched. RESULTS We included 32 articles published 1996-2022. A strong relationship between serotonin transporter (SERT) occupancy and drug concentration is well established for selective serotonin reuptake inhibitors. Lower limits of recommended therapeutic reference ranges largely corroborate with the findings from positron emission tomography studies (80% SERT occupancy). Only a few novel studies have investigated alternative targets, that is, norepinephrine transporters (NETs), dopamine transporters (DATs), or monoamine oxidase A (MAO-A). For certain classes of drugs, positron emission tomography study data are inconclusive. Low DAT occupancy after bupropion treatment speculates its discussed mechanism of action. For MAO inhibitors, a correlation between drug concentration and MAO-A occupancy could not be established. CONCLUSIONS Neuroimaging studies are critical in TDM-guided therapy for certain antidepressants, whereas for bupropion and MAO inhibitors, the available evidence offers no further insight. Evidence for selective serotonin reuptake inhibitors is strong and justifies a titration toward suggested ranges. For SNRIs, duloxetine, and venlafaxine, NETs are sufficiently occupied, well above the SERT efficacy threshold. For these drugs, a titration toward higher concentrations (within the recommended range) should be considered in case of no response at lower concentrations.
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Affiliation(s)
- Xenia M Hart
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; and
| | - Moritz Spangemacher
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Julie Defert
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; and
| | - Gerhard Gründer
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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2
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Rabiner EA, Gunn RN. Estimation of target occupancy in repeated dosing design studies using positron emission tomography: Biases due to target upregulation. J Cereb Blood Flow Metab 2024; 44:573-579. [PMID: 37944261 PMCID: PMC10981403 DOI: 10.1177/0271678x231214443] [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: 07/18/2023] [Revised: 10/13/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023]
Abstract
Positron emission tomography (PET) has become indispensable in the quantification of target engagement by brain targeting medications. The relationship between the drug plasma concentration (or drug dose administered) and target occupancy determined during a PET occupancy study has provided valuable information for the assessment of novel pharmaceuticals in the early phases of drug development. Such information is also critical for the understanding of the mechanisms of action and side-effect profile of approved medication commonly used in the clinic. Occupancy studies conducted following repeated drug dosing (RD) can produce systematic differences from those conducted following single drug dose (SD), differences that have not been adequately explored. We have hypothesised that when differences are observed between RD and SD studies, they are related to changes in target density induced by repeated drug accumulation. We have developed a modified occupancy model to account for potential changes in target density and tested it on a sample dataset. We found that target upregulation can parsimoniously explain the differences in drug affinity estimated in SD and RD studies. Our findings have implications for the interpretation of RD occupancy data in the literature and the relationship between specific target occupancy levels and drug efficacy and tolerability.
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Affiliation(s)
| | - Roger N Gunn
- Invicro, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
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3
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Naganawa M, Gallezot JD, Finnema SJ, Maguire RP, Mercier J, Nabulsi NB, Kervyn S, Henry S, Nicolas JM, Huang Y, Chen MK, Hannestad J, Klitgaard H, Stockis A, Carson RE. Drug characteristics derived from kinetic modeling: combined 11C-UCB-J human PET imaging with levetiracetam and brivaracetam occupancy of SV2A. EJNMMI Res 2022; 12:71. [PMID: 36346513 PMCID: PMC9643320 DOI: 10.1186/s13550-022-00944-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antiepileptic drugs, levetiracetam (LEV) and brivaracetam (BRV), bind to synaptic vesicle glycoprotein 2A (SV2A). In their anti-seizure activity, speed of brain entry may be an important factor. BRV showed faster entry into the human and non-human primate brain, based on more rapid displacement of SV2A tracer 11C-UCB-J. To extract additional information from previous human studies, we developed a nonlinear model that accounted for drug entry into the brain and binding to SV2A using brain 11C-UCB-J positron emission tomography (PET) data and the time-varying plasma drug concentration, to assess the kinetic parameter K1 (brain entry rate) of the drugs. METHOD Displacement (LEV or BRV p.i. 60 min post-tracer injection) and post-dose scans were conducted in five healthy subjects. Blood samples were collected for measurement of drug concentration and the tracer arterial input function. Fitting of nonlinear differential equations was applied simultaneously to time-activity curves (TACs) from displacement and post-dose scans to estimate 5 parameters: K1 (drug), K1(11C-UCB-J, displacement), K1(11C-UCB-J, post-dose), free fraction of 11C-UCB-J in brain (fND(11C-UCB-J)), and distribution volume of 11C-UCB-J (VT(UCB-J)). Other parameters (KD(drug), KD(11C-UCB-J), fP(drug), fP(11C-UCB-J, displacement), fP(11C-UCB-J, post-dose), fND(drug), koff(drug), koff(11C-UCB-J)) were fixed to literature or measured values. RESULTS The proposed model described well the TACs in all subjects; however, estimates of drug K1 were unstable in comparison with 11C-UCB-J K1 estimation. To provide a conservative estimate of the relative speed of brain entry for BRV vs. LEV, we determined a lower bound on the ratio BRV K1/LEV K1, by finding the lowest BRV K1 or highest LEV K1 that were statistically consistent with the data. Specifically, we used the F test to compare the residual sum of squares with fixed BRV K1 to that with floating BRV K1 to obtain the lowest possible BRV K1; the same analysis was performed to find the highest LEV K1. The lower bound of the ratio BRV K1/LEV K1 was ~ 7. CONCLUSIONS Under appropriate conditions, this advanced nonlinear model can directly estimate entry rates of drugs into tissue by analysis of PET TACs. Using a conservative statistical cutoff, BRV enters the brain at least sevenfold faster than LEV.
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Affiliation(s)
- Mika Naganawa
- Yale University School of Medicine, 801 Howard Ave, PO Box 208048, New Haven, CT, USA.
| | | | - Sjoerd J Finnema
- Yale University School of Medicine, 801 Howard Ave, PO Box 208048, New Haven, CT, USA
| | | | | | - Nabeel B Nabulsi
- Yale University School of Medicine, 801 Howard Ave, PO Box 208048, New Haven, CT, USA
| | | | - Shannan Henry
- Yale University School of Medicine, 801 Howard Ave, PO Box 208048, New Haven, CT, USA
| | | | - Yiyun Huang
- Yale University School of Medicine, 801 Howard Ave, PO Box 208048, New Haven, CT, USA
| | - Ming-Kai Chen
- Yale University School of Medicine, 801 Howard Ave, PO Box 208048, New Haven, CT, USA
| | | | | | | | - Richard E Carson
- Yale University School of Medicine, 801 Howard Ave, PO Box 208048, New Haven, CT, USA
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4
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den Boer JA, de Vries EJ, Borra RJ, Waarde AV, Lammertsma AA, Dierckx RA. Role of Brain Imaging in Drug Development for Psychiatry. Curr Rev Clin Exp Pharmacol 2022; 17:46-71. [DOI: 10.2174/1574884716666210322143458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/17/2020] [Accepted: 01/06/2021] [Indexed: 11/22/2022]
Abstract
Background:
Over the last decades, many brain imaging studies have contributed to
new insights in the pathogenesis of psychiatric disease. However, in spite of these developments,
progress in the development of novel therapeutic drugs for prevalent psychiatric health conditions
has been limited.
Objective:
In this review, we discuss translational, diagnostic and methodological issues that have
hampered drug development in CNS disorders with a particular focus on psychiatry. The role of
preclinical models is critically reviewed and opportunities for brain imaging in early stages of drug
development using PET and fMRI are discussed. The role of PET and fMRI in drug development
is reviewed emphasizing the need to engage in collaborations between industry, academia and
phase I units.
Conclusion:
Brain imaging technology has revolutionized the study of psychiatric illnesses, and
during the last decade, neuroimaging has provided valuable insights at different levels of analysis
and brain organization, such as effective connectivity (anatomical), functional connectivity patterns
and neurochemical information that may support both preclinical and clinical drug development.
Since there is no unifying pathophysiological theory of individual psychiatric syndromes and since
many symptoms cut across diagnostic boundaries, a new theoretical framework has been proposed
that may help in defining new targets for treatment and thus enhance drug development in CNS diseases.
In addition, it is argued that new proposals for data-mining and mathematical modelling as
well as freely available databanks for neural network and neurochemical models of rodents combined
with revised psychiatric classification will lead to new validated targets for drug development.
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Affiliation(s)
| | - Erik J.F. de Vries
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ronald J.H. Borra
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Aren van Waarde
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Adriaan A. Lammertsma
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Rudi A. Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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5
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Sørensen A, Ruhé HG, Munkholm K. The relationship between dose and serotonin transporter occupancy of antidepressants-a systematic review. Mol Psychiatry 2022; 27:192-201. [PMID: 34548628 PMCID: PMC8960396 DOI: 10.1038/s41380-021-01285-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/11/2021] [Accepted: 08/25/2021] [Indexed: 11/09/2022]
Abstract
Brain imaging techniques enable the visualization of serotonin transporter (SERT) occupancy as a measure of the proportion of SERT blocked by an antidepressant at a given dose. We aimed to systematically review the evidence on the relationship between antidepressant dose and SERT occupancy. We searched PubMed and Embase (last search 20 May 2021) for human in vivo, within-subject PET, or SPECT studies measuring SERT occupancy at any dose of any antidepressant with highly selective radioligands ([11C]-DASB, [123I]-ADAM, and [11C]-MADAM). We summarized and visualized the dose-occupancy relationship for antidepressants across studies, overlaying the plots with a curve based on predicted values of a standard 2-parameter Michaelis-Menten model fitted using the observed data. We included seventeen studies of 10 different SSRIs, SNRIs, and serotonin modulators comprising a total of 294 participants, involving 309 unique occupancy measures. Overall, following the Michaelis-Menten equation, SERT occupancy increased with a higher dose in a hyperbolic relationship, with occupancy increasing rapidly at lower doses and reaching a plateau at approximately 80% at the usual minimum recommended dose. All the studies were small, only a few investigated the same antidepressant, dose, and brain region, and few reported information on factors that may influence SERT occupancy. The hyperbolic dose-occupancy relationship may provide mechanistic insight of relevance to the limited clinical benefit of dose-escalation in antidepressant treatment and the potential emergence of withdrawal symptoms. The evidence is limited by non-transparent reporting, lack of standardized methods, small sample sizes, and short treatment duration. Future studies should standardize the imaging and reporting procedures, measure occupancy at lower antidepressant doses, and investigate the moderators of the dose-occupancy relationship.
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Affiliation(s)
- Anders Sørensen
- Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark.
| | - Henricus G. Ruhé
- grid.10417.330000 0004 0444 9382Department of Psychiatry, Radboudumc, Nijmegen, The Netherlands ,grid.5590.90000000122931605Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Klaus Munkholm
- grid.10825.3e0000 0001 0728 0170Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark ,grid.7143.10000 0004 0512 5013Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
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6
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Eap CB, Gründer G, Baumann P, Ansermot N, Conca A, Corruble E, Crettol S, Dahl ML, de Leon J, Greiner C, Howes O, Kim E, Lanzenberger R, Meyer JH, Moessner R, Mulder H, Müller DJ, Reis M, Riederer P, Ruhe HG, Spigset O, Spina E, Stegman B, Steimer W, Stingl J, Suzen S, Uchida H, Unterecker S, Vandenberghe F, Hiemke C. Tools for optimising pharmacotherapy in psychiatry (therapeutic drug monitoring, molecular brain imaging and pharmacogenetic tests): focus on antidepressants. World J Biol Psychiatry 2021; 22:561-628. [PMID: 33977870 DOI: 10.1080/15622975.2021.1878427] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objectives: More than 40 drugs are available to treat affective disorders. Individual selection of the optimal drug and dose is required to attain the highest possible efficacy and acceptable tolerability for every patient.Methods: This review, which includes more than 500 articles selected by 30 experts, combines relevant knowledge on studies investigating the pharmacokinetics, pharmacodynamics and pharmacogenetics of 33 antidepressant drugs and of 4 drugs approved for augmentation in cases of insufficient response to antidepressant monotherapy. Such studies typically measure drug concentrations in blood (i.e. therapeutic drug monitoring) and genotype relevant genetic polymorphisms of enzymes, transporters or receptors involved in drug metabolism or mechanism of action. Imaging studies, primarily positron emission tomography that relates drug concentrations in blood and radioligand binding, are considered to quantify target structure occupancy by the antidepressant drugs in vivo. Results: Evidence is given that in vivo imaging, therapeutic drug monitoring and genotyping and/or phenotyping of drug metabolising enzymes should be an integral part in the development of any new antidepressant drug.Conclusions: To guide antidepressant drug therapy in everyday practice, there are multiple indications such as uncertain adherence, polypharmacy, nonresponse and/or adverse reactions under therapeutically recommended doses, where therapeutic drug monitoring and cytochrome P450 genotyping and/or phenotyping should be applied as valid tools of precision medicine.
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Affiliation(s)
- C B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Lausanne, Switzerland, Geneva, Switzerland
| | - G Gründer
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - P Baumann
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - N Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - A Conca
- Department of Psychiatry, Health Service District Bolzano, Bolzano, Italy.,Department of Child and Adolescent Psychiatry, South Tyrolean Regional Health Service, Bolzano, Italy
| | - E Corruble
- INSERM CESP, Team ≪MOODS≫, Service Hospitalo-Universitaire de Psychiatrie, Universite Paris Saclay, Le Kremlin Bicetre, France.,Service Hospitalo-Universitaire de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - S Crettol
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M L Dahl
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - J de Leon
- Eastern State Hospital, University of Kentucky Mental Health Research Center, Lexington, KY, USA
| | - C Greiner
- Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn, Germany
| | - O Howes
- King's College London and MRC London Institute of Medical Sciences (LMS)-Imperial College, London, UK
| | - E Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - R Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - J H Meyer
- Campbell Family Mental Health Research Institute, CAMH and Department of Psychiatry, University of Toronto, Toronto, Canada
| | - R Moessner
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - H Mulder
- Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, The Netherlands.,GGZ Drenthe Mental Health Services Drenthe, Assen, The Netherlands.,Department of Pharmacotherapy, Epidemiology and Economics, Department of Pharmacy and Pharmaceutical Sciences, University of Groningen, Groningen, The Netherlands.,Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, University of Groningen, Groningen, The Netherlands
| | - D J Müller
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - M Reis
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Clinical Chemistry and Pharmacology, Skåne University Hospital, Lund, Sweden
| | - P Riederer
- Center of Mental Health, Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany.,Department of Psychiatry, University of Southern Denmark Odense, Odense, Denmark
| | - H G Ruhe
- Department of Psychiatry, Radboudumc, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - O Spigset
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - E Spina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - B Stegman
- Institut für Pharmazie der Universität Regensburg, Regensburg, Germany
| | - W Steimer
- Institute for Clinical Chemistry and Pathobiochemistry, Technical University of Munich, Munich, Germany
| | - J Stingl
- Institute for Clinical Pharmacology, University Hospital of RWTH Aachen, Germany
| | - S Suzen
- Department of Toxicology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - S Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - F Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - C Hiemke
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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7
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Yoneyama T, Sato S, Sykes A, Fradley R, Stafford S, Bechar S, Howley E, Patel T, Tagawa Y, Moriwaki T, Asahi S. Mechanistic Multilayer Quantitative Model for Nonlinear Pharmacokinetics, Target Occupancy and Pharmacodynamics (PK/TO/PD) Relationship of D-Amino Acid Oxidase Inhibitor, TAK-831 in Mice. Pharm Res 2020; 37:164. [PMID: 32901384 PMCID: PMC7478952 DOI: 10.1007/s11095-020-02893-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/24/2020] [Indexed: 02/06/2023]
Abstract
Purpose TAK-831 is a highly selective and potent inhibitor of D-amino acid oxidase (DAAO) currently under clinical development for schizophrenia. In this study, a mechanistic multilayer quantitative model that parsimoniously connects pharmacokinetics (PK), target occupancy (TO) and D-serine concentrations as a pharmacodynamic (PD) readout was established in mice. Methods PK, TO and PD time-profiles were obtained in mice and analyzed by mechanistic binding kinetics model connected with an indirect response model in a step wise fashion. Brain distribution was investigated to elucidate a possible mechanism driving the hysteresis between PK and TO. Results The observed nonlinear PK/TO/PD relationship was well captured by mechanistic modeling framework within a wide dose range of TAK-831 in mice. Remarkably different brain distribution was observed between target and reference regions, suggesting that the target-mediated slow binding kinetics rather than slow penetration through the blood brain barrier caused the observed distinct kinetics between PK and TO. Conclusion A quantitative mechanistic model for concentration- and time-dependent nonlinear PK/TO/PD relationship was established for TAK-831 in mice with accounting for possible rate-determining process. The established mechanistic modeling framework will provide a quantitative means for multilayer biomarker-assisted clinical development in multiple central nervous system indications. Electronic supplementary material The online version of this article (10.1007/s11095-020-02893-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tomoki Yoneyama
- Drug Metabolism and Pharmacokinetics Research Laboratories, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan.
| | - Sho Sato
- Drug Metabolism and Pharmacokinetics Research Laboratories, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan
| | - Andy Sykes
- Drug Metabolism and Pharmacokinetics Research Laboratories, Takeda Cambridge Ltd, Cambridge, UK
| | - Rosa Fradley
- Pharmacology, Takeda Cambridge Ltd, Cambridge, UK
| | | | - Shyam Bechar
- Pharmacology, Takeda Cambridge Ltd, Cambridge, UK
| | | | - Toshal Patel
- Pharmacology, Takeda Cambridge Ltd, Cambridge, UK
| | - Yoshihiko Tagawa
- Drug Metabolism and Pharmacokinetics Research Laboratories, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan
| | - Toshiya Moriwaki
- Drug Metabolism and Pharmacokinetics Research Laboratories, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan
| | - Satoru Asahi
- Drug Metabolism and Pharmacokinetics Research Laboratories, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan
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8
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Ishii H, Yamasaki T, Yui J, Zhang Y, Hanyu M, Ogawa M, Nengaki N, Tsuji AB, Terashima Y, Matsushima K, Zhang MR. Radiosynthesis of [thiocarbonyl- 11C]disulfiram and its first PET study in mice. Bioorg Med Chem Lett 2020; 30:126998. [PMID: 32014383 DOI: 10.1016/j.bmcl.2020.126998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/15/2020] [Accepted: 01/24/2020] [Indexed: 11/29/2022]
Abstract
[Thiocarbonyl-11C]disulfiram ([11C]DSF) was synthesized via iodine oxidation of [11C]diethylcarbamodithioic acid ([11C]DETC), which was prepared from [11C]carbon disulfide and diethylamine. The decay-corrected isolated radiochemical yield (RCY) of [11C]DSF was greatly affected by the addition of unlabeled carbon disulfide. In the presence of carbon disulfide, the RCY was increased up to 22% with low molar activity (Am, 0.27 GBq/μmol). On the other hand, [11C]DSF was obtained in 0.4% RCY with a high Am value (95 GBq/μmol) in the absence of carbon disulfide. The radiochemical purity of [11C]DSF was always >98%. The first PET study on [11C]DSF was performed in mice. A high uptake of radioactivity was observed in the liver, kidneys, and gallbladder. The uptake level and distribution pattern in mice were not significantly affected by the Am value of the [11C]DSF sample used. In vivo metabolite analysis showed the rapid decomposition of [11C]DSF in mouse plasma.
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Affiliation(s)
- Hideki Ishii
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.
| | - Tomoteru Yamasaki
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Joji Yui
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Yiding Zhang
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Masayuki Hanyu
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Masanao Ogawa
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Nobuki Nengaki
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Atsushi B Tsuji
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Yuya Terashima
- Division of Molecular Regulation of Inflammatory and Immune Diseases, Research Institute for Biomedical Science (RIBS), Tokyo University of Science, Chiba 278-0022, Japan
| | - Kouji Matsushima
- Division of Molecular Regulation of Inflammatory and Immune Diseases, Research Institute for Biomedical Science (RIBS), Tokyo University of Science, Chiba 278-0022, Japan
| | - Ming-Rong Zhang
- Department of Advanced Nuclear Medicine Sciences, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.
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9
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The application of positron emission tomography (PET) imaging in CNS drug development. Brain Imaging Behav 2019; 13:354-365. [PMID: 30259405 DOI: 10.1007/s11682-018-9967-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
As drug discovery and development in Neuroscience push beyond symptom management to disease modification, neuroimaging becomes a key area of translational research that enables measurements of the presence of drugs and downstream physiological consequences of drug action within the living brain. As such, neuroimaging can be used to help optimize decision-making processes throughout the various phases of drug development. Positron Emission Tomography (PET) is a functional imaging technique that allows the quantification and visualization of biochemical processes, by monitoring the time dependent distribution of molecules labelled with short-lived positron-emitting isotopes. This review focuses on the application of PET to support CNS drug development, particularly in the early clinical phases, by allowing us to measure tissue exposure, target engagement, and pharmacological activity. We will also discuss the application of PET imaging as tools to image the pathological hallmarks of disease and evaluate the potential disease-modifying effect of candidate drugs in slowing disease progression.
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Stadulytė A, Alcaide-Corral CJ, Walton T, Lucatelli C, Tavares AAS. Analysis of PK11195 concentrations in rodent whole blood and tissue samples by rapid and reproducible chromatographic method to support target-occupancy PET studies. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1118-1119:33-39. [PMID: 31005772 PMCID: PMC6522057 DOI: 10.1016/j.jchromb.2019.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 04/05/2019] [Accepted: 04/11/2019] [Indexed: 12/24/2022]
Abstract
In Positron Emission Tomography (PET) research, it is important to assess not only pharmacokinetics of a radiotracer in vivo, but also of the drugs used in blocking/displacement PET studies. Typically, pharmacokinetic/pharmacodynamic (PK/PD) analyses of drugs used in rodent PET studies are based on population average pharmacokinetic profiles of the drugs due to limited blood volume withdrawal while simultaneously maintaining physiological homeostasis. This likely results in bias of PET data quantification, including unknown bias of target occupancy (TO) measurements. This study aimed to develop a High Performance Liquid Chromatography (HPLC) method for PK/PD quantification of drugs used in preclinical rodent PET research, specifically the translocator 18 kDa protein (TSPO) selective drug, PK11195, that used sub-millilitre blood volumes. The lowest detection limit for the proposed HPLC method ranged between 7.5 and 10 ng/mL depending on the method used to calculate the limit of detection, and the measured average relative standard deviation for intermediate precision was equal to 17.2%. Most importantly, we were able to demonstrate a significant difference between calculated PK11195 concentrations at 0.5, 1, 2, 3, 5, 15 and 30 min post-administration and individually measured whole blood levels (significance level range from p < 0.05 to p < 0.001; one-way ANOVA, Dunnet's post hoc test, p < 0.05). The HPLC method developed here uses sub-millilitre sample volumes to reproducibly assess PK/PD of PK11195 in rodent blood. This study highlights the importance of individually measured PK/PD drug concentrations when quantifying the TO from blocking/displacement rodent PET experiments.
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Affiliation(s)
- Agnė Stadulytė
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK; Edinburgh Preclinical Imaging (EPI), University of Edinburgh, UK.
| | - Carlos José Alcaide-Corral
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK; Edinburgh Preclinical Imaging (EPI), University of Edinburgh, UK
| | - Tashfeen Walton
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK; Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, UK
| | - Christophe Lucatelli
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, UK
| | - Adriana Alexandre S Tavares
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, UK; Edinburgh Preclinical Imaging (EPI), University of Edinburgh, UK
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Esumi S, Kitamura Y, Yokota-Kumasaki H, Ushio S, Yamada-Takemoto A, Nagai R, Ogawa A, Kawasaki Y, Sendo T. Effects of Magnesium Oxide on the Serum Duloxetine Concentration and Antidepressant-Like Effects of Duloxetine in Rats. Biol Pharm Bull 2019; 41:1727-1731. [PMID: 30381673 DOI: 10.1248/bpb.b18-00392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Duloxetine is a serotonin/noradrenaline reuptake inhibitor that is used as an antidepressant. However, it is known to cause constipation as a side effect. Magnesium compounds, such as magnesium oxide and magnesium hydroxide aqueous solution, are often combined with duloxetine to ameliorate the constipation caused by duloxetine. However, there is concern that these magnesium compounds might alter the effects of duloxetine via physicochemical interactions. In this study, we attempted to clarify the interactions that take place between duloxetine and magnesium oxide using in vivo and in vitro experiments. We evaluated the influence of magnesium oxide on in vitro duloxetine concentrations using HPLC. In addition, we examined the in vivo antidepressant-like effects and serum concentrations of duloxetine in rats. In the in vitro experiment, the duloxetine concentration was significantly decreased by co-treatment with magnesium oxide. In the in vivo experiment, the antidepressant-like effects of duloxetine were not affected by the combined oral administration of magnesium oxide and a duloxetine formulation although the serum duloxetine level was significantly decreased. However, the antidepressant-like effects of a duloxetine reagent were significantly attenuated by the co-administration of magnesium oxide. These results suggest that duloxetine and magnesium oxide directly interact and that such interactions affect the absorption and antidepressant-like effects of duloxetine.
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Affiliation(s)
- Satoru Esumi
- Department of Hospital Pharmacy, Okayama University Medical School
| | | | - Hitomi Yokota-Kumasaki
- Department of Hospital Pharmacy, Okayama University Medical School.,Department of Pharmacy, Osaka General Medical Center
| | - Soichiro Ushio
- Department of Hospital Pharmacy, Okayama University Medical School
| | | | - Ryo Nagai
- Department of Hospital Pharmacy, Okayama University Medical School
| | - Atsushi Ogawa
- Department of Hospital Pharmacy, Okayama University Medical School
| | - Yoichi Kawasaki
- Department of Hospital Pharmacy, Okayama University Medical School
| | - Toshiaki Sendo
- Department of Hospital Pharmacy, Okayama University Medical School
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Xu Y, Li Z. Imaging metabotropic glutamate receptor system: Application of positron emission tomography technology in drug development. Med Res Rev 2019; 39:1892-1922. [DOI: 10.1002/med.21566] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 01/18/2019] [Accepted: 01/24/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Youwen Xu
- Independent Consultant and Contractor, Radiopharmaceutical Development, Validation and Bio-Application; Philadelphia Pennsylvania
| | - Zizhong Li
- Pharmaceutical Research and Development, SOFIE Biosciences; Somerset New Jersey
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13
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Quantitative PET Imaging in Drug Development: Estimation of Target Occupancy. Bull Math Biol 2017; 81:3508-3541. [PMID: 29230702 DOI: 10.1007/s11538-017-0374-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/27/2017] [Indexed: 01/13/2023]
Abstract
Positron emission tomography, an imaging tool using radiolabeled tracers in humans and preclinical species, has been widely used in recent years in drug development, particularly in the central nervous system. One important goal of PET in drug development is assessing the occupancy of various molecular targets (e.g., receptors, transporters, enzymes) by exogenous drugs. The current linear mathematical approaches used to determine occupancy using PET imaging experiments are presented. These algorithms use results from multiple regions with different target content in two scans, a baseline (pre-drug) scan and a post-drug scan. New mathematical estimation approaches to determine target occupancy, using maximum likelihood, are presented. A major challenge in these methods is the proper definition of the covariance matrix of the regional binding measures, accounting for different variance of the individual regional measures and their nonzero covariance, factors that have been ignored by conventional methods. The novel methods are compared to standard methods using simulation and real human occupancy data. The simulation data showed the expected reduction in variance and bias using the proper maximum likelihood methods, when the assumptions of the estimation method matched those in simulation. Between-method differences for data from human occupancy studies were less obvious, in part due to small dataset sizes. These maximum likelihood methods form the basis for development of improved PET covariance models, in order to minimize bias and variance in PET occupancy studies.
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Boscutti G, Huiban M, Passchier J. Use of carbon-11 labelled tool compounds in support of drug development. DRUG DISCOVERY TODAY. TECHNOLOGIES 2017; 25:3-10. [PMID: 29233265 DOI: 10.1016/j.ddtec.2017.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 06/07/2023]
Abstract
The pharmaceutical industry is facing key challenges to improve return on R&D investment. Positron emission tomography (PET), by itself or in combination with complementary technologies such as magnetic resonance imaging (MRI), provides a unique opportunity to confirm a candidate's ability to meet the so-called 'three pillars' of drug development. Positive confirmation provides confidence for go/no-go decision making at an early stage of the development process and enables informed clinical progression. Whereas fluorine-18 has probably gained wider use in the community, there are benefits to using carbon-11 given the greater flexibility the use of this isotope permits in adaptive clinical study design. This review explores the scope of available carbon-11 chemistries and provides clinical examples to highlight its value in PET studies in support of drug development.
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Affiliation(s)
- Giulia Boscutti
- Imanova Ltd., Burlington Danes Building, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Mickael Huiban
- Imanova Ltd., Burlington Danes Building, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Jan Passchier
- Imanova Ltd., Burlington Danes Building, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
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Moriguchi S, Takano H, Kimura Y, Nagashima T, Takahata K, Kubota M, Kitamura S, Ishii T, Ichise M, Zhang MR, Shimada H, Mimura M, Meyer JH, Higuchi M, Suhara T. Occupancy of Norepinephrine Transporter by Duloxetine in Human Brains Measured by Positron Emission Tomography with (S,S)-[18F]FMeNER-D2. Int J Neuropsychopharmacol 2017; 20:957-962. [PMID: 29016875 PMCID: PMC5716070 DOI: 10.1093/ijnp/pyx069] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/28/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The norepinephrine transporter in the brain has been targeted in the treatment of psychiatric disorders. Duloxetine is a serotonin and norepinephrine reuptake inhibitor that has been widely used for the treatment of depression. However, the relationship between dose and plasma concentration of duloxetine and norepinephrine transporter occupancy in the human brain has not been determined. In this study, we examined norepinephrine transporter occupancy by different doses of duloxetine. METHODS We calculated norepinephrine transporter occupancies from 2 positron emission tomography scans using (S,S)-[18F]FMeNER-D2 before and after a single oral dose of duloxetine (20 mg, n = 3; 40 mg, n = 3; 60 mg, n =2). Positron emission tomography scans were performed from 120 to 180 minutes after an i.v. bolus injection of (S,S)-[18F]FMeNER-D2. Venous blood samples were taken to measure the plasma concentration of duloxetine just before and after the second positron emission tomography scan. RESULTS Norepinephrine transporter occupancy by duloxetine was 29.7% at 20 mg, 30.5% at 40 mg, and 40.0% at 60 mg. The estimated dose of duloxetine inducing 50% norepinephrine transporter occupancy was 76.8 mg, and the estimated plasma drug concentration inducing 50% norepinephrine transporter occupancy was 58.0 ng/mL. CONCLUSIONS Norepinephrine transporter occupancy by clinical doses of duloxetine was approximately 30% to 40% in human brain as estimated using positron emission tomography with (S,S)-[18F]FMeNER-D2.
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Affiliation(s)
- Sho Moriguchi
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura),Correspondence: Sho Moriguchi, MD, PhD, Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, Chiba 263-8555, Japan ()
| | - Harumasa Takano
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Yasuyuki Kimura
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Tomohisa Nagashima
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Keisuke Takahata
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Manabu Kubota
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Soichiro Kitamura
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Tatsuya Ishii
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Masanori Ichise
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Ming-Rong Zhang
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Hitoshi Shimada
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Masaru Mimura
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Jeffrey H Meyer
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Makoto Higuchi
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
| | - Tetsuya Suhara
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan (Drs Moriguchi, Takano, Kimura, Nagashima, Takahata, Kubota, Kitamura, Ishii, Ichise, Zhang, Shimada, Higuchi, and Suhara); Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Drs Moriguchi, Takahata, and Mimura); Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada (Drs Moriguchi and Meyer); Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Takano); Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan (Dr Kimura)
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Abstract
The discovery and development of central nervous system (CNS) drugs is an extremely challenging process requiring large resources, timelines, and associated costs. The high risk of failure leads to high levels of risk. Over the past couple of decades PET imaging has become a central component of the CNS drug-development process, enabling decision-making in phase I studies, where early discharge of risk provides increased confidence to progress a candidate to more costly later phase testing at the right dose level or alternatively to kill a compound through failure to meet key criteria. The so called "3 pillars" of drug survival, namely; tissue exposure, target engagement, and pharmacologic activity, are particularly well suited for evaluation by PET imaging. This review introduces the process of CNS drug development before considering how PET imaging of the "3 pillars" has advanced to provide valuable tools for decision-making on the critical path of CNS drug development. Finally, we review the advances in PET science of biomarker development and analysis that enable sophisticated drug-development studies in man.
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Affiliation(s)
- Roger N Gunn
- Imanova Ltd, London, United Kingdom; Division of Brain Sciences, Imperial College London, London, United Kingdom; Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom.
| | - Eugenii A Rabiner
- Imanova Ltd, London, United Kingdom; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
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17
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Arakawa R, Tateno A, Kim W, Sakayori T, Ogawa K, Okubo Y. Time-course of serotonin transporter occupancy by single dose of three SSRIs in human brain: A positron emission tomography study with [(11)C]DASB. Psychiatry Res Neuroimaging 2016; 251:1-6. [PMID: 27082864 DOI: 10.1016/j.pscychresns.2016.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 02/15/2016] [Accepted: 03/23/2016] [Indexed: 11/18/2022]
Abstract
Sixteen healthy volunteers were enrolled and divided into four groups according to the single administration of 10mg or 20mg escitalopram, 50mg sertraline, or 20mg paroxetine. Four positron emission tomography scans with [(11)C]DASB were performed on each subject, the first prior to taking the drug, followed by the others at 4, 24, and 48h after. Serotonin transporter occupancies of the drugs at each time point were calculated. All drugs showed maximum occupancy at 4h after dosing and then decreasing occupancies with time. Escitalopram and sertraline showed high occupancies of 69.1-77.9% at 4h, remaining at 52.8-57.8% after 48h. On the other hand, paroxetine showed relatively low occupancy of 44.6%, then decreasing to 10.3% at 48h. Escitalopram (both 10mg and 20mg) and sertraline (50mg) showed high and sustained occupancy. Paroxetine (20mg) showed relatively low and rapidly decreasing occupancy, possibly due to the low plasma concentration by single dosing schedule. Applying the reported concentration of multiple dosing, 20mg paroxetine will induce over 80% occupancy. The present study suggested that these drugs and doses would be sufficient for the treatment of depression.
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Affiliation(s)
- Ryosuke Arakawa
- Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
| | - Amane Tateno
- Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
| | - WooChan Kim
- Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
| | - Takeshi Sakayori
- Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
| | - Kohei Ogawa
- Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
| | - Yoshiro Okubo
- Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan.
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18
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Naganawa M, Dickinson GL, Zheng MQ, Henry S, Vandenhende F, Witcher J, Bell R, Nabulsi N, Lin SF, Ropchan J, Neumeister A, Ranganathan M, Tauscher J, Huang Y, Carson RE. Receptor Occupancy of the κ-Opioid Antagonist LY2456302 Measured with Positron Emission Tomography and the Novel Radiotracer 11C-LY2795050. J Pharmacol Exp Ther 2015; 356:260-6. [PMID: 26628406 DOI: 10.1124/jpet.115.229278] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 11/30/2015] [Indexed: 11/22/2022] Open
Abstract
The κ-opioid receptor (KOR) is thought to play an important therapeutic role in a wide range of neuropsychiatric and substance abuse disorders, including alcohol dependence. LY2456302 is a recently developed KOR antagonist with high affinity and selectivity and showed efficacy in the suppression of ethanol consumption in rats. This study investigated brain penetration and KOR target engagement after single oral doses (0.5-25 mg) of LY2456302 in 13 healthy human subjects. Three positron emission tomography scans with the KOR antagonist radiotracer (11)C-LY2795050 were conducted at baseline, 2.5 hours postdose, and 24 hours postdose. LY2456302 was well tolerated in all subjects without serious adverse events. Distribution volume was estimated using the multilinear analysis 1 method for each scan. Receptor occupancy (RO) was derived from a graphical occupancy plot and related to LY2456302 plasma concentration to determine maximum occupancy (rmax) and IC50. LY2456302 dose dependently blocked the binding of (11)C-LY2795050 and nearly saturated the receptors at 10 mg, 2.5 hours postdose. Thus, a dose of 10 mg of LY2456302 appears well suited for further clinical testing. Based on the pharmacokinetic (PK)-RO model, the rmax and IC50 of LY2456302 were estimated as 93% and 0.58 ng/ml to 0.65 ng/ml, respectively. Assuming that rmax is 100%, IC50 was estimated as 0.83 ng/ml.
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Affiliation(s)
- Mika Naganawa
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Gemma L Dickinson
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Ming-Qiang Zheng
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Shannan Henry
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Francois Vandenhende
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Jennifer Witcher
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Robert Bell
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Nabeel Nabulsi
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Shu-Fei Lin
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Jim Ropchan
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Alexander Neumeister
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Mohini Ranganathan
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Johannes Tauscher
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Yiyun Huang
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
| | - Richard E Carson
- PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut (M.N., M.Z., S.H., N.N., S.L., J.R., Y.H., R.C.); Eli Lilly and Company, Indianapolis, Indiana (G.D., J.W., R.B., J.T.); ClinBAY, Belgium (F.V.); and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (A.N., M.R.)
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Gunn RN, Slifstein M, Searle GE, Price JC. Quantitative imaging of protein targets in the human brain with PET. Phys Med Biol 2015; 60:R363-411. [DOI: 10.1088/0031-9155/60/22/r363] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Smith JAM, Patil DL, Daniels OT, Ding YS, Gallezot JD, Henry S, Kim KHS, Kshirsagar S, Martin WJ, Obedencio GP, Stangeland E, Tsuruda PR, Williams W, Carson RE, Patil ST, Patil ST. Preclinical to clinical translation of CNS transporter occupancy of TD-9855, a novel norepinephrine and serotonin reuptake inhibitor. Int J Neuropsychopharmacol 2015; 18:pyu027. [PMID: 25522383 PMCID: PMC4368888 DOI: 10.1093/ijnp/pyu027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Monoamine reuptake inhibitors exhibit unique clinical profiles that reflect distinct engagement of the central nervous system (CNS) transporters. METHODS We used a translational strategy, including rodent pharmacokinetic/pharmacodynamic modeling and positron emission tomography (PET) imaging in humans, to establish the transporter profile of TD-9855, a novel norepinephrine and serotonin reuptake inhibitor. RESULTS TD-9855 was a potent inhibitor of norepinephrine (NE) and serotonin 5-HT uptake in vitro with an inhibitory selectivity of 4- to 10-fold for NE at human and rat transporters. TD-9855 engaged norepinephrine transporters (NET) and serotonin transporters (SERT) in rat spinal cord, with a plasma EC50 of 11.7 ng/mL and 50.8 ng/mL, respectively, consistent with modest selectivity for NET in vivo. Accounting for species differences in protein binding, the projected human NET and SERT plasma EC50 values were 5.5 ng/mL and 23.9 ng/mL, respectively. A single-dose, open-label PET study (4-20mg TD-9855, oral) was conducted in eight healthy males using the radiotracers [(11)C]-3-amino-4- [2-[(di(methyl)amino)methyl]phenyl]sulfanylbenzonitrile for SERT and [(11)C]-(S,S)-methylreboxetine for NET. The long pharmacokinetic half-life (30-40 h) of TD-9855 allowed for sequential assessment of SERT and NET occupancy in the same subject. The plasma EC50 for NET was estimated to be 1.21 ng/mL, and at doses of greater than 4 mg the projected steady-state NET occupancy is high (>75%). After a single oral dose of 20mg, SERT occupancy was 25 (±8)% at a plasma level of 6.35 ng/mL. CONCLUSIONS These data establish the CNS penetration and transporter profile of TD-9855 and inform the selection of potential doses for future clinical evaluation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S T Patil
- Theravance Biopharma US, Inc., San Francisco, CA (Drs Smith, Bourdet, Daniels, Kim, Kshirsagar, Martin, Obedencio, Stangeland, Tsururda, Williams, and Patil); Yale School of Medicine, New Haven, CT (Drs Ding, Gallezot, Henry, Williams, and Carson)
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Ridler K, Cunningham V, Huiban M, Martarello L, Pampols-Maso S, Passchier J, Gunn RN, Searle G, Abi-Dargham A, Slifstein M, Watson J, Laruelle M, Rabiner EA. An evaluation of the brain distribution of [(11)C]GSK1034702, a muscarinic-1 (M 1) positive allosteric modulator in the living human brain using positron emission tomography. EJNMMI Res 2014; 4:66. [PMID: 26116126 PMCID: PMC4452589 DOI: 10.1186/s13550-014-0066-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 11/11/2014] [Indexed: 12/21/2022] Open
Abstract
Background The ability to quantify the capacity of a central nervous system (CNS) drug to cross the human blood-brain barrier (BBB) provides valuable information for de-risking drug development of new molecules. Here, we present a study, where a suitable positron emission tomography (PET) ligand was not available for the evaluation of a potent muscarinic acetylcholine receptor type-1 (M1) allosteric agonist (GSK1034702) in the primate and human brain. Hence, direct radiolabelling of the novel molecule was performed and PET measurements were obtained and combined with in vitro equilibrium dialysis assays to enable assessment of BBB transport and estimation of the free brain concentration of GSK1034702 in vivo. Methods GSK1034702 was radiolabelled with 11C, and the brain distribution of [11C]GSK1034702 was investigated in two anaesthetised baboons and four healthy male humans. In humans, PET scans were performed (following intravenous injection of [11C]GSK1034702) at baseline and after a single oral 5-mg dose of GSK1034702. The in vitro brain and plasma protein binding of GSK1034702 was determined across a range of species using equilibrium dialysis. Results The distribution of [11C]GSK1034702 in the primate brain was homogenous and the whole brain partition coefficient (VT) was 3.97. In contrast, there was mild regional heterogeneity for GSK1034702 in the human brain. Human whole brain VT estimates (4.9) were in broad agreement with primate VT and the fP/fND ratio (3.97 and 2.63, respectively), consistent with transport by passive diffusion across the BBB. Conclusion In primate and human PET studies designed to evaluate the transport of a novel M1 allosteric agonist (GSK1034702) across the BBB, we have demonstrated good brain uptake and BBB passage consistent with passive diffusion or active influx. These studies discharged some of the perceived development risks for GSK1034702 and provided information to progress the molecule into the next stage of clinical development. Trial registration Clinical trial details: ‘Brain Uptake of GSK1034702: a Positron Emission Tomography (PET) Scan Study.’; clinicaltrial.gov identifier: NCT00937846. Electronic supplementary material The online version of this article (doi:10.1186/s13550-014-0066-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Khanum Ridler
- Clinical Imaging Centre, GlaxoSmithKline, Burlington Danes Building, Hammersmith Hospital, Du Cane Road, London, UK,
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Naganawa M, Jacobsen LK, Zheng MQ, Lin SF, Banerjee A, Byon W, Weinzimmer D, Tomasi G, Nabulsi N, Grimwood S, Badura LL, Carson RE, McCarthy TJ, Huang Y. Evaluation of the agonist PET radioligand [¹¹C]GR103545 to image kappa opioid receptor in humans: kinetic model selection, test-retest reproducibility and receptor occupancy by the antagonist PF-04455242. Neuroimage 2014; 99:69-79. [PMID: 24844744 DOI: 10.1016/j.neuroimage.2014.05.033] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/06/2014] [Accepted: 05/13/2014] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Kappa opioid receptors (KOR) are implicated in several brain disorders. In this report, a first-in-human positron emission tomography (PET) study was conducted with the potent and selective KOR agonist tracer, [(11)C]GR103545, to determine an appropriate kinetic model for analysis of PET imaging data and assess the test-retest reproducibility of model-derived binding parameters. The non-displaceable distribution volume (V(ND)) was estimated from a blocking study with naltrexone. In addition, KOR occupancy of PF-04455242, a selective KOR antagonist that is active in preclinical models of depression, was also investigated. METHODS For determination of a kinetic model and evaluation of test-retest reproducibility, 11 subjects were scanned twice with [(11)C]GR103545. Seven subjects were scanned before and 75 min after oral administration of naltrexone (150 mg). For the KOR occupancy study, six subjects were scanned at baseline and 1.5 h and 8 h after an oral dose of PF-04455242 (15 mg, n=1 and 30 mg, n=5). Metabolite-corrected arterial input functions were measured and all scans were 150 min in duration. Regional time-activity curves (TACs) were analyzed with 1- and 2-tissue compartment models (1TC and 2TC) and the multilinear analysis (MA1) method to derive regional volume of distribution (V(T)). Relative test-retest variability (TRV), absolute test-retest variability (aTRV) and intra-class coefficient (ICC) were calculated to assess test-retest reproducibility of regional VT. Occupancy plots were computed for blocking studies to estimate occupancy and V(ND). The half maximal inhibitory concentration (IC50) of PF-04455242 was determined from occupancies and drug concentrations in plasma. [(11)C]GR103545 in vivo K(D) was also estimated. RESULTS Regional TACs were well described by the 2TC model and MA1. However, 2TC VT was sometimes estimated with high standard error. Thus MA1 was the model of choice. Test-retest variability was ~15%, depending on the outcome measure. The blocking studies with naltrexone and PF-04455242 showed that V(T) was reduced in all regions; thus no suitable reference region is available for the radiotracer. V(ND) was estimated reliably from the occupancy plot of naltrexone blocking (V(ND)=3.4±0.9 mL/cm(3)). The IC50 of PF-04455242 was calculated as 55 ng/mL. [(11)C]GR103545 in vivo K(D) value was estimated as 0.069 nmol/L. CONCLUSIONS [(11)C]GR103545 PET can be used to image and quantify KOR in humans, although it has slow kinetics and variability of model-derived kinetic parameters is higher than desirable. This tracer should be suitable for use in receptor occupancy studies, particularly those that target high occupancy.
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Affiliation(s)
- Mika Naganawa
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA.
| | | | - Ming-Qiang Zheng
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - Shu-Fei Lin
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | | | | | - David Weinzimmer
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - Giampaolo Tomasi
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - Nabeel Nabulsi
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | | | | | - Richard E Carson
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | | | - Yiyun Huang
- PET Center, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
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Ridler K, Gunn RN, Searle GE, Barletta J, Passchier J, Dixson L, Hallett WA, Ashworth S, Gray FA, Burgess C, Poggesi I, Bullman JN, Ratti E, Laruelle MA, Rabiner EA. Characterising the plasma-target occupancy relationship of the neurokinin antagonist GSK1144814 with PET. J Psychopharmacol 2014; 28:244-53. [PMID: 24429221 DOI: 10.1177/0269881113517953] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
GSK1144814 is a potent, insurmountable antagonist at human NK₁ and NK₃ receptors. Understanding the relationship between plasma pharmacokinetics and receptor occupancy in the human brain, was crucial for dose selection in future clinical studies. GSK1144814 occupancy data were acquired in parallel with the first-time-in-human safety and tolerability study. [¹¹C]GR-205171 a selective NK₁ receptor PET ligand was used to estimate NK₁ occupancy at several time-points following single dose administration of GSK1144814. The time-plasma concentration-occupancy relationship post-single dose administration was assessed, and used to predict the plasma concentration-occupancy relationship following repeat dose administration. Repeat dose predictions were tested in a subsequent cohort of subjects examined following approximately 7 and 14 days dosing with GSK1144814. GSK1144814 was shown to demonstrate a dose-dependent occupancy of the NK₁ receptor with an estimated in vivo EC₅₀~0.9 ng/mL in the human brain. A direct relationship was seen between the GSK1144814 plasma concentration and its occupancy of the brain NK₁ receptor, indicating that in future clinical trials the occupancy of brain receptors can be accurately inferred from the measured plasma concentration. Our data provided support for the further progression of this compound and have optimised the likely therapeutic dose range.
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Park JS, Lee J, Meyer J, Ilankumaran P, Han S, Yim DS. Serotonin transporter occupancy of SKL10406 in humans: comparison of pharmacokinetic-pharmacodynamic modeling methods for estimation of occupancy parameters. Transl Clin Pharmacol 2014. [DOI: 10.12793/tcp.2014.22.2.83] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | - Jongtae Lee
- Department of Pharmacology, PIPET (Pharmacometrics Institute for Practical Education and Training), College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | - Jeffrey Meyer
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Seunghoon Han
- Department of Pharmacology, PIPET (Pharmacometrics Institute for Practical Education and Training), College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | - Dong-Seok Yim
- Department of Pharmacology, PIPET (Pharmacometrics Institute for Practical Education and Training), College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
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Nakatani Y, Suzuki M, Tokunaga M, Maeda J, Sakai M, Ishihara H, Yoshinaga T, Takenaka O, Zhang MR, Suhara T, Higuchi M. A small-animal pharmacokinetic/pharmacodynamic PET study of central serotonin 1A receptor occupancy by a potential therapeutic agent for overactive bladder. PLoS One 2013; 8:e75040. [PMID: 24086433 PMCID: PMC3781034 DOI: 10.1371/journal.pone.0075040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 08/08/2013] [Indexed: 02/06/2023] Open
Abstract
Serotonin 1A (5-HT1A) receptors have been mechanistically implicated in micturition control, and there has been a need for an appropriate biomarker surrogating the potency of a provisional drug acting on this receptor system for developing a new therapeutic approach to overactive bladder (OAB). Here, we analyzed the occupancy of 5-HT1A receptors in living Sprague-Dawley rat brains by a novel candidate drug for OAB, E2110, using positron emission tomography (PET) imaging, and assessed the utility of a receptor occupancy (RO) assay to establish a pharmacodynamic index translatable between animals and humans. The plasma concentrations inducing 50% RO (EC50) estimated by both direct and effect compartment models were in good agreement. Dose-dependent therapeutic effects of E2110 on dysregulated micturition in different rat models of pollakiuria were also consistently explained by achievement of 5-HT1A RO by E2110 in a certain range (≥ 60%). Plasma drug concentrations inducing this RO range and EC50 would accordingly be objective indices in comparing pharmacokinetics-RO relationships between rats and humans. These findings support the utility of PET RO and plasma pharmacokinetic assays with the aid of adequate mathematical models in determining the in vivo characteristics of a drug acting on 5-HT1A receptors and thereby counteracting OAB.
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Affiliation(s)
- Yosuke Nakatani
- Tsukuba Research Laboratories, Eisai Co, Ltd., Tsukuba, Ibaraki, Japan ; Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Chiba, Japan ; Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
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Hargreaves RJ, Rabiner EA. Translational PET imaging research. Neurobiol Dis 2013; 61:32-8. [PMID: 24055214 DOI: 10.1016/j.nbd.2013.08.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 08/07/2013] [Accepted: 08/14/2013] [Indexed: 10/26/2022] Open
Abstract
The goal of any early central nervous system (CNS) drug development program is always to test the mechanism and not the molecule in order to support additional research investments in late phase clinical trials. Confirmation that drugs reach their targets using translational positron emission tomography (PET) imaging markers of engagement is central to successful clinical proof-of-concept testing and has become an important feature of most neuropsychiatric drug development programs. CNS PET imaging can also play an important role in the clinical investigation of the neuropharmacological basis of psychiatric disease and the optimization of drug therapy.
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Affiliation(s)
- Richard J Hargreaves
- Merck and Co, WP-42-212, 770, Sumneytown Pike, PO Box 4, West Point, PA19486, USA.
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Wong DF, Kuwabara H, Brašić JR, Stock T, Maini A, Gean EG, Loebel A. Determination of dopamine D₂ receptor occupancy by lurasidone using positron emission tomography in healthy male subjects. Psychopharmacology (Berl) 2013; 229:245-52. [PMID: 23649882 DOI: 10.1007/s00213-013-3103-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 03/29/2013] [Indexed: 01/16/2023]
Abstract
RATIONALE A positron emission tomography (PET) study of dopamine D₂ receptor occupancy was conducted to support a rational dose selection for clinical efficacy studies with lurasidone, an atypical antipsychotic that was approved for the treatment of schizophrenia by the FDA in late 2010. OBJECTIVES To determine the dopamine D₂ receptor occupancy of lurasidone in the ventral striatum, putamen and caudate nucleus, and to characterize the relationship between lurasidone serum concentration and D₂ receptor occupancy. METHODS A single oral dose of lurasidone (10, 20, 40, 60, or 80 mg) was administered sequentially to healthy male subjects (n = 4 in each cohort). Two PET scans were performed. For each scan, 20 mCi of [¹¹C]raclopride was administered intravenously as a bolus injection, followed immediately by 90 min of PET scan acquisitions. RESULTS The D₂ receptor occupancy levels were 41-43% for 10 mg, 51-55% for 20 mg, 63-67% for 40 mg, 77-84% for 60 mg, and 73-79% for 80 mg of lurasidone. The relationship between D₂ receptor occupancy and the mean serum lurasidone concentration during the PET scan (C PET) was similar for the putamen, caudate nucleus, and ventral striatum regions. Mean D₂ receptor occupancy levels correlated well with average peak serum concentration of lurasidone. CONCLUSIONS In healthy volunteers, single doses of lurasidone 40-80 mg resulted in D₂ receptor occupancy levels of >60%, a level of receptor occupancy previously associated with clinical response for atypical antipsychotics.
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Affiliation(s)
- Dean F Wong
- Department of Radiology, Johns Hopkins Medical Institutions (JHMI), 601 North Caroline Street, Room JHOC 3245, Baltimore, MD 21287-0807, USA.
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Berges A, Cunningham VJ, Gunn RN, Zamuner S. Non linear mixed effects analysis in PET PK-receptor occupancy studies. Neuroimage 2013; 76:155-66. [PMID: 23518008 DOI: 10.1016/j.neuroimage.2013.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 02/22/2013] [Accepted: 03/06/2013] [Indexed: 11/25/2022] Open
Abstract
The characterisation of a pharmacokinetic-receptor occupancy (PK-RO) relationship derived from a PET study is typically modelled in a conventional non-linear least squares (NLLS) framework. In the present work, we explore the application of a non-linear mixed effects approach (NLME) and compare this with NLLS estimation (using both naive pooled data and two-stage approaches) in the context of a direct PK-RO relationship described by an Emax model, using simulated data sets. Target and reference tissue time-activity curves were simulated using a two-tissue compartmental model and an arterial plasma input function for a typical PET study (12 subjects in 3 dose groups with 3 scans each). A range of different PET scenarios was considered to evaluate the impact of between-subject variability and reference region availability. The PET outcome measures derived from the simulations were then used to estimate the parameters of the PK-RO model. The performance of the two approaches was compared in terms of parameters estimates (square mean error SME, root mean square error RMSE) and prediction of the exposure-occupancy relationship. In general, both NLME and NLLS estimation methods provided unbiassed and precise population estimates for the Emax model parameters, although a slight bias was observed for the individual-NLLS method due to a few outliers. The increased value of NLME over NLLS was most notable in the estimation of the between-subject variability (BSV), especially in the case of a more complex PK-RO model when no reference region was available (maximum SME and RMSE values related to BSV of EC₅₀ of 27.6% and 86.5% from NLME versus 264.6% and 689.5% from NLLS). Overall, the NLME approach provided a more robust estimation and produced less-biassed estimates of the population means and variances than either the NLLS approach for the simulations considered.
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Affiliation(s)
- Alienor Berges
- GlaxoSmithKline, Clinical Pharmacology Modelling & Simulation, Stockley Park, UK.
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Melhem M. Translation of Central Nervous System Occupancy from Animal Models: Application of Pharmacokinetic/Pharmacodynamic Modeling. J Pharmacol Exp Ther 2013; 347:2-6. [DOI: 10.1124/jpet.112.199794] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Comley RA, Salinas CA, Slifstein M, Petrone M, Marzano C, Bennacef I, Shotbolt P, Van der Aart J, Neve M, Iavarone L, Gomeni R, Laruelle M, Gray FA, Gunn RN, Rabiner EA. Monoamine transporter occupancy of a novel triple reuptake inhibitor in baboons and humans using positron emission tomography. J Pharmacol Exp Ther 2013; 346:311-7. [PMID: 23685546 DOI: 10.1124/jpet.112.202895] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The selection of a therapeutically meaningful dose of a novel pharmaceutical is a crucial step in drug development. Positron emission tomography (PET) allows the in vivo estimation of the relationship between the plasma concentration of a drug and its target occupancy, optimizing dose selection and reducing the time and cost of early development. Triple reuptake inhibitors (TRIs), also referred to as serotonin-norepinephrine-dopamine reuptake inhibitors, enhance monoaminergic neurotransmission by blocking the action of the monoamine transporters, raising extracellular concentrations of those neurotransmitters. GSK1360707 [(1R,6S)-1-(3,4-dichlorophenyl)-6-(methoxymethyl)-4-azabicyclo[4.1.0]heptane] is a novel TRI that until recently was under development for the treatment of major depressive disorder; its development was put on hold for strategic reasons. We present the results of an in vivo assessment of the relationship between plasma exposure and transporter blockade (occupancy). Studies were performed in baboons (Papio anubis) to determine the relationship between plasma concentration and occupancy of brain serotonin reuptake transporter (SERT), dopamine reuptake transporter (DAT), and norepinephrine uptake transporter (NET) using the radioligands [(11)C]DASB [(N,N-dimethyl-2-(2-amino-4-cyanophenylthio) benzylamine], [(11)C]PE2I [N-(3-iodoprop-2E-enyl)-2β-carbomethoxy-3β-(4-methylphenyl)nortropane], and [(11)C]2-[(2-methoxyphenoxy)phenylmethyl]morpholine (also known as [(11)C]MRB) and in humans using [(11)C]DASB and [(11)C]PE2I. In P. anubis, plasma concentrations resulting in half-maximal occupancy at SERT, DAT, and NET were 15.16, 15.56, and 0.97 ng/ml, respectively. In humans, the corresponding values for SERT and DAT were 6.80 and 18.00 ng/ml. GSK1360707 dose-dependently blocked the signal of SERT-, DAT-, and NET-selective PET ligands, confirming its penetration across the blood-brain barrier and blockade of all three monoamine transporters in vivo.
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Affiliation(s)
- Robert A Comley
- Clinical Imaging Centre, GlaxoSmithKline, London, United Kingdom
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Salinas C, Weinzimmer D, Searle G, Labaree D, Ropchan J, Huang Y, Rabiner EA, Carson RE, Gunn RN. Kinetic analysis of drug-target interactions with PET for characterization of pharmacological hysteresis. J Cereb Blood Flow Metab 2013; 33:700-7. [PMID: 23385202 PMCID: PMC3652698 DOI: 10.1038/jcbfm.2012.208] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In vivo characterization of the brain pharmacokinetics of novel compounds provides important information for drug development decisions involving dose selection and the determination of administration regimes. In this context, the compound-target affinity is the key parameter to be estimated. However, if compounds exhibit a dynamic lag between plasma and target bound concentrations leading to pharmacological hysteresis, care needs to be taken to ensure the appropriate modeling approach is used so that the system is characterized correctly and that the resultant estimates of affinity are correct. This work focuses on characterizing different pharmacokinetic models that relate the plasma concentration to positron emission tomography outcomes measurements (e.g., volume of distribution and target occupancy) and their performance in estimating the true in vivo affinity. Measured (histamine H3 receptor antagonist--GSK189254) and simulated data sets enabled the investigation of different modeling approaches. An indirect pharmacokinetic-receptor occupancy model was identified as a suitable model for the calculation of affinity when a compound exhibits pharmacological hysteresis.
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Affiliation(s)
- Cristian Salinas
- GlaxoSmithKline, Clinical Imaging Centre, Hammersmith Hospital, London, UK
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Schmidt ME, de Boer P, Andrews R, Neyens M, Rossenu S, William Falteos D, Mannaert E. D₂-receptor occupancy measurement of JNJ-37822681, a novel fast off-rate D₂-receptor antagonist, in healthy subjects using positron emission tomography: single dose versus steady state and dose selection. Psychopharmacology (Berl) 2012; 224:549-57. [PMID: 22773165 DOI: 10.1007/s00213-012-2782-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 06/14/2012] [Indexed: 10/28/2022]
Abstract
RATIONALE JNJ-37822681 is a highly selective, fast dissociating dopamine D₂-receptor antagonist being developed for the treatment of schizophrenia. A single dose [¹¹C]raclopride positron emission tomography (PET) imaging study had yielded an estimated clinical dose range. Receptor occupancy at steady state was explored to test the validity of the single-dose estimates during chronic treatment. OBJECTIVES The aims of this study are to characterize single and multiple dose pharmacokinetics and obtain striatal D₂-receptor occupancies to predict doses for efficacy studies and assess the safety and tolerability of JNJ-37822681. METHODS An open-label single- and multiple-dose study with 10 mg JNJ-37822681 (twice daily for 13 doses) was performed in 12 healthy men. Twenty [¹¹C]raclopride PET scans (up to 60 h after the last dose) from 11 subjects were used to estimate D₂-receptor occupancy. A direct effect O (max) model was applied to explore the relationship between JNJ-37822681 plasma concentration and striatal D₂-receptor occupancy. RESULTS Steady state was reached after 4-5 days of twice daily dosing. JNJ-37822681 plasma concentrations of 3.17 to 63.0 ng/mL resulted in D₂ occupancies of 0 % to 62 %. The concentration leading to 50 % occupancy was 18.5 ng/mL (coefficient of variation 3.9 %) after single dose and 26.0 ng/mL (8.2 %) at steady state. JNJ-37822681 was well tolerated. CONCLUSIONS Receptor occupancy after single dose and at steady state differed for JNJ-37822681 and the robustness of the estimates at steady state will be tested in phase 2 studies. Dose predictions indicated that 10, 20, and 30 mg JNJ-37822681 twice daily could be suitable for these studies.
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Affiliation(s)
- Mark E Schmidt
- Experimental Medicine, Janssen Research and Development, Janssen Pharmaceutica NV, Beerse, Belgium
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Müllauer J, Kuntner C, Bauer M, Bankstahl JP, Müller M, Voskuyl RA, Langer O, Syvänen S. Pharmacokinetic modeling of P-glycoprotein function at the rat and human blood-brain barriers studied with (R)-[11C]verapamil positron emission tomography. EJNMMI Res 2012; 2:58. [PMID: 23072492 PMCID: PMC3520775 DOI: 10.1186/2191-219x-2-58] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 09/26/2012] [Indexed: 12/11/2022] Open
Abstract
Background This study investigated the influence of P-glycoprotein (P-gp) inhibitor tariquidar on the pharmacokinetics of P-gp substrate radiotracer (R)-[11C]verapamil in plasma and brain of rats and humans by means of positron emission tomography (PET). Methods Data obtained from a preclinical and clinical study, in which paired (R)-[11C]verapamil PET scans were performed before, during, and after tariquidar administration, were analyzed using nonlinear mixed effects (NLME) modeling. Administration of tariquidar was included as a covariate on the influx and efflux parameters (Qin and Qout) in order to investigate if tariquidar increased influx or decreased outflux of radiotracer across the blood–brain barrier (BBB). Additionally, the influence of pilocarpine-induced status epilepticus (SE) was tested on all model parameters, and the brain-to-plasma partition coefficient (VT-NLME) was calculated. Results Our model indicated that tariquidar enhances brain uptake of (R)-[11C]verapamil by decreasing Qout. The reduction in Qout in rats during and immediately after tariquidar administration (sevenfold) was more pronounced than in the second PET scan acquired 2 h after tariquidar administration (fivefold). The effect of tariquidar on Qout in humans was apparent during and immediately after tariquidar administration (twofold reduction in Qout) but was negligible in the second PET scan. SE was found to influence the pharmacological volume of distribution of the central brain compartment Vbr1. Tariquidar treatment lead to an increase in VT-NLME, and pilocarpine-induced SE lead to increased (R)-[11C]verapamil distribution to the peripheral brain compartment. Conclusions Using NLME modeling, we were able to provide mechanistic insight into the effects of tariquidar and SE on (R)-[11C]verapamil transport across the BBB in control and 48 h post SE rats as well as in humans.
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Affiliation(s)
- Julia Müllauer
- Division of Pharmacology, Leiden University, Einsteinweg 55, Leiden, 2333 CC, The Netherlands.
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Martini C, Olofsen E, Yassen A, Aarts L, Dahan A. Pharmacokinetic-pharmacodynamic modeling in acute and chronic pain: an overview of the recent literature. Expert Rev Clin Pharmacol 2012; 4:719-28. [PMID: 22111858 DOI: 10.1586/ecp.11.59] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In acute and chronic pain, the objective of pharmacokinetic-pharmacodynamic (PKPD) modeling is the development and application of mathematical models to describe and/or predict the time course of the pharmacokinetics (PK) and pharmacodynamics (PD) of analgesic agents and link PK to PD. Performing population PKPD modeling using nonlinear mixed effects modeling allows, apart from the estimation of fixed effects (the PK and PD model estimates), the quantification of random effects as within- and between-subject variability. Effect-compartment models and mechanism-based biophase distribution models that incorporate drug-association and -dissociation kinetics are applied in PKPD modeling of pain treatment. Mechanism-based models enable the quantification of the rate-limiting factors in drug effect owing to drug distribution versus receptor kinetics (since receptor kinetics are nonlinear they are discernable from the linear effect-compartment kinetics). It is a helpful technique in understanding the complex behavior of specific analgesics, such as buprenorphine, but also morphine and its active metabolite morphine-6-glucuronide, especially with respect to the reversal of opioid-induced side effects, most importantly life-threatening respiratory depression. One approach in chronic pain studies is the application of mixture models. Mixture models do not necessarily need to take PK data into account and allow the objective differentiation of measured responses to analgesics into specific response subgroups, and as such, may play an important role in analyzing Phase I and II analgesia studies. Appropriate application of PKPD modeling leads to the improvement of current therapeutics with respect to dose design and outcome, understanding the interaction of analgesics within complex chronic pain disease processes and may play an important role in drug development. In the current article, novel observations using the aforementioned techniques on opioids, NSAIDs, epidural analgesia, ketamine and GABA-ergic drugs in acute and chronic pain are discussed.
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Affiliation(s)
- Christian Martini
- Department of Anesthesiology, Leiden University Medical Center, 2330 RC Leiden, The Netherlands
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Non-linear mixed effects modelling of positron emission tomography data for simultaneous estimation of radioligand kinetics and occupancy in healthy volunteers. Neuroimage 2012; 61:849-56. [DOI: 10.1016/j.neuroimage.2012.02.085] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 01/12/2012] [Accepted: 02/26/2012] [Indexed: 11/16/2022] Open
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Abstract
The early developments of brain positron emission tomography (PET), including the methodological advances that have driven progress, are outlined. The considerable past achievements of brain PET have been summarized in collaboration with contributing experts in specific clinical applications including cerebrovascular disease, movement disorders, dementia, epilepsy, schizophrenia, addiction, depression and anxiety, brain tumors, drug development, and the normal healthy brain. Despite a history of improving methodology and considerable achievements, brain PET research activity is not growing and appears to have diminished. Assessments of the reasons for decline are presented and strategies proposed for reinvigorating brain PET research. Central to this is widening the access to advanced PET procedures through the introduction of lower cost cyclotron and radiochemistry technologies. The support and expertize of the existing major PET centers, and the recruitment of new biologists, bio-mathematicians and chemists to the field would be important for such a revival. New future applications need to be identified, the scope of targets imaged broadened, and the developed expertize exploited in other areas of medical research. Such reinvigoration of the field would enable PET to continue making significant contributions to advance the understanding of the normal and diseased brain and support the development of advanced treatments.
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Affiliation(s)
- Terry Jones
- PET Research Advisory Company, 8 Prestbury Road, Wilmslow, Cheshire SK9 2LJ, UK.
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Matthews PM, Rabiner EA, Passchier J, Gunn RN. Positron emission tomography molecular imaging for drug development. Br J Clin Pharmacol 2012; 73:175-86. [PMID: 21838787 DOI: 10.1111/j.1365-2125.2011.04085.x] [Citation(s) in RCA: 231] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Human in vivo molecular imaging with positron emission tomography (PET) enables a new kind of 'precision pharmacology', able to address questions central to drug development. Biodistribution studies with drug molecules carrying positron-emitting radioisotopes can test whether a new chemical entity reaches a target tissue compartment (such as the brain) in sufficient amounts to be pharmacologically active. Competition studies, using a radioligand that binds to the target of therapeutic interest with adequate specificity, enable direct assessment of the relationship between drug plasma concentration and target occupancy. Tailored radiotracers can be used to measure relative rates of biological processes, while radioligands specific for tissue markers expected to change with treatment can provide specific pharmacodynamic information. Integrated application of PET and magnetic resonance imaging (MRI) methods allows molecular interactions to be related directly to anatomical or physiological changes in a tissue. Applications of imaging in early drug development can suggest approaches to patient stratification for a personalized medicine able to deliver higher value from a drug after approval. Although imaging experimental medicine adds complexity to early drug development and costs per patient are high, appropriate use can increase returns on R and D investment by improving early decision making to reduce new drug attrition in later stages. We urge that the potential value of a translational molecular imaging strategy be considered routinely and at the earliest stages of new drug development.
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Affiliation(s)
- Paul M Matthews
- GSK Clinical Imaging Centre, GlaxoSmithKline Research and Development Ltd, Hammersmith Hospital, London, UK.
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Predicting brain occupancy from plasma levels using PET: superiority of combining pharmacokinetics with pharmacodynamics while modeling the relationship. J Cereb Blood Flow Metab 2012; 32:759-68. [PMID: 22186667 PMCID: PMC3318151 DOI: 10.1038/jcbfm.2011.180] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Positron emission tomography (PET) studies of dopamine receptor occupancy can be used to assess dosing of antipsychotics. Typically, studies of antipsychotics have applied pharmacodynamic (PD) modeling alone to characterize the relationship between antipsychotic dose and its effect on the brain. However, a limitation of this approach is that it does not account for the discrepancy between the time courses of plasma concentration and receptor occupancy by antipsychotics. Combined pharmacokinetic-PD (PK-PD) modeling, by incorporating the time dependence of occupancy, is better suited for the reliable analysis of the concentration-occupancy relationship. To determine the effect of time on the concentration-occupancy relationship as a function of analysis approach, we measured dopamine receptor occupancy after the administration of aripiprazole using [(11)C]raclopride PET and obtained serial measurements of the plasma aripiprazole concentration in 18 volunteers. We then developed a PK-PD model for the relationship, and compared it with conventional approach (PD modeling alone). The hysteresis characteristics were observed in the competitor concentration-occupancy relationship and the value of EC(50) was different according to the analysis approach (EC(50) derived from PD modeling alone=11.1 ng/mL (95% confidence interval (CI)=10.1 to 12.1); while that derived from combined PK-PD modeling=8.63 ng/mL (95% CI=7.75 to 9.51)). This finding suggests that PK-PD modeling is required to obtain reliable prediction of brain occupancy by antipsychotics.
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Bourdet DL, Tsuruda PR, Obedencio GP, Smith JAM. Prediction of Human Serotonin and Norepinephrine Transporter Occupancy of Duloxetine by Pharmacokinetic/Pharmacodynamic Modeling in the Rat. J Pharmacol Exp Ther 2012; 341:137-45. [DOI: 10.1124/jpet.111.188417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Cole PE, Schwarz AJ, Schmidt ME. Applications of Imaging Biomarkers in the Early Clinical Development of Central Nervous System Therapeutic Agents. Clin Pharmacol Ther 2012; 91:315-20. [DOI: 10.1038/clpt.2011.286] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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A pharmacokinetic PET study of NK1 receptor occupancy. Eur J Nucl Med Mol Imaging 2011; 39:226-35. [DOI: 10.1007/s00259-011-1954-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 09/27/2011] [Indexed: 11/27/2022]
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Non-invasive imaging in experimental medicine for drug development. Curr Opin Pharmacol 2011; 11:501-7. [DOI: 10.1016/j.coph.2011.04.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 04/17/2011] [Indexed: 01/01/2023]
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Pharmacological differentiation of opioid receptor antagonists by molecular and functional imaging of target occupancy and food reward-related brain activation in humans. Mol Psychiatry 2011; 16:826-35, 785. [PMID: 21502953 PMCID: PMC3142667 DOI: 10.1038/mp.2011.29] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Opioid neurotransmission has a key role in mediating reward-related behaviours. Opioid receptor (OR) antagonists, such as naltrexone (NTX), can attenuate the behaviour-reinforcing effects of primary (food) and secondary rewards. GSK1521498 is a novel OR ligand, which behaves as an inverse agonist at the μ-OR sub-type. In a sample of healthy volunteers, we used [(11)C]-carfentanil positron emission tomography to measure the OR occupancy and functional magnetic resonance imaging (fMRI) to measure activation of brain reward centres by palatable food stimuli before and after single oral doses of GSK1521498 (range, 0.4-100 mg) or NTX (range, 2-50 mg). GSK1521498 had high affinity for human brain ORs (GSK1521498 effective concentration 50 = 7.10 ng ml(-1)) and there was a direct relationship between receptor occupancy (RO) and plasma concentrations of GSK1521498. However, for both NTX and its principal active metabolite in humans, 6-β-NTX, this relationship was indirect. GSK1521498, but not NTX, significantly attenuated the fMRI activation of the amygdala by a palatable food stimulus. We thus have shown how the pharmacological properties of OR antagonists can be characterised directly in humans by a novel integration of molecular and functional neuroimaging techniques. GSK1521498 was differentiated from NTX in terms of its pharmacokinetics, target affinity, plasma concentration-RO relationships and pharmacodynamic effects on food reward processing in the brain. Pharmacological differentiation of these molecules suggests that they may have different therapeutic profiles for treatment of overeating and other disorders of compulsive consumption.
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Gunn RN, Guo Q, Salinas CA, Tziortzi AC, Searle GE. Advances in biomathematical modeling for PET neuroreceptor imaging. DRUG DISCOVERY TODAY. TECHNOLOGIES 2011; 8:e45-e51. [PMID: 24990262 DOI: 10.1016/j.ddtec.2012.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The quantitative application of PET neuroreceptor imaging to study pathophysiology, diagnostics and drug development has continued to benefit from associated advances in biomathematical imaging methodology. We review some of these advances with particular focus on multi-modal image processing, tracer kinetic modeling, occupancy studies and discovery and development of novel radioligands.:
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Affiliation(s)
- Roger N Gunn
- Department of Medicine, Imperial College London, London, UK.
| | - Qi Guo
- Department of Medicine, Imperial College London, London, UK
| | - Cristian A Salinas
- Imanova Limited, Burlington Danes Building, Imperial College London, Hammersmith Hospital, London, Du Cane Road, W12 0NN, UK
| | - Andri C Tziortzi
- FMRIB Centre, Department of Clinical Neurology, University of Oxford, Oxford, UK
| | - Graham E Searle
- Imanova Limited, Burlington Danes Building, Imperial College London, Hammersmith Hospital, London, Du Cane Road, W12 0NN, UK
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