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Lee JH, Gohil VM, Heidari P, Seidel JL, Zulkifli M, Wei Y, Ji Y, Daneshmand A, Mahmood U, Clish CB, Mootha VK, Ayata C. Mechanism of Action and Translational Potential of ( S)-Meclizine in Preemptive Prophylaxis Against Stroke. Stroke 2024; 55:1370-1380. [PMID: 38572656 PMCID: PMC11039361 DOI: 10.1161/strokeaha.123.044397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/22/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Mild chemical inhibition of mitochondrial respiration can confer resilience against a subsequent stroke or myocardial infarction, also known as preconditioning. However, the lack of chemicals that can safely inhibit mitochondrial respiration has impeded the clinical translation of the preconditioning concept. We previously showed that meclizine, an over-the-counter antivertigo drug, can toggle metabolism from mitochondrial respiration toward glycolysis and protect against ischemia-reperfusion injury in the brain, heart, and kidney. Here, we examine the mechanism of action of meclizine and report the efficacy and improved safety of the (S) enantiomer. METHODS We determined the anoxic depolarization latency, tissue and neurological outcomes, and glucose uptake using micro-positron emission tomography after transient middle cerebral artery occlusion in mice pretreated (-17 and -3 hours) with either vehicle or meclizine. To exclude a direct effect on tissue excitability, we also examined spreading depression susceptibility. Furthermore, we accomplished the chiral synthesis of (R)- and (S)-meclizine and compared their effects on oxygen consumption and histamine H1 receptor binding along with their brain concentrations. RESULTS Micro-positron emission tomography showed meclizine increases glucose uptake in the ischemic penumbra, providing the first in vivo evidence that the neuroprotective effect of meclizine indeed stems from its ability to toggle metabolism toward glycolysis. Consistent with reduced reliance on oxidative phosphorylation to sustain the metabolism, meclizine delayed anoxic depolarization onset after middle cerebral artery occlusion. Moreover, the (S) enantiomer showed reduced H1 receptor binding, a dose-limiting side effect for the racemate, but retained its effect on mitochondrial respiration. (S)-meclizine was at least as efficacious as the racemate in delaying anoxic depolarization onset and decreasing infarct volumes after middle cerebral artery occlusion. CONCLUSIONS Our data identify (S)-meclizine as a promising new drug candidate with high translational potential as a chemical preconditioning agent for preemptive prophylaxis in patients with high imminent stroke or myocardial infarction risk.
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Affiliation(s)
- Jeong Hyun Lee
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Therapeutics & Biotechnology Division, Korea Research Institute of Chemical Technology; Graduate School of New Drug Discovery and Development, Chungnam National University, Daejeon, South Korea
| | - Vishal M. Gohil
- Department of Biochemistry and Biophysics, Texas A&M University, College Station, TX, USA
| | - Pedram Heidari
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Jessica L. Seidel
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Mohammad Zulkifli
- Department of Biochemistry and Biophysics, Texas A&M University, College Station, TX, USA
| | - Ying Wei
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Yuhua Ji
- Grace Science, LLC, Menlo Park, CA, USA
| | - Ali Daneshmand
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Umar Mahmood
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | | | - Vamsi K. Mootha
- Broad Institute of MIT and Harvard, Cambridge, MA 02142
- Howard Hughes Medical Institute and Department of Molecular Biology, Massachusetts General Hospital, Boston, MA, USA; Department of Systems Biology, Harvard Medical School, Boston, MA, USA
| | - Cenk Ayata
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
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Vasireddi A, Schaefer PW, Rohatgi S. Metabolic Imaging of Acute Ischemic Stroke (PET, 1Hydrogen Spectroscopy, 17Oxygen Imaging, 23Sodium MRI, pH Imaging). Neuroimaging Clin N Am 2024; 34:271-280. [PMID: 38604711 DOI: 10.1016/j.nic.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Acute stroke imaging plays a vital and time-sensitive role in therapeutic decision-making. Current clinical workflows widely use computed tomography (CT) and magnetic resonance (MR) techniques including CT and MR perfusion to estimate the volume of ischemic penumbra at risk for infarction without acute intervention. The use of imaging techniques aimed toward evaluating the metabolic derangements underlying a developing infarct may provide additional information for differentiating the penumbra from benign oligemia and infarct core. The authors review several modalities of metabolic imaging including PET, hydrogen and oxygen spectroscopy, sodium MRI, and pH-weighted MRI.
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Affiliation(s)
- Anil Vasireddi
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
| | - Pamela W Schaefer
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Saurabh Rohatgi
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
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3
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Dahlberg D, Holm S, Sagen EML, Michelsen AE, Stensland M, de Souza GA, Müller EG, Connelly JP, Revheim ME, Halvorsen B, Hassel B. Bacterial Brain Abscesses Expand Despite Effective Antibiotic Treatment: A Process Powered by Osmosis Due to Neutrophil Cell Death. Neurosurgery 2023; 94:00006123-990000000-00996. [PMID: 38084989 PMCID: PMC10990409 DOI: 10.1227/neu.0000000000002792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/22/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVES A bacterial brain abscess is an emergency and should be drained of pus within 24 hours of diagnosis, as recently recommended. In this cross-sectional study, we investigated whether delaying pus drainage entails brain abscess expansion and what the underlying mechanism might be. METHODS Repeated brain MRI of 47 patients who did not undergo immediate pus drainage, pus osmolarity measurements, immunocytochemistry, proteomics, and 18F-fluorodeoxyglucose positron emission tomography. RESULTS Time from first to last MRI before neurosurgery was 1 to 14 days. Abscesses expanded in all but 2 patients: The median average increase was 23% per day (range 0%-176%). Abscesses expanded during antibiotic therapy and even if the pus did not contain viable bacteria. In a separate patient cohort, we found that brain abscess pus tended to be hyperosmolar (median value 360 mOsm; range 266-497; n = 14; normal cerebrospinal fluid osmolarity is ∼290 mOsm). Hyperosmolarity would draw water into the abscess cavity, causing abscess expansion in a ballooning manner through increased pressure in the abscess cavity. A mechanism likely underlying pus hyperosmolarity was the recruitment of neutrophils to the abscess cavity with ensuing neutrophil cell death and decomposition of neutrophil proteins and other macromolecules to osmolytes: Pus analysis showed the presence of neutrophil proteins (protein-arginine deiminases, citrullinated histone, myeloperoxidase, elastase, cathelicidin). Previous studies have shown very high levels of osmolytes (ammonia, amino acids) in brain abscess pus. 18F-fluorodeoxyglucose positron emission tomography showed focal neocortical hypometabolism 1 to 8 years after brain abscess, indicating long-lasting damage to brain tissue. CONCLUSION Brain abscesses expand despite effective antibiotic treatment. Furthermore, brain abscesses cause lasting damage to surrounding brain tissue. These findings support drainage of brain abscesses within 24 hours of diagnosis.
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Affiliation(s)
- Daniel Dahlberg
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Sverre Holm
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Ellen Margaret Lund Sagen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Annika Elisabet Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maria Stensland
- Institute of Immunology and Centre for Immune Regulation, Oslo University Hospital, Oslo, Norway
| | - Gustavo Antonio de Souza
- Institute of Immunology and Centre for Immune Regulation, Oslo University Hospital, Oslo, Norway
- Department of Biochemistry, Universidade Federal Do Rio Grande Do Norte, Natal, Brazil
| | - Ebba Gløersen Müller
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Radiology and Nuclear Medicine, Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - James Patrick Connelly
- Division of Radiology and Nuclear Medicine, Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Mona-Elisabeth Revheim
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Radiology and Nuclear Medicine, Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway
- The Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bjørnar Hassel
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurohabilitation, Oslo University Hospital, Oslo, Norway
- Norwegian Defence Research Establishment (FFI), Kjeller, Norway
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4
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Lu KJ, Sheu JR, Teng RD, Jayakumar T, Chung CL, Hsieh CY. Ability of Local Clearance of Senescent Cells in Ipsilateral Hemisphere to Mitigate Acute Ischemic Brain Injury in Mice. Int J Biol Sci 2023; 19:2835-2847. [PMID: 37324944 PMCID: PMC10266088 DOI: 10.7150/ijbs.84060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/23/2023] [Indexed: 06/17/2023] Open
Abstract
Senolytic treatment has potential therapeutic efficacy for acute ischemic stroke (AIS). However, the systemic treatment of senolytics may produce off-target side effects and a toxic profile, which affect analysis of the role of acute senescence of neuronal cells in pathogenesis of AIS. We constructed a novel lenti-INK-ATTAC viral vector to introduce INK-ATTAC genes to the ipsilateral brain and locally eliminate senescent brain cells by administering AP20187 to activate caspase-8 apoptotic cascade. In this study, we have found that acute senescence is triggered by middle cerebral artery occlusion (MCAO) surgery, particularly in astrocytes and cerebral endothelial cells (CECs). The upregulation of p16INK4a and senescence-associated secretory phenotype (SASP) factors including matrix metalloproteinase-3, interleukin-1 alpha and -6 were observed in oxygen-glucose deprivation-treated astrocytes and CECs. The systemic administration of a senolytic, ABT-263, prevented the impairment of brain activity from hypoxic brain injury in mice, and significantly improved the neurological severity score, rotarod performance, locomotor activity, and weight loss. The treatment of ABT-263 reduced senescence of astrocytes and CECs in MCAO mice. Furthermore, the localized removal of senescent cells in the injured brain through the stereotaxical injection of lenti-INK-ATTAC viruses generates neuroprotective effects, protecting against acute ischemic brain injury in mice. The content of SASP factors and mRNA level of p16INK4a in the brain tissue of MCAO mice were significantly reduced by the infection of lenti-INK-ATTAC viruses. These results indicate that local clearance of senescent brain cells is a potential therapy on AIS, and demonstrate the correlation between neuronal senescence and pathogenesis of AIS.
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Affiliation(s)
- Kuan-Jung Lu
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Joen-Rong Sheu
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ruei-Dun Teng
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tanasekar Jayakumar
- Department of Ecology & Environmental Sciences, School of Life Science, Pondicherry University, Kalapet, India
| | - Chi-Li Chung
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Ying Hsieh
- Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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5
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Meerwaldt AE, Straathof M, Oosterveld W, van Heijningen CL, van Leent MMT, Toner YC, Munitz J, Teunissen AJP, Daemen CC, van der Toorn A, van Vliet G, van Tilborg GAF, De Feyter HM, de Graaf RA, Hol EM, Mulder WJM, Dijkhuizen RM. In vivo imaging of cerebral glucose metabolism informs on subacute to chronic post-stroke tissue status - A pilot study combining PET and deuterium metabolic imaging. J Cereb Blood Flow Metab 2023; 43:778-790. [PMID: 36606595 PMCID: PMC10108187 DOI: 10.1177/0271678x221148970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/04/2022] [Accepted: 11/21/2022] [Indexed: 01/07/2023]
Abstract
Recanalization therapy after acute ischemic stroke enables restoration of cerebral perfusion. However, a significant subset of patients has poor outcome, which may be caused by disruption of cerebral energy metabolism. To assess changes in glucose metabolism subacutely and chronically after recanalization, we applied two complementary imaging techniques, fluorodeoxyglucose (FDG) positron emission tomography (PET) and deuterium (2H) metabolic imaging (DMI), after 60-minute transient middle cerebral artery occlusion (tMCAO) in C57BL/6 mice. Glucose uptake, measured with FDG PET, was reduced at 48 hours after tMCAO and returned to baseline value after 11 days. DMI revealed effective glucose supply as well as elevated lactate production and reduced glutamate/glutamine synthesis in the lesion area at 48 hours post-tMCAO, of which the extent was dependent on stroke severity. A further decrease in oxidative metabolism was evident after 11 days. Immunohistochemistry revealed significant glial activation in and around the lesion, which may play a role in the observed metabolic profiles. Our findings indicate that imaging (altered) active glucose metabolism in and around reperfused stroke lesions can provide substantial information on (secondary) pathophysiological changes in post-ischemic brain tissue.
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Affiliation(s)
- Anu E Meerwaldt
- Biomedical MR Imaging and
Spectroscopy Group, Center for Image Sciences, University Medical Center
Utrecht/Utrecht University, Utrecht, Netherlands
- BioMedical Engineering and Imaging
Institute, Icahn School of Medicine at Mount Sinai, New York, USA
- Diagnostic, Molecular and
Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Milou Straathof
- Biomedical MR Imaging and
Spectroscopy Group, Center for Image Sciences, University Medical Center
Utrecht/Utrecht University, Utrecht, Netherlands
| | - Wija Oosterveld
- Biomedical MR Imaging and
Spectroscopy Group, Center for Image Sciences, University Medical Center
Utrecht/Utrecht University, Utrecht, Netherlands
| | - Caroline L van Heijningen
- Biomedical MR Imaging and
Spectroscopy Group, Center for Image Sciences, University Medical Center
Utrecht/Utrecht University, Utrecht, Netherlands
| | - Mandy MT van Leent
- BioMedical Engineering and Imaging
Institute, Icahn School of Medicine at Mount Sinai, New York, USA
- Diagnostic, Molecular and
Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Yohana C Toner
- BioMedical Engineering and Imaging
Institute, Icahn School of Medicine at Mount Sinai, New York, USA
- Diagnostic, Molecular and
Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
- Department of Internal Medicine and
Radboud Center for Infectious Diseases, Radboud University Medical Center,
Nijmegen, Netherlands
| | - Jazz Munitz
- BioMedical Engineering and Imaging
Institute, Icahn School of Medicine at Mount Sinai, New York, USA
- Diagnostic, Molecular and
Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Abraham JP Teunissen
- BioMedical Engineering and Imaging
Institute, Icahn School of Medicine at Mount Sinai, New York, USA
- Diagnostic, Molecular and
Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
- Cardiovascular Research Institute,
Icahn School of Medicine at Mount Sinai, New York, USA
- Icahn Genomics Institute, Icahn
School of Medicine at Mount Sinai, New York, USA
| | - Charlotte C Daemen
- Department of Translational
Neuroscience, University Medical Center Utrecht Brain Center, Utrecht
University, Utrecht, The Netherlands
| | - Annette van der Toorn
- Biomedical MR Imaging and
Spectroscopy Group, Center for Image Sciences, University Medical Center
Utrecht/Utrecht University, Utrecht, Netherlands
| | - Gerard van Vliet
- Biomedical MR Imaging and
Spectroscopy Group, Center for Image Sciences, University Medical Center
Utrecht/Utrecht University, Utrecht, Netherlands
| | - Geralda AF van Tilborg
- Biomedical MR Imaging and
Spectroscopy Group, Center for Image Sciences, University Medical Center
Utrecht/Utrecht University, Utrecht, Netherlands
| | - Henk M De Feyter
- Department of Radiology and
Biomedical Imaging, Magnetic Resonance Research Center, Yale University School
of Medicine, New Haven, CT, USA
| | - Robin A de Graaf
- Department of Radiology and
Biomedical Imaging, Magnetic Resonance Research Center, Yale University School
of Medicine, New Haven, CT, USA
- Department of Biomedical
Engineering, Yale University School of Medicine, New Haven, CT, USA
| | - Elly M Hol
- Department of Translational
Neuroscience, University Medical Center Utrecht Brain Center, Utrecht
University, Utrecht, The Netherlands
| | - Willem JM Mulder
- BioMedical Engineering and Imaging
Institute, Icahn School of Medicine at Mount Sinai, New York, USA
- Diagnostic, Molecular and
Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
- Department of Internal Medicine and
Radboud Center for Infectious Diseases, Radboud University Medical Center,
Nijmegen, Netherlands
- Department of Chemical Biology,
Eindhoven University of Technology, Eindhoven, Netherlands
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and
Spectroscopy Group, Center for Image Sciences, University Medical Center
Utrecht/Utrecht University, Utrecht, Netherlands
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Ayubcha C, Amanullah A, Patel KH, Teichner E, Gokhale S, Marquez-Valenzuela U, Werner TJ, Alavi A. Stroke and molecular imaging: a focus on FDG-PET. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2023; 13:51-63. [PMID: 37214267 PMCID: PMC10193198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/23/2023] [Indexed: 05/24/2023]
Abstract
Stroke is the leading cause of disability worldwide, the second most common cause of dementia and the third leading cause of death. Though the etiology of stroke has been explored extensively, there remains open questions in the scientific and clinical study of stroke. Traditional imaging techniques, such as magnetic resonance imaging and computed tomography, have been applied extensively and remain mainstays in clinical practice. Nevertheless, positron emission tomography has proven to be a powerful molecular imaging tool in exploring the scientific aspects of neurological disease, and stroke remains an area of great interest. This review article examines the role of positron emission tomography in the study of stroke including its contributions to elaborating related pathophysiology and delving into possible clinical applications.
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Affiliation(s)
- Cyrus Ayubcha
- Harvard Medical SchoolBoston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public HealthBoston, MA, USA
| | - Aamir Amanullah
- Department of Radiology, Hospital of University of PennsylvaniaPhiladelphia, PA, USA
- Lewis Katz School of Medicine at Temple UniversityPhiladelphia, PA, USA
| | | | - Eric Teichner
- Department of Radiology, Hospital of University of PennsylvaniaPhiladelphia, PA, USA
- Thomas Jefferson UniversityPhiladelphia, PA, USA
| | - Saket Gokhale
- Department of Radiology, Hospital of University of PennsylvaniaPhiladelphia, PA, USA
- Thomas Jefferson UniversityPhiladelphia, PA, USA
| | | | - Thomas J Werner
- Department of Radiology, Hospital of University of PennsylvaniaPhiladelphia, PA, USA
| | - Abass Alavi
- Department of Radiology, Hospital of University of PennsylvaniaPhiladelphia, PA, USA
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7
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Ospel J, Rex N, Kandregula S, Goyal M. The Vessel Has Been Recanalized: Now What? Neurotherapeutics 2023; 20:679-692. [PMID: 37014594 PMCID: PMC10275828 DOI: 10.1007/s13311-023-01367-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
When treating acute ischemic stroke patients in our daily clinical practice, we strive to achieve recanalization of the occluded blood vessel as fast as possible using pharmacological thrombolysis and mechanical clot removal. However, successful recanalization does not equal successful reperfusion of the ischemic tissue due to mechanisms such as microvascular obstruction. Even if successful reperfusion is achieved, numerous other post-recanalization tissue damage mechanisms may impair patient outcomes, namely blood-brain barrier breakdown, reperfusion injury and excitotoxicity, late secondary changes, and post-infarction local and global brain atrophy. Several cerebroprotectants are currently evaluated as adjunctive treatments to pharmacological thrombolysis and mechanical clot removal, many of which interfere with post-recanalization tissue damage pathways. However, our current lack of knowledge about the prevalence and importance of the various post-recanalization tissue damage mechanisms makes it difficult to reliably identify the most promising cerebroprotectants and to design appropriate clinical trials to evaluate them. Serial human MRI studies with complementary animal studies in higher order primates could provide answers to these critical questions and should be first conducted to allow for adequate cerebroprotection trial design, which could accelerate the translation of cerebroprotective agents from bench to bedside to further improve patient outcomes.
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Affiliation(s)
- Johanna Ospel
- Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, 1403 29th St. NW, Calgary, AB, T2N2T9, Canada
- Department of Diagnostic Imaging, University of Calgary, Calgary, Canada
| | - Nathaniel Rex
- Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, 1403 29th St. NW, Calgary, AB, T2N2T9, Canada
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sandeep Kandregula
- Department of Neurosurgery, Louisiana State University Health, Shreveport, LA, USA
| | - Mayank Goyal
- Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, 1403 29th St. NW, Calgary, AB, T2N2T9, Canada.
- Department of Diagnostic Imaging, University of Calgary, Calgary, Canada.
- Department of Radiology, Foothills Medical Centre, University of Calgary, 1403 29th St. NW, Calgary, AB, T2N2T9, Canada.
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8
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He W, Tang H, Li J, Hou C, Shen X, Li C, Liu H, Yu W. Feature-based Quality Assessment of Middle Cerebral Artery Occlusion Using 18F-Fluorodeoxyglucose Positron Emission Tomography. Neurosci Bull 2022; 38:1057-1068. [PMID: 35639276 PMCID: PMC9468193 DOI: 10.1007/s12264-022-00865-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/13/2022] [Indexed: 10/18/2022] Open
Abstract
In animal experiments, ischemic stroke is usually induced through middle cerebral artery occlusion (MCAO), and quality assessment of this procedure is crucial. However, an accurate assessment method based on 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is still lacking. The difficulty lies in the inconsistent preprocessing pipeline, biased intensity normalization, or unclear spatiotemporal uptake of FDG. Here, we propose an image feature-based protocol to assess the quality of the procedure using a 3D scale-invariant feature transform and support vector machine. This feature-based protocol provides a convenient, accurate, and reliable tool to assess the quality of the MCAO procedure in FDG PET studies. Compared with existing approaches, the proposed protocol is fully quantitative, objective, automatic, and bypasses the intensity normalization step. An online interface was constructed to check images and obtain assessment results.
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Affiliation(s)
- Wuxian He
- Department of Electronic and Computer Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Hongtu Tang
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan, 430065, China
| | - Jia Li
- Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan, 430065, China
| | - Chenze Hou
- Department of Electronic and Computer Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Xiaoyan Shen
- College of Science, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Chenrui Li
- Department of Electronic and Computer Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Huafeng Liu
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou , 310027, China.
- Intelligent Optics & Photonics Research Center, Jiaxing Research Institute of Zhejiang University, Jiaxing , 314000, China.
| | - Weichuan Yu
- Department of Electronic and Computer Engineering, The Hong Kong University of Science and Technology, Hong Kong, China.
- HKUST Shenzhen-Hong Kong Collaborative Innovation Research Institute, Futian, Shenzhen, China.
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9
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Wang Z, Chen S, Smith MF, Jia X. Effect of Graded Targeted Temperature Management on Cerebral Glucose Spatiotemporal Characteristics after Cardiac Arrest. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:182-185. [PMID: 36086320 PMCID: PMC9639334 DOI: 10.1109/embc48229.2022.9871454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Cardiac arrest (CA) is a fatal disease with high rates of neurological impairment. At present, targeted temperature management (TTM) is the only strategy with firm clinical evidence to prove its effectiveness. However, there is still controversy on the implementation of TTM, particularly on its depth, with a lack of elucidated underlying therapeutic mechanisms. Six Wistar rats were subjected to 8 min asphyxia-CA and randomly divided into TTM at 33oC(n=3) or 35° C groups (n=3). The spatiotemporal characteristics of cerebral glucose metabolism after CA were investigated by 18F-FDG microPET/CT. Myelin Basic Protein (MBP) immunofluorescence staining was used to assess acute injury and recovery of oligodendrocytes. Functional recovery was evaluated using the neurological deficit score (NDS). There was a significant improvement in functional recovery by NDS (p < 0.05) in the 33oC group compared with the 35° C group. Glucose metabolism of the 33° C group was higher than that of the 35oC group early after resuscitation (within 10 minutes). Immunofluorescence analysis showed that positive MBP signals in the cortex and hippocampus in the 33oC group were greater than in the 35oC group. In conclusion, compared to 35oC TTM, 33° C TTM changed the spatiotemporal characteristics of brain glucose metabolisms with improved neurological function, which may be through oligodendrocyte participation.
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10
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Li J, Chen Y, Peng C, Hong X, Liu H, Fang J, Zhuang R, Pan W, Zhang D, Guo Z, Zhang X. Micro-SPECT Imaging of Acute Ischemic Stroke with Radioiodinated Riboflavin in Rat MCAO Models via Riboflavin Transporter Targeting. ACS Chem Neurosci 2022; 13:1966-1973. [PMID: 35758284 DOI: 10.1021/acschemneuro.2c00177] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Riboflavin transporter-3 (RFVT3) is a recently discovered and novel biomarker for the theranostics of nervous system diseases. RFVT3 is significantly overexpressed in cerebral injury after ischemic stroke. Herein, we first reported an RFVT3-targeted tracer 131I-riboflavin (131I-RFLA) for SPECT imaging of ischemic stroke in vivo. 131I-RFLA was radiosynthesized by the iodogen-coating method. 131I-RFLA possessed a radiochemical yield of 69.2 ± 3.7% and greater than 95% radiochemical purity. The representative SPECT/CT images using 131I-RFLA demonstrated the conspicuously increased tracer uptake in the cerebral injury by comparison with the contralateral normal brain at 1 h and 3 and 7 d after stroke. Ex vivo autoradiography demonstrated that the ratio of infarcted to normal brain uptake was 3.63 and it was decreased to 1.98 after blocking, which reconfirmed the results of SPECT images. Importantly, a significant correlation was identified between RFVT3 expression and brain injury by H&E and immunohistochemistry staining. Therefore, RFVT3 is a new and potential biomarker for the early diagnosis of ischemic stroke. In addition, 131I-RFLA is a promising SPECT tracer for imaging RFVT3-related ischemic cerebral injury in vivo.
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Affiliation(s)
- Jindian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Yingxi Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Chenyu Peng
- Department of Radiology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Xingfang Hong
- Laboratory of Pathogen Biology, School of Basic Medical, Dali University, Dali 671000, China
| | - Huanhuan Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Jianyang Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Rongqiang Zhuang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Weimin Pan
- Department of Nuclear Medicine, Xiang'an Hospital Affiliated to Xiamen University, Xiamen 361102, China
| | - Deliang Zhang
- Department of Nuclear Medicine, Xiang'an Hospital Affiliated to Xiamen University, Xiamen 361102, China
| | - Zhide Guo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Xianzhong Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, China
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11
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Liu S, Luo W, Wang Y. Emerging role of PARP-1 and PARthanatos in ischemic stroke. J Neurochem 2021; 160:74-87. [PMID: 34241907 DOI: 10.1111/jnc.15464] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/10/2021] [Accepted: 07/06/2021] [Indexed: 01/01/2023]
Abstract
Cell death is a key feature of neurological diseases, including stroke and neurodegenerative disorders. Studies in a variety of ischemic/hypoxic mouse models demonstrate that poly(ADP-ribose) polymerase 1 (PARP-1)-dependent cell death, also named PARthanatos, plays a pivotal role in ischemic neuronal cell death and disease progress. PARthanatos has its unique triggers, processors, and executors that convey a highly orchestrated and programmed signaling cascade. In addition to its role in gene transcription, DNA damage repair, and energy homeostasis through PARylation of its various targets, PARP-1 activation in neuron and glia attributes to brain damage following ischemia/reperfusion. Pharmacological inhibition or genetic deletion of PARP-1 reduces infarct volume, eliminates inflammation, and improves recovery of neurological functions in stroke. Here, we reviewed the role of PARP-1 and PARthanatos in stroke and their therapeutic potential.
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Affiliation(s)
- Shuiqiao Liu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Weibo Luo
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Yingfei Wang
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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12
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Sundaraiya S, Rajendran A, Sulaiman A, Pradeep S, Vidhyadharan S, Hedne N. Metabolically Active Subacute Infarct Masquerading as Metastasis: A Finding not to be overlooked in Asymptomatic Oncology Patients. Indian J Nucl Med 2021; 36:85-87. [PMID: 34040309 PMCID: PMC8130700 DOI: 10.4103/ijnm.ijnm_171_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/04/2020] [Accepted: 09/07/2020] [Indexed: 11/07/2022] Open
Abstract
A 50-year-old man with carcinoma of the right buccal mucosa underwent staging whole-body 18F-fluorodeoxyglucose positron emission tomography–computed tomography, which revealed a hypermetabolic heterogeneously enhancing lobulated primary lesion in the right buccal region and an incidental finding of subacute stroke. The case highlights the importance of discriminating brain neoplasms mimicking stroke from true ischemic stroke, which is crucial for appropriate management of patients in an oncology setting.
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Affiliation(s)
- Sumati Sundaraiya
- Department of Nuclear Medicine, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Adhithyan Rajendran
- Department of Radiology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Abubacker Sulaiman
- Department of Radiology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Sivakumar Pradeep
- Department of Head and Neck Surgical Oncology Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Sivakumar Vidhyadharan
- Department of Head and Neck Surgical Oncology Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Naveen Hedne
- Department of Head and Neck Surgical Oncology Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
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13
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Mishima K, Ayano M, Nishida T, Tatsutani T, Inokuchi S, Kimoto Y, Mitoma H, Akahoshi M, Arinobu Y, Akashi K, Horiuchi T, Niiro H. Use of 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography to successfully diagnose central nervous system vasculitis in systemic lupus erythematosus and antiphospholipid syndrome: a case report. Mod Rheumatol Case Rep 2021; 5:278-284. [PMID: 33783324 DOI: 10.1080/24725625.2021.1905220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 53-year-old woman was admitted to our hospital for headache secondary to an acute subdural haematoma in the right cerebellar tentorium. She had been diagnosed with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) two years before presentation and was initiated on prednisolone (PSL) 40 mg/day as induction therapy, which was subsequently tapered to 5 mg/day. Her thrombocytopenia and renal impairment were managed by warfarin with a target prothrombin time-international normalised ratio of 2-3. Her history also included 5 instances of triggerless acute subdural haematoma in the right cerebellar tentorium in the preceding 8 months. Warfarin therapy was suspected as the cause of her bleeding; however, dose adjustment was ineffective. During the current admission, neither magnetic resonance imaging nor cerebral angiography could reveal the cause of the bleeding. However, spinal fluid IL-6 was 25.7 pg/mL, and 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography showed fluorodeoxyglucose accumulation in the right medial occipital lobe cortex in the proximity of the haemorrhage site. Based on these two findings, we suspected vasculitis as the cause of recurrent bleeding. After ruling out malignancy, re-induction therapy with intravenous cyclophosphamide 500 mg/m2/month and PSL 30 mg/day was initiated. PSL was tapered to 2 mg/day and no signs of relapse have developed at 2 years after discharge. Her clinical course also supported vasculitis as the cause of recurrent central nervous system (CNS) bleeding and we discuss the usefulness of 18F-Fluorodeoxyglucose-Positron Emission Tomography in the diagnosis and treatment of CNS vasculitis in SLE and/or APS.
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Affiliation(s)
- Koji Mishima
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Masahiro Ayano
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.,Department of Cancer Stem Cell Research, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Tomoya Nishida
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Tomofumi Tatsutani
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Shoichiro Inokuchi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yasutaka Kimoto
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | - Hiroki Mitoma
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Mitsuteru Akahoshi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yojiro Arinobu
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiko Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | - Hiroaki Niiro
- Department of Medical Education, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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14
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Stancioiu F, Papadakis GZ, Lazopoulos G, Spandidos DA, Tsatsakis A, Floroiu M, Badiu C. CD271 + stem cell treatment of patients with chronic stroke: : A retrospective case series report. Exp Ther Med 2020; 20:2055-2062. [PMID: 32782517 PMCID: PMC7401309 DOI: 10.3892/etm.2020.8948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/25/2020] [Indexed: 12/12/2022] Open
Abstract
Patients with chronic stroke have currently little hope for motor improvement towards regaining independent activities of daily living; stem cell treatments offer a new treatment option and needs to be developed. Patients with chronic stroke (more than 3 months prior to stem cell treatment, mean 21.2 months post-stroke) were treated with CD271+ stem cells, 7 patients received autologous and 1 allogeneic cells from first degree relative; administration was intravenous in 1 and intrathecal in 7 patients. Each patient received a single treatment consisting of 2-5x106 cells/kg and they were followed up for up to 12 months. There were significant improvements in expressive aphasia (2/3 patients) spasticity (5/5, of which 2 were transient), and small improvements in motor function (2/8 patients). Although motor improvements were minor in our chronic stroke patients, improvements in aphasia and spasticity were significant and in the context of good safety we are advocating further administration and clinical studies of CD271+ stem cells not only in chronic stroke patients, but also for spastic paresis/plegia; a different, yet unexplored application is pulmonary emphysema.
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Affiliation(s)
| | - Georgios Z. Papadakis
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
- Foundation for Research and Technology Hellas (FORTH), Computational Biomedicine Laboratory (CBML), 70013 Heraklion, Greece
| | - George Lazopoulos
- Department of Cardiothoracic Surgery, University General Hospital of Heraklion, 71003 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Marius Floroiu
- Cardiovascular Surgery Department, Angiomedica Hospital, 020657 Bucharest, Romania
| | - Corin Badiu
- CI Parhon Institute of Endocrinology, 011863 Bucharest, Romania
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15
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Backhaus P, Roll W, Beuker C, Zinnhardt B, Seifert R, Wenning C, Eisenblätter M, Thomas C, Schmidt-Pogoda A, Strunk D, Wagner S, Faust A, Tüttelmann F, Röpke A, Jacobs AH, Stummer W, Wiendl H, Meuth SG, Schäfers M, Grauer O, Minnerup J. Initial experience with [ 18F]DPA-714 TSPO-PET to image inflammation in primary angiitis of the central nervous system. Eur J Nucl Med Mol Imaging 2020; 47:2131-2141. [PMID: 31960097 PMCID: PMC7338821 DOI: 10.1007/s00259-019-04662-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/16/2019] [Indexed: 12/16/2022]
Abstract
Purpose Primary angiitis of the central nervous system (PACNS) is a heterogeneous, rare, and poorly understood inflammatory disease. We aimed at non-invasive imaging of activated microglia/macrophages in patients with PACNS by PET-MRI targeting the translocator protein (TSPO) with [18F]DPA-714 to potentially assist differential diagnosis, therapy monitoring, and biopsy planning. Methods In total, nine patients with ischemic stroke and diagnosed or suspected PACNS underwent [18F]DPA-714-PET-MRI. Dynamic PET scanning was performed for 60 min after injection of 233 ± 19 MBq [18F]DPA-714, and MRI was simultaneously acquired. Results In two PACNS patients, [18F]DPA-714 uptake patterns exceeded MRI correlates of infarction, whereas uptake was confined to the infarct in four patients where initial suspicion of PACNS could not be confirmed. About three patients with PACNS or cerebral predominant lymphocytic vasculitis showed no or only faintly increased uptake. Short-term [18F]DPA-714-PET follow-up in a patient with PACNS showed reduced lesional [18F]DPA-714 uptake after anti-inflammatory treatment. Biopsy in the same patient pinpointed the source of tracer uptake to TSPO-expressing immune cells. Conclusions [18F]DPA-714-PET imaging may facilitate the diagnosis and treatment monitoring of PACNS. Further studies are needed to fully understand the potential of TSPO-PET in deciphering the heterogeneity of the disease. Electronic supplementary material The online version of this article (10.1007/s00259-019-04662-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Philipp Backhaus
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany. .,European Institute for Molecular Imaging, University of Münster, Münster, Germany.
| | - Wolfgang Roll
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Carolin Beuker
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Bastian Zinnhardt
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.,European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Robert Seifert
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.,European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Christian Wenning
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Michel Eisenblätter
- Institute of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Christian Thomas
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Antje Schmidt-Pogoda
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Daniel Strunk
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Stefan Wagner
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Andreas Faust
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Frank Tüttelmann
- Institute of Human Genetics, University Hospital Münster, Münster, Germany
| | - Albrecht Röpke
- Institute of Human Genetics, University Hospital Münster, Münster, Germany
| | - Andreas H Jacobs
- European Institute for Molecular Imaging, University of Münster, Münster, Germany.,Department of Geriatrics, Johanniter Hospital, Evangelische Kliniken, Bonn, Germany
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Sven G Meuth
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.,European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Oliver Grauer
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Jens Minnerup
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
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16
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Wang Z, Mascarenhas C, Jia X. Positron Emission Tomography After Ischemic Brain Injury: Current Challenges and Future Developments. Transl Stroke Res 2020; 11:628-642. [PMID: 31939060 DOI: 10.1007/s12975-019-00765-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/22/2019] [Accepted: 12/04/2019] [Indexed: 12/19/2022]
Abstract
Positron emission tomography (PET) is widely used in clinical and animal studies, along with the development of diverse tracers. The biochemical characteristics of PET tracers may help uncover the pathophysiological consequences of cardiac arrest (CA) and ischemic stroke, which include cerebral ischemia and reperfusion, depletion of oxygen and glucose, and neuroinflammation. PubMed was searched for studies of the application of PET for "cardiac arrest," "ischemic stroke," and "targeted temperature management." Available studies were included and classified according to the biochemical properties involved and metabolic processes of PET tracers, and were summarized. The mechanisms of ischemic brain injuries were investigated by PET with various tracers to elucidate the pathological process from the initial decrease of cerebral blood flow (CBF) to the subsequent abnormalities in energy and oxygen metabolism, to the monitoring of inflammation. In general, the trends of cerebral blood flow and oxygen metabolism after ischemic attack are not unidirectional but closely related to the time point of injury and recovery. Glucose metabolism after injury showed significant differences in different brain regions whereas global cerebral metabolic rate of glucose (CMRglc) declined. PET monitoring of neuroinflammation shows comparable efficacy to immunostaining. The technology of PET targeting in brain metabolism and the development of tracers provide new tools to track and evaluate the brain's pathological changes after ischemic brain injury. Despite no existing evidence for an available PET-based prediction method, discoveries of new tracers are expected to provide more possibilities for the whole field.
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Affiliation(s)
- Zhuoran Wang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 43007, China.,Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Conrad Mascarenhas
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Xiaofeng Jia
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA. .,Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, 21201, USA. .,Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA. .,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA. .,Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
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17
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Simultaneous PET-MRI imaging of cerebral blood flow and glucose metabolism in the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease. Eur J Nucl Med Mol Imaging 2019; 47:1668-1677. [PMID: 31691843 PMCID: PMC7248051 DOI: 10.1007/s00259-019-04551-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/24/2019] [Indexed: 11/19/2022]
Abstract
Purpose Cerebral blood flow (CBF) and glucose metabolism are important and significant factors in ischaemic cerebrovascular disease. The objective of this study was to use quantitative hybrid PET/MR to evaluate the effects of surgery treatment on the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease. Methods Fifteen patients diagnosed with ischaemic cerebrovascular disease were evaluated using a hybrid TOF PET/MR system (Signa, GE Healthcare). The CBF value measured by arterial spin labelling (ASL) and the standardized uptake value ratio (SUVR) measured by 18F-FDG PET were obtained, except for the infarct area and its contralateral side, before and after bypass surgery. The asymmetry index (AI) was calculated from the CBF and SUVR of the ipsilateral and contralateral cerebral hemispheres, respectively. The ΔCBF and ΔSUVR were calculated as the percent changes of CBF and SUVR between before and after surgery, and paired t tests were used to determine whether a significant change occurred. Spearman’s rank correlation was also used to compare CBF with glucose metabolism in the same region. Results The analysis primarily revealed that after bypass surgery, a statistically significant increase occurred in the CBF on the affected side (P < 0.01). The postprocedural SUVR was not significantly higher than the preprocedural SUVR (P > 0.05). However, the postprocedural AI values for CBF and SUVR were significantly lower after surgery than before surgery (P < 0.01). A significant correlation was found between the AI values for preoperative CBF and SUVR on the ipsilateral hemisphere (P < 0.01). Conclusions The present study demonstrates that a combination of ASL and 18F-FDG PET could be used to simultaneously analyse changes in patients’ cerebral haemodynamic patterns and metabolism between before and after superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery. This therefore represents an essential tool for the evaluation of critical haemodynamic and metabolic status in patients with symptomatic unilateral ischaemic cerebrovascular disease.
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18
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Stroke detection with 3 different PET tracers. Radiol Case Rep 2019; 14:1447-1451. [PMID: 31695834 PMCID: PMC6823742 DOI: 10.1016/j.radcr.2019.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/30/2019] [Accepted: 09/02/2019] [Indexed: 12/24/2022] Open
Abstract
Stroke is a common cause of patient morbidity and mortality, being the fifth leading cause of death in the United States. Positron emission tomography (PET) is a proven tool for oncology patients, and may have utility in patients with stroke. We demonstrate findings of stroke incidentally detected on oncologic PET/CTs using 18F-FDG, 11C-Choline, and 68Ga-DOTATATE radiotracers. Specifically, focal 11C-Choline or 68Ga-DOTATATE uptakes localized in areas of MRI confirmed ischemia, and paradoxically increased 18F-FDG activity was visualized surrounding a region of hemorrhage, in different patients. These cases demonstrate that PET may have utility in evaluating patients with stroke based on flow dynamics, metabolic activity, and receptor expression.
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19
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Yu Z, Shi X, Zhou Z, Yang Y, Li P, Zhang Y. Cerebral glucose metabolism changes in chronic ischemia patients following subcranial-intracranial bypass. Neurosurg Rev 2019; 43:1383-1389. [PMID: 31502029 DOI: 10.1007/s10143-019-01177-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/15/2019] [Accepted: 09/04/2019] [Indexed: 11/30/2022]
Abstract
The use of the internal maxillary artery (IMA) in intracranial artery bypass or subcranial-intracranial (SC-IC) bypass has recently been described as an alternative to traditional bypass. This study explores cerebral glucose metabolism characteristics of SC-IC bypass. Ten crescendo transient ischemic attack (TIA) patients with chronic occlusion of the middle cerebral artery (MCA) received bypass surgery of IMA with the radial artery graft (RAG) to the branch of MCA. The graft's flow volume (FV) was measured by operative intraoperative duplex ultrasonography. Positron emission tomography (PET)/computed tomography (CT) was used to calculate the preoperational and postoperational average of the standard uptake value (SUVavg) of the 18-fluoro-2-deoxy-D-glucose (18F-FDG) in the region of interest (ROI). The asymmetric index (AI) is recommended to reflect the SUVavg changes, and subsequently, cerebral glucose metabolism changes are supposedly clarified. Patent IMA-RAG-MCA bypass in ten chronic ischemia patients was confirmed by angiography after surgery. The intraoperative FV measurement value was 65.64 ± 10.52 (58.11-73.17) ml/min. Before the operation, the SUVavg of the ROI in the ischemic hemisphere (4.76 ± 2.35 (3.08-6.04)) clearly decreased compared to the one (5.99 ± 2.63 (4.11-7.87)) in the contralateral mirror region (P = 0.003). The result of AI of preoperation minus AI of postoperation was more than 10% (P = 0.031), which indicated suspicious significant changes in cerebral metabolism. All symptoms of study patients having crescendo ischemia were resolved in 1 month after the operation. In the cerebral hypoperfusion territory, uptake of 18F-FDG deceased. Improving the flow volume via SC-IC bypass makes available an elevated uptake of 18F-FDG.
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Affiliation(s)
- Zaitao Yu
- Department of Neurosurgery, Yu Quan Hospital, Tsinghua University, No. 5 Shijingshan Rd, Shijingshan District, Beijing, 100040, China
| | - Xiangen Shi
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Zhongqing Zhou
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Yang Yang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Pengbo Li
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Yuqi Zhang
- Department of Neurosurgery, Yu Quan Hospital, Tsinghua University, No. 5 Shijingshan Rd, Shijingshan District, Beijing, 100040, China.
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20
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Kapanadze T, Bankstahl JP, Wittneben A, Koestner W, Ballmaier M, Gamrekelashvili J, Krishnasamy K, Limbourg A, Ross TL, Meyer GJ, Haller H, Bengel FM, Limbourg FP. Multimodal and Multiscale Analysis Reveals Distinct Vascular, Metabolic and Inflammatory Components of the Tissue Response to Limb Ischemia. Am J Cancer Res 2019; 9:152-166. [PMID: 30662559 PMCID: PMC6332799 DOI: 10.7150/thno.27175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 11/12/2018] [Indexed: 12/12/2022] Open
Abstract
Ischemia triggers a complex tissue response involving vascular, metabolic and inflammatory changes. Methods: We combined hybrid SPECT/CT or PET/CT nuclear imaging studies of perfusion, metabolism and inflammation with multicolor flow cytometry-based cell population analysis to comprehensively analyze the ischemic tissue response and to elucidate the cellular substrate of noninvasive molecular imaging techniques in a mouse model of hind limb ischemia. Results: Comparative analysis of tissue perfusion with [99mTc]-Sestamibi and arterial influx with [99mTc]-labeled albumin microspheres by SPECT/CT revealed a distinct pattern of response to vascular occlusion: an early ischemic period of matched suppression of tissue perfusion and arterial influx, a subacute ischemic period of normalized arterial influx but impaired tissue perfusion, and a protracted post-ischemic period of hyperdynamic arterial and normalized tissue perfusion, indicating coordination of macrovascular and microvascular responses. In addition, the subacute period showed increased glucose uptake by [18F]-FDG PET/CT scanning as the metabolic response of viable tissue to hypoperfusion. This was associated with robust macrophage infiltration by flow cytometry, and glucose uptake studies identified macrophages as major contributors to glucose utilization in ischemic tissue. Furthermore, imaging with the TSPO ligand [18F]-GE180 showed a peaked response during the subacute phase due to preferential labeling of monocytes and macrophages, while imaging with [68Ga]-RGD, an integrin ligand, showed prolonged post-ischemic upregulation, which was attributed to labeling of macrophages and endothelial cells by flow cytometry. Conclusion: Combined nuclear imaging and cell population analysis reveals distinct components of the ischemic tissue response and associated cell subsets, which could be targeted for therapeutic interventions.
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Suh JY, Cho G, Song Y, Woo DC, Choi YS, Ryu EK, Park BW, Shim WH, Kim YR, Kim JK. Hyperoxia-Induced ΔR 1. Stroke 2018; 49:3012-3019. [PMID: 30571431 DOI: 10.1161/strokeaha.118.021469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Acceleration of longitudinal relaxation under hyperoxic challenge (ie, hyperoxia-induced ΔR1) indicates oxygen accumulation and reflects baseline tissue oxygenation. We evaluated the feasibility of hyperoxia-induced ΔR1 for evaluating cerebral oxygenation status and degree of ischemic damage in stroke. Methods- In 24-hour transient stroke rat models (n=13), hyperoxia-induced ΔR1, ischemic severity (apparent diffusion coefficient [ADC]), vasogenic edema (R2), total and microvascular blood volume (superparamagnetic iron oxide-driven ΔR2* and ΔR2, respectively), and glucose metabolism activity (18F-fluorodeoxyglucose uptake on positron emission tomography) were measured. The distribution of these parameters according to hyperoxia-induced ΔR1 was analyzed. The partial pressure of tissue oxygen change during hyperoxic challenge was measured using fiberoptic tissue oximetry. In 4-hour stroke models (n=6), ADC and hyperoxia-induced ΔR1 was analyzed with 2,3,5-triphenyltetrazolium chloride staining being a criterion of infarction. Results- Ischemic hemisphere showed significantly higher hyperoxia-induced ΔR1 than nonischemic brain in a pattern depending on ADC. During hyperoxic challenge, ischemic hemisphere demonstrated uncontrolled increase of partial pressure of tissue oxygen, whereas contralateral hemisphere rapidly plateaued. Ischemic hemisphere also demonstrated significant correlation between hyperoxia-induced ΔR1 and R2. Hyperoxia-induced ΔR1 showed a significant negative correlation with 18F-fluorodeoxyglucose uptake. The ADC, R2, ΔR2, and 18F-fluorodeoxyglucose uptake showed a dichotomized distribution according to the hyperoxia-induced ΔR1 as their slopes and values were higher at low hyperoxia-induced ΔR1 (<50 ms-1) than at high ΔR1. In 4-hour stroke rats, the distribution of ADC according to the hyperoxia-induced ΔR1 was similar with 24-hour stroke rats. The hyperoxia-induced ΔR1 was greater in the infarct area (47±10 ms-1) than in peri-infarct area (16±4 ms-1; P<0.01). Conclusions- Hyperoxia-induced ΔR1 adequately indicates cerebral oxygenation and can be a feasible biomarker to classify the degree of ischemia-induced damage in neurovascular function and metabolism in stroke brain.
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Affiliation(s)
- Ji-Yeon Suh
- From the Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.-Y.S., D.-C.W., B.W.P., W.H.S., J.K.K.).,Bioimaging Research Team, Korea Basic Science Institute, Ochang Cheongwon, Chungbuk, Korea (J.-Y.S., G.C., Y.S., E.K.R.)
| | - Gyunggoo Cho
- Bioimaging Research Team, Korea Basic Science Institute, Ochang Cheongwon, Chungbuk, Korea (J.-Y.S., G.C., Y.S., E.K.R.)
| | - Youngkyu Song
- Bioimaging Research Team, Korea Basic Science Institute, Ochang Cheongwon, Chungbuk, Korea (J.-Y.S., G.C., Y.S., E.K.R.)
| | - Dong-Cheol Woo
- From the Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.-Y.S., D.-C.W., B.W.P., W.H.S., J.K.K.)
| | - Yoon Seok Choi
- Medical Research Institute, Gangneung Asan Hospital, Gangwon-do, South Korea (Y.S.C.)
| | - Eun Kyung Ryu
- Bioimaging Research Team, Korea Basic Science Institute, Ochang Cheongwon, Chungbuk, Korea (J.-Y.S., G.C., Y.S., E.K.R.)
| | - Bum Woo Park
- From the Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.-Y.S., D.-C.W., B.W.P., W.H.S., J.K.K.)
| | - Woo Hyun Shim
- From the Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.-Y.S., D.-C.W., B.W.P., W.H.S., J.K.K.)
| | - Young Ro Kim
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown (Y.R.K.)
| | - Jeong Kon Kim
- From the Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.-Y.S., D.-C.W., B.W.P., W.H.S., J.K.K.)
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22
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Wang Y, An FF, Chan M, Friedman B, Rodriguez EA, Tsien RY, Aras O, Ting R. 18F-positron-emitting/fluorescent labeled erythrocytes allow imaging of internal hemorrhage in a murine intracranial hemorrhage model. J Cereb Blood Flow Metab 2017; 37:776-786. [PMID: 28054494 PMCID: PMC5363488 DOI: 10.1177/0271678x16682510] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An agent for visualizing cells by positron emission tomography is described and used to label red blood cells. The labeled red blood cells are injected systemically so that intracranial hemorrhage can be visualized by positron emission tomography (PET). Red blood cells are labeled with 0.3 µg of a positron-emitting, fluorescent multimodal imaging probe, and used to non-invasively image cryolesion induced intracranial hemorrhage in a murine model (BALB/c, 2.36 × 108 cells, 100 µCi, <4 mm hemorrhage). Intracranial hemorrhage is confirmed by histology, fluorescence, bright-field, and PET ex vivo imaging. The low required activity, minimal mass, and high resolution of this technique make this strategy an attractive alternative for imaging intracranial hemorrhage. PET is one solution to a spectrum of issues that complicate single photon emission computed tomography (SPECT). For this reason, this application serves as a PET alternative to [99mTc]-agents, and SPECT technology that is used in 2 million annual medical procedures. PET contrast is also superior to gadolinium and iodide contrast angiography for its lack of clinical contraindications.
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Affiliation(s)
- Ye Wang
- 1 Department of Radiology, Molecular Imaging Innovations Institute (MI3), New York, USA
| | - Fei-Fei An
- 1 Department of Radiology, Molecular Imaging Innovations Institute (MI3), New York, USA
| | - Mark Chan
- 1 Department of Radiology, Molecular Imaging Innovations Institute (MI3), New York, USA
| | - Beth Friedman
- 2 Department of Pharmacology, University of California, La Jolla, USA
| | - Erik A Rodriguez
- 2 Department of Pharmacology, University of California, La Jolla, USA
| | - Roger Y Tsien
- 2 Department of Pharmacology, University of California, La Jolla, USA.,3 Howard Hughes Medical Institute, La Jolla, USA
| | - Omer Aras
- 4 Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Richard Ting
- 1 Department of Radiology, Molecular Imaging Innovations Institute (MI3), New York, USA
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23
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Fifty years of brain imaging in neonatal encephalopathy following perinatal asphyxia. Pediatr Res 2017; 81:150-155. [PMID: 27673422 DOI: 10.1038/pr.2016.195] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/22/2016] [Indexed: 12/21/2022]
Abstract
In the past brain imaging of term infants with hypoxic-ischemic encephalopathy (HIE) was performed with cranial ultrasound (cUS) and computed tomography (CT). Both techniques have several disadvantages sensitivity and specificity is limited compared with magnetic resonance imaging (MRI) and CT makes use of radiation. At present MRI including diffusion weighted MRI during the first week of life, has become the method of choice for imaging infants with HIE. In addition to imaging, blood vessels and blood flow can be visualized using MR angiography, MR venography, and arterial spin labeling. Since the use of these techniques additional lesions in infants with HIE, such as arterial ischemic stroke, sinovenous thrombosis, and subdural hemorrhages can be diagnosed, and the incidence appears to be higher than shown previously. Phosphorus magnetic resonance spectroscopy (MRS) has led to the concept of secondary energy failure in infants with HIE, but has not been widely used. Proton MRS of the basal ganglia and thalamus is one of the best predictors of neurodevelopmental outcome. cUS should still be used for screening infants admitted to a NICU with neonatal encephalopathy. In the future magnetic resonance techniques will be increasingly used as early biomarkers of neurodevelopmental outcome in trials of neuroprotective strategies.
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24
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Liu NW, Ke CC, Zhao Y, Chen YA, Chan KC, Tan DTW, Lee JS, Chen YY, Hsu TW, Hsieh YJ, Chang CW, Yang BH, Huang WS, Liu RS. Evolutional Characterization of Photochemically Induced Stroke in Rats: a Multimodality Imaging and Molecular Biological Study. Transl Stroke Res 2016; 8:244-256. [PMID: 27910074 PMCID: PMC5435782 DOI: 10.1007/s12975-016-0512-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/05/2016] [Accepted: 11/08/2016] [Indexed: 12/20/2022]
Abstract
Photochemically induced cerebral ischemia is an easy-manipulated, reproducible, relatively noninvasive, and lesion controllable model for translational study of ischemic stroke. In order to longitudinally investigate the characterization of the model, magnetic resonance imaging, 18F-2-deoxy-glucose positron emission tomography, fluorescence, and bioluminescence imaging system were performed in correlation with triphenyl tetrazolium chloride (TTC), hematoxylin-eosin staining, and immunohistochemistry examinations of glial fibrillary acidic protein, CD68, NeuN, von willebrand factor, and α-smooth muscle actin in the infarct zone. The results suggested that the number of inflammatory cells, astrocytes, and neovascularization significantly elevated in peri-infarct region from day 7 and a belt of macrophage/microglial and astrocytes was formed surrounding infarct lesion at day 14. Both vasogenic and cytotoxic edema, as well as blood brain-barrier leakage, occurred since day 1 after stroke induction and gradually attenuated with time. Numerous cells other than neuronal cells infiltrated into infarct lesion, which resulted in no visible TTC negative regional existence at day 14. Furthermore, recovery of cerebral blood flow and glucose utilization in peri-infarct zone were noted and more remarkably than that in infarct core following the stroke progression. In conclusion, these characterizations may be highly beneficial to the development of therapeutic strategies for ischemic stroke.
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Affiliation(s)
- Nai-Wei Liu
- State Key Laboratory of Quality Research in Chinese Medicine, Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, 999078, Macau
| | - Chien-Chih Ke
- Biomedical Imaging Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Yonghua Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, 999078, Macau.
| | - Yi-An Chen
- Biomedical Imaging Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kim-Chuan Chan
- Biomedical Imaging Research Center, National Yang-Ming University, Taipei, Taiwan
| | - David Tat-Wei Tan
- Biomedical Imaging Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Jhih-Shian Lee
- Biomedical Imaging Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - You-Yin Chen
- Department of Medical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Tun-Wei Hsu
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ya-Ju Hsieh
- Department of Biomedical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Wei Chang
- Molecular and Genetic Imaging Core/Taiwan Mouse Clinic, National Comprehensive Mouse Phenotyping and Drug Testing Center, Taipei, Taiwan
| | - Bang-Hung Yang
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.,Department of Nuclear Medicine and National PET/Cyclotron Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Sheng Huang
- Department of Nuclear Medicine and National PET/Cyclotron Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ren-Shyan Liu
- Biomedical Imaging Research Center, National Yang-Ming University, Taipei, Taiwan. .,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan. .,Department of Medical Engineering, National Yang-Ming University, Taipei, Taiwan. .,Molecular and Genetic Imaging Core/Taiwan Mouse Clinic, National Comprehensive Mouse Phenotyping and Drug Testing Center, Taipei, Taiwan. .,Department of Nuclear Medicine and National PET/Cyclotron Center, Taipei Veterans General Hospital, Taipei, Taiwan.
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25
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Kim J, Park JE, Nahrendorf M, Kim DE. Direct Thrombus Imaging in Stroke. J Stroke 2016; 18:286-296. [PMID: 27733029 PMCID: PMC5066439 DOI: 10.5853/jos.2016.00906] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/01/2016] [Accepted: 09/17/2016] [Indexed: 01/02/2023] Open
Abstract
There is an emergent need for imaging methods to better triage patients with acute stroke for tissue-plasminogen activator (tPA)-mediated thrombolysis or endovascular clot retrieval by directly visualizing the size and distribution of cerebral thromboemboli. Currently, magnetic resonance (MR) or computed tomography (CT) angiography visualizes the obstruction of blood flow within the vessel lumen rather than the thrombus itself. The present visualization method, which relies on observation of the dense artery sign (the appearance of cerebral thrombi on a non-enhanced CT), suffers from low sensitivity. When translated into the clinical setting, direct thrombus imaging is likely to enable individualized acute stroke therapy by allowing clinicians to detect the thrombus with high sensitivity, assess the size and nature of the thrombus more precisely, serially monitor the therapeutic effects of thrombolysis, and detect post-treatment recurrence. This review is intended to provide recent updates on stroke-related direct thrombus imaging using MR imaging, positron emission tomography, or CT.
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Affiliation(s)
- Jongseong Kim
- Molecular Imaging and Neurovascular Research (MINER) Laboratory, Dongguk University Ilsan Hospital, Goyang, Korea.,Global Research Laboratory for Thrombus-targeted Theranostics at Dongguk University Ilsan Hospital (Korea) and Massachusetts General Hospital ( USA )
| | - Jung E Park
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Matthias Nahrendorf
- Global Research Laboratory for Thrombus-targeted Theranostics at Dongguk University Ilsan Hospital (Korea) and Massachusetts General Hospital ( USA ).,Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Dong-Eog Kim
- Molecular Imaging and Neurovascular Research (MINER) Laboratory, Dongguk University Ilsan Hospital, Goyang, Korea.,Global Research Laboratory for Thrombus-targeted Theranostics at Dongguk University Ilsan Hospital (Korea) and Massachusetts General Hospital ( USA ).,Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea
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26
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Kapasi A, Schneider JA. Vascular contributions to cognitive impairment, clinical Alzheimer's disease, and dementia in older persons. BIOCHIMICA ET BIOPHYSICA ACTA 2016; 1862:878-86. [PMID: 26769363 PMCID: PMC11062590 DOI: 10.1016/j.bbadis.2015.12.023] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/29/2015] [Accepted: 12/29/2015] [Indexed: 12/27/2022]
Abstract
There is growing evidence suggesting that vascular pathologies and dysfunction play a critical role in cognitive impairment, clinical Alzheimer's disease, and dementia. Vascular pathologies such as macroinfarcts, microinfarcts, microbleeds, small and large vessel cerebrovascular disease, and white matter disease are common especially in the brains of older persons where they contribute to cognitive impairment and lower the dementia threshold. Vascular dysfunction resulting in decreased cerebral blood flow, and abnormalities in the blood brain barrier may also contribute to the Alzheimer's disease (AD) pathophysiologic process and AD dementia. This review provides a clinical-pathological perspective on the role of vessel disease, vascular brain injury, alterations of the neurovascular unit, and mixed pathologies in the Alzheimer's disease pathophysiologic process and Alzheimer's dementia. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.
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Affiliation(s)
- A Kapasi
- Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Street, IL 60612, Chicago, USA.
| | - J A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Street, IL 60612, Chicago, USA.
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27
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Akbar M, Essa MM, Daradkeh G, Abdelmegeed MA, Choi Y, Mahmood L, Song BJ. Mitochondrial dysfunction and cell death in neurodegenerative diseases through nitroxidative stress. Brain Res 2016; 1637:34-55. [PMID: 26883165 PMCID: PMC4821765 DOI: 10.1016/j.brainres.2016.02.016] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 12/12/2022]
Abstract
Mitochondria are important for providing cellular energy ATP through the oxidative phosphorylation pathway. They are also critical in regulating many cellular functions including the fatty acid oxidation, the metabolism of glutamate and urea, the anti-oxidant defense, and the apoptosis pathway. Mitochondria are an important source of reactive oxygen species leaked from the electron transport chain while they are susceptible to oxidative damage, leading to mitochondrial dysfunction and tissue injury. In fact, impaired mitochondrial function is commonly observed in many types of neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease, alcoholic dementia, brain ischemia-reperfusion related injury, and others, although many of these neurological disorders have unique etiological factors. Mitochondrial dysfunction under many pathological conditions is likely to be promoted by increased nitroxidative stress, which can stimulate post-translational modifications (PTMs) of mitochondrial proteins and/or oxidative damage to mitochondrial DNA and lipids. Furthermore, recent studies have demonstrated that various antioxidants, including naturally occurring flavonoids and polyphenols as well as synthetic compounds, can block the formation of reactive oxygen and/or nitrogen species, and thus ultimately prevent the PTMs of many proteins with improved disease conditions. Therefore, the present review is aimed to describe the recent research developments in the molecular mechanisms for mitochondrial dysfunction and tissue injury in neurodegenerative diseases and discuss translational research opportunities.
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Affiliation(s)
- Mohammed Akbar
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Musthafa Mohamed Essa
- Department of Food Science and Nutrition, College of Agriculture and Marine Sciences, Sultan Qaboos University, Oman; Ageing and Dementia Research Group, Sultan Qaboos University, Oman
| | - Ghazi Daradkeh
- Department of Food Science and Nutrition, College of Agriculture and Marine Sciences, Sultan Qaboos University, Oman
| | - Mohamed A Abdelmegeed
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Youngshim Choi
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Lubna Mahmood
- Department of Nutritional Sciences, Qatar University, Qatar
| | - Byoung-Joon Song
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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28
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Shaikh F, Savells D, Awan O, Inayat F, Chaudhry A, Jerath N, Graham MM. Quantitative Imaging Analysis of FDG PET/CT Imaging for Detection of Central Neurolymphomatosis in a Case of Recurrent Diffuse B-Cell Lymphoma. Cureus 2015; 7:e379. [PMID: 26719822 PMCID: PMC4689559 DOI: 10.7759/cureus.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Neurolymphomatosis (NL) is a rare disease characterized by malignant lymphocytes infiltrating various structures of the nervous system. It typically manifests as a neuropathy involving the peripheral nerves, nerve roots, plexuses, or cranial nerves. It often presents as a complication of lymphoma, but it can be the presenting feature of recurrent lymphoma. It is essential to identify and initiate treatment early with chemotherapy and/or radiation therapy in all cases of nodal or visceral (including neural) involvement with lymphoma. There are various diagnostic tests that can be used for its detection, such as cerebrospinal spinal fluid (CSF) cytology, electromyography (EMG), magnetic resonance imaging (MRI), and positron-emission tomography/computed tomography (PET/CT). FDG-PET/CT is the standard of care in lymphoma staging, restaging, and therapy response assessment, but has an inherent limitation in the detection of disease involvement in the central nervous system. While that is mostly true for visual assessment, there are quantitative methods to measure variation in the metabolic activity in the brain, which in turn helps detect the occurrence of neurolymphomatosis.
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Affiliation(s)
- Faiq Shaikh
- Imaging Informatics, University of Pittsburgh Medical Center ; Molecular Imaging Physician, S&L Readings, LLC
| | - Derek Savells
- Department of Radiology, University of Iowa Hospitals and Clinics
| | - Omer Awan
- Department of Radiology, Dartmouth Hitchcock Medical Center
| | - Faisal Inayat
- Department of Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, N.Y., USA
| | - Ammar Chaudhry
- Neuroradiology, Johns Hopkins University School of Medicine
| | - Nivedita Jerath
- Department of Neurosurgery, University of Iowa Hospitals and Clinics
| | - Michael M Graham
- Department of Radiology, University of Iowa Hospitals and Clinics
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29
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Hwang H, Jeong HS, Oh PS, Na KS, Kwon J, Kim J, Lim S, Sohn MH, Jeong HJ. Improving Cerebral Blood Flow Through Liposomal Delivery of Angiogenic Peptides: Potential of ¹⁸F-FDG PET Imaging in Ischemic Stroke Treatment. J Nucl Med 2015; 56:1106-11. [PMID: 25977466 DOI: 10.2967/jnumed.115.154443] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/09/2015] [Indexed: 12/25/2022] Open
Abstract
UNLABELLED Strategies to promote angiogenesis can benefit cerebral ischemia. We determined whether liposomal delivery of angiogenic peptides with a known biologic activity of vascular endothelial growth factor benefitted cerebral ischemia. Also, the study examined the potential of (18)F-FDG PET imaging in ischemic stroke treatment. METHODS Male Sprague-Dawley rats (n = 40) underwent 40 min of middle cerebral artery occlusion. After 15 min of reperfusion, the rats (n = 10) received angiogenic peptides incorporated into liposomes. Animals receiving phosphate-buffered solution or liposomes without peptides served as controls. One week later, (18)F-FDG PET imaging was performed to examine regional changes in glucose utilization in response to the angiogenic therapy. The following day, (99m)Tc-hexamethylpropyleneamine oxime autoradiography was performed to determine changes in cerebral perfusion after angiogenic therapy. Corresponding changes in angiogenic markers, including von Willebrand factor and angiopoietin-1 and -2, were determined by immunostaining and polymerase chain reaction analysis, respectively. RESULTS A 40-min period of middle cerebral artery occlusion decreased blood perfusion in the ipsilateral ischemic cortex of the brain, compared with that in the contralateral cortex, as measured by (99m)Tc-hexamethylpropyleneamine oxime autoradiography. Liposomal delivery of angiogenic peptides to the ischemic hemisphere of the brain attenuated the cerebral perfusion defect compared with controls. Similarly, vascular density evidenced by von Willebrand factor-positive staining was increased in response to angiogenic therapy, compared with that of controls. This increase was accompanied by an early increase in angiopoietin-2 expression, a gene participating in angiogenesis. (18)F-FDG PET imaging measured at 7 d after treatment revealed that liposomal delivery of angiogenic peptides facilitated glucose utilization in the ipsilateral ischemic cortex of the brain, compared with that in the controls. Furthermore, the change in regional glucose utilization was correlated with the extent of improvement in cerebral perfusion (r = 0.742, P = 0.035). CONCLUSION Liposomal delivery of angiogenic peptides benefits cerebral ischemia. (18)F-FDG PET imaging holds promise as an indicator of the effectiveness of angiogenic therapy in cerebral ischemia.
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Affiliation(s)
- Hyosook Hwang
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Hwan-Seok Jeong
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Phil-Sun Oh
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Kyung-Suk Na
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - JeongIl Kwon
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Jeonghun Kim
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - SeokTae Lim
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Myung-Hee Sohn
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Hwan-Jeong Jeong
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Cyclotron Research Center, Institute for Medical Sciences, Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
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Choi KH, Park MS, Kim HS, Kim KT, Kim HS, Kim JT, Kim BC, Kim MK, Park JT, Cho KH. Alpha-lipoic acid treatment is neurorestorative and promotes functional recovery after stroke in rats. Mol Brain 2015; 8:9. [PMID: 25761600 PMCID: PMC4339247 DOI: 10.1186/s13041-015-0101-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 02/03/2015] [Indexed: 12/12/2022] Open
Abstract
The antioxidant properties of alpha-lipoic acid (aLA) correlate with its ability to promote neuroproliferation. However, there have been no comprehensive studies examining the neurorestorative effects of aLA administration after the onset of ischemia. The middle cerebral artery (MCA) of adult rats was occluded for 2 hours and then reperfused. aLA (20 mg/kg) was administered in 71 animals (aLA group) through the left external jugular vein immediately after reperfusion. An equivalent volume of vehicle was administered to 71 animals (control group). Functional outcome, levels of endogenous neural precursors with neurogenesis, glial cell activation, and brain metabolism were evaluated. Immediate aLA administration after reperfusion resulted in significantly reduced mortality, infarct size, and neurological deficit score (NDS) in the test group compared to the control group. Long-term functional outcomes, measured by the rotarod test, were markedly improved by aLA treatment. There was a significant increase in the number of cells expressing nestin and GFAP in the boundary zone and infarct core regions after aLA treatment. Furthermore, significantly more BrdU/GFAP, BrdU/DCX, and BrdU/NeuN double-labeled cells were observed along the boundary zone of the aLA group on days 7, 14, and 28 days, respectively. And brain metabolism using 18F-FDG microPET imaging was markedly improved in aLA group. The effects of aLA was blocked by insulin receptor inhibitor, HNMPA (AM)3. These results indicate that immediate treatment with aLA after ischemic injury may have significant neurorestorative effects mediated at least partially via insulin receptor activation. Thus, aLA may be useful for the treatment of acute ischemic stroke.
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Affiliation(s)
- Kang-Ho Choi
- Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea. .,Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea.
| | - Man-Seok Park
- Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea.
| | - Hyung-Seok Kim
- Department of Forensic medicine, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea.
| | - Kyung-Tae Kim
- Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
| | - Hyeon-Sik Kim
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
| | - Joon-Tae Kim
- Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea.
| | - Byeong-Chae Kim
- Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea.
| | - Myeong-Kyu Kim
- Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea.
| | - Jong-Tae Park
- Department of Forensic medicine, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea.
| | - Ki-Hyun Cho
- Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea.
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Bunevicius A, Iervasi G, Bunevicius R. Neuroprotective actions of thyroid hormones and low-T3 syndrome as a biomarker in acute cerebrovascular disorders. Expert Rev Neurother 2015; 15:315-26. [DOI: 10.1586/14737175.2015.1013465] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Benathan-Tordjmann J, Bailly P, Meyer ME, Daouk J. Cerebral arterial inflow assessment with 18F-FDG PET: methodology and feasibility. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2014; 116:177-183. [PMID: 25015567 DOI: 10.1016/j.cmpb.2014.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 06/12/2014] [Accepted: 06/17/2014] [Indexed: 06/03/2023]
Abstract
Positron emission tomography (PET) with 18fluorodeoxyglucose (18F-FDG) is increasingly used in neurology. The measurement of cerebral arterial inflow (QA) using 18F-FDG complements the information provided by standard brain PET imaging. Here, injections were performed after the beginning of dynamic acquisitions and the time to arrival (t0) of activity in the gantry's field of view was computed. We performed a phantom study using a branched tube (internal diameter: 4mm) and a 18F-FDG solution injected at 240 mL/min. Data processing consisted of (i) reconstruction of the first 3s after t0, (ii) vascular signal enhancement and (iii) clustering. This method was then applied in four subjects. We measured the volumes of the tubes or vascular trees and calculated the corresponding flows. In the phantom, the flow was calculated to be 244.2 mL/min. In each subject, our QA value was compared with that obtained by quantitative cine-phase contrast magnetic resonance imaging; the mean QA value of 581.4±217.5 mL/min calculated with 18F-FDG PET was consistent with the mean value of 593.3±205.8 mL/min calculated with quantitative cine-phase contrast magnetic resonance imaging. Our 18F-FDG PET method constitutes a novel, fully automatic means of measuring QA.
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Affiliation(s)
- Jennifer Benathan-Tordjmann
- Service de médecine nucléaire et de traitement de l'image médicale, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Pascal Bailly
- Service de médecine nucléaire et de traitement de l'image médicale, Centre Hospitalier Universitaire d'Amiens, Amiens, France.
| | - Marc-Etienne Meyer
- Service de médecine nucléaire et de traitement de l'image médicale, Centre Hospitalier Universitaire d'Amiens, Amiens, France; Université de Picardie Jules Verne, Amiens, France
| | - Joël Daouk
- Université de Picardie Jules Verne, Amiens, France
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Chakravarty R, Hong H, Cai W. Positron emission tomography image-guided drug delivery: current status and future perspectives. Mol Pharm 2014; 11:3777-97. [PMID: 24865108 PMCID: PMC4218872 DOI: 10.1021/mp500173s] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
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Positron
emission tomography (PET) is an important modality in
the field of molecular imaging, which is gradually impacting patient
care by providing safe, fast, and reliable techniques that help to
alter the course of patient care by revealing invasive, de facto procedures
to be unnecessary or rendering them obsolete. Also, PET provides a
key connection between the molecular mechanisms involved in the pathophysiology
of disease and the according targeted therapies. Recently, PET imaging
is also gaining ground in the field of drug delivery. Current drug
delivery research is focused on developing novel drug delivery systems
with emphasis on precise targeting, accurate dose delivery, and minimal
toxicity in order to achieve maximum therapeutic efficacy. At the
intersection between PET imaging and controlled drug delivery, interest
has grown in combining both these paradigms into clinically effective
formulations. PET image-guided drug delivery has great potential to
revolutionize patient care by in vivo assessment
of drug biodistribution and accumulation at the target site and real-time
monitoring of the therapeutic outcome. The expected end point of this
approach is to provide fundamental support for the optimization of
innovative diagnostic and therapeutic strategies that could contribute
to emerging concepts in the field of “personalized medicine”.
This review focuses on the recent developments in PET image-guided
drug delivery and discusses intriguing opportunities for future development.
The preclinical data reported to date are quite promising, and it
is evident that such strategies in cancer management hold promise
for clinically translatable advances that can positively impact the
overall diagnostic and therapeutic processes and result in enhanced
quality of life for cancer patients.
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Affiliation(s)
- Rubel Chakravarty
- Department of Radiology, University of Wisconsin-Madison , Madison, Wisconsin 53705-2275, United States
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