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Chaumeil MM, Bankson JA, Brindle KM, Epstein S, Gallagher FA, Grashei M, Guglielmetti C, Kaggie JD, Keshari KR, Knecht S, Laustsen C, Schmidt AB, Vigneron D, Yen YF, Schilling F. New Horizons in Hyperpolarized 13C MRI. Mol Imaging Biol 2024; 26:222-232. [PMID: 38147265 PMCID: PMC10972948 DOI: 10.1007/s11307-023-01888-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/27/2023]
Abstract
Hyperpolarization techniques significantly enhance the sensitivity of magnetic resonance (MR) and thus present fascinating new directions for research and applications with in vivo MR imaging and spectroscopy (MRI/S). Hyperpolarized 13C MRI/S, in particular, enables real-time non-invasive assessment of metabolic processes and holds great promise for a diverse range of clinical applications spanning fields like oncology, neurology, and cardiology, with a potential for improving early diagnosis of disease, patient stratification, and therapy response assessment. Despite its potential, technical challenges remain for achieving clinical translation. This paper provides an overview of the discussions that took place at the international workshop "New Horizons in Hyperpolarized 13C MRI," in March 2023 at the Bavarian Academy of Sciences and Humanities, Munich, Germany. The workshop covered new developments, as well as future directions, in topics including polarization techniques (particularly focusing on parahydrogen-based methods), novel probes, considerations related to data acquisition and analysis, and emerging clinical applications in oncology and other fields.
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Affiliation(s)
- Myriam M Chaumeil
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA.
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
| | - James A Bankson
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | | | - Ferdia A Gallagher
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Martin Grashei
- Department of Nuclear Medicine, TUM School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Caroline Guglielmetti
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Joshua D Kaggie
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Kayvan R Keshari
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
- Weill Cornell Graduate School, New York City, NY, USA
| | | | - Christoffer Laustsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
| | - Andreas B Schmidt
- Partner Site Freiburg and German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5a, 79106, Freiburg, Germany
- Department of Chemistry, Integrative Biosciences (Ibio), Karmanos Cancer Institute (KCI), Wayne State University, Detroit, MI, 48202, USA
| | - Daniel Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Yi-Fen Yen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Franz Schilling
- Department of Nuclear Medicine, TUM School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
- Partner Site Freiburg and German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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2
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Ouyang J, Wang H, Huang J. The role of lactate in cardiovascular diseases. Cell Commun Signal 2023; 21:317. [PMID: 37924124 PMCID: PMC10623854 DOI: 10.1186/s12964-023-01350-7] [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: 07/16/2023] [Accepted: 10/06/2023] [Indexed: 11/06/2023] Open
Abstract
Cardiovascular diseases pose a major threat worldwide. Common cardiovascular diseases include acute myocardial infarction (AMI), heart failure, atrial fibrillation (AF) and atherosclerosis. Glycolysis process often has changed during these cardiovascular diseases. Lactate, the end-product of glycolysis, has been overlooked in the past but has gradually been identified to play major biological functions in recent years. Similarly, the role of lactate in cardiovascular disease is gradually being recognized. Targeting lactate production, regulating lactate transport, and modulating circulating lactate levels may serve as potential strategies for the treatment of cardiovascular diseases in the future. The purpose of this review is to integrate relevant clinical and basic research on the role of lactate in the pathophysiological process of cardiovascular disease in recent years to clarify the important role of lactate in cardiovascular disease and to guide further studies exploring the role of lactate in cardiovascular and other diseases. Video Abstract.
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Affiliation(s)
- Jun Ouyang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Hui Wang
- School of Pharmacy, Guangxi Medical University, Nanning, China.
| | - Jiangnan Huang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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3
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Sejersen S, Rasmussen CW, Bøgh N, Kjaergaard U, Hansen ESS, Schulte RF, Laustsen C. Considering whole-body metabolism in hyperpolarized MRI through 13 C breath analysis-An alternative way to quantification and normalization? Magn Reson Med 2023; 90:664-672. [PMID: 37094025 DOI: 10.1002/mrm.29669] [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: 11/21/2022] [Revised: 03/12/2023] [Accepted: 03/27/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE Hyperpolarized [1-13 C]pyruvate MRI is an emerging clinical tool for metabolic imaging. It has the potential for absolute quantitative metabolic imaging. However, the method itself is not quantitative, limiting comparison of images across both time and between individuals. Here, we propose a simple signal normalization to the whole-body oxidative metabolism to overcome this limitation. THEORY AND METHODS A simple extension of the model-free ratiometric analysis of hyperpolarized [1-13 C]pyruvate MRI is presented, using the expired 13 CO2 in breath for normalization. The proposed framework was investigated in two porcine cohorts (N = 11) subjected to local renal hypoperfusion defects and subsequent [1-13 C]pyruvate MRI. A breath sample was taken before the [1-13 C]pyruvate injection and 5 min after. The raw MR signal from both the healthy and intervened kidney in the two cohorts was normalized using the 13 CO2 in the expired air. RESULTS 13 CO2 content in the expired air was significantly different between the two cohorts. Normalization to this reduced the coefficients of variance in the aerobic metabolic sensitive pathways by 25% for the alanine/pyruvate ratio, and numerical changes were observed in the bicarbonate/pyruvate ratio. The lactate/pyruvate ratio was largely unaltered (<2%). CONCLUSION Our results indicate that normalizing the hyperpolarized 13 C-signal ratios by the 13 CO2 content in expired air can reduce variation as well as improve specificity of the method by normalizing the metabolic readout to the overall metabolic status of the individual. The method is a simple and cheap extension to the hyperpolarized 13 C exam.
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Affiliation(s)
- Steffen Sejersen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Camilla W Rasmussen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Uffe Kjaergaard
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Esben S S Hansen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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4
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Wei Y, Yang C, Jiang H, Li Q, Che F, Wan S, Yao S, Gao F, Zhang T, Wang J, Song B. Multi-nuclear magnetic resonance spectroscopy: state of the art and future directions. Insights Imaging 2022; 13:135. [PMID: 35976510 PMCID: PMC9382599 DOI: 10.1186/s13244-022-01262-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/04/2022] [Indexed: 12/16/2022] Open
Abstract
With the development of heteronuclear fluorine, sodium, phosphorus, and other probes and imaging technologies as well as the optimization of magnetic resonance imaging (MRI) equipment and sequences, multi-nuclear magnetic resonance (multi-NMR) has enabled localize molecular activities in vivo that are central to a variety of diseases, including cardiovascular disease, neurodegenerative pathologies, metabolic diseases, kidney, and tumor, to shift from the traditional morphological imaging to the molecular imaging, precision diagnosis, and treatment mode. However, due to the low natural abundance and low gyromagnetic ratios, the clinical application of multi-NMR has been hampered. Several techniques have been developed to amplify the NMR sensitivity such as the dynamic nuclear polarization, spin-exchange optical pumping, and brute-force polarization. Meanwhile, a wide range of nuclei can be hyperpolarized, such as 2H, 3He, 13C, 15 N, 31P, and 129Xe. The signal can be increased and allows real-time observation of biological perfusion, metabolite transport, and metabolic reactions in vivo, overcoming the disadvantages of conventional magnetic resonance of low sensitivity. HP-NMR imaging of different nuclear substrates provides a unique opportunity and invention to map the metabolic changes in various organs without invasive procedures. This review aims to focus on the recent applications of multi-NMR technology not only in a range of preliminary animal experiments but also in various disease spectrum in human. Furthermore, we will discuss the future challenges and opportunities of this multi-NMR from a clinical perspective, in the hope of truly bridging the gap between cutting-edge molecular biology and clinical applications.
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Affiliation(s)
- Yi Wei
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Caiwei Yang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Hanyu Jiang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Qian Li
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Feng Che
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Shang Wan
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Shan Yao
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Feifei Gao
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Tong Zhang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Jiazheng Wang
- Clinical & Technical Support, Philips Healthcare, Beijing, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China. .,Department of Radiology, Sanya People's Hospital, Sanya, China.
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5
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Yoshihara HAI, Comment A, Schwitter J. Assessment of Aspartate and Bicarbonate Produced From Hyperpolarized [1- 13C]Pyruvate as Markers of Renal Gluconeogenesis. Front Physiol 2021; 12:792769. [PMID: 34955898 PMCID: PMC8702956 DOI: 10.3389/fphys.2021.792769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
As both a consumer and producer of glucose, the kidney plays a significant role in glucose homeostasis. Measuring renal gluconeogenesis requires invasive techniques, and less invasive methods would allow renal gluconeogenesis to be measured more routinely. Magnetic resonance spectroscopy and imaging of infused substrates bearing hyperpolarized carbon-13 spin labels allows metabolism to be detected within the body with excellent sensitivity. Conversion of hyperpolarized 1-13C pyruvate in the fasted rat liver is associated with gluconeogenic flux through phosphoenolpyruvate carboxykinase (PEPCK) rather than pyruvate dehydrogenase (PDH), and this study tested whether this was also the case in the kidney. The left kidney was scanned in fed and overnight-fasted rats either with or without prior treatment by the PEPCK inhibitor 3-mercaptopicolinic acid (3-MPA) following infusion of hyperpolarized 1-13C pyruvate. The 13C-bicarbonate signal normalized to the total metabolite signal was 3.2-fold lower in fasted rats (p = 0.00073) and was not significantly affected by 3-MPA treatment in either nutritional state. By contrast, the normalized [1-13C]aspartate signal was on average 2.2-fold higher in the fasted state (p = 0.038), and following 3-MPA treatment it was 2.8-fold lower in fed rats and 15-fold lower in fasted rats (p = 0.001). These results confirm that, unlike in the liver, most of the pyruvate-to-bicarbonate conversion in the fasted kidney results from PDH flux. The higher conversion to aspartate in fasted kidney and the marked drop following PEPCK inhibition demonstrate the potential of this metabolite as a marker of renal gluconeogenesis.
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Affiliation(s)
- Hikari A. I. Yoshihara
- Laboratory for Functional and Metabolic Imaging, Institute of Physics, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Arnaud Comment
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
- General Electric Healthcare, Chalfont St Giles, United Kingdom
| | - Juerg Schwitter
- Division of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Cardiac MR Center, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
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6
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Tougaard RS, Laustsen C, Lassen TR, Qi H, Lindhardt JL, Schroeder M, Jespersen NR, Hansen ESS, Ringgaard S, Bøtker HE, Kim WY, Stødkilde-Jørgensen H, Wiggers H. Remodeling after myocardial infarction and effects of heart failure treatment investigated by hyperpolarized [1- 13 C]pyruvate magnetic resonance spectroscopy. Magn Reson Med 2021; 87:57-69. [PMID: 34378800 DOI: 10.1002/mrm.28964] [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: 02/06/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE Hyperpolarized [1-13 C]pyruvate MRS can measure cardiac metabolism in vivo. We investigated whether [1-13 C]pyruvate MRS could predict left ventricular remodeling following myocardial infarction (MI), long-term left ventricular effects of heart failure medication, and could identify responders to treatment. METHODS Thirty-five rats were scanned with hyperpolarized [1-13 C]pyruvate MRS 3 days after MI or sham surgery. The animals were re-examined after 30 days of therapy with β-blockers and ACE-inhibitors (active group, n = 12), placebo treatment (placebo group, n = 13) or no treatment (sham group, n = 10). Furthermore, heart tissue mitochondrial respiratory capacity was assessed by high-resolution respirometry. Metabolic results were compared between groups, over time and correlated to functional MR data at each time point. RESULTS At 30 ± 0.5 days post MI, left ventricular ejection fraction (LVEF) differed between groups (sham, 77% ± 1%; placebo, 52% ± 3%; active, 63% ± 2%, P < .001). Cardiac metabolism, measured by both hyperpolarized [1-13 C]pyruvate MRS and respirometry, neither differed between groups nor between baseline and follow-up. Three days post MI, low bicarbonate + CO2 /pyruvate ratio was associated with low LVEF. At follow-up, in the active group, a poor recovery of LVEF was associated with high bicarbonate + CO2 /pyruvate ratio, as measured by hyperpolarized MRS. CONCLUSION In a rat model of moderate heart failure, medical treatment improved function, but did not on average influence [1-13 C]pyruvate flux as measured by MRS; however, responders to heart failure medication had reduced capacity for carbohydrate metabolism.
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Affiliation(s)
- Rasmus Stilling Tougaard
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.,MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | | | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Jakob Lykke Lindhardt
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Marie Schroeder
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | | | | | - Steffen Ringgaard
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Won Yong Kim
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.,MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | | | - Henrik Wiggers
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
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7
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van Erp AC, Qi H, Jespersen NR, Hjortbak MV, Ottens PJ, Wiersema‐Buist J, Nørregaard R, Pedersen M, Laustsen C, Leuvenink HGD, Jespersen B. Organ-specific metabolic profiles of the liver and kidney during brain death and afterwards during normothermic machine perfusion of the kidney. Am J Transplant 2020; 20:2425-2436. [PMID: 32282984 PMCID: PMC7496945 DOI: 10.1111/ajt.15885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 02/06/2023]
Abstract
We investigated metabolic changes during brain death (BD) using hyperpolarized magnetic resonance (MR) spectroscopy and ex vivo graft glucose metabolism during normothermic isolated perfused kidney (IPK) machine perfusion. BD was induced in mechanically ventilated rats by inflation of an epidurally placed catheter; sham-operated rats served as controls. Hyperpolarized [1-13 C]pyruvate MR spectroscopy was performed to quantify pyruvate metabolism in the liver and kidneys at 3 time points during BD, preceded by injecting hyperpolarized[1-13 C]pyruvate. Following BD, glucose oxidation was measured using tritium-labeled glucose (d-6-3H-glucose) during IPK reperfusion. Quantitative polymerase chain reaction and biochemistry were performed on tissue/plasma. Immediately following BD induction, lactate increased in both organs (liver: eµd 0.21, 95% confidence interval [CI] [-0.27, -0.15]; kidney: eµd 0.26, 95% CI [-0.40, -0.12]. After 4 hours of BD, alanine production decreased in the kidney (eµd 0.14, 95% CI [0.03, 0.25], P < .05). Hepatic lactate and alanine profiles were significantly different throughout the experiment between groups (P < .01). During IPK perfusion, renal glucose oxidation was reduced following BD vs sham animals (eµd 0.012, 95% CI [0.004, 0.03], P < .001). No differences in enzyme activities were found. Renal gene expression of lactate-transporter MCT4 increased following BD (P < .01). In conclusion, metabolic processes during BD can be visualized in vivo using hyperpolarized magnetic resonance imaging and with glucose oxidation during ex vivo renal machine perfusion. These techniques can detect differences in the metabolic profiles of the liver and kidney following BD.
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Affiliation(s)
- Anne C. van Erp
- University of GroningenUniversity Medical Center GroningenDepartment of surgeryGroningenthe Netherlands
| | - Haiyun Qi
- MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | | | | | - Petra J. Ottens
- University of GroningenUniversity Medical Center GroningenDepartment of surgeryGroningenthe Netherlands
| | - Janneke Wiersema‐Buist
- University of GroningenUniversity Medical Center GroningenDepartment of surgeryGroningenthe Netherlands
| | | | | | - Christoffer Laustsen
- MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Henri G. D. Leuvenink
- University of GroningenUniversity Medical Center GroningenDepartment of surgeryGroningenthe Netherlands
| | - Bente Jespersen
- Department of Clinical MedicineAarhus UniversityAarhusDenmark,Department of Renal MedicineAarhus University HospitalAarhusDenmark
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Laustsen C, Nielsen PM, Qi H, Løbner MH, Palmfeldt J, Bertelsen LB. Hyperpolarized [1,4- 13C]fumarate imaging detects microvascular complications and hypoxia mediated cell death in diabetic nephropathy. Sci Rep 2020; 10:9650. [PMID: 32541797 PMCID: PMC7295762 DOI: 10.1038/s41598-020-66265-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022] Open
Abstract
Today, there is a general lack of prognostic biomarkers for development of renal disease and in particular diabetic nephropathy. Increased glycolytic activity, lactate accumulation and altered mitochondrial oxygen utilization are hallmarks of diabetic kidney disease. Fumarate hydratase activity has been linked to mitochondrial dysfunction as well as activation of the hypoxia inducible factor, induction of apoptosis and necrosis. Here, we investigate fumarate hydratase activity in biofluids in combination with the molecular imaging probe, hyperpolarized [1,4-13C2]fumarate, to identify the early changes associated with hemodynamics and cell death in a streptozotocin rat model of type 1 diabetes. We found a significantly altered hemodynamic signature of [1,4-13C2]fumarate in the diabetic kidneys as well as an systemic increased metabolic conversion of fumarate-to-malate, indicative of increased cell death associated with progression of diabetes, while little to no renal specific conversion was observed. This suggest apoptosis as the main cause of cell death in the diabetic kidney. This is likely resulting from an increased reactive oxygen species production following uncoupling of the electron transport chain at complex II. The mechanism coupling the enzyme leakage and apoptotic phenotype is hypoxia inducible factor independent and seemingly functions as a protective mechanism in the kidney cells.
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Affiliation(s)
- Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mette Hadberg Løbner
- Research Unit for Molecular Medicine, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Johan Palmfeldt
- Research Unit for Molecular Medicine, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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9
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Nielsen PM, Qi H, Bertelsen LB, Laustsen C. Metabolic reprogramming associated with progression of renal ischemia reperfusion injury assessed with hyperpolarized [1- 13C]pyruvate. Sci Rep 2020; 10:8915. [PMID: 32488151 PMCID: PMC7265284 DOI: 10.1038/s41598-020-65816-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 05/11/2020] [Indexed: 01/02/2023] Open
Abstract
Acute kidney injury is a major clinical challenge affecting as many as 1 percent of all hospitalized patients. Currently it is not possible to accurately stratify and predict the outcome of the individual patient. Increasing evidence supports metabolic reprogramming as a potential target for new biomarkers. Hyperpolarized [1-13C]pyruvate imaging is a promising new tool for evaluating the metabolic status directly in the kidneys. We here investigate the prognostic potential of hyperpolarized [1-13C]pyruvate in the setting of acute kidney injury in a rodent model of ischemia reperfusion. A significant correlation was found between the intra-renal metabolic profile 24 hours after reperfusion and 7 days after injury induction, as well as a correlation with the conventional plasma creatinine biomarker of renal function and markers of renal injury. This leads to a possible outcome prediction of renal function and injury development from a metabolic profile measured in vivo. The results support human translation of this new technology to renal patients as all experiements have been performed using clinical MRI equipment.
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Affiliation(s)
- Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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10
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Nielsen PM, Mariager CØ, Mølmer M, Sparding N, Genovese F, Karsdal MA, Nørregaard R, Bertelsen LB, Laustsen C. Hyperpolarized [1- 13 C] alanine production: A novel imaging biomarker of renal fibrosis. Magn Reson Med 2020; 84:2063-2073. [PMID: 32452096 DOI: 10.1002/mrm.28326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Renal tubulointerstitial fibrosis is strongly linked to the progressive decline of renal function seen in chronic kidney disease. State-of-the-art noninvasive diagnostic modalities are currently unable to detect the earliest changes associated with the onset of fibrosis. This study was undertaken to evaluate the potential for detecting the earliest alterations in fibrogenesis using a biofluid-based method and metabolic hyperpolarized [1-13 C]pyruvate imaging. METHODS We evaluated renal fibrosis in a combined ischemia reperfusion-induced and streptozotocin-induced diabetic nephropathy rodent model by hyperpolarized [1-13 C]pyruvate MRI and correlated the metabolic MRI parameters with biomarkers of fibrosis measured on renal tissue and plasma/urine. RESULTS The hyperglycemic rats experienced maladaptive injury repair after the ischemic insults, as shown by the elevation in the injury markers kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin. Renal function was significantly impaired in the ischemic hyperglycemic kidney, as seen in the reduced perfusion and single-kidney glomerular filtration rate. A deranged energy metabolism was detected in the ischemic hyperglycemic kidney, as seen in the reduced fractional perfusion of lactate. Renal fibrosis biomarkers correlated significantly with the alanine production. CONCLUSION Hyperpolarized carbon-13 MRI provides a promising approach to assess renal fibrosis in an animal model of fibrotic chronic kidney disease. In particular, the metabolic supply of amino acids for fibrogenesis (alanine production) correlates well with biomarkers of fibrosis. Thus, [1-13 C]pyruvate-to-[1-13 C]alanine conversion might be a candidate for noninvasive assessment of renal fibrogenesis.
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Affiliation(s)
- Per Mose Nielsen
- MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Maria Mølmer
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | | | | | - Rikke Nørregaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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11
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Pedersen M, Ursprung S, Jensen JD, Jespersen B, Gallagher F, Laustsen C. Hyperpolarised 13C-MRI metabolic and functional imaging: an emerging renal MR diagnostic modality. MAGMA (NEW YORK, N.Y.) 2020; 33:23-32. [PMID: 31782036 DOI: 10.1007/s10334-019-00801-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/21/2019] [Accepted: 11/12/2019] [Indexed: 12/11/2022]
Abstract
Magnetic resonance imaging (MRI) is a well-established modality for assessing renal morphology and function, as well as changes that occur during disease. However, the significant metabolic changes associated with renal disease are more challenging to assess with MRI. Hyperpolarized carbon-13 MRI is an emerging technique which provides an opportunity to probe metabolic alterations at high sensitivity by providing an increase in the signal-to-noise ratio of 20,000-fold or more. This review will highlight the current status of hyperpolarised 13C-MRI and its translation into the clinic and how it compares to metabolic measurements provided by competing technologies such as positron emission tomography (PET).
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Affiliation(s)
| | - Stephan Ursprung
- Department of Radiology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Jens Dam Jensen
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Jespersen
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ferdia Gallagher
- Department of Radiology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University Hospital, Palle Juul Jensens Boulevard, 8200, Aarhus N, Denmark.
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12
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Laustsen C, Lipsø K, Østergaard JA, Nielsen PM, Bertelsen LB, Flyvbjerg A, Pedersen M, Palm F, Ardenkjær-Larsen JH. High Intrarenal Lactate Production Inhibits the Renal Pseudohypoxic Response to Acutely Induced Hypoxia in Diabetes. ACTA ACUST UNITED AC 2020; 5:239-247. [PMID: 31245545 PMCID: PMC6588198 DOI: 10.18383/j.tom.2019.00003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Intrarenal hypoxia develops within a few days after the onset of insulinopenic diabetes in an experimental animal model (ie, a model of type-1 diabetes). Although diabetes-induced hypoxia results in increased renal lactate formation, mitochondrial function is well maintained, a condition commonly referred to as pseudohypoxia. However, the metabolic effects of significantly elevated lactate levels remain unclear. We therefore investigated in diabetic animals the response to acute intrarenal hypoxia in the presence of high renal lactate formation to delineate mechanistic pathways and compare these findings to healthy control animals. Hyperpolarized 13C-MRI and blood oxygenation level–dependent 1H-MRI was used to investigate the renal metabolism of [1-13C]pyruvate and oxygenation following acutely altered oxygen content in the breathing gas in a streptozotocin rat model of type-1 diabetes with and without insulin treatment and compared with healthy control rats. The lactate signal in the diabetic kidney was reduced by 12%–16% during hypoxia in diabetic rats irrespective of insulin supplementation. In contrast, healthy controls displayed the well-known Pasteur effect manifested as a 10% increased lactate signal following reduction of oxygen in the inspired air. Reduced expression of the monocarboxyl transporter-4 may account for altered response to hypoxia in diabetes with a high intrarenal pyruvate-to-lactate conversion. Reduced intrarenal lactate formation in response to hypoxia in diabetes shows the existence of a different metabolic phenotype, which is independent of insulin, as insulin supplementation was unable to affect the pyruvate-to-lactate conversion in the diabetic kidney.
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Affiliation(s)
- Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Kasper Lipsø
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Electrical Engineering, Technical University of Denmark, Kgs Lyngby, Denmark
| | - Jakob Appel Østergaard
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Per Mose Nielsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Allan Flyvbjerg
- Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Gentofte, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - Michael Pedersen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Fredrik Palm
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden; and
| | - Jan Henrik Ardenkjær-Larsen
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Electrical Engineering, Technical University of Denmark, Kgs Lyngby, Denmark.,GE Healthcare, Copenhagen, Denmark
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13
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Koellisch U, Laustsen C, Nørlinger TS, Østergaard JA, Flyvbjerg A, Gringeri CV, Menzel MI, Schulte RF, Haase A, Stødkilde-Jørgensen H. Current state-of-the-art hyperpolarized 13C-acetate-to-acetylcarnitine imaging is not indicative of the altered balance between glucose and fatty acid utilization associated with diabetes. Physiol Rep 2019; 4:4/17/e12975. [PMID: 27624689 PMCID: PMC5027367 DOI: 10.14814/phy2.12975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 08/25/2016] [Indexed: 01/06/2023] Open
Affiliation(s)
- Ulrich Koellisch
- Institute of Medical Engineering, Technische Universit at Munchen, Munich, Germany
| | | | | | - Jakob A Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Endocrinology and Internal medicine, Aarhus University Hospital, Aarhus, Denmark Danish Diabetes Academy, Aarhus, Denmark
| | - Allan Flyvbjerg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Endocrinology and Internal medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Concetta V Gringeri
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | | | | | - Axel Haase
- Institute of Medical Engineering, Technische Universit at Munchen, Munich, Germany
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14
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Qi H, Mariager CØ, Nielsen PM, Schroeder M, Lindhardt J, Nørregaard R, Klein JD, Sands JM, Laustsen C. Glucagon infusion alters the hyperpolarized 13 C-urea renal hemodynamic signature. NMR IN BIOMEDICINE 2019; 32:e4028. [PMID: 30426590 DOI: 10.1002/nbm.4028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/13/2018] [Accepted: 09/19/2018] [Indexed: 06/09/2023]
Abstract
Renal urea handling is central to the urine concentrating mechanism, and as such the ability to image urea transport in the kidney is an important potential imaging biomarker for renal functional assessment. Glucagon levels associated with changes in dietary protein intake have been shown to influence renal urea handling; however, the exact mechanism has still to be fully understood. Here we investigate renal function and osmolite distribution using [13 C,15 N] urea dynamics and 23 Na distribution before and 60 min after glucagon infusion in six female rats. Glucagon infusion increased the renal [13 C,15 N] urea mean transit time by 14%, while no change was seen in the sodium distribution, glomerular filtration rate or oxygen consumption. This change is related to the well-known effect of increased urea excretion associated with glucagon infusion, independent of renal functional effects. This study demonstrates for the first time that hyperpolarized 13 C-urea enables monitoring of renal urinary excretion effects in vivo.
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Affiliation(s)
- Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Marie Schroeder
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jakob Lindhardt
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Rikke Nørregaard
- Water Salt Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Janet D Klein
- Renal Division, Department of Medicine, Emory University, Giorgia, USA
| | - Jeff M Sands
- Renal Division, Department of Medicine, Emory University, Giorgia, USA
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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15
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Kjærgaard U, Laustsen C, Nørlinger T, Tougaard RS, Mikkelsen E, Qi H, Bertelsen LB, Jessen N, Stødkilde‐Jørgensen H. Hyperpolarized [1- 13 C] pyruvate as a possible diagnostic tool in liver disease. Physiol Rep 2018; 6:e13943. [PMID: 30548433 PMCID: PMC6289910 DOI: 10.14814/phy2.13943] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/24/2018] [Accepted: 11/19/2018] [Indexed: 12/18/2022] Open
Abstract
Introduction of hyperpolarized magnetic resonance in preclinical studies and lately translation to patients provides new detailed in vivo information of metabolic flux in organs. Hyperpolarized magnetic resonance based on 13 C enriched pyruvate is performed without ionizing radiation and allows quantification of the pyruvate conversion products: alanine, lactate and bicarbonate in real time. Thus, this methodology has a promising potential for in vivo monitoring of energetic alterations in hepatic diseases. Using 13 C pyruvate, we investigated the metabolism in the porcine liver before and after intravenous injection of glucose. The overall mean lactate to pyruvate ratio increased significantly after the injection of glucose whereas the bicarbonate to pyruvate ratio was unaffected, representative of the levels of pyruvate entering the tricarboxylic acid cycle. Similarly, alanine to pyruvate ratio did not change. The increased lactate to pyruvate ratio over time showed an exponential correlation with insulin, glucagon and free fatty acids. Together, these data, obtained by hyperpolarized 13 C magnetic resonance spectroscopy and by blood sampling, indicate a hepatic metabolic shift in glucose utilization following a glucose challenge. Our findings demonstrate the capacity of hyperpolarized 13 C magnetic resonance spectroscopy for quantifying hepatic substrate metabolism in accordance with well-known physiological processes. When combined with concentration of blood insulin, glucagon and free fatty acids in the blood, the results indicate the potential of hyperpolarized magnetic resonance spectroscopy as a future clinical method for quantification of hepatic substrate metabolism.
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Affiliation(s)
- Uffe Kjærgaard
- MR Research CentreAarhus University HospitalAarhusDenmark
| | | | | | - Rasmus S. Tougaard
- MR Research CentreAarhus University HospitalAarhusDenmark
- Department of CardiologyAarhus University HospitalAarhusDenmark
| | | | - Haiyun Qi
- MR Research CentreAarhus University HospitalAarhusDenmark
| | | | - Niels Jessen
- Department of BiomedicineAarhus UniversityAarhusDenmark
- Department of Clinical PharmacologyAarhus University HospitalAarhusDenmark
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16
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Tougaard RS, Szocska Hansen ES, Laustsen C, Nørlinger TS, Mikkelsen E, Lindhardt J, Nielsen PM, Bertelsen LB, Schroeder M, Bøtker HE, Kim WY, Wiggers H, Stødkilde-Jørgensen H. Hyperpolarized [1- 13 C]pyruvate MRI can image the metabolic shift in cardiac metabolism between the fasted and fed state in a porcine model. Magn Reson Med 2018; 81:2655-2665. [PMID: 30387898 DOI: 10.1002/mrm.27560] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/20/2018] [Accepted: 09/14/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE Owing to its noninvasive nature, hyperpolarized MRI may improve delineation of myocardial metabolic derangement in heart disease. However, consistency may depend on the changeable nature of cardiac metabolism in relation to whole-body metabolic state. This study investigates the impact of feeding status on cardiac hyperpolarized MRI in a large animal model resembling human physiology. METHODS Thirteen 30-kg pigs were subjected to an overnight fast, and 5 pigs were fed a carbohydrate-rich meal on the morning of the experiments. Vital parameters and blood samples were registered. All pigs were then scanned by hyperpolarized [1-13 C]pyruvate cardiac MRI, and results were compared between the 2 groups and correlated with circulating substrates and hormones. RESULTS The fed group had higher blood glucose concentration and mean arterial pressure than the fasted group. Plasma concentrations of free fatty acids (FFAs) were decreased in the fed group, whereas plasma insulin concentrations were similar between groups. Hyperpolarized MRI showed that fed animals had increased lactate/pyruvate, alanine/pyruvate, and bicarbonate/pyruvate ratios. Metabolic ratios correlated negatively with FFA levels. CONCLUSION Hyperpolarized MR can identify the effects of different metabolic states on cardiac metabolism in a large animal model. Unlike previous rodent studies, all metabolic derivatives of pyruvate increased in the myocardium of fed pigs. Carbohydrate-rich feeding seems to be a feasible model for standardized, large animal hyperpolarized MRI studies of myocardial carbohydrate metabolism.
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Affiliation(s)
- Rasmus Stilling Tougaard
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Esben Søvsø Szocska Hansen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Danish Diabetes Academy, Odense, Denmark
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Emmeli Mikkelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jakob Lindhardt
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Marie Schroeder
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Won Yong Kim
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Wiggers
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
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17
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Bertelsen LB, Nielsen PM, Qi H, Mariager CØ, Lindhardt J, Laustsen C. Renal Energy Metabolism Following Acute Dichloroacetate and 2,4-Dinitrophenol Administration: Assessing the Cumulative Action with Hyperpolarized [1- 13C]Pyruvate MRI. ACTA ACUST UNITED AC 2018; 4:105-109. [PMID: 30320210 PMCID: PMC6173791 DOI: 10.18383/j.tom.2018.00022] [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: 11/24/2022]
Abstract
Numerous patient groups receive >1 medication and as such represent a potential point of improvement in today's healthcare setup, as the combined or cumulative effects are difficult to monitor in an individual patient. Here we show the ability to monitor the pharmacological effect of 2 classes of medications sequentially, namely, 2,4-dinitrophenol, a mitochondrial uncoupler, and dichloroacetate, a pyruvate dehydrogenase kinase inhibitor, both targeting the oxygen-dependent energy metabolism. We show that although the 2 drugs target 2 different metabolic pathways connected ultimately to oxygen metabolism, we could distinguish the 2 in vivo by using hyperpolarized [1-13C]pyruvate magnetic resonance imaging. A statistically significantly different pyruvate dehydrogenase flux was observed by reversing the treatment order of 2,4-dinitrophenol and dichloroacetate. The significance of this study is the demonstration of the ability to monitor the metabolic cumulative effects of 2 distinct therapeutics on an in vivo organ level using hyperpolarized magnetic resonance imaging.
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Affiliation(s)
- Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Jakob Lindhardt
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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18
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Abstract
Globally, diabetes is the leading cause of chronic kidney disease and end-stage renal disease, which are major risk factors for cardiovascular disease and death. Despite this burden, the factors that precipitate the development and progression of diabetic kidney disease (DKD) remain to be fully elucidated. Mitochondrial dysfunction is associated with kidney disease in nondiabetic contexts, and increasing evidence suggests that dysfunctional renal mitochondria are pathological mediators of DKD. These complex organelles have a broad range of functions, including the generation of ATP. The kidneys are mitochondrially rich, highly metabolic organs that require vast amounts of ATP for their normal function. The delivery of metabolic substrates for ATP production, such as fatty acids and oxygen, is altered by diabetes. Changes in metabolic fuel sources in diabetes to meet ATP demands result in increased oxygen consumption, which contributes to renal hypoxia. Inherited factors including mutations in genes that impact mitochondrial function and/or substrate delivery may also be important risk factors for DKD. Hence, we postulate that the diabetic milieu and inherited factors that underlie abnormalities in mitochondrial function synergistically drive the development and progression of DKD.
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Affiliation(s)
- Josephine M Forbes
- Glycation and Diabetes Group, Mater Research Institute, The University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia.,Mater Clinical School, School of Medicine, The University of Queensland, St Lucia, Queensland, Australia.,Departments of Medicine and Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David R Thorburn
- Departments of Medicine and Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
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19
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Mikkelsen EFR, Mariager CØ, Nørlinger T, Qi H, Schulte RF, Jakobsen S, Frøkiær J, Pedersen M, Stødkilde-Jørgensen H, Laustsen C. Hyperpolarized [1- 13C]-acetate Renal Metabolic Clearance Rate Mapping. Sci Rep 2017; 7:16002. [PMID: 29167446 PMCID: PMC5700138 DOI: 10.1038/s41598-017-15929-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/03/2017] [Indexed: 01/02/2023] Open
Abstract
11C-acetate is a positron emission tomography (PET) tracer of oxidative metabolism, whereas hyperpolarized 13C-acetate can be used in magnetic resonance imaging (MRI) for investigating specific metabolic processes. The aims of this study were to examine if the kinetic formalism of 11C-acetate PET in the kidneys is comparable to that of 13C-acetate MRI, and to compare the dynamic metabolic information of hyperpolarized 13C-acetate MRI with that obtained with 11C-acetate PET. Rats were examined with dynamic hyperpolarized 13C-acetate MRI or 11C-acetate PET before and after intravenous injection of furosemide, a loop diuretic known to alter both the hemodynamics and oxygen consumption in the kidney. The metabolic clearance rates (MCR) were estimated and compared between the two modalities experimentally in vivo and in simulations. There was a clear dependency on the mean transit time and MCR for both 13C-acetate and 11C-acetate following furosemide administration, while no dependencies on the apparent renal perfusion were observed. This study demonstrated that hyperpolarized 13C-acetate MRI is feasible for measurements of the intrarenal energetic demand via the MCR, and that the quantitative measures are correlated with those measured by 11C-acetate PET, even though the temporal window is more than 30 times longer with 11C-acetate.
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Affiliation(s)
- Emmeli F R Mikkelsen
- MR Research Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.,Comparative Medicine Lab, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | | | - Thomas Nørlinger
- MR Research Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.,Comparative Medicine Lab, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Haiyun Qi
- MR Research Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Rolf F Schulte
- GE healthcare, Freisinger Landstraße 50, 85748, Munich, Germany
| | - Steen Jakobsen
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Nørrebrogade, 8000, Aarhus C, Denmark
| | - Jørgen Frøkiær
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Nørrebrogade, 8000, Aarhus C, Denmark
| | - Michael Pedersen
- Comparative Medicine Lab, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Hans Stødkilde-Jørgensen
- MR Research Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Christoffer Laustsen
- MR Research Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
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20
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Østergaard Mariager C, Nielsen PM, Qi H, Schroeder M, Bertelsen LB, Laustsen C. Can Hyperpolarized 13C-Urea be Used to Assess Glomerular Filtration Rate? A Retrospective Study. ACTA ACUST UNITED AC 2017; 3:146-152. [PMID: 30042978 PMCID: PMC6024438 DOI: 10.18383/j.tom.2017.00010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This study investigated a simple method for calculating the single-kidney glomerular filtration rate (GFR) using dynamic hyperpolarized 13C-urea magnetic resonance (MR) renography. A retrospective data analysis was applied to renal hyperpolarized 13C-urea MR data acquired from control rats, prediabetic nephropathy rats, and rats in which 1 kidney was subjected to ischemia-reperfusion. Renal blood flow was determined by the model-free bolus differentiation method, GFR was determined using the Baumann–Rudin model method. Reference single-kidney and total GFRs were measured by plasma creatinine content and compared to 1H dynamic contrast-enhanced estimated GFR and fluorescein isothiocyanate-inulin clearance GFR estimation. In healthy and prediabetic nephropathy rats, single-kidney hyperpolarized 13C-urea GFR was estimated to be 2.5 ± 0.7 mL/min in good agreement with both gold-standard inulin clearance GFR (2.7 ± 1.2 ml/min) and 1H dynamic contrast-enhanced estimated GFR (1.8 ± 0.8 mL/min), as well as plasma creatinine measurements and literature findings. Following ischemia-reperfusion, hyperpolarized 13C-urea revealed a significant reduction in single-kidney GFR of 57% compared with the contralateral kidney. Hyperpolarized 13C MR could be a promising tool for accurate determination of GFR. The model-free renal blood flow and arterial input function-insensitive GFR estimations are simple to implement and warrant further translational adaptation.
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Affiliation(s)
| | - Per Mose Nielsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Haiyun Qi
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Marie Schroeder
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
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21
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Hansen ESS, Tougaard RS, Nørlinger TS, Mikkelsen E, Nielsen PM, Bertelsen LB, Bøtker HE, Jørgensen HS, Laustsen C. Imaging porcine cardiac substrate selection modulations by glucose, insulin and potassium intervention: A hyperpolarized [1- 13 C]pyruvate study. NMR IN BIOMEDICINE 2017; 30. [PMID: 28186677 DOI: 10.1002/nbm.3702] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/21/2016] [Accepted: 12/30/2016] [Indexed: 05/07/2023]
Abstract
Cardiac metabolism has received considerable attention in terms of both diagnostics and prognostics, as well as a novel target for treatment. As human trials involving hyperpolarized magnetic resonance in the heart are imminent, we sought to evaluate the general feasibility of detection of an imposed shift in metabolic substrate utilization during metabolic modulation with glucose-insulin-potassium (GIK) infusion, and thus the limitations associated with this strategy, in a large animal model resembling human physiology. Four [1-13 C]pyruvate injections did not alter the blood pressure or ejection fraction over 180 min. Hyperpolarized [1-13 C]pyruvate conversion showed a generally high reproducibility, with intraclass correlation coefficients between the baseline measurements at 0 and 30 min as follows: lactate to pyruvate, 0.85; alanine to pyruvate, 1.00; bicarbonate to pyruvate, 0.83. This study demonstrates that hyperpolarized [1-13 C]pyruvate imaging is a feasible technique for cardiac studies and shows a generally high reproducibility in fasted large animals. GIK infusion increases the metabolic conversion of pyruvate to its metabolic derivatives lactate, alanine and bicarbonate, but with increased variability.
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Affiliation(s)
- Esben Søvsø Szocska Hansen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - Rasmus Stilling Tougaard
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital Skejby, Aarhus N, Denmark
| | | | - Emmeli Mikkelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital Skejby, Aarhus N, Denmark
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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22
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Gilbert RE. Proximal Tubulopathy: Prime Mover and Key Therapeutic Target in Diabetic Kidney Disease. Diabetes 2017; 66:791-800. [PMID: 28325740 DOI: 10.2337/db16-0796] [Citation(s) in RCA: 204] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 01/02/2017] [Indexed: 11/13/2022]
Abstract
The current view of diabetic kidney disease, based on meticulously acquired ultrastructural morphometry and the utility of measuring plasma creatinine and urinary albumin, has been almost entirely focused on the glomerulus. While clearly of great importance, changes in the glomerulus are not the major determinant of renal prognosis in diabetes and may not be the primary event in the development of diabetic kidney disease either. Indeed, advances in biomarker discovery and a greater appreciation of tubulointerstitial histopathology and the role of tubular hypoxia in the pathogenesis of chronic kidney disease have given us pause to reconsider the current "glomerulocentric" paradigm and focus attention on the proximal tubule that by virtue of the high energy requirements and reliance on aerobic metabolism render it particularly susceptible to the derangements of the diabetic state. Such findings raise important issues for therapeutic advances specifically targeting the pathophysiological perturbations that develop in this part of the nephron.
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Affiliation(s)
- Richard E Gilbert
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada
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23
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Nørlinger TS, Nielsen PM, Qi H, Mikkelsen E, Hansen K, Schmidt NH, Pedersen M, Agger P, Palm F, Laustsen C. Hyperbaric oxygen therapy reduces renal lactate production. Physiol Rep 2017; 5:e13217. [PMID: 28336821 PMCID: PMC5371573 DOI: 10.14814/phy2.13217] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 02/26/2017] [Accepted: 02/28/2017] [Indexed: 01/27/2023] Open
Abstract
Intrarenal hypoxia is an acknowledged factor contributing to the development of diabetic nephropathy. Hyperbaric oxygen (HBO) therapy is a well-known adjuvant treatment for several medical conditions, such as decompression sickness, infections, and wound healing. The underlying metabolic response of HBO is largely unknown. In this study, we investigated the effect of HBO on the intrarenal metabolic alteration in diabetes. Hyperpolarized [1-13C]pyruvate MRI was performed to assess intrarenal energy metabolism in normoglycemic controls and short-term (2 weeks) streptozotocin-induced diabetic rats with and without HBO for five consecutive days. HBO therapy blunted intrarenal lactate production, 3 days after the therapy, in both normoglycemic controls and diabetic rats without affecting either lactate dehydrogenase mRNA expression or activity. HBO therapy reduced lactate formation in both normoglycemic and hyperglycemic rats. These findings support hyperpolarized [1-13C]pyruvate MRI as a novel method for monitoring HBO therapy via the pyruvate to lactate conversion.
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Affiliation(s)
- Thomas S Nørlinger
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Per Mose Nielsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Haiyun Qi
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Emmeli Mikkelsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Kasper Hansen
- Department of Clinical Medicine, Comparative Medicine Lab, Aarhus University, Aarhus, Denmark
| | - Nikolaj H Schmidt
- Department of Clinical Medicine, Comparative Medicine Lab, Aarhus University, Aarhus, Denmark
| | - Michael Pedersen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Comparative Medicine Lab, Aarhus University, Aarhus, Denmark
| | - Peter Agger
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Comparative Medicine Lab, Aarhus University, Aarhus, Denmark
| | - Fredrik Palm
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
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Nielsen PM, Laustsen C, Bertelsen LB, Qi H, Mikkelsen E, Kristensen MLV, Nørregaard R, Stødkilde-Jørgensen H. In situ lactate dehydrogenase activity: a novel renal cortical imaging biomarker of tubular injury? Am J Physiol Renal Physiol 2017; 312:F465-F473. [DOI: 10.1152/ajprenal.00561.2015] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 09/15/2016] [Indexed: 12/11/2022] Open
Abstract
Renal ischemia-reperfusion injury is the state of which a tissue experiences injury after a phase of restrictive blood supply and recirculation. Ischemia-reperfusion injury (I/R-I) is a leading cause of acute kidney injury (AKI) in several disease states, including kidney transplantation, sepsis, and hypovolemic shock. The most common methods to evaluate AKI are creatinine clearance, plasma creatinine, blood urea nitrogen, or renal histology. However, currently, there are no precise methods to directly assess renal injury state noninvasively. Hyperpolarized 13C-pyruvate MRI enables noninvasive accurate quantification of the in vivo conversion of pyruvate to lactate, alanine, and bicarbonate. In the present study, we investigated the in situ alterations of metabolic conversion of pyruvate to lactate, alanine, and bicarbonate in a unilateral I/R-I rat model with 30 min and 60 min of ischemia followed by 24 h of reperfusion. The pyruvate conversion was unaltered compared with sham in the 30 min I/R-I group, while a significant reduced metabolic conversion was found in the postischemic kidney after 60 min of ischemia. This indicates that after 30 min of ischemia, the kidney maintains normal metabolic function in spite of decreased kidney function, whereas the postischemic kidney after 60 min of ischemia show a generally reduced metabolic enzyme activity concomitant with a reduced kidney function. We have confidence that these findings can have a high prognostic value in prediction of kidney injury and the outcome of renal injury.
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Affiliation(s)
- Per Mose Nielsen
- MRI Research Centre, Aarhus University Hospital, Aarhus N, Denmark; and
| | | | | | - Haiyun Qi
- MRI Research Centre, Aarhus University Hospital, Aarhus N, Denmark; and
| | - Emmeli Mikkelsen
- MRI Research Centre, Aarhus University Hospital, Aarhus N, Denmark; and
| | | | - Rikke Nørregaard
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus N, Denmark
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25
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Imaging oxygen metabolism with hyperpolarized magnetic resonance: a novel approach for the examination of cardiac and renal function. Biosci Rep 2017; 37:BSR20160186. [PMID: 27899435 PMCID: PMC5270319 DOI: 10.1042/bsr20160186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 12/24/2022] Open
Abstract
Every tissue in the body critically depends on meeting its energetic demands with sufficient oxygen supply. Oxygen supply/demand imbalances underlie the diseases that inflict the greatest socio-economic burden globally. The purpose of this review is to examine how hyperpolarized contrast media, used in combination with MR data acquisition methods, may advance our ability to assess oxygen metabolism non-invasively and thus improve management of clinical disease. We first introduce the concept of hyperpolarization and how hyperpolarized contrast media have been practically implemented to achieve translational and clinical research. We will then analyse how incorporating hyperpolarized contrast media could enable realization of unmet technical needs in clinical practice. We will focus on imaging cardiac and renal oxygen metabolism, as both organs have unique physiological demands to satisfy their requirements for tissue oxygenation, their dysfunction plays a fundamental role in society’s most prevalent diseases, and each organ presents unique imaging challenges. It is our aim that this review attracts a multi-disciplinary audience and sparks collaborations that utilize an exciting, emergent technology to advance our ability to treat patients adversely affected by an oxygen supply/demand mismatch.
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26
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Fumarase activity: an in vivo and in vitro biomarker for acute kidney injury. Sci Rep 2017; 7:40812. [PMID: 28094329 PMCID: PMC5240145 DOI: 10.1038/srep40812] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 12/12/2016] [Indexed: 11/08/2022] Open
Abstract
Renal ischemia/reperfusion injury (IRI) is a leading cause of acute kidney injury (AKI), and at present, there is a lack of reliable biomarkers that can diagnose AKI and measure early progression because the commonly used methods cannot evaluate single-kidney IRI. Hyperpolarized [1,4-13C2]fumarate conversion to [1,4-13C2]malate by fumarase has been proposed as a measure of necrosis in rat tumor models and in chemically induced AKI rats. Here we show that the degradation of cell membranes in connection with necrosis leads to elevated fumarase activity in plasma and urine and secondly that hyperpolarized [1,4-13C2]malate production 24 h after reperfusion correlates with renal necrosis in a 40-min unilateral ischemic rat model. Fumarase activity screening on bio-fluids can detect injury severity, in bilateral as well as unilateral AKI models, differentiating moderate and severe AKI as well as short- and long-term AKI. Furthermore after verification of renal injury by bio-fluid analysis the precise injury location can be monitored by in vivo measurements of the fumarase activity non-invasively by hyperpolarized [1,4-13C]fumarate MR imaging. The combined in vitro and in vivo biomarker of AKI responds to the essential requirements for a new reliable biomarker of AKI.
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27
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Laustsen C, Nielsen PM, Nørlinger TS, Qi H, Pedersen UK, Bertelsen LB, Østergaard JA, Flyvbjerg A, Ardenkjær-Larsen JH, Palm F, Stødkilde-Jørgensen H. Antioxidant treatment attenuates lactate production in diabetic nephropathy. Am J Physiol Renal Physiol 2017; 312:F192-F199. [DOI: 10.1152/ajprenal.00148.2016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 10/31/2016] [Accepted: 10/31/2016] [Indexed: 12/28/2022] Open
Abstract
The early progression of diabetic nephropathy is notoriously difficult to detect and quantify before the occurrence of substantial histological damage. Recently, hyperpolarized [1-13C]pyruvate has demonstrated increased lactate production in the kidney early after the onset of diabetes, implying increased lactate dehydrogenase activity as a consequence of increased nicotinamide adenine dinucleotide substrate availability due to upregulation of the polyol pathway, i.e., pseudohypoxia. In this study, we investigated the role of oxidative stress in mediating these metabolic alterations using state-of-the-art hyperpolarized magnetic resonance (MR) imaging. Ten-week-old female Wistar rats were randomly divided into three groups: healthy controls, untreated diabetic (streptozotocin treatment to induce insulinopenic diabetes), and diabetic, receiving chronic antioxidant treatment with TEMPOL (4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl) via the drinking water. Examinations were performed 2, 3, and 4 wk after the induction of diabetes by using a 3T Clinical MR system equipped with a dual tuned 13C/1H-volume rat coil. The rats received intravenous hyperpolarized [1-13C]pyruvate and were imaged using a slice-selective 13C-IDEAL spiral sequence. Untreated diabetic rats showed increased renal lactate production compared with that shown by the controls. However, chronic TEMPOL treatment significantly attenuated diabetes-induced lactate production. No significant effects of diabetes or TEMPOL were observed on [13C]alanine levels, indicating an intact glucose-alanine cycle, or [13C]bicarbonate, indicating normal flux through the Krebs cycle. In conclusion, this study demonstrates that diabetes-induced pseudohypoxia, as indicated by an increased lactate-to-pyruvate ratio, is significantly attenuated by antioxidant treatment. This demonstrates a pivotal role of oxidative stress in renal metabolic alterations occurring in early diabetes.
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Affiliation(s)
- Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jakob Appel Østergaard
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - Allan Flyvbjerg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jan Henrik Ardenkjær-Larsen
- GE Healthcare, Copenhagen, Denmark; and
- Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Fredrik Palm
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
- Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
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28
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Lipsø KW, Bowen S, Rybalko O, Ardenkjær-Larsen JH. Large dose hyperpolarized water with dissolution-DNP at high magnetic field. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2017; 274:65-72. [PMID: 27889650 DOI: 10.1016/j.jmr.2016.11.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 05/25/2023]
Abstract
We demonstrate a method for the preparation of hyperpolarized water by dissolution Dynamic Nuclear Polarization at high magnetic field. Protons were polarized at 6.7T and 1.1K to >70% with frequency modulated microwave irradiation at 188GHz. 97.2±0.7% of the radical was extracted from the sample in the dissolution in a two-phase system. 16±1mL of 5.0M 1H in D2O with a polarization of 13.0±0.9% in the liquid state was obtained, corresponding to an enhancement factor of 4000±300 compared to the thermal equilibrium at 9.4T and 293K. A longitudinal relaxation time constant of 16±1s was measured. The sample was polarized and dissolved in a fluid path compatible with clinical polarizers. The volume of hyperpolarized water produced by this method enables angiography and perfusion measurements in large animals, as well as NMR experiments for studies of e.g. proton exchange and polarization transfer to other nuclei.
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Affiliation(s)
- Kasper Wigh Lipsø
- Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Sean Bowen
- Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Oleksandr Rybalko
- Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Jan Henrik Ardenkjær-Larsen
- Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark; GE Healthcare, Brøndby, Denmark.
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29
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Qi H, Nørlinger TS, Nielsen PM, Bertelsen LB, Mikkelsen E, Xu Y, Stødkilde Jørgensen H, Laustsen C. Early diabetic kidney maintains the corticomedullary urea and sodium gradient. Physiol Rep 2016; 4:4/5/e12714. [PMID: 26997625 PMCID: PMC4823596 DOI: 10.14814/phy2.12714] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Early diabetic nephropathy is largely undetectable before substantial functional changes have occurred. In the present study, we investigated the distribution of electrolytes and urea in the early diabetic kidney in order to explore whether pathophysiological and metabolic changes appear concomitantly with a decreased sodium and urea gradient. By using hyperpolarized 13C urea it was possible to measure the essential intrarenal electrolyte gradients and the acute changes following furosemide treatment. No differences in either intrarenal urea or sodium gradients were observed in early diabetes compared to healthy controls. These results indicate that the early metabolic and hypertrophic changes occurring in the diabetic kidney prelude the later functional alterations in diabetic kidney function, thus driving the increased metabolic demand commonly occurring in the diabetic kidney.
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Affiliation(s)
- Haiyun Qi
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Thomas S Nørlinger
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Per M Nielsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Lotte B Bertelsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Emmeli Mikkelsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Yafang Xu
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | | | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
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30
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Nielsen PM, Szocska Hansen ES, Nørlinger TS, Nørregaard R, Bonde Bertelsen L, Stødkilde Jørgensen H, Laustsen C. Renal ischemia and reperfusion assessment with three-dimensional hyperpolarized 13 C, 15 N2-urea. Magn Reson Med 2016; 76:1524-1530. [PMID: 27548739 DOI: 10.1002/mrm.26377] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/25/2016] [Accepted: 07/19/2016] [Indexed: 01/01/2023]
Abstract
PURPOSE The aim of this work was to investigate whether hyperpolarized 13 C,15 N2 -urea can be used as an imaging marker of renal injury in renal unilateral ischemic reperfusion injury (IRI), given that urea is correlated with the renal osmotic gradient, which describes the renal function. METHODS Hyperpolarized three-dimensional balanced steady-state 13 C magnetic resonance imaging (MRI) experiments alongside kidney function parameters and quantitative polymerase chain reaction measurements were performed in rats subjected to unilateral renal ischemia for 60-minute and 24-hour reperfusion. RESULTS We revealed a significant reduction in the intrarenal gradient in the ischemic kidney in agreement with cortical injury markers neutrophil gelatinase-associated lipocalin and kidney injury molecule 1, as well as functional kidney parameters. CONCLUSION Hyperpolarized functional 13 C,15 N2 urea MRI can be used to successfully detect changes in the intrarenal urea gradient post-IRI, thereby enabling in vivo monitoring of the intrarenal functional status in the rat kidney. Magn Reson Med 76:1524-1530, 2016. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Esben Søvsø Szocska Hansen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Danish Diabetes Academy, Odense, Denmark
| | | | - Rikke Nørregaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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31
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Juul T, Palm F, Nielsen PM, Bertelsen LB, Laustsen C. Ex vivo hyperpolarized MR spectroscopy on isolated renal tubular cells: A novel technique for cell energy phenotyping. Magn Reson Med 2016; 78:457-461. [PMID: 27529808 DOI: 10.1002/mrm.26379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 06/23/2016] [Accepted: 07/20/2016] [Indexed: 01/22/2023]
Abstract
PURPOSE It has been demonstrated that hyperpolarized 13 C MR is a useful tool to study cultured cells. However, cells in culture can alter phenotype, which raises concerns regarding the in vivo significance of such findings. Here we investigate if metabolic phenotyping using hyperpolarized 13 C MR is suitable for cells isolated from kidney tissue, without prior cell culture. METHODS Isolation of tubular cells from freshly excised kidney tissue and treatment with either ouabain or antimycin A was investigated with hyperpolarized MR spectroscopy on a 9.4 Tesla preclinical imaging system. RESULTS Isolation of tubular cells from less than 2 g of kidney tissue generally resulted in more than 10 million live tubular cells. This amount of cells was enough to yield robust signals from the conversion of 13 C-pyruvate to lactate, bicarbonate and alanine, demonstrating that metabolic flux by means of both anaerobic and aerobic pathways can be quantified using this technique. CONCLUSION Ex vivo metabolic phenotyping using hyperpolarized 13 C MR in a preclinical system is a useful technique to study energy metabolism in freshly isolated renal tubular cells. This technique has the potential to advance our understanding of both normal cell physiology as well as pathological processes contributing to kidney disease. Magn Reson Med 78:457-461, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Troels Juul
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Fredrik Palm
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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32
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Bertelsen LB, Nielsen PM, Qi H, Nørlinger TS, Zhang X, Stødkilde-Jørgensen H, Laustsen C. Diabetes induced renal urea transport alterations assessed with 3D hyperpolarized 13 C, 15 N-Urea. Magn Reson Med 2016; 77:1650-1655. [PMID: 27172094 DOI: 10.1002/mrm.26256] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/15/2016] [Accepted: 04/01/2016] [Indexed: 12/29/2022]
Abstract
PURPOSE In the current study, we investigated hyperpolarized urea as a possible imaging biomarker of the renal function by means of the intrarenal osmolality gradient. METHODS Hyperpolarized three-dimensional balanced steady state 13 C MRI experiments alongside kidney function parameters and quantitative polymerase chain reaction measurements was performed on two groups of rats, a streptozotocin type 1 diabetic group and a healthy control group. RESULTS A significant decline in intrarenal steepness of the urea gradient was found after 4 weeks of untreated insulinopenic diabetes in agreement with an increased urea transport transcription. CONCLUSION MRI and hyperpolarized [13 C,15 N]urea can monitor the changes in the corticomedullary urea concentration gradients in diabetic and healthy control rats. Magn Reson Med 77:1650-1655, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Lotte B Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per M Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Thomas S Nørlinger
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Xiaolu Zhang
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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33
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Laustsen C. Hyperpolarized Renal Magnetic Resonance Imaging: Potential and Pitfalls. Front Physiol 2016; 7:72. [PMID: 26973539 PMCID: PMC4771722 DOI: 10.3389/fphys.2016.00072] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/15/2016] [Indexed: 01/02/2023] Open
Abstract
The introduction of dissolution dynamic nuclear polarization (d-DNP) technology has enabled a new paradigm for renal imaging investigations. It allows standard magnetic resonance imaging complementary renal metabolic and functional fingerprints within seconds without the use of ionizing radiation. Increasing evidence supports its utility in preclinical research in which the real-time interrogation of metabolic turnover can aid the physiological and pathophysiological metabolic and functional effects in ex vivo and in vivo models. The method has already been translated to humans, although the clinical value of this technology is unknown. In this paper, I review the potential benefits and pitfalls associated with dissolution dynamic nuclear polarization in preclinical research and its translation to renal patients.
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Affiliation(s)
- Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University Aarhus, Denmark
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34
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Aleksandar J, Vladan P, Markovic-Jovanovic S, Stolic R, Mitic J, Smilic T. Hyperlactatemia and the Outcome of Type 2 Diabetic Patients Suffering Acute Myocardial Infarction. J Diabetes Res 2016; 2016:6901345. [PMID: 27975067 PMCID: PMC5128715 DOI: 10.1155/2016/6901345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/27/2016] [Accepted: 10/19/2016] [Indexed: 02/01/2023] Open
Abstract
Background. Increased lactate production is frequent in unregulated/complicated diabetes mellitus. Methods. Three groups, each consisting of 40 patients (type 2 diabetics with myocardial infarction, DM+AMI, nondiabetics suffering myocardial infarction, MI, and diabetics with no apparent cardiovascular pathology, DM group), were tested for pH, serum bicarbonate and electrolytes, blood lactate, and CK-MB. Results. Blood lactate levels were markedly higher in AMI+DM compared to MI group (4.54 ± 1.44 versus 3.19 ± 1.005 mmol/L, p < 0.05); they correlated with the incidence of heart failure (ρ = 0.66), cardiac rhythm disorders (ρ = 0.54), oxygen saturation (ρ = 0.72), CK-MB levels (ρ = 0.62), and poor short-term outcome. Lactic acidosis in DM+AMI group was not always related to lethal outcome. Discussion. The lactate cutoff value associated with grave prognosis depends on the specific disease. While some authors proposed cutoff values ranging from 0.76 to 4 mmol/L, others argued that only occurrence of lactic acidosis may be truly predictive of lethal outcome. Conclusion. Both defective glucose metabolism and low tissue oxygenation may contribute to the lactate production in diabetic patients with acute myocardial infarction; high lactate levels indicate increased risk for poor outcome in this population comparing to nondiabetic patients. The rise in blood lactate concentration in diabetics with AMI was associated with increased incidence of heart failure, severe arrhythmias, cardiogenic shock, and high mortality rate.
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Affiliation(s)
- Jovanovic Aleksandar
- Department of Endocrinology, Medical Faculty, University of Pristina, Mitrovica, Serbia
- *Jovanovic Aleksandar:
| | - Peric Vladan
- Department of Cardiology, Medical Faculty, University of Pristina, Mitrovica, Serbia
| | | | - Radojica Stolic
- Department of Urology/Nephrology, Medical Faculty, University of Kragujevac, Kragujevac, Serbia
| | - Jadranka Mitic
- Department of Pediatrics, Medical Faculty, University of Pristina, Mitrovica, Serbia
| | - Tanja Smilic
- Department of Endocrinology, Medical Faculty, University of Pristina, Mitrovica, Serbia
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35
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Terreno E, Aime S. MRI Contrast Agents for Pharmacological Research. Front Pharmacol 2015; 6:290. [PMID: 26696890 PMCID: PMC4673339 DOI: 10.3389/fphar.2015.00290] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/19/2015] [Indexed: 12/17/2022] Open
Affiliation(s)
- Enzo Terreno
- Department of Molecular Biotechnology and Health Sciences, Molecular and Preclinical Imaging Centers, University of Torino Torino, Italy
| | - Silvio Aime
- Department of Molecular Biotechnology and Health Sciences, Molecular and Preclinical Imaging Centers, University of Torino Torino, Italy
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36
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Laustsen C, Stokholm Nørlinger T, Christoffer Hansen D, Qi H, Mose Nielsen P, Bonde Bertelsen L, Henrik Ardenkjaer-Larsen J, Stødkilde Jørgensen H. Hyperpolarized 13C urea relaxation mechanism reveals renal changes in diabetic nephropathy. Magn Reson Med 2015; 75:515-8. [PMID: 26584247 PMCID: PMC4738460 DOI: 10.1002/mrm.26036] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/01/2015] [Accepted: 10/15/2015] [Indexed: 01/01/2023]
Abstract
PURPOSE Our aim was to assess a novel (13) C radial fast spin echo golden ratio single shot method for interrogating early renal changes in the diabetic kidney, using hyperpolarized (HP) [(13) C,(15) N2 ]urea as a T2 relaxation based contrast bio-probe. METHODS A novel HP (13) C MR contrast experiment was conducted in a group of streptozotocin type-1 diabetic rat model and age matched controls. RESULTS A significantly different relaxation time (P = 0.004) was found in the diabetic kidney (0.49 ± 0.03 s) compared with the controls (0.64 ± 0.02 s) and secondly, a strong correlation between the blood oxygen saturation level and the relaxation times were observed in the healthy controls. CONCLUSION HP [(13) C,(15) N2 ]urea apparent T2 mapping may be a useful for interrogating local renal pO2 status and renal tissue alterations. Magn Reson Med, 2015. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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Affiliation(s)
- Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | | | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jan Henrik Ardenkjaer-Larsen
- GE Healthcare, Broendby, Denmark.,Department of Electrical Engineering, Technical University of Denmark, Kgs Lyngby, Denmark
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Koellisch U, Laustsen C, Nørlinger TS, Østergaard JA, Flyvbjerg A, Gringeri CV, Menzel MI, Schulte RF, Haase A, Stødkilde-Jørgensen H. Investigation of metabolic changes in STZ-induced diabetic rats with hyperpolarized [1-13C]acetate. Physiol Rep 2015; 3:3/8/e12474. [PMID: 26272734 PMCID: PMC4562560 DOI: 10.14814/phy2.12474] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In the metabolism of acetate several enzymes are involved, which play an important role in free fatty acid oxidation. Fatty acid metabolism is altered in diabetes patients and therefore acetate might serve as a marker for pathological changes in the fuel selection of cells, as these changes occur in diabetes patients. Acetylcarnitine is a metabolic product of acetate, which enables its transport into the mitochondria for energy production. This study investigates whether the ratio of acetylcarnitine to acetate, measured by noninvasive hyperpolarized [1-13C]acetate magnetic resonance spectroscopy, could serve as a marker for myocardial, hepatic, and renal metabolic changes in rats with Streptozotocin (STZ)-induced diabetes in vivo. We demonstrate that the conversion of acetate to acetylcarnitine could be detected and quantified in all three organs of interest. More interestingly, we found that the hyperpolarized acetylcarnitine to acetate ratio was independent of blood glucose levels and prolonged hyperglycemia following diabetes induction in a type-1 diabetes model.
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Affiliation(s)
- Ulrich Koellisch
- Institute of Medical Engineering, Technische Universität München, Munich, Germany
| | | | | | - Jakob Appel Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Endocrinology and Internal medicine, Aarhus University Hospital, Aarhus, Denmark Danish Diabetes Academy, Aarhus, Denmark
| | - Allan Flyvbjerg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Endocrinology and Internal medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Concetta V Gringeri
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | | | | | - Axel Haase
- Institute of Medical Engineering, Technische Universität München, Munich, Germany
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Laustsen C, Hansen ESS, Kjaergaard U, Bertelsen LB, Ringgaard S, Stødkilde-Jørgensen H. Acute porcine renal metabolic effect of endogastric soft drink administration assessed with hyperpolarized [1-(13)C]pyruvate. Magn Reson Med 2015; 74:558-63. [PMID: 26014387 PMCID: PMC4736686 DOI: 10.1002/mrm.25692] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 02/18/2015] [Accepted: 02/20/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE Our aim was to determine the quantitative reproducibility of metabolic breakdown products in the kidney following intravenous injection of hyperpolarized [1-(13)C]pyruvate and secondly to investigate the metabolic effect on the pyruvate metabolism of oral sucrose load using dissolution dynamic nuclear polarization. By this technique, metabolic alterations in several different metabolic related diseases and their metabolic treatment responses can be accessed. METHODS In four healthy pigs the lactate-to-pyruvate, alanine-to-pyruvate and bicarbonate-to-pyruvate ratio was measured following administration of regular cola and consecutive injections of hyperpolarized [1-(13)C]pyruvate four times within an hour. RESULTS The overall lactate-to-pyruvate metabolic profile changed significantly over one hour following an acute sucrose load leading to a significant rise in blood glucose. CONCLUSION The reproducibility of hyperpolarized magnetic resonance spectroscopy in the healthy pig kidney demonstrated a repeatability of more than 94% for all metabolites and, furthermore, that the pyruvate to lactate conversion and the blood glucose level is elevated following endogastric sucrose administration.
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Affiliation(s)
| | - Esben Søvsø Szocska Hansen
- MR Research Centre, Aarhus University Hospital, Aarhus, Denmark.,Danish Diabetes Academy, Odense, Denmark
| | - Uffe Kjaergaard
- MR Research Centre, Aarhus University Hospital, Aarhus, Denmark
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