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Schultz JL, Gander PE, Workman CD, Ponto LL, Cross S, Nance CS, Groth CL, Taylor EB, Ernst SE, Xu J, Uc EY, Magnotta VA, Welsh MJ, Narayanan NS. A pilot dose-finding study of Terazosin in humans. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.22.24307622. [PMID: 38826433 PMCID: PMC11142298 DOI: 10.1101/2024.05.22.24307622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Background Parkinson's disease (PD) is a prevalent neurodegenerative disorder where progressive neuron loss is driven by impaired brain bioenergetics, particularly mitochondrial dysfunction and disrupted cellular respiration. Terazosin (TZ), an α-1 adrenergic receptor antagonist with a known efficacy in treating benign prostatic hypertrophy and hypertension, has shown potential in addressing energy metabolism deficits associated with PD due to its action on phosphoglycerate kinase 1 (PGK1). This study aimed to investigate the safety, tolerability, bioenergetic target engagement, and optimal dose of TZ in neurologically healthy subjects. Methods Eighteen healthy men and women (60 - 85 years old) were stratified into two cohorts based on maximum TZ dosages (5 mg and 10 mg daily). Methods included plasma and cerebrospinal fluid TZ concentration measurements, whole blood ATP levels, 31 Phosphorous magnetic resonance spectroscopy for brain ATP levels, 18 F-FDG PET imaging for cerebral metabolic activity, and plasma metabolomics. Results Our results indicated that a 5 mg/day dose of TZ significantly increased whole blood ATP levels and reduced global cerebral 18 F-FDG PET uptake without significant side effects or orthostatic hypotension. These effects were consistent across sexes. Higher doses did not result in additional benefits and showed a potential biphasic dose-response. Conclusions TZ at a dosage of 5 mg/day engages its metabolic targets effectively in both sexes without inducing significant adverse effects and provides a promising therapeutic avenue for mitigating energetic deficiencies. Further investigation via clinical trials to validate TZ's efficacy and safety in neurodegenerative (i.e., PD) contexts is warranted.
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Ren J, Dewey RB, Rynders A, Evan J, Evan J, Ligozio S, Ho KS, Sguigna PV, Glanzman R, Hotchkin MT, Dewey RB, Greenberg BM. Evidence of brain target engagement in Parkinson's disease and multiple sclerosis by the investigational nanomedicine, CNM-Au8, in the REPAIR phase 2 clinical trials. J Nanobiotechnology 2023; 21:478. [PMID: 38087362 PMCID: PMC10717868 DOI: 10.1186/s12951-023-02236-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Impaired brain energy metabolism has been observed in many neurodegenerative diseases, including Parkinson's disease (PD) and multiple sclerosis (MS). In both diseases, mitochondrial dysfunction and energetic impairment can lead to neuronal dysfunction and death. CNM-Au8® is a suspension of faceted, clean-surfaced gold nanocrystals that catalytically improves energetic metabolism in CNS cells, supporting neuroprotection and remyelination as demonstrated in multiple independent preclinical models. The objective of the Phase 2 REPAIR-MS and REPAIR-PD clinical trials was to investigate the effects of CNM-Au8, administered orally once daily for twelve or more weeks, on brain phosphorous-containing energy metabolite levels in participants with diagnoses of relapsing MS or idiopathic PD, respectively. RESULTS Brain metabolites were measured using 7-Tesla 31P-MRS in two disease cohorts, 11 participants with stable relapsing MS and 13 participants with PD (n = 24 evaluable post-baseline scans). Compared to pre-treatment baseline, the mean NAD+/NADH ratio in the brain, a measure of energetic capacity, was significantly increased by 10.4% after 12 + weeks of treatment with CNM-Au8 (0.584 units, SD: 1.3; p = 0.037, paired t-test) in prespecified analyses of the combined treatment cohorts. Each disease cohort concordantly demonstrated increases in the NAD+/NADH ratio but did not reach significance individually (p = 0.11 and p = 0.14, PD and MS cohorts, respectively). Significant treatment effects were also observed for secondary and exploratory imaging outcomes, including β-ATP and phosphorylation potential across both cohorts. CONCLUSIONS Our results demonstrate brain target engagement of CNM-Au8 as a direct modulator of brain energy metabolism, and support the further investigation of CNM-Au8 as a potential disease modifying drug for PD and MS.
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Affiliation(s)
- Jimin Ren
- University of Texas Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Richard B Dewey
- University of Texas Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Parkinson's Disease and Movement Disorders Center, Boca Raton, FL, 33486, USA
| | - Austin Rynders
- Clene Nanomedicine, Inc., 6550 S Millrock Dr., Suite G50, Salt Lake City, UT, 84121, USA
| | - Jacob Evan
- Clene Nanomedicine, Inc., 6550 S Millrock Dr., Suite G50, Salt Lake City, UT, 84121, USA
| | - Jeremy Evan
- Clene Nanomedicine, Inc., 6550 S Millrock Dr., Suite G50, Salt Lake City, UT, 84121, USA
| | - Shelia Ligozio
- Instat Clinical Research, A Veristat Company, 1 Wilson St., Chatham, NJ, 07928, USA
| | - Karen S Ho
- Clene Nanomedicine, Inc., 6550 S Millrock Dr., Suite G50, Salt Lake City, UT, 84121, USA.
| | - Peter V Sguigna
- University of Texas Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Robert Glanzman
- Clene Nanomedicine, Inc., 6550 S Millrock Dr., Suite G50, Salt Lake City, UT, 84121, USA
| | - Michael T Hotchkin
- Clene Nanomedicine, Inc., 6550 S Millrock Dr., Suite G50, Salt Lake City, UT, 84121, USA
| | - Richard B Dewey
- University of Texas Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Parkinson's Disease and Movement Disorders Center, Boca Raton, FL, 33486, USA
| | - Benjamin M Greenberg
- University of Texas Southwestern Medical Center, Department of Neurology, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
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Kamski-Hennekam ER, Huang J, Ahmed R, Melacini G. Toward a molecular mechanism for the interaction of ATP with alpha-synuclein. Chem Sci 2023; 14:9933-9942. [PMID: 37736631 PMCID: PMC10510630 DOI: 10.1039/d3sc03612j] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/19/2023] [Indexed: 09/23/2023] Open
Abstract
The ability of Adenosine Triphosphate (ATP) to modulate protein solubility establishes a critical link between ATP homeostasis and proteinopathies, such as Parkinson's (PD). The most significant risk factor for PD is aging, and ATP levels decline dramatically with age. However, the mechanism by which ATP interacts with alpha-synuclein (αS), whose aggregation is characteristic of PD, is currently not fully understood, as is ATP's effect on αS aggregation. Here, we use nuclear magnetic resonance spectroscopy as well as fluorescence, dynamic light scattering and microscopy to show that ATP affects multiple species in the αS self-association cascade. The triphosphate moiety of ATP disrupts long-range electrostatic intramolecular contacts in αS monomers to enhance initial aggregation, while also inhibiting the formation of late-stage β-sheet fibrils by disrupting monomer-fibril interactions. These effects are modulated by magnesium ions and early onset PD-related αS mutations, suggesting that loss of the ATP hydrotropic function on αS fibrillization may play a role in PD etiology.
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Affiliation(s)
| | - Jinfeng Huang
- Department of Chemistry and Chemical Biology, McMaster University Hamilton ON L8S 4M1 Canada
| | - Rashik Ahmed
- Department of Biochemistry and Biomedical Sciences, McMaster University Hamilton ON L8S 4M1 Canada
| | - Giuseppe Melacini
- Department of Chemistry and Chemical Biology, McMaster University Hamilton ON L8S 4M1 Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University Hamilton ON L8S 4M1 Canada
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Sammi MK, Fryman A, Baker E, Moloney B, Powers K, West R, Bittner F, Lane M, Martin K, Pepelyayeva Y, Anderson VC, Rooney WD, Yadav V. Vascular disease risk factors in multiple sclerosis: Effect on metabolism and brain volumes. Mult Scler Relat Disord 2023; 74:104675. [PMID: 37121104 PMCID: PMC10560072 DOI: 10.1016/j.msard.2023.104675] [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: 01/05/2023] [Revised: 03/21/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Vascular disease risk factors (VDRF) such as hypertension, hyperlipidemia, obesity, diabetes and heart disease likely play a role in disease progression in people with multiple sclerosis (PwMS) (Marrie, Rudick et al. 2010). Studies exploring the mechanistic connection between vascular disease and MS disease progression are scant. We hypothesized that phosphate energy metabolism impairment in PwMS with VDRFs (VDRF+) will be greater compared to PwMS without VDRFs (VDRF-) and is related to increased brain atrophy in VDRF+. To test this hypothesis, we planned to study the differences in the high energy phosphate (HEP) metabolites in cerebral gray matter as assessed by 31P magnetic resonance spectroscopic imaging (MRSI) and MRI brain volumetric in the VDRF+ and VDRF- PwMS at four different timepoints over a 3 yearlong period using a 7T MR system. We present here the results from the cross-sectional evaluation of HEP metabolites and brain volumes. We also evaluated the differences in clinical impairment, blood metabolic biomarkers and quality of life in VDRF+ and VDRF- PwMS in this cohort. METHODS Group differences in high energy phosphate metabolites were assessed from a volume of interest in the occipital region using linear mixed models. Brain parenchymal and white matter lesion volumes were determined from MR anatomic images. We present here the cross-sectional analysis of the baseline data collected as part of a longitudinal 3 yearlong study where we obtained baseline and subsequent 6-monthly clinical and laboratory data and annual 7T MRI volumetric and 31P MR spectroscopic imaging (MRSI) data on 52 PwMS with and without VDRF. Key clinical and laboratory outcomes included: body mass index (BMI), waist and thigh circumferences and disability [Expanded Disability Status Scale (EDSS)], safety (complete blood count with differential, complete metabolic), lipid panel including total cholesterol and HbA1C. We analyzed clinical and laboratory data for the group differences using student's t or χ2 test. We investigated relationship between phosphate metabolites and VDRF using mixed effect linear regression. RESULTS Complete MRI data were available for 29 VDRF+, age 56.3 (6.8) years [mean (SD)] (83% female), and 23 VDRF-, age 52.5 (7.5) years (57% female) individuals with MS. The mean value of normalized adenosine triphosphate (ATP) (calculated as the ratio of ATP to total phosphate signal in a voxel) was decreased by 4.5% (p < .05) in VDRF+ compared to VDRF- MS group. White matter lesion (WML) volume fraction in VDRF+ individuals {0.007 (0.007)} was more than doubled compared to VDRF- participants {0.003 (0.006), p= .02}. CONCLUSIONS We found significantly lower brain ATP and higher inorganic phosphate (Pi) in those PwMS with VDRFs compared to those without. ATP depletion may reflect mitochondrial dysfunction. Ongoing longitudinal data analysis from this study, not presented here, will evaluate the relationship of phosphate metabolites, brain atrophy and disease progression in PwMS with and without vascular disease.
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Affiliation(s)
- Manoj K Sammi
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA.
| | - Allison Fryman
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Department of Veterans Affairs MS Center of Excellence-West, Portland, OR, USA
| | - Eric Baker
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Brendan Moloney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Katherine Powers
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Randy West
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Frank Bittner
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Michael Lane
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Department of Veterans Affairs MS Center of Excellence-West, Portland, OR, USA
| | - Kayla Martin
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Department of Veterans Affairs MS Center of Excellence-West, Portland, OR, USA
| | - Yuliya Pepelyayeva
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Valerie C Anderson
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Vijayshree Yadav
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Department of Veterans Affairs MS Center of Excellence-West, Portland, OR, USA.
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ATP and NAD + Deficiency in Parkinson's Disease. Nutrients 2023; 15:nu15040943. [PMID: 36839301 PMCID: PMC9961646 DOI: 10.3390/nu15040943] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
The goal of this study is to identify a signature of bioenergetic and functional markers in the muscles of individuals with Parkinson's disease (PD). Quantitative physiological properties of in vivo hand muscle (FDI, first dorsal interosseus) and leg muscle (TA, Tibialis Anterior) of older individuals with PD were compared to historical age/gender-matched controls (N = 30). Magnetic resonance spectroscopy and imaging (MRS) were used to assess in vivo mitochondrial and cell energetic dysfunction, including maximum mitochondrial ATP production (ATPmax), NAD concentrations linked to energy/stress pathways, and muscle size. Muscle function was measured via a single muscle fatigue test. TA ATPmax and NAD levels were significantly lower in the PD cohort compared to controls (ATPmax: 0.66 mM/s ± 0.03 vs. 0.76 ± 0.02; NAD: 0.75 mM ± 0.05 vs. 0.91 ± 0.04). Muscle endurance and specific force were also lower in both hand and leg muscles in the PD subjects. Exploratory analyses of mitochondrial markers and individual symptoms suggested that higher ATPmax was associated with a greater sense of motivation and engagement and less REM sleep behavior disorder (RBD). ATPmax was not associated with clinical severity or individual symptom(s), years since diagnosis, or quality of life. Results from this pilot study contribute to a growing body of evidence that PD is not a brain disease, but a systemic metabolic syndrome with disrupted cellular energetics and function in peripheral tissues. The significant impairment of both mitochondrial ATP production and resting metabolite levels in the TA muscles of the PD patients suggests that skeletal muscle mitochondrial function may be an important tool for mechanistic understanding and clinical application in PD patients. This study looked at individuals with mid-stage PD; future research should evaluate whether the observed metabolic perturbations in muscle dysfunction occur in the early stages of the disease and whether they have value as theragnostic biomarkers.
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Yang J, Sun H, Yang X, Jin B, Shen J, Hu L. Value of MRS combined with DTI in evaluating brain development of infants aged from 2 months to 2 years old. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2022; 47:910-919. [PMID: 36039588 PMCID: PMC10930286 DOI: 10.11817/j.issn.1672-7347.2022.220135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Many neuropsychiatric diseases are related to the abnormal development of brain tissue in infants. This study aims to analyze the changes in the parameters of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in brain development of infants aged from 2 months to 2 years old, and to explore the value of MRS combined with DTI in evaluating brain development of infants aged from 2 months to 2 years old. METHODS A total of 116 normal infants, who received whole brain MRS and DTI examinations after delivery in Children Hospital of Shanxi Province from September 2020 to May 2021, were selected and were divided into a group A (n=7, at the age of 2-6 months), a group B (n=28, at the age of 7-12 months), a group C (n=41, at the age of 13-18 months), and a group D (n=40, at the age of 19-24 months). After collecting the MRS and DTI data, statistical analysis was performed to compare DTI parameters and MRS metabolic products ratio. RESULTS There were significant differences in the DTI parameters of frontal lobe, temporal lobe, occipital lobe, hind limb of internal capsule, fore limb of internal capsule, knee of corpus callosum, splenium of corpus callosum, and optic radiation among the 4 groups (P<0.05 or P<0.01). The values of fractional anisotropy (FA) showed an upward trend from the group A to the group D, while the values of apparent diffusion coefficient (ADC), axial diffusivity (AD), and radial diffusivity (RD) showed a downward trend, and the changes of parameters tended to slow down with age. In the left or right lentiform nucleus, the ratio of choline (Cho)/creatine (Cr) was decreased from the group A to the group D, and the group D was significantly lower than the group A and B (all P<0.01). The ratio of Cho/N-acetyl aspartate (NAA) was decreased from the group A to the group D, and the group D was significantly lower than the group A, B, and C (left lentiform nucleus, P<0.05 or P<0.01) or the group A, B (right lentiform nucleus, both P<0.01). The ratio of glutamine/glutamate (Glx)/Cr was decreased from the group A to the group D, and the group D was significantly lower than the group A, B and C (P<0.05 or P<0.01). The ratio of myo-inositol (mI)/Cr was increased from the group A to the group D, and the group D was significantly higher than the group A, B, and C (P<0.05 or P<0.01). The ratio of NAA/Cr was increased from the group A to the group D, and the group B, C, and D were significantly higher than the group A (P<0.05 or P<0.01). The ratios of mI/Cr and NAA/Cr in different brain regions from the group A to the group D showed an upward trend, and the ratios of Cho/Cr, Cho/NAA, and Glx/Cr showed a downward trend. The variation of each parameter tends to decrease with age. CONCLUSIONS MRS and DTI can detect the brain development of infants aged from 2 months to 2 years old, and provide a basis for predicting brain diseases.
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Affiliation(s)
- Jie Yang
- Department of MRI, Children Hospital of Shanxi Province (Shanxi Maternal and Child Health Hospital), Taiyuan 030013.
| | - Huimiao Sun
- Department of MRI, Children Hospital of Shanxi Province (Shanxi Maternal and Child Health Hospital), Taiyuan 030013.
| | - Xiaoyan Yang
- Department of MRI, Children Hospital of Shanxi Province (Shanxi Maternal and Child Health Hospital), Taiyuan 030013
| | - Bo Jin
- Department of MRI, Children Hospital of Shanxi Province (Shanxi Maternal and Child Health Hospital), Taiyuan 030013
| | - Jiaxin Shen
- Department of Hospital-Acquired Infection Control, Children Hospital of Shanxi Province (Shanxi Maternal and Child Health Hospital), Taiyuan 030013, China
| | - Lei Hu
- Department of MRI, Children Hospital of Shanxi Province (Shanxi Maternal and Child Health Hospital), Taiyuan 030013
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7
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Larkin JR, Foo LS, Sutherland BA, Khrapitchev A, Tee YK. Magnetic Resonance pH Imaging in Stroke – Combining the Old With the New. Front Physiol 2022; 12:793741. [PMID: 35185600 PMCID: PMC8852727 DOI: 10.3389/fphys.2021.793741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022] Open
Abstract
The study of stroke has historically made use of traditional spectroscopy techniques to provide the ground truth for parameters like pH. However, techniques like 31P spectroscopy have limitations, in particular poor temporal and spatial resolution, coupled with a need for a high field strength and specialized coils. More modern magnetic resonance spectroscopy (MRS)-based imaging techniques like chemical exchange saturation transfer (CEST) have been developed to counter some of these limitations but lack the definitive gold standard for pH that 31P spectroscopy provides. In this perspective, both the traditional (31P spectroscopy) and emerging (CEST) techniques in the measurement of pH for ischemic imaging will be discussed. Although each has its own advantages and limitations, it is likely that CEST may be preferable simply due to the hardware, acquisition time and image resolution advantages. However, more experiments on CEST are needed to determine the specificity of endogenous CEST to absolute pH, and 31P MRS can be used to calibrate CEST for pH measurement in the preclinical model to enhance our understanding of the relationship between CEST and pH. Combining the two imaging techniques, one old and one new, we may be able to obtain new insights into stroke physiology that would not be possible otherwise with either alone.
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Affiliation(s)
- James R. Larkin
- Department of Oncology, Medical Research Council Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
- *Correspondence: James R. Larkin,
| | - Lee Sze Foo
- Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang, Malaysia
| | - Brad A. Sutherland
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Alexandre Khrapitchev
- Department of Oncology, Medical Research Council Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - Yee Kai Tee
- Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang, Malaysia
- Yee Kai Tee,
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Metabolomics Insights into Inflammatory Bowel Disease: A Comprehensive Review. Pharmaceuticals (Basel) 2021; 14:ph14111190. [PMID: 34832973 PMCID: PMC8625096 DOI: 10.3390/ph14111190] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic, complex relapsing disorder characterised by immune dysregulation, gut microbiota alteration, and disturbed intestinal permeability. The diagnosis and the management of IBD are challenging due to the recurrent nature and complex evolution of the disease. Furthermore, the molecular mechanism underlying the aetiology and pathogenesis of IBD is still poorly understood. There is an unmet need for novel, reliable, and noninvasive tools for diagnosing and monitoring IBD. In addition, metabolomic profiles may provide a priori determination of optimal therapeutics and reveal novel targets for therapies. This review tries to gather scientific evidence to summarise the emerging contribution of metabolomics to elucidate the mechanisms underlying IBD and changes associated with disease phenotype and therapies, as well as to identify biomarkers with metabolic imbalance in those patients. Metabolite changes during health and disease could provide insights into the disease pathogenesis and the discovery of novel indicators for the diagnosis and prognosis assessment of IBD. Metabolomic studies in IBD have shown changes in tricarboxylic acid cycle intermediates, amino-acid and fatty-acid metabolism, and oxidative pathways. Metabolomics has made progress towards identifying metabolic alterations that may provide clinically useful biomarkers and a deeper understanding of the disease. However, at present, there is insufficient evidence evaluating the predictive accuracy of these molecular signatures and their diagnostic ability, which is necessary before metabolomic data can be translated into clinical practice.
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Platt T, Ladd ME, Paech D. 7 Tesla and Beyond: Advanced Methods and Clinical Applications in Magnetic Resonance Imaging. Invest Radiol 2021; 56:705-725. [PMID: 34510098 PMCID: PMC8505159 DOI: 10.1097/rli.0000000000000820] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/07/2021] [Accepted: 08/07/2021] [Indexed: 12/15/2022]
Abstract
ABSTRACT Ultrahigh magnetic fields offer significantly higher signal-to-noise ratio, and several magnetic resonance applications additionally benefit from a higher contrast-to-noise ratio, with static magnetic field strengths of B0 ≥ 7 T currently being referred to as ultrahigh fields (UHFs). The advantages of UHF can be used to resolve structures more precisely or to visualize physiological/pathophysiological effects that would be difficult or even impossible to detect at lower field strengths. However, with these advantages also come challenges, such as inhomogeneities applying standard radiofrequency excitation techniques, higher energy deposition in the human body, and enhanced B0 field inhomogeneities. The advantages but also the challenges of UHF as well as promising advanced methodological developments and clinical applications that particularly benefit from UHF are discussed in this review article.
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Affiliation(s)
- Tanja Platt
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
| | - Mark E. Ladd
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
- Faculty of Physics and Astronomy
- Faculty of Medicine, University of Heidelberg, Heidelberg
- Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen
| | - Daniel Paech
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg
- Clinic for Neuroradiology, University of Bonn, Bonn, Germany
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