Preclinical In Vitro and In Vivo Characterization of Synaptic Vesicle 2A-Targeting Compounds Amenable to F-18 Labeling as Potential PET Radioligands for Imaging of Synapse Integrity

PURPOSE

Current synaptic vesicle 2A (SV2A) positron emission tomography (PET) imaging agents include the nanomolar affinity probes [¹¹C]UCB-J and [¹⁸F]UCB-H derived from the anti-epileptic drug levitaracetam (Keppra®). An industry-utilized "de-risking" approach was used to carry out initial pharmacological characterization and to assess potential next-generation candidates amenable to F-18 radiolabeling for preliminary evaluation.

PROCEDURES

Radioligand binding methods were employed in mammalian brain homogenates to determine the SV2A affinity (K_d) and maximal binding capacity (B_max) of [³H]UCB-J. Novel leads were then screened to identify compounds minimally with comparable binding affinities with UCB-J in order to select a F-18-labeled candidate for subsequent in vivo assessment in rat. In parallel, mammalian brain tissue section autoradiography was performed to assess specific SV2A distribution.

RESULTS

[³H]UCB-J bound with high affinity to a single population of sites in the rat brain (K_d = 2.6 ± 0.25 nM; B_max = 810 ± 25 fmol/mg protein) and control human cortex (K_d = 2.9 ± 0.54 nM; B_max = 10,000 ± 640 fmol/mg protein). Distribution of specific SV2A binding was shown to be homogeneous throughout the rodent brain and primarily in gray matter regions of rodent and human brain sections. Analog screening identified MNI-1038, MNI-1126/SDM-8, and SDM-2 as having comparable binding affinities with the currently available PET ligands. Subsequent [¹⁸F]MNI-1126/[¹⁸F]SDM-8 dynamic micro-PET imaging in rats revealed in vivo uptake and accumulation in the brain with favorable kinetics. Chase studies using 30 mg/kg levetiracetam confirmed that in vivo brain uptake of [¹⁸F]MNI-1126/[¹⁸F]SDM-8 was reversible.

CONCLUSIONS

Taken together, these data suggest [¹⁸F]MNI-1126/[¹⁸F]SDM-8 (since renamed as [¹⁸F]SynVesT-1) characterized via an in vitro screening cascade provided a measurable in vivo SV2A specific signal in the rodent brain. This tracer as well as the close analog [¹⁸F]SDM-2 (since renamed as [¹⁸F]SynVesT-2) is currently undergoing further evaluation in preclinical and clinical studies.

Dynamic single-cell RNA sequencing identifies immunotherapy persister cells following PD-1 blockade

Resistance to oncogene-targeted therapies involves discrete drug-tolerant persister cells, originally discovered through in vitro assays. Whether a similar phenomenon limits efficacy of programmed cell death 1 (PD-1) blockade is poorly understood. Here, we performed dynamic single-cell RNA-Seq of murine organotypic tumor spheroids undergoing PD-1 blockade, identifying a discrete subpopulation of immunotherapy persister cells (IPCs) that resisted CD8+ T cell-mediated killing. These cells expressed Snai1 and stem cell antigen 1 (Sca-1) and exhibited hybrid epithelial-mesenchymal features characteristic of a stem cell-like state. IPCs were expanded by IL-6 but were vulnerable to TNF-α-induced cytotoxicity, relying on baculoviral IAP repeat-containing protein 2 (Birc2) and Birc3 as survival factors. Combining PD-1 blockade with Birc2/3 antagonism in mice reduced IPCs and enhanced tumor cell killing in vivo, resulting in durable responsiveness that matched TNF cytotoxicity thresholds in vitro. Together, these data demonstrate the power of high-resolution functional ex vivo profiling to uncover fundamental mechanisms of immune escape from durable anti-PD-1 responses, while identifying IPCs as a cancer cell subpopulation targetable by specific therapeutic combinations.

Evaluation of a candidate anti-arthritic drug using the mouse collagen antibody induced arthritis model and clinically relevant biomarkers

The most rigorous scenario for testing a candidate rheumatoid arthritis therapeutic would be to use clinically relevant biomarkers and readouts to monitor disease development in an animal model that has a mechanism of disease that reflects the human condition. Treatment should begin when the full spectrum of arthritic processes, including bone damage, is present. We have tried to take this approach to evaluate a novel EP4 receptor antagonist (ER-886046) for its anti-arthritic potential. This work aimed not only to test a potential drug, but to also demonstrate a strategy for performing a more clinically relevant evaluation of future candidate arthritis treatments. A variety of biomarkers including: radiographic evaluation, clinical scoring, histology analysis, F4/80 macrophage immunohistochemistry, luminol bioluminescent imaging and (99m)Tc-MDP-SPECT imaging were evaluated as disease readouts in the mouse anti-collagen antibody induced arthritis model (CAIA). CAIA mice were treated either prophylactically or therapeutically with ER-886046 and the compound's efficacy was probed using the various biomarkers and compared to the reference drugs prednisolone and celecoxib. The various biomarkers effectively measured different aspects of arthritis pathology and consistently demonstrated the efficacy of ER-886046. The compound was found to be effective even when dosed therapeutically after bone damaging processes had initiated. The results presented herein demonstrate how biomarkers and a clinically relevant experimental design can be used to evaluate a candidate therapeutic. Utilization of clinically relevant biomarkers may provide a means for more translatable pre-clinical testing of candidate therapeutics and may provide information on their mechanism of action.

Characterization of sepsis pathogenesis using molecular biomarkers and drug treatments in the mouse CLP model (56.6)

Sepsis is a severe systemic disease caused by an uncontrolled immune response to an inflammatory stimulus. Sepsis has a high mortality rate and few successful treatments are available. Furthermore, one of the confounding aspects of sepsis treatment is the highly variable and dynamic manifestation of the disease. Thus, there is a need not only for new sepsis treatments but also for biomarkers of sepsis that may guide physicians in patient treatment. The cecal ligation and puncture model (CLP) is a clinically relevant model that replicates the nature of human sepsis after trauma as it has a focus of infection rather than a systemic initiation. Thus, we have chosen to characterize the CLP model and use it to evaluate candidate sepsis biomarkers and therapeutics. We evaluated a variety of potential biomarkers and correlated them with body temperature to determine which ones best reflect the health of the animal. Interestingly, some cytokines and blood chemistry markers highly correlated with health and bacterial load while others did not. To gain further insight into sepsis pathogenesis we tested drugs with differing mechanisms of action. A significant observation was that an antibiotic was highly efficacious while the immunosuppressive dexamethasone was not beneficial; suggesting that bacterial elimination is crucial for survival. In summary, our results suggest potential biomarkers for guiding sepsis treatment and provide insight into sepsis pathogenesis.