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Biomedical subjects

H N Wagner

Publications and source records attributed to H N Wagner.

At least 55 records · Page 3Linked to original sources

Molecular nuclear medicine: from genotype to phenotype via chemotype.

Molecular nuclear medicine can image in vivo biochemistry. Studies with receptor-based radiopharmaceuticals provide windows to the biochemical processes of proteins as they carry out instructions from genetic coding. The patient's genotype determines this biochemical expression of phenotype. Radiotracer studies that visualize in vivo biochemistry provide a glimpse at a patient's "chemotype." Molecular nuclear medicine enables us to connect genotype to phenotype via chemotype. Diagnostic medicine will move past the point of grouping patients according to clinical signs and symptoms. More and more, diseases will be viewed as biochemical processes rather than the clinical manifestations of those processes. Today, there are examples of molecular nuclear medicine studies that affect medical decision-making.

Biochemical Phenomena↗

Comparison of [11C]diprenorphine and [11C]carfentanil in vivo binding to opiate receptors in man using a dual detector system.

A simple dual detector coincidence system was used to measure the binding of [11C]carfentanil and [11C]diprenorphine to opiate receptors in normal volunteers before and after the administration of naloxone. Total radioactivity without naloxone and the ratio of total/non-specific radioactivity was 2 times greater for [11C]diprenorphine than [11C]carfentanil. The dose of naloxone required to maximally block specific [11C]diprenorphine binding was 10 times that for [11C]carfentanil, indicating that [11C]diprenorphine labels opiate receptor subtypes in addition to mu opiate receptors.

Analgesics, Opioid↗

Pulmonary accumulation of neutral diamine dithiol complexes of technetium-99m.

Twenty-two neutral, lipid-soluble 99mTc complexes have been synthesized from diamine dithiol (DADT) ligands which vary in alkyl substitution pattern on nitrogen and carbon. The logarithm of the partition coefficients (log PC), as well as the capacity factor k', of the purified complexes increased linearly with molecular weight. The biodistribution of these complexes was determined in normal mice, and several of the complexes selectively accumulated in the lungs as compared to the liver or other organs. Pulmonary accumulation varied greatly with subtle changes in structure, and a 30-fold range of lung uptake (1-31% of the injected dose/organ) was observed for isomeric technetium complexes which have identical molecular weights and similar log PC. Further, a parabolic relationship between lung uptake and log PC was observed for a subset of the complexes which are derived from a homologous series of tetramethyl-DADT ligands. Neutral and lipophilic radiopharmaceuticals labeled with technetium can therefore be developed which exhibit structurally specific uptake in the lung.

Animals↗

Novel technetium ligands with affinity for the muscarinic cholinergic receptor.

The synthesis and preliminary biological characterization of two isomeric technetium labeled complexes (2,5,5,9-tetramethyl-4,7-diaza-7-(3' (R)-quinuclidinylcarboxymethyl)-2,9-decanedithiolato oxo 99/99mtechnetium(V), [99/99mTc]-1 and [99/99mTc]-2) designed to exhibit affinity to muscarinic cholinergic receptors are described. In vitro binding assays were conducted in mouse brain homogenates (whole brain-cerebellum) at 37 degrees C by the centrifugation method, where non-specific binding was defined by atropine (1 microM). The measured affinity (KD) of [99Tc]-1 for mAChR was 1.9 +/- 0.5 microM (mean +/- SEM; n = 3) and [99Tc]-2 was 4.5 +/- 0.5 microM (mean +/- SEM; n = 3). Scatchard analysis indicated that Bmax values were 10.6 +/- 0.5 and 16.9 +/- 0.5 pmol/mg tissue, respectively. In competition assays, [99Tc]-1 exhibited an apparent affinity (KI) of 16.5 microM (n = 2) against [125I] iododexetimide, whereas [99Tc]-2 exhibited an affinity (KI) of 105 microM. In vivo, 0.3% of the injected dose of [99mTc]-1 and [99mTc]-2 accumulated in the brain at 5 min after injection. These values indicate technetium analogues of neuroreceptor binding ligands can be synthesized and retain some affinity for the receptor.

Animals↗

Highly potent indanamine serotonin uptake blockers as radiotracers for imaging serotonin uptake sites.

Two highly potent indanamine serotonin (5-HT) uptake blockers, trans-3'-(4'-bromophenyl)-1-indanamine (trans-[11C]DBPI or [11C]Lu 19-056) and its iodo analog, trans-3'(4'-[125I]iodophenyl)-1-indanamine (trans-[125I]DIPI) were evaluated as radiotracers for imaging 5-HT uptake sites in vivo Trans-[11C]DBPI was synthesized by N-methylation of the normethyl precursor with [11C]iodomethane. Trans-[125I]DIPI was synthesized by iododestannylation of the tributyltin precursor with [125I]NaI. Radiochemical yields for the [11C] and [125I] radiotracers were 34 and 40% with specific activities of 4000 and 1800 mCi/mumol, respectively. In vitro, the iodo analog, trans-DIPI, showed an IC50 value of 0.26 nM in inhibition of [3H]paroxetine binding to 5-HT uptake sites in rat cortex. The potency was found to be equivalent to that of paroxetine or McN5652. In vivo, after i.v. injection into mice, both radiotracers showed high uptake in brain (3-4% dose/whole brain at 15 min) and high accumulation into target tissues such as hypothalamus and olfactory tubercles (7-8% dose/g at 60 min). The binding was blocked by pre-injection of 5 mg/kg of peroxetine. While the in vivo distribution agreed with previously reported 5-HT uptake site distribution, the radiotracers showed high uptake in non-target tissues such as cerebellum, resulting in low target-to-non-target ratios (1.5-1.6 at 60 min). Since washout from non-target regions was slower than from target regions, longer-time observation with 125I up to 6 h did not improve the ratios. HPLC analyses of mouse brain homogenates and blocking studies indicated that the high uptake in non-target regions is not the result of metabolism or any interaction of the radiotracers with those tissues via specific binding sites. In spite of low target-to-non-target ratios, target regions with high density of 5-HT uptake sites, such as the raphe nuclei, superior colliculi and substantia nigra, were visualized with trans-[125I]DIPI by ex vivo autoradiography, since the radiotracer showed high specific binding (total mimus nonspecific binding).

Animals↗

Development of PET/SPECT ligands for the serotonin transporter.

There is a great need for PET and SPECT ligands with high affinity and selectivity for the serotonin uptake site. These imaging agents would be useful in screening human populations at risk (e.g., individuals exposed to neurotoxic amphetamines such as MDMA and fenfluramine). Moreover, these radioligands would allow the study of serotonergic function in the normal living human brain, and they also would be useful in the examination of altered serotonergic neurotransmission in diseases such as depression and obsessive-compulsive and other neuropsychiatric disorders. Over the past several years, a number of radioligands have been studied in several laboratories for their in vivo binding to 5-HT uptake sites. Although [3H]paroxetine showed promising binding characteristics, conversion of authentic paroxetine into a PET or SPECT tracer turned out to be difficult and has not been achieved yet. Analogs of paroxetine displayed considerable loss of binding affinity and were, therefore, not useful for imaging purposes. For [11C]fluoxetine, [11C]citalopram, and cis-[11C]DDPI, target-to-nontarget (hypothalamus-to-cerebellar) ratios remained less than 2.0:1 over a 90-min period after injection. The most promising PET agents identified today are [11C]RTI-55 and [11C]McN-5652-X. [11C]RTI-55 labels both 5-HT and DA uptake sites. [11C]McN-5652-X is highly selective for 5-HT uptake sites, and its distribution is consistent with the neuroanatomical distribution of the 5-HT uptake site. Because [11C]McN-5652-Z is a racemic mixture of two stereoisomers, of which the (+) isomer (McN-5652-X) binds to the 5-HT uptake site in vivo and the (-) isomer (McN-5652-W) does not, the possibility exists that regional-specific binding can be determined by subtracting nonspecific binding of the (-) isomer from total radioactivity counts obtained with the (+) isomer. [11C]McN-5652-X is the best PET radioligand for the 5-HT uptake site described thus far. This tracer warrants further testing in nonhuman primates. Efforts are underway to obtain an investigational new drug application for use of the tracer in humans. Promising candidates as SPECT imaging agents for the 5-HT uptake site are [123I]RTI-55 and [123I]-iodo-6-nitroquipazine. Both agents are under intense investigation in different laboratories in the United States.

Animals↗

Intrastriatal infusion of lisuride--a potential treatment for Parkinson's disease? Behavioral and autoradiographic studies in 6-OHDA lesioned rats.

The present study examined the effect of chronic intrastriatal infusion of the dopamine receptor agonist lisuride on apomorphine-induced rotational behaviour and on D2-dopamine receptors in rats with unilateral 6-hydroxydopamine (6-OHDA) lesions of the nigrostriatal dopaminergic pathway. The completeness of the lesion of the right ascending nigrostriatal dopaminergic pathway was confirmed by apomorphine-induced rotation and [3H]-mazindol autoradiography. The intrastriatal infusion of lisuride (0.5 microgram/h) into the lesioned striatum for 2 weeks induced an immediate but temporary spontaneous contralateral rotation and a reduction of apomorphine-induced rotation of 47.2% relative to pre-lisuride infusion. The density of D2-receptors in the lisuride-infused striatum was significantly decreased by 40% relative to vehicle-infused 6-OHDA lesioned rats. The level of D2-dopamine receptors returned to normal levels 3 weeks after the termination of lisuride infusion. These results show that the intrastriatal infusion of lisuride reverses the behavioural and D2-dopamine receptor changes present in the 6-OHDA lesion rat model of Parkinson's disease.

Animals↗

Myocardial perfusion with [11C]methyl triphenyl phosphonium: measurements of the extraction fraction and myocardial uptake.

The present study describes extraction fraction and uptake measurements of the [11C]methyl triphenyl phosphonium (11C-MTP), a promising positron emission tomography (PET) agent for cardiac imaging. PET imaging was performed in mongrel dogs. Under physiological flow conditions 11C-MTP uptake reached a maximum within the first 10 minutes after injection and remained constant during the entire observation period of 80 minutes. Over the same time period, the heart/blood ratio was 46-106:1, and the heart/lung ratio 14:1. Following permanent occlusion of the left anterior descending coronary artery, 11C-MTP uptake in the normally perfused myocardium also reached a maximum at 10 minutes after injection, whereas in the infarcted area there was no significant accumulation of 11C-MTP. For a time period of 80 minutes the noninfarcted/infarcted myocardium ratio was 12:1. Extraction was measured in anesthetized dogs with a double isotope method using 99mTc-HSA as the reference tracer. The extraction fraction was 91% at a flow of 69 mL/min/100g. As flow increased to five-fold (342 mL/min/100g) following administration of adenosine, extraction fell to 61%. Following coronary artery occlusion, the 11C-MTP content in the myocardium was highly correlated (r = 0.93, p < 0.01; y = 10.46 + 0.92x) with the microsphere determined regional myocardial blood flow.

Animals↗

Paralimbic hypoperfusion in unipolar depression.

METHODS: Relative regional cerebral blood flow was measured with SPECT using 99mTc-hexamethylpropyleneamine oxime in 13 patients with severe unipolar depression that was nonresponsive to drug therapy and 11 age-matched nondepressed controls. RESULTS: All patients were clinically depressed and taking antidepressant drugs at the time of the study. The relative blood flow was significantly decreased bilaterally in the frontal cortex, anterior temporal cortex, anterior cingulate gyrus and caudate in the depressed patients compared with the nondepressed healthy controls. The greatest decreases were seen in the paralimbic regions, specifically, the inferior frontal and cingulate cortex. No significant changes were seen in the parietal cortex, occipital cortex or thalami. Psychiatric rating scales correlated poorly with regional blood flow, except for the degree of psychomotor slowing, which was negatively correlated with frontal and cingulate perfusion. CONCLUSION: These findings implicate selective dysfunction of paralimbic brain regions in clinically depressed patients, independent of their medication use, and support the concept of specific neural systems that regulate mood. Recognition of these regional abnormalities may have clinical utility in both the diagnosis and treatment of depression.

Adult↗

Decreased hippocampal muscarinic cholinergic receptor binding measured by 123I-iododexetimide and single-photon emission computed tomography in epilepsy.

Regional binding of 123I-iododexetimide, a muscarinic acetylcholine receptor antagonist, was measured in vivo in the temporal lobes of 4 patients with complex partial seizures using single-photon emission computed tomography. In the anterior hippocampus ipsilateral to the electrical focus, 123I-iododexetimide binding was decreased by 40 +/- 9% (mean +/- SD, p < 0.01) compared with the contralateral hippocampus; 123I-iododexetimide binding in other temporal lobe regions was symmetrical. The data indicate a regionally specific change of muscarinic acetylcholine receptor in anterior hippocampus in complex partial seizures of temporal lobe origin.

Adult↗

[11C](+)McN5652 as a radiotracer for imaging serotonin uptake sites with PET.

The in vivo behavior of the stereoisomers of [11C]McN5652, a highly potent serotonin (5-HT) uptake blocker, was determined to evaluate their utility as radiotracers for imaging 5-HT uptake sites by positron emission tomography (PET). After intravenous injection into mice, [11C](+)McN5652 showed markedly higher uptake and longer retention in regions with high density of 5-HT uptake sites than the [11C]-labeled racemic mixture, while [11C](-)McN5652 washed out rapidly. With the [11C](+)-enantiomer, the ratio between hypothalamus and cerebellum reached 6 at 90 minutes. The binding of [11C](+)McN5652 was inhibited by 45-73% by pre-injection of 5 mg/kg of paroxetine, a selective 5-HT uptake blocker, in all regions examined except cerebellum where no significant effect of the drug was observed. [11C](-)McN5652 showed no specific binding in any of the regions. The [11C]-labeled cis isomer, [11C]McN5655, revealed surprisingly low brain penetration and showed no significantly higher uptake in regions of interest than cerebellum. These results suggest that [11C](+)McN5652 is a promising candidate as a PET radiotracer for studying 5-HT uptake sites in vivo.

Animals↗

Assessment of brain muscarinic acetylcholinergic receptors in living mice using a simple probe, [125I]-4-iododexetimide and [125I]-4-iodolevetimide.

This study describes assessment of brain muscarinic acetylcholinergic receptors in living mice using a single-crystal radiation detection system, the high-affinity antagonist [125I]-4-iododexetimide, and the inactive enantiomer [125I]-4-iodolevetimide. Kinetics of radioligand binding, as well as perturbation by atropine displacement, can be determined using this simple probe technique.

Animals↗

Estimating renal function from the visual analysis of Tc-99m DTPA images.

Eleven visual parameters of Tc-99m DTPA imaging studies were evaluated to identify scintigraphic findings that best detect changes in renal function, to determine at which GFR levels they appear, and to establish criteria for visual estimation of renal function. Visual parameters were compared to in vitro GFR determinations in 41 patients. Three visual parameters offered best discrimination. The first one appeared at GFR values below 70 mL/min (sensitivity: 76%). The renal peak activity on the flow study (normally equal or greater than aortic) no longer reached the intensity of the aortic peak (pK < pA). The second parameter appeared at GFR values below 50 mL/min (sensitivity: 85%). The estimated kidney-to-liver ratio in the 2-minute image (usually 3 or greater) decreased to values less than 3. The third scintigraphic finding, pelvicalyceal system nonvisualization, appeared at GFR levels below 20 mL/min (sensitivity 100%). Use of these 3 scintigraphic findings allows categorization of patients into four functional groups: 1) severe dysfunction (GFR: 0-20 mL/min), 2) moderate to severe dysfunction (GFR: 21-50 mL/min), 3) moderate dysfunction (GFR: 50-70 mL/min), and 4) Normal study (GFR > 70 mL/min). Visual analysis of Tc-99m DTPA images does not identify patients with mildly decreased renal function (GFR: 70-90 mL/min).

Glomerular Filtration Rate↗