Design, Synthesis, and validation of Imaging Probes MRI CEST agents: basic principles, mechanism of action and classification Enzo Terreno Torino, September 19 to 30, 2011 Lesson outline CEST agents mechanism of action Sensitivity issue CEST agents vs conventional MRI agents CEST agents classification LIPOCEST CEST (Chemical Exchange Saturation Transfer) agents Dw (rad.Hz) = wWAT - wCEST If Dw > kex then…. wWAT CEST Agent wCEST 40 water molecule CEST agent mobile protons 30 20 10 Dw 0 -10 -20 -30 -40 KHz The MR-CEST experiment OFF resonance irradiation Aqueous solution of a CEST agent IS IS = 7.8 a.u. Bulk water 40 30 20 10 IWAT = 16.9 a.u. rf field rf field 0 -10 -20 -30 -40 kHz I0 CEST agent 40 30 20 10 Dw 0 -10 -20 -30 -40 Dw kHz OFF* resonance irradiation 40 30 20 10 I0 = 14.5 a.u. 0 -10 -20 -30 -40 kHz The decrease of IWAT is the source of the MR contrast The net ST % effect is calculated as ( 1 - IS/I0 ) . 100 CEST agents: the sensitivity issue Sherry D. et al.Chem. Soc. Rev., 2006, 35, 500–511 tsat R1w kex fCEST IS kex fCEST ST 1 w (1 e ) I 0 R1 kex fCEST Where: fCEST n CA 2[ BulkW ] Exchange rate of the mobile protons belonging to the contrast agent(CA) Relaxation rate of the bulk water protons Concentration of the contrast agent Number of magnetically equivalent mobile protons Experimental parameter: irradiation time tsat R1w kex fCEST IS kex fCEST ST 1 w (1 e ) I 0 R1 kex fCEST Increase of R1 bulk water pool Simulation parameters* fCEST= 5×10-4, R2bw= 2×R1bw, R1CEST = 2 s-1, R2CEST = 50 s-1, kCEST = 1600 s-1, B2 = 6 mT Woessner et al, MRM 2005 The steady-state condition is reached when e CEST R1bw kex f CEST In addition to R1bw, also an increase of the exchange rate accelerates the achievement of the steady state condition 0 Sensitivity of CEST agents: playing with kex In principle, the CEST efficiency is proportional to kex, but the exchange rate cannot be increased at will, because: i) the condition Dw > kex has to be satisfied ii) increasing kex Max. CEST kex 2 B2 Fast exchange requires high-intensity saturation fields for achieving full saturation overcoming SAR* limitations direct saturation of bulk water unsafe saturation less efficient CEST contrast *SAR = Specific Absorption Rate. It is defined as the RF power absorbed per unit of mass of an object, and is measured in watts per kilogram (W/kg).SAR of 1 Wkg-1 applied for an hour would result in a temperature rise of about 1 °C. Sensitivity of CEST agents: increasing the number of saturated protons The CEST efficiency is proportional to the number of mobile protons A CEST contrast of 10% requires few millimolar of mobile protons The sensitivity can be improved by increasing the number of mobile protons (with equal or similar Dw values) per CEST molecule Mobile protons Sensitivity Chemical system < 10 mM Low MW molecules 103 mM Macromolecules 106 nM Nanoparticles Optimizing the saturation scheme The overall saturation time can be covered by: a single cw rectangular pulse a train of shaped pulses Single cw saturation pulses (2-10 s long) have been observed to be more efficient in case of probes with relatively slow exchange: DIACEST (B2 1-3 mT), PARACEST (typically amide protons or slowly exchanging Ln-bound water protons, B2 12-24 mT), and LipoCEST (B2 6-12 mT) BUT Pulsed shaped pulses are definitely better in terms of deposited energy and clinical translation CEST agents: the sensitivity issue CEST contrast is quite sensitive because few millimolar of saturated mobile protons are sufficient to affect the MRI signal (> 100 molar) However, the development of highly sensitive agents is an hot issue, especially for molecular imaging purposes. H2 O Saturation rf pulse Variables affecting the CEST contrast 50 40 30 20 10 0 -10 -20 -30 -40 -50 ppm Exchange rate of the CEST protons Duration of saturation time Resonance frequency of the CEST protons Saturation scheme (cw, pulsed) Total concentration of saturated spins Saturation pulse power T1 and T2 of both the exchanging sites Magnetic field strength (affects Dw) CEST agents: mechanism of action H2 O Saturation rf pulse 50 ST-spectrum 45 40 0 -10 -20 -30 -40 -50 ppm 30 ST % 50 40 30 20 10 ST % = 100 (1- IS/I0) 35 25 20 15 Dw 100 10 Dw 5 0 I water % 80 I0 60 40 20 IS Z-spectrum 0 50 40 30 20 10 0 -10 -20 -30 -40 -50 ppm 0 10 20 ppm 30 40 50 Field homogeneity B0 field homogeneity plays a key-role for the detection of CEST contrast, especially in biological specimen Dw 100 Dw 50 40 I I0 60 IS ST % = 100 (1- IS/I0) 35 30 ST % water % 80 40 ST-spectrum 45 25 20 15 20 10 Z-spectrum 5 0 50 40 30 20 10 0 -10 -20 -30 -40 -50 ppm 0 0 10 20 ppm 30 40 50 An accurate contrast assessment requires that the two MR signal intensities are measured at frequency offsets symmetrically distributed with respect to the resonance frequency of the bulk water Field homogeneity The pixel-by-pixel evaluation of the spatial distribution of the frequency offset of the bulk water is necessary to avoid CEST artifacts… Human astrocytoma Zhou et al., MRM 2008, 60, 842 Field homogeneity …but, of course, acquiring B0 maps takes time Several methods have been proposed so far: B0 (and also B2) compensation algorithm (Sun et al., MRM 2007) relatively fast (in addition to the couple of CEST scans, it requires few images for generating the B0/B1 maps) Not suitable for large inhomogeneities Z-spectrum interpolation (Zhou et al., Nat. Med. 2003 – Stancanello et al., CMMI 2008) broad applicability, good accuracy Relatively time consuming (depending on the frequency sampling) WAter Saturation Shift Referencing (WASSR) (Kim et al., MRM 2009) excellent accuracy; optimal for detecting CEST contrast from very little shifted agents Time consuming (an additional Z spectrum is required) CEST agents vs conventional MRI contrast agents Gd-based fibrin-targeting agent (visualisation of non-occlusive thrombi) 3D-Gd-MR Angiography Do we actually need a new class of MRI agent ? Gd-enhanced MR images MRI cell tracking experiment (Glioma) (Limph node targeting by tumor specific SPIO-labeled dendritic cells) in vivo pH mapping of tumors Multiple visualization of MRI agents In vivo multiple visualization of MRI probes would considerably improve the potential of MRI in many molecular imaging experiments (e.g. multi- detection of epitopes, simultaneous tracking of different populations, dynamic measurements,...) Example: vivo Fluorescence image of a lymph node R .N. Germain et al, Nature Rev. Imm., 2006, 6, 497 Can we get similar results using MRI agents? cell NMR provides a parameter that can characterise any molecule: the resonance frequency of its spins 1H-NMR spectrum bulk water Multiple detection can be achieved by generating a “frequency encoded” contrast Agent A 10 8 6 4 Agent B 2 0 ppm For imaging purposes, this information must be transferred to the intensity of bulk water protons CEST agents vs conventional MRI agents MULTIPLE DETECTION 1,8 1,5 B D A 1,2 50 A 40 B 30 C 20 ppm 10 C D 0 -10 Concentration dependence of the MRI contrast R2 10 60 -1 8 R1water s CEST % 80 40 6 4 R1 20 2 0 0 20 40 60 [CEST] - mM 80 100 0 0,0 0,2 0,4 0,6 0,8 1,0 [agent] mM Responsive contrast requires the MRI observable to depend only on the parameter of interest A ratiometric analysis of the intensity of the water signal after the irradiation of two different mobile pools allows to get rid of the concentration of the MRI probes CEST agents are very suitable Responsive probes Ratiometric analysis ST 1 IS I0 (1); IS 1 I 0 1 kbwT1w (2); IS I0 by substitution of eq.3 into eq.2 kex n CAT1w I0 1 IS 2[ BulkW ] kbw (5); kex n CA 2[ BulkW ] 1 kex n CA 1 T1w 2[ BulkW ] (3); (4); kex n CAT1w I0 1 IS 2[ BulkW ] If two exchanging pools (A and B) are present in a known ratio (R) then... poolA A A A I0 k n CA T1w ex 1 A A A A k n CA I k ex S 2[ BulkW ] ex R B poolB B B B B B B kex kex n CA T1w kex n CA I0 1 2[ BulkW ] IS Classification of CEST agents Diamagnetic CEST agents Paramagnetic CEST agents Diamagnetic - vs. Paramagnetic -CEST agents Dw > kex Dwpara R HN O Dwdia OH2 NH R N O R N O Ln3+ N N HN O NH R DIACEST PARACEST 30 25 20 15 10 5 0 ppm The extension of the Dw range facilitates multiple visualization and allow to exploit larger exchange rate before coalescence takes place, but the associated line broadening may introduce SAR issues and the T1 and T2 shortening may be detrimental for the CEST eficacy Field homogeneity and highly shifted agents The detrimental effect of B0 inhomogeneity progressively vanishes moving away from the resonance of the bulk water mouse bearing a B16 melanoma xenograft (B2 6 mT) ST@ 3.5 ppm Uncorrected CEST maps Morphological T2w- image Water shift map Highly shifted CEST agents can be accurately detected by a simple two scans experiments ST@ 20 ppm Classification of CEST agents Small-sized (sugars, aminoacids) DIACEST Macromolecular /Polymeric (poliaminoacids, RNA-like,…) Diamagnetic CEST agents EndoCEST peptides/proteins, glycogen... Paramagnetic CEST agents Endogenous CEST agents (2): APT imaging Human patient with a meningioma (3 T) APT imaging may help to discriminate between tumor and edema Endogenous CEST agents (4): gagCEST In vitro cartilage depletion by tripsine In vivo CEST-MR images of a human patella Classification of CEST agents Small-sized (sugars, aminoacids) DIACEST Macromolecular /Polymeric (poliaminoacids, RNA-like,…) Diamagnetic CEST agents EndoCEST peptides/proteins, glycogen... Small-sized ParaCEST Paramagnetic CEST agents SupraCEST LipoCEST Eu CEST agents for cell-labeling experiments (1) CEST agents can be used to label different cell populations 1,4 Eu-H2O 1,2 Tb-H2O 1,0 200 0 -200 -400 -600 -800 ppm Angew. Chem. Int. Ed. 2005, 44, 1813 Classification of CEST agents Small-sized (sugars, aminoacids) DIACEST Macromolecular /Polymeric (poliaminoacids, RNA-like,…) Diamagnetic CEST agents EndoCEST peptides/proteins, glycogen... Small-sized ParaCEST Paramagnetic CEST agents SupraCEST LipoCEST Macromolecular /Polymeric (dendrimers...) CEST agents for assessing tumor vascular permeability Simultaneous injection of two agents with different size Yb-G2 Eu-G5 MCF-7 xenograft tumor on mice Meser Ali et al., Mol. Pharm. 2009, 6, 1409 Classification of CEST agents Small-sized (sugars, aminoacids) DIACEST Macromolecular /Polymeric (poliaminoacids, RNA-like,…) Diamagnetic CEST agents EndoCEST peptides/proteins, glycogen... Small-sized ParaCEST Paramagnetic CEST agents SupraCEST LipoCEST Macromolecular /Polymeric (dendrimers...) Nano-sized, (perfluorocarbon...) The route to high sensitivity: exploiting nanotechnology Usually, the typical approach consists of loading a large number of CEST agents to the external surface of the nanosystem: Perfluorocarbon nanoemulsions P.M. Winter et al. Mag. Reson. Med., 2006, 56, 1384 R HN O OH2 NH R N O N Ln3+ N N O Adenovirus R HN O NH O. Vasalatiy et al. Bioconjugate Chem., 2008, 19, 598 The sensitivity of such nanoprobes is primarily dependent on the maximum payload that can be achieved (generally 103-105 PARACEST units per nanosystem) Macromolecular Paramagnetic CEST agents To exploit the reversible interaction between a paramagnetic Shift Reagent and a substrate rich of mobile protons SUPRACEST Example: Interaction between [TmDOTP]52- O3P N N PO32- 3+ Tm 2- N O3P N PO32- and polyArginine Sensitivity threshold (referred to the paramagnetic complex) of tens of mmolar S. Aime et al., Angew. Chemie Int. Ed., 2003, 42, 4527 1) Small-sized molecules small number of mobile protons (<10) per molecule Sensitivity a)Diamagnetic agents (sugars, aminoacids,…) B1 field intensity tens of mM few mM hundreds of mM b)Paramagnetic agents PARACEST Amide, hydroxilic protons metal bound water protons 2) Macromolecular agents a)Diamagnetic agents (poliaminoacids, RNA-like,…) large number of mobile protons (~103) per molecule mM few mM b)Paramagnetic agents SUPRACEST agents 3) Nanoparticles extremely high number of mobile protons (>106) per molecule LIPOCEST agents tens of pM Liposomes Biocompatibles, extremely versatiles, successfully used in pharmaceutical field Cryo-TEM image DPPC: DiPalmitoyl-PhosphatidylCholine The external surface may be easily functionalized with a wide variety of chemicals including targeting vectors, or PEG chains for prolonging the blood half lifetime (Stealth® liposomes). Liposomes can be passively accumulated in pathological body regions (tumors, atherosclerotic plaques,…) The ST efficiency to kex and number of mobile protons WATER MOLECULE kex The number of mobile protons for Large Unilamellar Vescicles (LUV) range from 2,4x106 (50 nm) to 2,1x109 (500 nm) Liposomes can be very efficient CEST Probes kex can be modulated by: varying the liposome membrane permeability (P) (kex= P S/V) Saturated phospholipids Membrane tightly packed Slow exchange Unsaturated phospholipids Less tightly packed Fast exchange Cholesterol insert himself in the hole Reduce the exchange rate Varying the liposome size (kex= P S/V=P x 3/radius) kex n° of mobile protons How the resonance frequencies of inner and outer water protons can be separated ? Encapsulating a paramagnetic shift reagent (SR) in the liposome Bulk water intraliposomal water Bulk+ water O kex O OH2 N O O N Ln3+ N N O O O O intraliposomal water 10 O O O O N Ln3+ N N O 4 2 0 -2 -4 -6 -8 -10 O O O 6 ppm OH2 N 8 Lanthanide-based SR Angew. Chem. Int. Ed., 2005, 44, 5513. The chemical shift of the water protons () in the presence of a paramagnetic SR is the sum of three contributions: DIA HYP BMS DIA often negligible HYP requires a “chemical” interaction between the paramagnetic center (the Ln(III) ion) and the water molecule (through bond: contact shift; through space: pseudocontact shift) BMS does not require a “chemical” interaction and it is dependent on the bulk magnetic susceptibility of the compartment containing the SR In the case of spherical compartment BMS=0 Conventional liposomes Shift Reagent for intraliposomal water protons When kex Dw then: [ H 2O ]bound to SR int ralipo = bound [ H 2O ]total water water H H O Ln bound HYP pseudo D G water contact D is the magnetic anisotropy of the lanthanide complex Ln D CJ A02 r 2 - CJ is a constant of the metal CJ > 0 for Eu, Er, Tm e Yb CJ < 0 for Ce, Pr, Nd, Sm, Tb, Dy and Ho CJ = 0 for Gd - (A02 <r2>) depends on the crystal field Magnetic axis of the complex H H O Ln G 3 cos 2 1 r3 O DyDOTMA O DOTA O DyDOTA N N N N O DyHPDO3A O DyDTPA O TmDOTMA O O O TmDOTA O O DOTMA TmDTPA 35 30 25 20 15 10 5 N N TmHPDO3A N N O O 0 -5 -10-15-20-25-30-35 O HYP - ppm/M O O O O HOOC O COOH N N N N O HOOC N N OH COOH HPDO3A N DTPA O O COOH -Shift differences are due to the geometric differences among the complexes (parameter G) LIPOCEST agents SR Hydration Vortexing MLV Extrusion 55 °C LUV Dialisis 55 °C Lipidic film Bulk water SR unit Water protons inside liposomes 1H-NMR spectrum (7 T, 298 K) Tm [TmDOTMA]0.12 M inside liposomes DPPC/DPPG 95/5 (w/w) liposomes LipoCEST agents: sensitivity LipoCEST formulation: POPC/DPPG/Chol (55/5/40 in moles) size:250 nm Experimental condition: 7 T – 37°C – pH 7.4 - B2 field 6 mT O O N O O N OH2 N Ln3+ N O O O O Normalized Intensity Values, a.u. Z-spectra GLOBAL ROI NMR spectrum 1 0.8 Z-spectrum sample 1 0.6 0.4 0.2 0 -15 -10 -5 0 5 Sat. offset, ppm 10 15 Seleziona le ROI manualmente - sulla prima viene calcolato l'ST globale LipoCEST conc. 1. 2. 3. 4. 5. 6. 1.5 nM 750 pM 320 pM 160 pM 80 pM 40 pM 1 2 6 5 3 4 T2W Image CEST map @ 3.8 ppm LipoCEST agents: factors affecting sensitivity - Water permeability of the liposome bilayer (Pw) Can be modulated by changing the packaging properties of the phospholipids Phospholipids with saturated aliphatic chains (e.g. dipalmitoyl) displays lower Pw than unsaturated ones (e.g. di-oleyl) Cholesterol intercalates in the bilayer and reduces Pw 1000 -5 -1 10 x Pw (cm s ) 800 600 400 200 9 6 3 0 DPPC POPC/CHOL (20) POPC/CHOL (40) DSPE-PEG2000 DSPE-PEG2000 DSPE-PEG2000 J. Inorg. Biochem., 2008, 102, 1112. First generation LIPOCEST: spherical liposomes Pro: Highly sensitive (pM range) Con: Little frequency range Tm 4ppm -4ppm Dy How to increase the shift? Exploiting the BMS shift LISBulk = BMS Dip water BMS depends on the concentration of the shift reagent and its sign depends on the shape and orientation (wrt B0) of the compartment in which the shift reagent is confined Second generation of LIPOCEST: non-spherical liposomes Osmotic shrinkage -H2O Cryo-TEM images of osmotically shrunken LIPOCEST agents in collaboration with E. Sanders and N. Sommerdijk from University of Eindhoven (NL) Cj Gd=0 D 0 bound dia water Gd Before dialysis Gd(III)-complexes has Dip = 0 BMS SR meff 2 DOsm meff Gd = 7.94 Lanthanides showing the higher values for meff: Gd, Tb, Dy, Ho, Aime S. et al., J. Am. Chem. Soc., 2007, 129, 2430 Er and Tm O Hydrophilic SR O N O 2nd generation O OH2 N Tm3+ N O O O O OH2 N O CH3 O N Amphiphilic SR O Tm3+ N HO N O N O N 3rd generation 12 ppm 22 ppm LISint ralipo Dip BMS water Terreno E. et al., Angew. Chemie Int. Ed., 2007, 46, 966. A further DLIPO increase can be achieved by encapsulating neutral multimeric SRs - COO- OOC N - COO- OOC N N N N OOC N OH N - OOC OOC Gd OOC - N N N HNOC OOC N Tm3+ - N CONH COO- [Tm-dimer] CONH N N Tm N [Tm-HPDO3A] - COO- OOC Tm Tm - - N HNOC COO- N N COO- COO- HNOC N N Tm3+ Gd Gd CONH COO- N Tm3+ - N OOC N COO- [Tm-trimer] Tm-HPDO3A 25 mM Tm-dimer 25 mM 28 ppm Tm-trimer 25 mM DPPC/Tm-1/DSPE-PEG2000 (75/20/5 mol %) Terreno E. et al., Chem. Commun., 2008, 600 In addition to increase the magnitude of DLIPO, the incorporation of amphiphilic SRs may also affect he sign of the shift through the modulation of the magnetic alignment of the vesicles. The sign of the BMS contribution depends on the orientation of the compartment with respect to the external B0 field B0 For a cylinder DBMS 0 DBMS 0 As non-spherical vesicles, also the osmotically shrunken LIPOCEST could orient themselves in the field, thus changing the DLIPO sign Phospholipid-based systems, e.g bicelles, are bicelle oriented in the field with their principal symmetry axis perpendicular to B0 Alignment energy The driving force of the orientation is the interaction between B0 and the magnetic susceptibility anisotropy (D) of the phospholipidic membrane. B0 Incorporation in the membrane of a lanthanide complex with D 0 COOH D 0 N CONH HOOC N 22270 Ln CONH D 0 N COOH S. Prosser et al., J. Magn. Res., 1999, 141, 256. COOH - CONH HOOC O O N 22270 Ln N COO- OOC N O O N N OH2 N Ln3+ N O O N O CONH N - OOC N [LnHPDO3A] Ln O N OH COOH ( D )SR C jLn A02 r 2 Tm Tm CJ > 0 (D )SR 0 (D )LIPO 0 Gd Gd CJ = 0 (D )SR 0 (D )LIPO 0 Dy Dy CJ < 0 (D )SR 0 (D )LIPO 0 20 10 D LIPO 0 -10 -20 - ppm B0 O O N O O N OH2 N Ln3+ N O O O N O O O O O N OH2 N Ln3+ N O O O O D LIPO 0 D LIPO 0 with the same amphiphilic ligand it is possible to change the liposome orientation by changing the Ln(III) ion - COO- OOC N N Tm [Tm-HPDO3A] - O N OOC N OH O N O O N OH2 N Ln3+ N O O O O ( D )SR C jLn A02 r 2 Tm CJ > 0 Tm(III) complexes1 - COO- OOC N N Tm N - N B0 CON OOC O O N O - O COO OH2 N Ln3+ N O O O O N O O O O N OH2 N Ln3+ N O O O O 2 N - N OOC D LIPO 0 D LIPO 0 CON N Tm - OOC N Tm-1 COO- 3 OOC N N - OOC N Tm N N - OOC Tm-3 N N - Tm-2 N OOC COO - 4 N CONH - OOC N Tm-4 Tm CONH Tm-5 N COO- COOO N CONH - OOC O O Tm N CONH N COO- O 5 30 20 10 0 D LIPO -10 -20 -30 -40 - ppm O O Delli Castelli D. et al., Inorg. Chem., 2008, 47, 2928. Extending the range of DLIPO values O N O O O O N OH2 N Ln3+ N O O OH2 N O O O O O N N Ln3+ N O N O O N O O N Ln3+ N Entrapping monomeric or multimeric neutral hydrophilic shift reagents O O O O O 1st generation OH2 O O 2nd generation 3nd generation DLIPO 80 B0 60 O N O O N O OH2 N Ln3+ N O N O N N Ln3+ N O O OH2 O O O O O O O O O OH2 N O O N N Ln3+ N O O O O DLIPO 0 DLIPO 0 CEST % O 40 20 The DLIPO sign for not spherical LipoCEST agents depends on their orientation in the B0 field 0 40 20 0 -20 Saturation frequency offset (ppm) Terreno E. et al., Methods Enzymol. , 2009, 464, 193. -40 Multiple detection of LipoCEST agents: buffer vs. agar O A O O O OH2 N O N Ln3+ N N O B O O O 7 T – 312 K – sat. intensity 6 mT DLIPO 6.7 ppm O N O N O OH2 N Ln3+ N O O O O DLIPO 18 ppm Control (buffer) A A+B In buffer A B 6.7 ppm B In agarose gel Control (agar) A+B @18 ppm In vivo Multiple detection of LipoCEST agents Intramuscolar injection Subcutaneous injection O O O O N Ln3+ N N O N OH2 N O O O O O O N O O O O N O OH2 N Ln3+ N N OH2 N Ln3+ N O O O O O O @-17 ppm O O @ 7 ppm @-17 ppm O O N O O N OH2 N Ln3+ N O O O O @3.5 ppm Some readings… S. Zhang et al., Acc. Chem. Res., 36, 783, 2003 - M. Woods et al., Chem. Soc. Rev., 35, 500, 2006 - J. Zhou et al., Progr. NMR Spectr., 48, 109, 2006 - S. Viswanathan et al., Chem. Rev., 110, 2960, 2010 - E. Terreno et al., Contrast Media Mol. I., 5, 78, 2010 - Hancu I. et al., Acta Radiol., 51, 910, 2010