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      Imaging articular cartilage in osteoarthritis using targeted peptide radiocontrast agents

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          Abstract

          Background

          Established MRI and emerging X-ray contrast agents for non-invasive imaging of articular cartilage rely on non-selective electrostatic interactions with negatively charged proteoglycans. These contrast agents have limited prognostic utility in diseases such as osteoarthritis (OA) due to the characteristic high turnover of proteoglycans. To overcome this limitation, we developed a radiocontrast agent that targets the type II collagen macromolecule in cartilage and used it to monitor disease progression in a murine model of OA.

          Methods

          To confer radiopacity to cartilage contrast agents, the naturally occurring tyrosine derivative 3,5-diiodo-L-tyrosine (DIT) was introduced into a selective peptide for type II collagen. Synthetic DIT peptide derivatives were synthesised by Fmoc-based solid-phase peptide synthesis and binding to ex vivo mouse tibial cartilage evaluated by high-resolution micro-CT. Di-Iodotyrosinated Peptide Imaging of Cartilage (DIPIC) was performed ex vivo and in vivo 4, 8 and 12 weeks in mice after induction of OA by destabilisation of the medial meniscus (DMM). Finally, human osteochondral plugs were imaged ex vivo using DIPIC.

          Results

          Fifteen DIT peptides were synthesised and tested, yielding seven leads with varying cartilage binding strengths. DIPIC visualised ex vivo murine articular cartilage comparably to the ex vivo contrast agent phosphotungstic acid. Intra-articular injection of contrast agent followed by in vivo DIPIC enabled delineation of damaged murine articular cartilage. Finally, the translational potential of the contrast agent was confirmed by visualisation of ex vivo human cartilage explants.

          Conclusion

          DIPIC has reduction and refinement implications in OA animal research and potential clinical translation to imaging human disease.

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          Most cited references36

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          The surgical destabilization of the medial meniscus (DMM) model of osteoarthritis in the 129/SvEv mouse.

          To evaluate anterior cruciate ligament transection (ACLT) and destabilization of the medial meniscus (DMM) surgical instability models of osteoarthritis (OA) in the 129/SvEv mouse knee joint. Micro-surgical techniques were used to perform ACLT or DMM under direct visualization. Histological scoring was performed on multiple sections to assess cartilage damage across the entire joint. The ACLT model gave severe OA, chondrogenesis of the joint capsule and, in some cases, severe subchondral erosion of the posterior tibial plateau. Surgical DMM was less invasive than the ACLT procedure and resulted in lesions primarily on the central weight-bearing region of the medial tibial plateau and medial femoral condyles. Lesions in the DMM model progressed from mild-to-moderate OA at 4 weeks, to moderate-to-severe OA at 8 weeks post-surgery. Destruction of the subchondral bone was never observed in the DMM model. ACLT is not recommended in the mouse due to the high surgical proficiency required and the development of severe OA that may involve subchondral bone erosion. The severity and location of lesions following DMM are consistent with lesions observed in aged spontaneous mouse models of OA. The DMM model has sufficient sensitivity to show disease modification, as observed with the ADAMTS-5 knock out (KO) mouse. The DMM model should be a first choice to challenge mice with gene deletions of potential targets in OA.
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            Ageing and the pathogenesis of osteoarthritis.

            Ageing-associated changes that affect articular tissues promote the development of osteoarthritis (OA). Although ageing and OA are closely linked, they are independent processes. Several potential mechanisms by which ageing contributes to OA have been elucidated. This Review focuses on the contributions of the following factors: age-related inflammation (also referred to as 'inflammaging'); cellular senescence (including the senescence-associated secretory phenotype (SASP)); mitochondrial dysfunction and oxidative stress; dysfunction in energy metabolism due to reduced activity of 5'-AMP-activated protein kinase (AMPK), which is associated with reduced autophagy; and alterations in cell signalling due to age-related changes in the extracellular matrix. These various processes contribute to the development of OA by promoting a proinflammatory, catabolic state accompanied by increased susceptibility to cell death that together lead to increased joint tissue destruction and defective repair of damaged matrix. The majority of studies to date have focused on articular cartilage, and it will be important to determine whether similar mechanisms occur in other joint tissues. Improved understanding of ageing-related mechanisms that promote OA could lead to the discovery of new targets for therapies that aim to slow or stop the progression of this chronic and disabling condition.
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              A molecular imaging primer: modalities, imaging agents, and applications.

              Molecular imaging is revolutionizing the way we study the inner workings of the human body, diagnose diseases, approach drug design, and assess therapies. The field as a whole is making possible the visualization of complex biochemical processes involved in normal physiology and disease states, in real time, in living cells, tissues, and intact subjects. In this review, we focus specifically on molecular imaging of intact living subjects. We provide a basic primer for those who are new to molecular imaging, and a resource for those involved in the field. We begin by describing classical molecular imaging techniques together with their key strengths and limitations, after which we introduce some of the latest emerging imaging modalities. We provide an overview of the main classes of molecular imaging agents (i.e., small molecules, peptides, aptamers, engineered proteins, and nanoparticles) and cite examples of how molecular imaging is being applied in oncology, neuroscience, cardiology, gene therapy, cell tracking, and theranostics (therapy combined with diagnostics). A step-by-step guide to answering biological and/or clinical questions using the tools of molecular imaging is also provided. We conclude by discussing the grand challenges of the field, its future directions, and enormous potential for further impacting how we approach research and medicine.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: InvestigationRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: Project administrationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                10 May 2022
                2022
                : 17
                : 5
                : e0268223
                Affiliations
                [1 ] Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
                [2 ] Diamond Light Source Ltd, Diamond House, Harwell Science and Innovation Campus, Didcot, United Kingdom
                [3 ] Target Discovery Institute, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
                University of Patras, GREECE
                Author notes

                Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: MMF and NHL are named inventors on patents for radiopaque compounds containing DIT (WO2018020262A1, EP3490614A1). All other authors declare that they have no competing interests.

                Author information
                https://orcid.org/0000-0003-3373-7714
                Article
                PONE-D-21-34457
                10.1371/journal.pone.0268223
                9089912
                35536857
                0936e613-4ead-44f6-b160-00c5d1f45697
                © 2022 Fowkes et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 29 October 2021
                : 25 April 2022
                Page count
                Figures: 4, Tables: 1, Pages: 15
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100000849, National Centre for the Replacement, Refinement and Reduction of Animals in Research;
                Award ID: NC/M000141/1
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100012041, Versus Arthritis;
                Award ID: 20205
                Funded by: funder-id http://dx.doi.org/10.13039/501100012041, Versus Arthritis;
                Award ID: 21621
                This work was supported by the National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3R grant NC/M000141/1, NHL, https://www.nc3rs.org.uk/) and the Centre for OA Pathogenesis Versus Arthritis (Versus Arthritis grants 20205, 21621, https://www.versusarthritis.org/). The human tissue work was supported by the National Institute for Health Research (NIHR) via the Oxford Biomedical Research Centre. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Anatomy
                Biological Tissue
                Connective Tissue
                Cartilage
                Medicine and Health Sciences
                Anatomy
                Biological Tissue
                Connective Tissue
                Cartilage
                Biology and Life Sciences
                Anatomy
                Biological Tissue
                Connective Tissue
                Cartilage
                Articular Cartilage
                Medicine and Health Sciences
                Anatomy
                Biological Tissue
                Connective Tissue
                Cartilage
                Articular Cartilage
                Medicine and Health Sciences
                Rheumatology
                Arthritis
                Osteoarthritis
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Tibia
                Medicine and Health Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Tibia
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Magnetic Resonance Imaging
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Magnetic Resonance Imaging
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Magnetic Resonance Imaging
                Biology and Life Sciences
                Biochemistry
                Proteins
                Collagens
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Bone Imaging
                X-Ray Radiography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Bone Imaging
                X-Ray Radiography
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Bone Imaging
                X-Ray Radiography
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                X-Ray Radiography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                X-Ray Radiography
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                X-Ray Radiography
                Research and Analysis Methods
                Imaging Techniques
                In Vivo Imaging
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