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CCR2 Positron Emission Tomography for the Assessment of Abdominal Aortic Aneurysm Inflammation and Rupture Prediction.

Authors:
Sean J English Sergio E Sastriques Lisa Detering Deborah Sultan Hannah Luehmann Batool Arif Gyu Seong Heo Xiaohui Zhang Richard Laforest Jie Zheng Chieh-Yu Lin Robert J Gropler Yongjian Liu

Circ Cardiovasc Imaging 2020 03 13;13(3):e009889. Epub 2020 Mar 13.

Department of Radiology (L.D., D.S., H.L., G.S.H., X.Z., R.L., J.Z., R.J.G., Y.L.), Washington University, St. Louis, MO.

Background: The monocyte chemoattractant protein-1/CCR2 (chemokine receptor 2) axis plays an important role in abdominal aortic aneurysm (AAA) pathogenesis, with effects on disease progression and anatomic stability. We assessed the expression of CCR2 in a rodent model and human tissues, using a targeted positron emission tomography radiotracer (Cu-DOTA-ECL1i).

Methods: AAAs were generated in Sprague-Dawley rats by exposing the infrarenal, intraluminal aorta to PPE (porcine pancreatic elastase) under pressure to induce aneurysmal degeneration. Heat-inactivated PPE was used to generate a sham operative control. Rat AAA rupture was stimulated by the administration of β-aminopropionitrile, a lysyl oxidase inhibitor. Biodistribution was performed in wild-type rats at 1 hour post tail vein injection of Cu-DOTA-ECL1i. Dynamic positron emission tomography/computed tomography imaging was performed in rats to determine the in vivo distribution of radiotracer.

Results: Biodistribution showed fast renal clearance. The localization of radiotracer uptake in AAA was verified with high-resolution computed tomography. At day 7 post-AAA induction, the radiotracer uptake (standardized uptake value [SUV]=0.91±0.25) was approximately twice that of sham-controls (SUV=0.47±0.10; <0.01). At 14 days post-AAA induction, radiotracer uptake by either group did not significantly change (AAA SUV=0.86±0.17 and sham-control SUV=0.46±0.10), independent of variations in aortic diameter. Competitive CCR2 receptor blocking significantly decreased AAA uptake (SUV=0.42±0.09). Tracer uptake in AAAs that subsequently ruptured (SUV=1.31±0.14; <0.005) demonstrated uptake nearly twice that of nonruptured AAAs (SUV=0.73±0.11). Histopathologic characterization of rat and human AAA tissues obtained from surgery revealed increased expression of CCR2 that was co-localized with CD68 macrophages. Ex vivo autoradiography demonstrated specific binding of Cu-DOTA-ECL1i to CCR2 in both rat and human aortic tissues.

Conclusions: CCR2 positron emission tomography is a promising new biomarker for the noninvasive assessment of AAA inflammation that may aid in associated rupture prediction.

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Source
http://dx.doi.org/10.1161/CIRCIMAGING.119.009889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7101060PMC
March 2020

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