Discovery of 7-[18F]Fluorotryptophan as a Novel Positron Emission Tomography (PET) Probe for the Visualization of Tryptophan Metabolism in Vivo.

Tryptophan and its metabolites are involved in different physiological and pathophysiological processes. Consequently, positron emission tomography (PET) tracers addressing tryptophan metabolic pathways should allow the detection of different pathologies like neurological disorders and cancer. Herein we report an efficient method for the preparation of fluorotryptophans labeled in different positions with 18F and their biological evaluation. 4-7-[18F]Fluorotryptophans ([18F]FTrps) were prepared according to a modified protocol of alcohol-enhanced Cu-mediated radiofluorination in 30-53% radiochemical yields. In vitro experiments demonstrated high cellular uptake of 4-7-[18F]FTrps in different tumor cell lines. 4, 5-, and 6-[18F]FTrps, although stable in vitro, suffered from rapid in vivo defluorination. In contrast, 7-[18F]FTrp demonstrated a high in vivo stability and enabled a clear delineation of serotonergic areas and melatonin-producing pineal gland in rat brains. Moreover 7-[18F]FTrp accumulated in different tumor xenografts in a chick embryo CAM model. Thus, 7-[18F]FTrp represents a highly promising PET probe for imaging of Trp metabolism.

Radiosynthesis of 4-[(18)F]fluoro-L-tryptophan by isotopic exchange on carbonyl-activated precursors.

Several (18)F-labeled aromatic amino acids have been developed primarily for tumor imaging with positron-emission-tomography (PET). Also, (18)F-labeled tryptophan derivatives were synthesized by electrophilic (18)F-fluorination or by introducing a [(18)F]fluoroalkyl group. Here, a 3-step method for a nucleophilic radiosynthesis of 4-[(18)F]fluoro-L-tryptophan was developed. A carbonyl activated precursor containing a chiral amino acid building block was radiofluorinated by isotopic exchange, followed by removal of the activating formyl group by reductive decarbonylation and subsequent cleavage of the building block under acidic conditions. The title compound was obtained within 100 min with a radiochemical yield of about 13%, a molar activity of >70 MBq/mmol and an enantiomeric excess of >99%.

The potential value of blood biomarkers of intervertebral disk metabolism in the follow-up of patients with sciatica.

STUDY DESIGN: This is a prospective study with a follow-up period of 4 years. OBJECTIVES: The study aimed to evaluate the possible clinical utility of three biomarkers [i.e., keratan sulfate (KS), hyaluronan, and cartilage oligomeric matrix protein] measured in peripheral blood in severe acute sciatica at intake and follow-up. SUMMARY OF BACKGROUND: Our previous study and others have pointed out the interest of different laboratory tests in the acute phase of sciatica. Several blood biomarkers have been reported useful in the long-term follow-up of patients with osteoarthritis. We have found no information about the potential interest of these tests in spinal disorders. METHODS: Patients were admitted to the hospital for intensive conservative management of acute sciatica (n=82). A subgroup of patients (n=33) was selected based on the duration of symptoms at visit 1, and included those with the shortest (n=24) as well as those with the longest (n=9) duration of sciatica. Blood samples were drawn, centrifuged, and the plasma frozen. Antigenic KS, hyaluronan, and cartilage oligomeric matrix protein were measured by ELISA. Patients were re-evaluated at an average of 4.3 years (range: 2.1-6.8 years). RESULTS: Thirty-three subjects with an average age of 49.2+/-10.2 years participated. At intake, levels of the three biomarkers evaluated were within the range of normal values. No significant differences were found between the results of patients with a short history of sciatica (< or =3 weeks) and those with a long duration of symptoms (>20 weeks). At follow-up, a significant increase (P<0.05) in all three biomarkers was found. CONCLUSIONS: A single measurement of these three biomarker molecules does not seem to have any diagnostic or therapeutic relevance in patients with acute radicular compression. The significance of the increase in all three biomarkers after a mean follow-up of 4.3 years is unclear; it might reflect metabolic processes involved in degenerative spinal disorders. Even though we found no correlation with clinical outcome, we believe that more research is needed.

Glycosphingolipid antibodies in serum in patients with sciatica.

STUDY DESIGN: Serum antibody titers against 10 different glycosphingolipids were investigated by enzyme-linked immunosorbent assay in three groups of patients: patients with acute sciatica (Group IA, radicular pain for 32 +/- 36 days, n = 68), a subgroup of these patients 4 years later (Group IB, n = 23), and patients undergoing lumbar discectomy because of disc herniation (Group II, n = 37). OBJECTIVES: To investigate the immunologic response in sciatica patients by analyzing circulating autoantibodies against glycosphingolipids, molecules highly expressed in cells from the nervous system, and the possible correlation of such antibodies to clinical and imaging findings as well as to subjective symptoms. SUMMARY OF BACKGROUND DATA: The titers of glycosphingolipid antibodies are elevated in neurologic diseases with autoimmune stimulation such as Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy. METHODS: Antiglycosphingolipid antibodies were assayed by a microtiter enzyme-linked immunosorbent assay method. Antibody titers were related to a healthy population by a method that judges all positive results (positive result = patient sera/pooled blood donor serum >2, at titer 1/400) as indicating a pathologic condition. RESULTS: Increased levels of circulating antibodies against one or more glycosphingolipids were detected in 71% of patients with acute sciatica, in 61% of sciatica patients at a 4-year follow-up visit (eight antigens analyzed) and in 54% in patients undergoing discectomy. These frequencies were somewhat higher than, and in the last group similar to, those reported for generalized nervous system disorders with autoimmune involvement. In the acute sciatica patients, positive neurologic findings were associated with increased levels of two of the examined antibodies: 3'LM1 (immunoglobulin M and/or immunoglobulin G), P = 0.023, and GD1a (immunoglobulin M), P = 0.017. CONCLUSION: The presence of glycosphingolipid antibodies in patients with sciatica and disc herniation suggests an activation of the immune system and thus a process possibly involved in the pathophysiology of sciatica. The autoimmune response was not limited to antibodies against one specific glycosphingolipid target; rather, an overall increase in autoantibodies against nervous system-associated glycosphingolipids was observed. These results encourage further studies of the pathophysiologic and clinical relevance of autoimmune responses in patients with sciatica and disc herniation.