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BACKGROUND Hepatopulmonary syndrome (HPS) is an arterial oxygenation defect induced by intrapulmonary vascular dilatation (IPVD) in the setting of liver disease and/or portal hypertension. This syndrome occurs most often in cirrhotic patients (4%–32%) and has been shown to be detrimental to functional status, quality of life, and survival. The diagnosis of HPS in the setting of liver disease and/or portal hypertension requires the demonstration of IPVD (i.e., diffuse or localized abnormally dilated pulmonary capillaries and pulmonary and pleural arteriovenous communications) and arterial oxygenation defects, preferably by contrast-enhanced echocardiography and measurement of the alveolar-arterial oxygen gradient, respectively. AIM To compare brain and whole-body uptake of technetium for diagnosing HPS. METHODS Sixty-nine patients with chronic liver disease and/or portal hypertension were prospectively included. Brain uptake and whole-body uptake were calculated using the geometric mean of technetium counts in the brain and lungs and in the entire body and lungs, respectively. RESULTS Thirty-two (46%) patients had IPVD as detected by contrast-enhanced echocardiography. The demographics and clinical characteristics of the patients with and without IPVD were not significantly different with the exception of the creatinine level (0.71 ± 0.18 mg/dL vs 0.83 ± 0.23 mg/dL; P = 0.041), alveolar-arterial oxygen gradient (23.2 ± 13.3 mmHg vs 16.4 ± 14.1 mmHg; P = 0.043), and arterial partial pressure of oxygen (81.0 ± 12.1 mmHg vs 90.1 ± 12.8 mmHg; P = 0.004). Whole-body uptake was significantly higher in patients with IPVD than in patients without IPVD (48.0% ± 6.1% vs 40.1% ± 8.1%; P = 0.001). The area under the curve of whole-body uptake for detecting IPVD was significantly higher than that of brain uptake (0.75 vs 0.54; P = 0.025). The optimal cut-off values of brain uptake and whole-body uptake for detecting IPVD were 5.7% and 42.5%, respectively, based on Youden’s index. The sensitivity, specificity, and accuracy of brain uptake > 5.7% and whole-body uptake > 42.5% for detecting IPVD were 23%, 89%, and 59% and 100%, 52%, and 74%, respectively. CONCLUSION Whole-body uptake is superior to brain uptake for diagnosing HPS.

The cause of antiseizure drug (ASD) resistance in epilepsy is poorly understood. Here, we focus on the transporter P-glycoprotein (P-gp) that is partly responsible for limited ASD brain uptake, which is thought to contribute to ASD resistance. We previously demonstrated that cyclooxygenase-2 (COX-2) and the prostaglandin E receptor, prostanoid E receptor subtype 1, are involved in seizure-mediated P-gp up-regulation. Thus, we hypothesized that inhibiting microsomal prostaglandin E(2) (PGE2) synthase-1 (mPGES-1), the enzyme generating PGE2, prevents blood-brain barrier P-gp up-regulation after status epilepticus (SE). To test our hypothesis, we exposed isolated brain capillaries to glutamate ex vivo and used a combined in vivo–ex vivo approach by isolating brain capillaries from humanized mPGES-1 mice to study P-gp levels. We demonstrate that glutamate signaling through the NMDA receptor, cytosolic phospholipase A2, COX-2, and mPGES-1 increases P-gp protein expression and transport activity levels. We show that mPGES-1 is expressed in human, rat, and mouse brain capillaries. We show that BI1029539, an mPGES-1 inhibitor, prevented up-regulation of P-gp expression and transport activity in capillaries exposed to glutamate and in capillaries from humanized mPGES-1 mice after SE. Our data provide key signaling steps underlying seizure-induced P-gp up-regulation and suggest that mPGES-1 inhibitors could potentially prevent P-gp up-regulation in epilepsy.—Soldner, E. L. B., Hartz, A. M. S., Akanuma, S.-I., Pekcec, A., Doods, H., Kryscio, R. J., Hosoya, K.-I., Bauer, B. Inhibition of human microsomal PGE2 synthase-1 reduces seizure-induced increases of P-glycoprotein expression and activity at the blood-brain barrier.

Chitosan-based nanomaterials have attracted significant attention in the biomedical field because of their unique biodegradable, biocompatible, non-toxic, and antimicrobial nature. Multiple perspectives of the proposed antibacterial effect and mode of action of chitosan-based nanomaterials are reviewed. Chitosan is presented as an ideal biomaterial for antimicrobial wound dressings that can either be fabricated alone in its native form or upgraded and incorporated with antibiotics, metallic antimicrobial particles, natural compounds and extracts in order to increase the antimicrobial effect. Since chitosan and its derivatives can enhance drug permeability across the blood-brain barrier, they can be also used as effective brain drug delivery carriers. Some of the recent chitosan formulations for brain uptake of various drugs are presented. The use of chitosan and its derivatives in other biomedical applications is also briefly discussed.

Gd chelates are widely used as contrast agents in magnetic resonance imaging. In 2015, the finding of T1 hyperintensities in brain structures was associated with the prior administrations of these agents in patients. This observation raised the question of the long-term tolerance of these molecules. The Gd³⁺ ionic radius is very close to that of Ca²⁺, and therefore this lanthanide interferes with numerous Ca²⁺-dependent biological processes. Its chelation by a ligand considerably improves its tolerance. Gd chelates are categorized into 2 classes: macrocylic and linear agents, differing in their thermodynamic stabilities, and therefore in their ability to dissociate. It is classically admitted that Gd chelates do not cross the healthy blood-brain-barrier. The observation of these hyperintensities, in the dentate nucleus of the cerebellum, the globus pallidus, and sometimes other structures, questioned this assumption.This thesis aimed to study the mechanism of Gd accumulation in the central nervous system: access pathways, tissue and subcellular location, Gd speciation). Potential neuro-toxicological effects associated with long term Gd presence in the brain were also researched.Using a rat model, we evidenced that the lower the thermodynamic stability of Gd chelates, the greater the cerebral Gd concertation was, thus confirming clinical observations. T1 hyperintensities exclusively appeared following administrations of linear Gd chelates. We also established that moderate renal failure potentiates Gd brain uptake in the case of linear Gd chelate. We also observed that brain structures accumulate even more Gd that their endogenous Fe concentration is high. Administration of linear Gd chelates resulted in an increased zincuria. Gadolinium vs. Zn transmetalation may be responsible for this effect.The combination of X fluorescence, transmission electronic microscopy, and NanoSIMS, showed Gd deposits at various scales and in various forms. It allowed us to document Gd pathways, and the role of endogenous metals and phosphorus in this phenomenon. X fluorescence analysis depicted, in rat deep cerebellar nuclei, that the majority of Gd was accumulated in the form of elongated and ramified structures, believed to be blood vessels where Gd would be retained in the perivascular area. By means of electron microscopy in rats, Gd insoluble deposits were observed in basal lamina of vessels, in cerebellar interstitium, and in the perivascular space. These Gd deposits, of spiny aspect, were rich in phosphorus, thus suggesting the presence of GdPO₄. Co-presence of Gd and phosphorous was also identified into glial cells, accumulated in intracellular lipofuscine pigments. No Gd deposits were found in rats treated with a macrocyclic Gd chelate.The established mechanistic hypothesis consists in the early access of Gd chelates to cerebrospinal fluid, followed by their passive diffusion into the parenchyma close to cerebral ventricles, through the ependyma. Encountering areas rich in endogenous metals and/or phosphorus, the less thermodynamically stable Gd chelates would dissociate, and Gd would bind endogenous macromolecules, or precipitate. Cerebrospinal fluid circulation along penetrating arterioles would also trap Gd at the perivascular level. Intact Gd chelates would be eliminated through perivascular glymphatic pathway, or “intramural periarterial drainage”, where probably dissociated Gd is also found.Except a non-specific hypoactivity, neurobehavioural, histopathological and neurochemical studies performed in rats did not demonstrate any obvious neurotoxicity, even at high doses.; Les chélates de Gd sont largement utilisés en tant qu’agents de contraste en imagerie par résonance magnétique. En 2015, un lien a été établi entre l’observation d’hypersignaux T1 de certaines structures cérébrales et le nombre d’administrations préalables de ces chélates de Gd reçues par les patients. Cette observation fortuite pose la question de la tolérance à long-terme de ces molécules. L’ion Gd³⁺ ayant un rayon ionique très proche de celui du Ca²⁺, il interfère avec de nombreux processus biologiques Ca²⁺-dépendants. Sa chélation par un ligand améliore considérablement sa tolérance. Les chélates de Gd sont répartis en 2 classes : macrocycliques et linéaires, différant par leur stabilité thermodynamique et donc leur tendance à se dissocier. Il est classiquement admis que les chélates de Gd ne traversent pas la barrière hémato-encéphalique saine. L’observation de ces hypersignaux au niveau du noyau dentelé du cervelet, du globus pallidus et parfois d’autres structures, remet en cause ce postulat.Les travaux de cette thèse visent à étudier le mécanisme d’accumulation du Gd dans le système nerveux central (voies de passage, localisations, spéciation du Gd accumulé). Les potentiels effets neurotoxiques associés à la présence de Gd dans le cerveau ont aussi été recherchés.Nous avons mis en évidence chez le Rat que l’accumulation cérébrale est d’autant plus importante que la stabilité thermodynamique du chélate de Gd est faible, confirmant les observations cliniques. Les hypersignaux T1 sont en effet liés à des injections répétées de chélates linéaires de Gd. Nous avons aussi établi qu’une insuffisance rénale modérée potentialise la capture cérébrale de Gd dans le cas d’un chélate de Gd linéaire. Nous avons observé que les structures cérébrales accumulent d’autant plus de Gd qu’elles sont riches en fer endogène. Une augmentation de la zincurie, après administration de chélates de Gd linéaires, a également été observée, suggérant un phénomène de transmétallation.La combinaison des techniques de fluorescence X (XRF), de microscopie électronique en transmission (TEM) et du NanoSIMS, a permis l’observation des dépôts de Gd à différentes échelles et sous différentes formes. Cela a permis de documenter les voies de passage du Gd, le rôle des métaux endogènes et du phosphore. L’analyse XRF a permis d’observer qu’au sein des noyaux cérébelleux profonds du Rat, la majorité du Gd est accumulée sous la forme de structures allongées et ramifiées. Ces structures pourraient être des vaisseaux sanguins. Le Gd serait accumulé dans l’espace périvasculaire. En TEM, des dépôts insolubles de Gd ont été observés dans les lames basales de vaisseaux, dans l’interstitium cérébelleux, et dans l’espace périvasculaire. Ces dépôts à l’apparence épineuse sont riches en phosphore, suggérant des dépôts de GdPO₄. Du Gd et du phosphore ont également été identifiés dans des cellules gliales, au sein de pigments intracellulaires de lipofuscine. Aucun dépôt de Gd n’a été trouvé chez des rats traités par un chélate de Gd macrocyclique.L’hypothèse mécanistique établie consiste en l’accès précoce des chélates de Gd au liquide céphalo-rachidien (LCR), puis leur diffusion passive dans le parenchyme proche des ventricules cérébraux, à travers l’épendyme. Arrivés dans des zones riches en métaux endogènes et/ou en phosphore, leschélates de Gd les moins stables thermodynamiquement se dissocieraient, le Gd se liant à des macromolécules endogènes, ou précipitant. La circulation du LCR le long des artérioles pénétrantes piègerait également du Gd au niveau périvasculaire. Les chélates de Gd intacts seraient éliminés par le système glymphatique périvasculaire ou « drainage périartériel intrapariétal ». On retrouve aussi du Gd probablement dissocié à ce niveau.Hormis une hypoactivité, non spécifique, les études neurocomportementales, histopathologiques et neurochimiques menées chez le Rat n’ont pas permis de mettre en évidence une toxicité avérée, même à des doses élevées.

INTRODUCTION: In the last decade PET has been useful in studying and understanding the 5-HT(1B) receptor. [(11)C] AZ10419369 and [(11)C]P943 have been applied as radioligands in these studies. Both use carbon-11 (t(1/2) = 20.4 min) as radionuclide, which limits the application to PET centres that have an on-site cyclotron and radiochemistry facilities. In this paper we report the synthesis and initial evaluation of the first fluorine-18 PET radioligand to image 5-HT(1B) receptors in brain, [(18)F]AZ10419096. MATERIALS AND METHODS: A boronate-precursor for [(18)F]AZ10419096 was synthesized from an intermediate provided by AstraZeneca and was labeled with fluorine 18 using Cu-mediated radio-fluorination. [(18)F] AZ10419096 was used in PET baseline and pretreatment measurements in nonhuman primates. PET data were analyzed using SRTM using the cerebellum as reference region. Blood samples for radio-metabolite analysis were collected during PET measurements. RESULTS: Radio-fluorination gave [(18)F]AZ10419096 in sufficient amounts and molar activity and with high radiochemical purity to be applied in PET measurements. In a baseline PET measurement [(18)F]AZ10419096 showed a high brain uptake and regional distribution consistent with reported 5-HT(1B) receptor densities. In a pretreatment PET measurement, AR-A000002 (2.0 mg/kg) blocked the binding of [(18)F]AZ10419096 to 5-HT(1B) receptors in occipital cortex by 80%, thereby demonstrating high specific binding. CONCLUSION: [(18)F]AZ10419096 is the first fluorine-18 PET radioligand for imaging 5-HT(1B) receptors in vivo with high specific binding and binding potential. [(18)F]AZ10419096 is a candidate for further development for use in clinical PET studies.

Numerous oral treatment options have been reported for neurological disorders, especially Alzheimer's disease (AD). Galantamine (GAL) is one of such drugs duly approved for management of AD. However, it exhibits poor brain penetration, low intestinal permeation and requires frequent dosing in AD treatment. The present studies, accordingly, were undertaken to develop DSPE-PEG 2000-based micelles loaded with GAL for efficient brain uptake, improved and extended pharmacokinetics, along with reduced dosing regimen.Mixed nanomicelles (MNMs) were systematically formulated using QbD approach, and characterized for morphology, entrapment efficiency andin vitrodrug release.Studies on CaCo-2 and neuronal U-87 cell lines exhibited substantial enhancement in the cellular permeability and uptake of the developed MNMs. Pharmacokinetic studies performed on rats showed significantly improved values of plasma AUC (i.e., 2.28-fold, p 0.001), ostensibly due to bypassing of hepatic first-pass metabolism and improved intestinal permeability, together with significant rise in MRT (2.08-fold, p 0.001) and tThe preclinical findings of the developed nanocarrier systems successfully demonstrate the notable potential of enhanced drug efficacy, extended duration of action and improved patient compliance.

Purpose: O-(2-[18F]fluoroethyl)-L-tyrosine (FET), a PET radiotracer of amino acid uptake, has shown potential for diagnosis and treatment planning in patients with glioblastoma (GBM). To improve quantitative assessment of FET PET imaging, we evaluated the repeatability of uptake of this tracer in patients with GBM. Methods: Test-retest FET PET imaging was performed on 8 patients with histologically confirmed GBM, who previously underwent surgical resection of the tumour. Data were acquired according to the protocol of a prospective clinical trial validating FET PET as a clinical tool in GBM. SUVmean, SUVmax and SUV98% metrics were extracted for both test and retest images and used to calculate 95% Bland-Altman limits of agreement (LoA) on lesion-level, as well as on volumes of varying sizes. Impact of healthy brain normalization on repeatability of lesion SUV metrics was evaluated. Results: Tumour LoA were [0.72, 1.46] for SUVmean and SUVtotal, [0.79,1.23] for SUVmax, and [0.80,1.18] for SUV98%. Healthy brain LoA were [0.80,1.25] for SUVmean, [0.80,1.25] for SUVmax, and [0.81,1.23] for SUV98%. Voxel-level SUV LoA were [0.76, 1.32] for tumour volumes and [0.80, 1.25] for healthy brain. When sampled over maximum volume, SUV LoA were [0.90,1.12] for tumour and [0.92,1.08] for healthy brain. Normalization of uptake using healthy brain volumes was found to improve repeatability, but not after normalization volume size of about 15 cm3. Conclusions Advances in Knowledge and Implications for Patient Care: Repeatability of FET PET is comparable to existing tracers such as FDG and FLT. Healthy brain uptake is slightly more repeatable than uptake of tumour volumes. Repeatability was found to increase with sampled volume. SUV normalization between scans using healthy brain uptake should be performed using volumes at least 15 cm3 in size to ensure best imaging repeatability.

The aim of this study was to determine the uptake of intravenously administered N-[11CH3]-dimethylaminoparthenolide (DMAPT) into orthotopic 9LSF glioblastoma brain tumors in Fisher 344 rats from positron emission tomography (PET) imaging studies. [11C]methyl iodide (11CH3I) was utilized as a [11C]-labeling reagent to label the precursor methylaminoparthenolide (MAPT) intermediate. From PET imaging studies it was found that brain uptake of N-[11CH3]DMAPT into brain tumor tissue was rapid (30min), and considerably higher than that in the normal brain tissue.

Schizophrenia is a serious illness that affects millions of patients and has been associated with N-methyl-d-aspartate receptor (NMDAR) hypofunction. It has been demonstrated that activation of metabotropic glutamate receptor 5 (mGluR5) enhances NMDA receptor function, suggesting the potential utility of mGluR5 positive allosteric modulators (PAMs) in the treatment of schizophrenia. Herein we describe the optimization of an mGluR5 PAM by replacement of a phenyl with aliphatic heterocycles and carbocycles as a strategy to reduce bioactivation in a biaryl acetylene chemotype. Replacement with a difluorocyclobutane followed by further optimization culminated in the identification of compound 32, a low fold shift PAM with reduced bioactivation potential. Compound 32 demonstrated favorable brain uptake and robust efficacy in mouse novel object recognition (NOR) at low doses.

O-Desmethylvenlafaxine (desvenlafaxine, ODV) is the active metabolite of venlafaxine, with similar activity and less risk for pharmacokinetic drug interactions compared to its parent compound venlafaxine. The purpose of this study was to design a series of esters of ODV and assess their potential as ODV prodrugs with improved bioavailability and brain uptake. Seven esters were synthesized and pharmacokinetic screening was performed in rats. The monoester formed on the phenolic hydroxyl of ODV (ODVP-1, ODVP-2, ODVP-3 and ODVP-5) could be degraded to ODV in rat plasma. These four compounds confirmed as possible prodrugs were then studied to evaluated the relative bioavailability of ODV they produced in beagle dogs. ODVP-1, ODVP-2 and ODVP-3 demonstrated higher relative bioavailability of ODV. Finally, ODVP-1, ODVP-2 and ODVP-3 were studied to evaluate their brain uptake in rats. The concentration of ODV in the rat plasma, brain and hypothalamus after administration of ODVP-1, ODVP-2 or ODVP-3 was higher compared with that of ODV. The higher bioavailability, improved pharmacokineics properties and more rapid penetration and translation of ODV suggest that ODVP-1, ODVP-2 or ODVP-3 may warrant further development and application as ODV prodrugs.

Anti‐transferrin receptor (TfR)‐based bispecific antibodies have shown promise for boosting antibody uptake in the brain. Nevertheless, there are limited data on the molecular properties, including affinity required for successful development of TfR‐based therapeutics. A complex nonmonotonic relationship exists between affinity of the anti‐TfR arm and brain uptake at therapeutically relevant doses. However, the quantitative nature of this relationship and its translatability to humans is heretofore unexplored. Therefore, we developed a mechanistic pharmacokinetic‐pharmacodynamic (PK‐PD) model for bispecific anti‐TfR/BACE1 antibodies that accounts for antibody‐TfR interactions at the blood‐brain barrier (BBB) as well as the pharmacodynamic (PD) effect of anti‐BACE1 arm. The calibrated model correctly predicted the optimal anti‐TfR affinity required to maximize brain exposure of therapeutic antibodies in the cynomolgus monkey and was scaled to predict the optimal affinity of anti‐TfR bispecifics in humans. Thus, this model provides a framework for testing critical translational predictions for anti‐TfR bispecific antibodies, including choice of candidate molecule for clinical development.

In continuation of our investigation of the dibenzylideneacetone scaffold as Aβ imaging probes, a series of derivatives containing pyridine rings with lower lipophilicity was synthesized and evaluated. Some of these probes displayed high affinities to Aβ1–42 aggregates, which ranged from 18.0 to 8.2 nM. The high and specific binding of the radiolabeled tracers was further confirmed by in vitro autoradiography on brain sections from AD patients and transgenic mouse. In biodistribution experiments, two 18F-labeled tracers [18F]17a and [18F]18 displayed high initial brain uptake (5.05 and 6.24% ID g−1, respectively, at 2 min postinjection) and fast clearance from the brain with brain2 min/brain60 min ratios of 6.08 and 8.00. These results demonstrate that the probes [18F]17a and [18F]18 with a dibenzylideneacetone structure containing pyridine rings have great strength in imaging Aβ plaques in the brain.

It is generally recognized that aggregates of α-synuclein (α-syn) in the brain are closely associated with the pathogenesis of Parkinson's disease (PD). Therefore, the development of in vivo imaging probes targeting α-syn aggregates is currently expected. In this study, we investigated the structure–activity relationships of radioiodinated diphenyl (IDP) derivatives with different conjugated double bonds as ligands for α-syn aggregates. An in vitro binding assay revealed that the binding affinity of the derivatives to α-syn aggregates increased as the length of the conjugated double bonds in their molecule extended. In contrast, brain uptake of the derivatives in biodistribution studies decreased in accordance with the extension of the double bonds. These findings from structure-relationship studies suggested that the length of the conjugated double bonds in the IDP derivatives plays an important role in the binding affinity for α-syn aggregates and uptake in the brain. Also, the present study may provide valuable information on molecular design for the development of new imaging probes targeting α-syn aggregates in the future.

The diaryl sulfonylurea MCC950/CRID3 is a potent NLRP3 inhibitor (IC50 = 8 nM) and, in animal models, MCC950 protects against numerous NLRP3-related neurodegenerative disorders. To evaluate the brain uptake and investigate target engagement of MCC950, we synthesised [11C-urea]MCC950 via carrier added [11C]CO2 fixation chemistry (activity yield = 237 MBq; radiochemical purity >99%; molar activity = 7 GBq/µmol; radiochemical yield (decay-corrected from [11C]CO2) = 1.1%; synthesis time from end-of-bombardment = 31 min; radiochemically stable for >1 h). Despite preclinical efficacy in neurodegeneration studies, preclinical positron emission tomography (PET) imaging studies in mouse, rat and rhesus monkey revealed poor brain uptake of low molar activity [11C]MCC950 and rapid washout. In silico prediction tools suggest efflux transporter liabilities for MCC950 at microdoses, and this information should be taken into account when developing next generation NLRP3 inhibitors and/or PET radiotracers.

Dysregulation of microtubules is commonly associated with several psychiatric and neurological disorders, including addiction and Alzheimer’s disease. Imaging of microtubules in vivo using positron emission tomography (PET) could provide valuable information on their role in the development of disease pathogenesis and aid in improving therapeutic regimens. We developed [11C]MPC-6827, the first brain-penetrating PET radiotracer to image microtubules in vivo in the mouse brain. The aim of the present study was to assess the reproducibility of [11C]MPC-6827 PET imaging in non-human primate brains. Two dynamic 0–120 min PET/CT imaging scans were performed in each of four healthy male cynomolgus monkeys approximately one week apart. Time activity curves (TACs) and standard uptake values (SUVs) were determined for whole brains and specific regions of the brains and compared between the “test” and “retest” data. [11C]MPC-6827 showed excellent brain uptake with good pharmacokinetics in non-human primate brains, with significant correlation between the test and retest scan data (r = 0.77, p = 0.023). These initial evaluations demonstrate the high translational potential of [11C]MPC-6827 to image microtubules in the brain in vivo in monkey models of neurological and psychiatric diseases.

Although the advent of enzyme replacement therapy (ERT) for mucopolysaccharidoses (MPS) has paved the way for the treatment for these hereditary disorders, the blood brain barrier (BBB) has prevented patients with MPS involving the central nervous system (CNS) from benefitting from ERT. Therefore, finding ways to increase drug delivery into the brain across the BBB remains a crucial challenge for researchers and clinicians in the field. Attempts have been made to boost brain uptake of enzymes by targeting various receptors (e.g., insulin and transferrin), and several other administration routes have also been tested. This review summarizes the available information on clinical trials (completed, ongoing, and planned) of novel therapeutic agents with efficacy against CNS symptoms in neuropathic MPS and also discusses the common associated challenges and pitfalls, some of which may help elucidate the pathogenesis of the neurodegeneration leading to the manifold CNS symptoms. A summary of current knowledge pertaining to the neuropathological progression and resultant neuropsychiatric manifestations is also provided, because it should be useful to ERT researchers looking for better approaches to treating CNS lesions in MPS.

Scope Docosahexaenoic acid (DHA, 22:6n-3) is crucial for optimal neuronal development and function, but the brain has a poor capacity to synthesize this fatty acid. When consumed acutely esterified to phosphatidylcholine, DHA is more efficient at targeting the brain than when consumed esterified to triacylglycerol. However, the brain DHA bioavailability of other forms of DHA-containing phospholipids, after oral ingestion, is unknown. The objective of this study is to compare brain uptake of DHA after acute gavage with different DHA carriers. Methods and results Ten-week-old rats were gavaged with 3 H-labeled DHA esterified to phosphatidylcholine (DHA-PtdCho), phosphatidylethanolamine (DHA-PtdEtn), phosphatidylserine (DHA-PtdSer) or triacylglycerol (DHA-TG). Six hours post-gavage, the animals were euthanized and radioactivity was quantified in the cortex and serum lipid classes. Radioactivity recovered in cortex total phospholipids was similar between the DHA-PtdCho and DHA-PtdSer groups and were 5.8 and 6.7 times higher than in the DHA-TG group, respectively. Serum total lipid radioactivity was higher in the DHA-PtdSer group than in the DHA-PtdCho and DHA-PtdEtn groups, but not compared to the DHA-TG group. Conclusion These results suggest that different mechanisms must be present to explain the serum and brain bioavailability differences between DHA-PtdCho and DHA-PtdSer, but these require further investigation.

The blood–brain barrier (BBB) segregates the central nervous system from the systemic circulation. As such, the BBB not only prevents toxins and pathogens from entering the brain, but also limits the brain uptake of therapeutic molecules. However, under certain pathological conditions, the BBB is disrupted, allowing direct interaction between blood components and the diseased site. Moreover, techniques such as focused ultrasound can further disrupt the BBB in diseased regions. This review focuses on strategies that leverage such BBB disruption for delivering nanocarriers to the central nervous system (CNS). BBB disruption, as it relates to nanocarrier delivery, will be discussed in the context of acute pathologies such as stroke and traumatic brain injury, as well as chronic pathologies such as brain tumors, Alzheimer’s disease, and Parkinson’s disease. Key aspects of nanocarrier design as they relate to penetration and retention in the CNS are also highlighted.

Background: Birds comprise the most diverse group of terrestrial vertebrates. This success likely is related to the evolution of powered flight over 75 mya. Modern approaches for studying brain function, however, have yet to be fully adapted and applied to birds, especially as they relate to specific behaviors including flight. New method: We have developed a comprehensive set of in vivo experimental methods utilizing PET imaging with F-18 labeled fluorodeoxyglucose (FDG) to study regional changes in metabolism specifically related to flight, yet applicable to other behaviors as well. It incorporates approaches for selection of species, behavioral/imaging paradigm, animal preparation, radiotracer injection route, image quantification, and image analysis via an enhanced brain atlas. We also carried out preliminary modeling studies to better understand tracer kinetics. Results: The methods were successful in identifying brain regions statistically associated with flight using only 8 animals. Peak brain uptake of FDG between birds and rodents is similar despite much higher blood glucose levels in birds. We also confirmed that brain uptake of FDG steadily decreases after the initial peak and provide evidence that it may be related to greater dephosphorylation of FDG phosphate than that observed in mammals. Comparison with existing methods: FDG PET has been used in only a few studies of the bird brain. We introduce a new species, more realistic flight behavior, paired (test/retest) design, and improved quantification and analysis approaches. Conclusions: The proposed imaging protocol is non-invasive yet sensitive to regional metabolic changes in the bird brain related to behavior.

Compounds 1-14 were synthesized in a search for high-affinity CRF1 receptor ligands that could be radiolabeled with (11)C or (18)F for use as positron emission tomography (PET) radiotracers. Derivatives of 2 were developed which contained amide N-fluoroalkyl substituents. Compounds [(18)F]24 and [(18)F]25 were found to have appropriate lipophilicities of logP7.4=2.2 but microPET imaging with [(18)F]25 demonstrated limited brain uptake.

A new series of fluoro-pegylated benzyloxybenzenes were designed, synthesized and evaluated as PET probes for early detection of Aβ plaques. Molecular docking revealed that all of the flexible benzyloxybenzenes inserted themselves into the hydrophobic Val18_Phe20 cleft on the flat spine of the Aβ fiber, in a manner similar to that of IMPY molecule. The most potent probe, [(18)F]9a, exhibited a combination of high binding affinity to Aβ aggregates (Ki = 21.0 ± 4.9 nM), high initial brain uptake (9.14% ID/g at 2 min), fast clearance from normal brain tissue (1.79% ID/g at 60 min), and satisfactory in vivo biostability in the brain (95% of intact form at 2 min). [(18)F]9a clearly labeled Aβ plaques in in vitro autoradiography of postmortem AD patients and Tg mice brain sections. Ex vivo autoradiography further demonstrated that [(18)F]9a did penetrate the intact BBB and specifically bind to Aβ plaques in vivo. Overall, [(18)F]9a may be a potential PET probe for imaging Aβ plaques in AD brains.

The blood-brain barrier (BBB) is a complex system controlling two-way substances traffic between circulatory (cardiovascular) system and central nervous system (CNS). It is almost perfectly crafted to regulate brain homeostasis and to permit selective transport of molecules that are essential for brain function. For potential drug candidates, the CNSoriented neuropharmaceuticals as well as for those of primary targets in the periphery, the extent to which a substance in the circulation gains access to the CNS seems crucial. With the advent of nanopharmacology, the problem of the BBB permeability for drug nano-carriers gains new significance. Compared to some other fields of medicinal chemistry, the computational science of nano-delivery is still premature to offer the black-box type solutions, especially for the BBB-case. However, even its enormous complexity can spell out the physical principles, and as such subjected to computation. The basic understanding of various physicochemical parameters describing the brain uptake is required to take advantage of their usage for the BBB-nano delivery. This mini-review provides a sketchy introduction of essential concepts allowing application of computational simulation to the BBB-nano delivery design.

DB213 is an HIV-1 replication inhibitor targeting the Central Nervous System for the treatment of HIV-associated neurocognitive disorders. Current study aims to develop an in situ thermosensitive gelling system for intranasal delivery of DB213 facilitated by Statistical Design of Experiment (DoE) to conduct a more efficient experimentation by extracting the maximum amount of information from limited experiments. In our current study, information was extracted from twenty-five experimental designs from MODDE® Software and a mathematical model was successfully developed to predict formulations to achieve desired performance as well as to analyze relationships between the amount of Pluronic F-127, Pluronic F-68, Chitosan, DB213 and the performances of in situ thermosensitive gels. Based on DoE, in situ thermosensitive gels of 1% DB213 (F1) and 5% DB213 (F2) were developed for further in vivo bioavailability and brain uptake evaluations in Sprague-Dawley rats and C57BL/6 mice, respectively. In comparison to DB213 water solution, intranasal administrations of F1 at 1 mg/kg in rats and F2 at 25 mg/kg in mice demonstrated relative bioavailabilities of 145% and 165% with significant increase in brain uptake.

Introduction Phosphodiesterase 10A (PDE10A) is a member of the PDE enzyme family that degrades cyclic adenosine and guanosine monophosphates (cAMP and cGMP). Based on the successful development of [ 11 C]T-773 as PDE10A positron emission tomography (PET) radioligand, in this study our aim was to develop and evaluate fluorine-18 analogs of [ 11 C]T-773. Methods [ 18 F]FM-T-773-d 2 and [ 18 F]FE-T-773-d 4 were synthesized from the same precursor used for 11 C-labeling of T-773 in a two-step approach via 18 F-fluoromethylation and 18 F-fluoroethylation, respectively, using corresponding deuterated synthons. A total of 12 PET measurements were performed in seven non-human primates. First, baseline PET measurements were performed using High Resolution Research Tomograph system with both [ 18 F]FM-T-773-d 2 and [ 18 F]FE-T-773-d 4 ; the uptake in whole brain and separate brain regions, as well as the specific binding and tissue ratio between putamen and cerebellum, was examined. Second, baseline and pretreatment PET measurements using MP-10 as the blocker were performed for [ 18 F]FM-T-773-d 2 including arterial blood sampling with radiometabolite analysis in four NHPs. Results Both [ 18 F]FM-T-773-d 2 and [ 18 F]FE-T-773-d 4 were successfully radiolabeled with an average molar activity of 293 ± 114 GBq/μmol (n=8) for [ 18 F]FM-T-773-d 2 and 209 ± 26 GBq/μmol (n=4) for [ 18 F]FE-T-773-d 4 , and a radiochemical yield of 10% (EOB, n=12, range 3%–16%). Both radioligands displayed high brain uptake (~5.5% of injected radioactivity for [ 18 F]FM-T-773-d 2 and ~3.5% for [ 18 F]FE-T-773-d 4 at the peak) and a fast washout. Specific binding reached maximum within 30 min for [ 18 F]FM-T-773-d 2 and after approximately 45 min for [ 18 F]FE-T-773-d 4 . [ 18 F]FM-T-773-d 2 data fitted well with kinetic compartment models. BP ND values obtained indirectly through compartment models were correlated well with those obtained by SRTM. BP ND calculated with SRTM was 1.0–1.7 in the putamen. The occupancy with 1.8 mg/kg of MP-10 was approximately 60%. Conclusions [ 18 F]FM-T-773-d 2 and [ 18 F]FE-T-773-d 4 were developed as fluorine-18 PET radioligands for PDE10A, with the [ 18 F]FM-T-773-d 2 being the more promising PET radioligand warranting further evaluation.

Background Increased brain uptake on [18F]AV45 PET is a biomarker for Alzheimers disease (AD). The standardised uptake value ratio (SUVR) is widely used for quantification but is subject to variability. Here we evaluate how SUVR of a cortical target region is affected by blood flow changes in the target and two frequently used reference regions. Methods Regional baseline time-activity curves (TACs) were simulated based on metabolite-corrected plasma input functions and pharmacokinetic parameters obtained from our previously acquired data in healthy control (HC; n = 10), amnestic mild cognitive impairment (aMCI; n = 15) and AD cohorts (n = 9). Blood flow changes were simulated by altering the regional tracer delivery rate K1 (and clearance rate k2) between -40% and +40% from its regional baseline value in the target region and/or cerebellar grey (CB) or subcortical white matter (WM) reference regions. The corresponding change in SUVR was calculated at 5060 min post-injection. Results A -40% blood flow reduction in the target resulted in an increased SUVRtarget (e.g. SUVRprecuneus: +10.0±5% in HC, +2.5±2% in AD), irrespective of the used reference region. A -40% blood flow reduction in the WM reference region increased SUVRWM (+11.5±4% in HC, +13.5±3% in AD) while a blood flow reduction in CB decreased SUVRCB (-9.5±6% in HC, -5.5±2% in AD), irrespective of the used target region. A -40% flow reduction in both the precuneus and reference WM (i.e., global flow change) induced an increased SUVR (+22.5±8% in HC, +16.0±4% in AD). When considering reference CB instead, SUVR was decreased by less than -5% (both in HC and AD). Conclusion Blood flow changes introduce alterations in [18F]AV45 PET SUVR. Flow reductions in the CB and WM reference regions resulted in a decreased and increased SUVR of the target, respectively. SUVR was more affected by global blood flow changes when considering WM instead of CB normalization.

MAGL is a potential therapeutic target for oncological and psychiatric diseases. Our objective was to develop a PET tracer for in vivo quantification of MAGL. We report [11C]MA-PB-1 as an irreversible MAGL inhibitor PET tracer. The in vitro inhibitory activity, ex vivo distribution, brain kinetics and specificity of [11C]MA-PB-1 binding were studied. Ex vivo biodistribution and microPET showed good brain uptake which could be blocked by pretreatment with both MA-PB-1 and a structurally non-related MAGL inhibitor MJN110. These initial results suggest that [11C]MA-PB-1 is a suitable tracer for in vivo imaging of MAGL., final draft, peerReviewed

The 2-phenyl benzothiazole pharmacophore is known to have high affinity for amyloid beta (Aβ) and is therefore derivatized, to [N-(4′-benzothiazol-pyridin-2-yl-methyl-amino)-acetic acid (BTPAA)] for radiolabeling with [99mTc(CO)3(H2O)3]+ precursor. The radiotracer, 99mTc(CO)3–BTPAA is evaluated in vitro and in vivo to determine its binding with the Aβ and ability to cross the blood brain barrier. The radiotracer prepared in >95 % radiochemical yield, showed ~25 % inhibition in presence of thioflavin-T, indicating its specificity towards aggregated Aβ protein. The radiotracer also showed brain uptake of 0.25 ± 0.04 % injected dose/g at 2 min post injection, indicating its ability to cross the blood brain barrier.

Central nervous system disorders are already prevalent and steadily increasing among populations worldwide. However, most of the pharmaceuticals present on world markets are ineffective in treating cerebral diseases, because they cannot effectively cross the blood brain barrier (BBB). Solid lipid nanoparticles (SLN) are nanospheres made from biocompatible solid lipids, with unique advantages among drug carriers: they can be used as vehicles to cross the BBB. This review examines the main aspects surrounding brain delivery with SLN, and illustrates the principal mechanisms used to enhance brain uptake of the delivered drug.

Poor permeability of methotrexate across blood brain barrier limits its scope for application against brain cancer. Glutamine is transported to brain actively by multiple amino acid transporters and protects against complications of chemotherapy. To use glutamine as a carrier, a reversible conjugate of methotrexate was developed with structural features of glutamine. This was stable and released methotrexate effectively. The brain uptake was enhanced significantly

Vortioxetine is a new multi-modal drug against major depressive disorder with high affinity for a range of different serotonergic targets in the CNS. We report the (11)C-labeling of vortioxetine with [(11)C]MeI using a Suzuki-protocol that allows for the presence of an unprotected amine. Preliminary evaluation of [(11)C]vortioxetine in a Danish Landrace pig showed rapid brain uptake and brain distribution in accordance with the pharmacological profile, all though an unexpected high binding in cerebellum was also observed. [(11)C]vortioxetine displayed slow tracer kinetics with peak uptake after 60 min and with limited wash-out from the brain. Further studies are needed but this radioligand may prove to be a valuable tool in unraveling the clinical effects of vortioxetine.

Recently, the development of novel brain imaging agents has aroused much interest thanks to limited number of brain cancer or diseases diagnosis agents. It is aimed to synthesize a novel brain imaging agent including a promise for further studies on AD diagnosis potential and investigate its bioaffinity with biodistribution studies on healthy Balb/c mice. A novel radiolabeled agent was syn- thesized and characterized. Quality control of 99m Tc-BH was performed utilizing solvent extraction and chromato- graphic (Radio TLC and Radio HPLC) methods. Bioaf- finity of the 99m Tc-BH was investigated on male Balb/c mice at various time points (5, 30, 60, 120 min post- injection). Paper electrophoresis showed that 99m Tc-BH has a neutral structure. Radiochemical purity of 99m Tc-BH was over 95 % with appropriate stability for imaging per- iod. Selected brain regions have uptakes over 4 % ID/g following intravenous injection. Hippocampus has uptake approximately 10 % ID/g. 99m Tc-BH has shown brain uptake, so it may prove to be valuable for brain imaging as a novel technetium-labeled agent. Further investigations with AD animal model are our on going effort to show that this agent has AD diagnosis potential.

Risperidone and lamotrigine were successfully labeled with 125I via direct electrophilic substitution reaction at 80 °C with maximum labeling yields of 89 ± 3.75 and 97.5 ± 1.0 %, respectively. Stability of 125I-risperidone was up to 6 h while that of 125I-lamotrigine was up to 24 h. Biodistribution studies showed that maximum uptakes of 125I-risperidone and 125I-lamotrigine in the brain of mice were 4.35 ± 0.17 and 2.51 ± 0.18 % of the injected activity/g tissue organ at 10 min post-injection, respectively. Both radioiodinated drugs showed higher brain uptake and stability compared to commercially available technetium-99m d,l-hexamethyl propyleneamine oxime.

The present study discusses possibility of targeting an anti-Alzheimer's drug rivastigmine tartarate (RT) to the brain using novel synthesized L-lactide-depsipeptide polymeric nanoparticles (NPs). Single emulsion-solvent evaporation technique was used for preparation of NPs. The mean particle size, zeta potential and entrapment efficiency of drug loaded NPs were found to be 142.2 +/- 21.3 nm, +4.85 mV and 60.72 +/- 3.72% respectively. Pharmacodynamic study showed faster regain of memory loss in amnesic rat with RT loaded NPs as compared to RT solution. In pharmacokinetic study, total concentration and mean residence time was increased up to 3.79 fold and 2 fold respectively while clearance was decreased to 1.91 fold on intravenous administration of RT loaded NPs as compared to RT solution. The biodistribution study demonstrated 5.45 fold and 2 fold increase in brain concentration of drug after administration of RT loaded NPs (i.v; 10.52 +/- 1.31 ng/ml) as compared to plain RT solution by oral (1.93 +/- 1.23 ng/ml) and intravenous (5.34 +/- 1.22 ng/ml) route, respectively. Therefore, RT loaded L-lactide-depsipeptide polymeric NPs might be a potential drug delivery system in treatment of Alzheimer's disease.

O -Desmethylvenlafaxine (desvenlafaxine, ODV) is a recently approved antidepressant which in some clinical studies failed to meet a satisfactory end-point. The aim of this study was to prepare a series of phenolic esters of ODV and evaluate their potential as ODV prodrugs with improved brain uptake. Fifteen phenolic esters (compounds 1a – o) were synthesized and their pharmacokinetic profiles evaluated in rat. The four compounds producing the highest relative bioavailability of ODV in rat (compounds 1c , 1e , 1n , 1o ) were then studied to evaluate their brain uptake. Of these four compounds, compound 1n (the piperonylic acid ester of ODV) demonstrated the highest C max of ODV both in the rat hypothalamus and total brain. Finally the pharmacokinetics of 1n were evaluated in beagle dog where the increase in relative bioavailability of ODV was found to be as great as in rat. This high relative bioavailability of ODV coupled with its good brain penetration make 1n the most promising candidate for development as an ODV prodrug.