Molecular and functional MRI enables detection of cardiac fibrosis and evaluation of treatment response after chordin-like 1 gene therapy in myocardial infarction.

IF 13.3 1区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Theranostics Pub Date : 2025-08-08 eCollection Date: 2025-01-01 DOI:10.7150/thno.114459
Konstantina Amoiradaki, Mateusz Tomczyk, Xiaoying Wang, Gastão Cruz, Carlos Velasco, Lorena Zentilin, Francesca Bortolotti, Claudia Prieto, René M Botnar, Mauro Giacca, Alkystis Phinikaridou
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引用次数: 0

Abstract

Cardiac fibrosis (CF), characterised by accumulation of collagen and elastin, drives adverse cardiac remodelling and heart failure after myocardial infarction (MI). Currently, there are no non-invasive imaging methods to sensitively and directly assess CF and evaluate treatment response and no regenerative therapies for patients with MI. We hypothesised that functional and molecular magnetic resonance imaging (MRI) of collagen and elastin can detect and measure cardiac fibrosis and changes in response to Chordin-like 1 (Chrdl1) gene therapy after MI. Methods: MI was induced in mice by permanent occlusion of the coronary artery. Mice received adeno-associated vectors serotype 9 (AAV9) expressing Chrdl1 (AAV9-Chrdl1) or an empty polylinker (AAV9-Control) by either intramyocardial injection, at the time of MI, or intravenous injection at 1 week post-MI. Mice receiving AAV9-Chrdl1 intramyocardially were imaged in vivo at 4 weeks after treatment. Animals treated intravenously were imaged before treatment, at 1 week post-MI, and again at 3 weeks after treatment. In vivo cine MRI at 3 Tesla was used to assess cardiac function. Molecular MRI was used to measure CF and treatment response using late gadolinium enhancement and T1 mapping after administration of collagen and elastin specific gadolinium probes. The imaging data were complemented by tissue analyses. Results MRI showed that intramyocardial treatment with AAV9-Chrdl1, immediately after MI, improved the ejection fraction (EF) (+48%) and decreased collagen (-62.1%) and elastin (-80%) fibrosis after 4 weeks of treatment compared with mice receiving AAV9-Control. Systemic administration of AAV9-Chrdl1 at 1 week post-MI, when CF was established and fibrogenesis was ongoing, effectively improved the EF (+6.9%) and reduced collagen (-42.1%) and elastin (-14.8%) fibrosis after 3 weeks of treatment. Conversely, in mice receiving the AAV9-Control the EF worsened (-30.7%) and CF increased (collagen +22.2% and elastin +40.8%). Changes in CF measured by MRI were validated by histology. Conclusions: This study shows the power of functional and molecular MRI to detect the therapeutic efficacy of Chrdl1 on cardiac fibrosis. Chrdl1 treatment inhibited the development and reduced existing collagen and elastin fibrosis resulting in improved cardiac function. This non-invasive image-guided theranostic strategy has the potential to accelerate the development of effective anti-fibrotic therapies.

分子和功能MRI可以检测心肌纤维化,并评估心肌梗死后索样1基因治疗的治疗反应。
心肌纤维化(CF)以胶原蛋白和弹性蛋白的积累为特征,在心肌梗死(MI)后驱动不良的心脏重构和心力衰竭。目前,没有非侵入性成像方法可以灵敏、直接地评估CF和评估治疗反应,也没有心肌梗死患者的再生治疗方法。我们假设,胶原和弹性蛋白的功能和分子磁共振成像(MRI)可以检测和测量心肌梗死后心肌纤维化和对Chrdl1基因治疗的反应变化。方法:永久性闭塞冠状动脉诱导小鼠心肌梗死。通过心肌梗死时心内注射或心肌梗死后1周静脉注射,小鼠接受了表达Chrdl1 (AAV9-Chrdl1)或空多联蛋白(AAV9- control)的9型腺相关载体(AAV9)。心脏内注射AAV9-Chrdl1的小鼠在治疗后4周进行体内成像。静脉注射治疗的动物在治疗前、心肌梗死后1周和治疗后3周再次成像。采用3特斯拉的体内MRI评估心功能。在给予胶原蛋白和弹性蛋白特异性钆探针后,使用分子MRI测量CF和治疗反应,使用晚期钆增强和T1定位。影像资料辅以组织分析。结果MRI显示,心肌梗死后立即用AAV9-Chrdl1治疗,与对照组相比,治疗4周后,射血分数(EF)提高(+48%),胶原蛋白(-62.1%)和弹性蛋白(-80%)纤维化降低。在心肌梗死后1周,当CF建立且纤维形成仍在进行时,全身给予AAV9-Chrdl1,治疗3周后有效改善EF(+6.9%),减少胶原(-42.1%)和弹性蛋白(-14.8%)纤维化。相反,在接受aav9控制的小鼠中,EF恶化(-30.7%),CF增加(胶原蛋白+22.2%,弹性蛋白+40.8%)。MRI测量CF的变化经组织学证实。结论:本研究显示了功能和分子MRI检测Chrdl1对心脏纤维化治疗效果的能力。Chrdl1治疗抑制了发展,减少了现有的胶原和弹性蛋白纤维化,从而改善了心功能。这种非侵入性的图像引导治疗策略有可能加速有效的抗纤维化治疗的发展。
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来源期刊
Theranostics
Theranostics MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
25.40
自引率
1.60%
发文量
433
审稿时长
1 months
期刊介绍: Theranostics serves as a pivotal platform for the exchange of clinical and scientific insights within the diagnostic and therapeutic molecular and nanomedicine community, along with allied professions engaged in integrating molecular imaging and therapy. As a multidisciplinary journal, Theranostics showcases innovative research articles spanning fields such as in vitro diagnostics and prognostics, in vivo molecular imaging, molecular therapeutics, image-guided therapy, biosensor technology, nanobiosensors, bioelectronics, system biology, translational medicine, point-of-care applications, and personalized medicine. Encouraging a broad spectrum of biomedical research with potential theranostic applications, the journal rigorously peer-reviews primary research, alongside publishing reviews, news, and commentary that aim to bridge the gap between the laboratory, clinic, and biotechnology industries.
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