Abstract
Purpose
In vivo detection of transactivation response element DNA binding protein-43 kDa (TDP-43) aggregates through positron emission tomography (PET) would impact the ability to successfully develop therapeutic interventions for a variety of neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS). The purpose of the present study is to evaluate the ability of six tau PET radioligands to bind to TDP-43 aggregates in post-mortem brain tissues from ALS patients.
Procedures
Herein, we report the first head-to-head evaluation of six tritium labeled isotopologs of tau-targeting PET radioligands, [3H]MK-6240 (a.k.a. florquinitau), [3H]Genentech Tau Probe-1 (GTP-1), [3H]JNJ-64326067(JNJ-067), [3H]CBD-2115, [3H]flortaucipir, and [3H]APN-1607, and their ability to bind to the β-pleated sheet structures of aggregate TDP-43 in post-mortem ALS brain tissues by autoradiography and immunostaining methods. Post-mortem frontal cortex, motor cortex, and cerebellum tissues were evaluated, and binding intensity was aligned with areas of elevated phosphorylated tau (ptau), pTDP-43, and \(\beta\)-amyloid.
Results
Negligible binding was observed with [3H]MK-6240, [3H]JNJ-067, and [3H]GTP-1. While [3H]CBD-2115 displayed marginal specific binding, this binding did not significantly correlate with the distribution of pTDP-43 and AT8 inclusions. Of the remaining ligands, the distribution of [3H]flortaucipir did not significantly correlate to pTDP-43 pathology; however, specific binding trends to a positive relationship with tau. Finally, [3H]APN-1607 relates most strongly to amyloid load and does not indicate pTDP-43 pathology as confirmed by [3H]PiB distribution in sister sections.
Conclusions
Our results demonstrate the prominent nature of mixed pathology in ALS, and do not support the application of [3H]MK-6240, [3H]JNJ-067, [3H]GTP-1, [3H]CBD-2115, [3H]flortaucipir, or [3H]APN-1607 for selective imaging TDP-43 in ALS for clinical research with the currently available in vitro data. Identification of potent and selective radiotracers for TDP-43 remains an ongoing challenge.
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Abbreviations
- TDP-43:
-
Transactivation response element DNA binding protein-43 kDa
- pTDP-43:
-
Phosphorylated TDP-43
- ALS:
-
Amyotrophic lateral sclerosis
- ptau:
-
Phosphorylated tau
- AD:
-
Alzheimer’s disease
- PET:
-
Positron emission tomography
- CNS:
-
Central nervous system
- Cryo-EM:
-
Cryo-electron microscopy
- FTLD:
-
Frontotemporal lobar degeneration
- FTD:
-
Frontotemporal dementia
- nM:
-
Nanomolar
- µM:
-
Micromolar
- JNJ-067:
-
JNJ-64326067
- GTP-1:
-
Genentech Tau Probe-1
- ARG:
-
Autoradiography
- IHC:
-
Immunohistochemistry
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Acknowledgements
The authors thank Enigma Biomedical Group, Inc., and its affiliates (Cerveau Technologies and Meilleur Technologies) for the use of radiolabeled and/or unlabeled MK-6240, CBD-2115, and NAV-4694. We also thank Dr. Samuel Svensson from Oxiant Pharmaceuticals for the support with CBD-2115 and Target ALS for the post-mortem tissue samples. N.V. thanks the National Institute on Aging of the NIH (R01AG054473 and R01AG052414), Azrieli Foundation, Canada Foundation for Innovation, Ontario Research Fund, the Canada Research Chairs Program, and Takeda Pharmaceutical Company for the support. C.V. thanks the Canadian Institutes of Health Research (CIHR) for the receipt of the Canada Graduate Scholarship (Doctoral). C.D.M. acknowledges support from the CAMH Discovery Fund.
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ACK, CDM, and CV performed the research and analyzed the data; ACK, CDM, CV, and NV wrote the manuscript; ACK, PM, and NV designed the study. ACK, CDM, CV, WHY, PM, and NV reviewed the manuscript.
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All tissues were obtained in accordance with the guidelines put forth by the Centre for Addiction and Mental Health Research Ethics Board (protocol no. 036–2019).
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A.C.K. and P.M. are employed by Takeda Pharmaceutical Company. N.V. is a co-founder of MedChem Imaging, Inc. All authors declare that the research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest.
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Knight, A.C., Morrone, C.D., Varlow, C. et al. Head-to-Head Comparison of Tau-PET Radioligands for Imaging TDP-43 in Post-Mortem ALS Brain. Mol Imaging Biol 25, 513–527 (2023). https://doi.org/10.1007/s11307-022-01779-1
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DOI: https://doi.org/10.1007/s11307-022-01779-1