Abstract
Molecular imaging is highly advantageous as various insidious inflammatory events can be imaged in a serial and quantitative fashion. Combined with the conventional imaging modalities like computed tomography (CT), magnetic resonance (MR), and nuclear imaging, it helps us resolve the extent of ongoing pathology, quantify inflammation, and predict outcome. Macrophages are increasingly gaining importance as an imaging biomarker in inflammatory cardiovascular diseases. Macrophages, recruited to the site of injury, internalize necrotic or foreign material. Along with phagocytosis, activated macrophages release proteolytic enzymes like matrix metalloproteinases (MMPs) and cathepsins into the extracellular environment. Proinflammatory monocytes and macrophages also induce tissue oxidative damage through the inflammatory enzyme myeloperoxidase (MPO). In this review we will highlight recent advances in molecular macrophage imaging. Particular stress will be given to macrophage functional and enzymatic activity imaging, which targets phagocytosis, proteolysis, and myeloperoxidase activity imaging.
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Libby P. Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr. 2006;83(2):456S–60S.
Majmudar MD, Nahrendorf M. Cardiovascular molecular imaging: the road ahead. J Nucl Med. 2012;53(5):673–6.
Nahrendorf M, Sosnovik DE, French BA, Swirski FK, Bengel F, Sadeghi MM, et al. Multimodality cardiovascular molecular imaging, Part II. Circ Cardiovasc Imaging. 2009;2(1):56–70.
Sinusas AJ, Bengel F, Nahrendorf M, Epstein FH, Wu JC, Villanueva FS, et al. Multimodality cardiovascular molecular imaging, part I. Circ Cardiovasc Imaging. 2008;1(3):244–56.
Nahrendorf M, Swirski FK, Aikawa E, Stangenberg L, Wurdinger T, Figueiredo JL, et al. The healing myocardium sequentially mobilizes two monocyte subsets with divergent and complementary functions. J Exp Med. 2007;204(12):3037–47.
Dutta P, Courties G, Wei Y, Leuschner F, Gorbatov R, Robbins CS, et al. Myocardial infarction accelerates atherosclerosis. Nature. 2012;487(7407):325–9.
Robbins CS, Hilgendorf I, Weber GF, Theurl I, Iwamoto Y, Figueiredo JL, et al. Local proliferation dominates lesional macrophage accumulation in atherosclerosis. Nat Med. 2013;19(9):1166–72.
Wyburn KR, Jose MD, Wu H, Atkins RC, Chadban SJ. The role of macrophages in allograft rejection. Transplantation. 2005;80(12):1641–7.
Geissmann F, Gordon S, Hume DA, Mowat AM, Randolph GJ. Unravelling mononuclear phagocyte heterogeneity. Nat Rev Immunol. 2010;10(6):453–60.
Quillard T, Libby P. Molecular imaging of atherosclerosis for improving diagnostic and therapeutic development. Circ Res. 2012;111(2):231–44.
Nahrendorf M, Keliher E, Panizzi P, Zhang H, Hembrador S, Figueiredo JL, et al. 18F-4V for PET-CT imaging of VCAM-1 expression in atherosclerosis. JACC Cardiovasc Imaging. 2009;2(10):1213–22.
Choi KS, Kim SH, Cai QY, Kim SY, Kim HO, Lee HJ, et al. Inflammation-specific T1 imaging using anti-intercellular adhesion molecule 1 antibody-conjugated gadolinium diethylenetriaminepentaacetic acid. Mol Imaging. 2007;6(2):75–84.
Kitagawa T, Kosuge H, Chang E, James ML, Yamamoto T, Shen B, et al. Integrin-targeted molecular imaging of experimental abdominal aortic aneurysms by (18)F-labeled Arg-Gly-Asp positron-emission tomography. Circ Cardiovasc Imaging. 2013;6(6):950–6.
Aderem A, Underhill DM. Mechanisms of phagocytosis in macrophages. Annu Rev Immunol. 1999;17:593–623.
Sosnovik DE, Nahrendorf M, Weissleder R. Magnetic nanoparticles for MR imaging: agents, techniques and cardiovascular applications. Basic Res Cardiol. 2008;103(2):122–30.
Wunderbaldinger P, Josephson L, Weissleder R. Crosslinked iron oxides (CLIO): a new platform for the development of targeted MR contrast agents. Acad Radiol. 2002;9 Suppl 2:S304–6.
Frias JC, Williams KJ, Fisher EA, Fayad ZA. Recombinant HDL-like nanoparticles: a specific contrast agent for MRI of atherosclerotic plaques. J Am Chem Soc. 2004;126(50):16316–7.
Lipinski MJ, Amirbekian V, Frias JC, Aguinaldo JG, Mani V, Briley-Saebo KC, et al. MRI to detect atherosclerosis with gadolinium-containing immunomicelles targeting the macrophage scavenger receptor. Magn Reson Med. 2006;56(3):601–10.
Tassa C, Shaw SY, Weissleder R. Dextran-coated iron oxide nanoparticles: a versatile platform for targeted molecular imaging, molecular diagnostics, and therapy. Acc Chem Res. 2011;44(10):842–52.
Morawski AM, Winter PM, Crowder KC, Caruthers SD, Fuhrhop RW, Scott MJ, et al. Targeted nanoparticles for quantitative imaging of sparse molecular epitopes with MRI. Magn Reson Med. 2004;51(3):480–6.
Weissleder R, Kelly K, Sun EY, Shtatland T, Josephson L. Cell-specific targeting of nanoparticles by multivalent attachment of small molecules. Nat Biotechnol. 2005;23(11):1418–23.
Segers FM, den Adel B, Bot I, van der Graaf LM, van der Veer EP, Gonzalez W, et al. Scavenger receptor-AI-targeted iron oxide nanoparticles for in vivo MRI detection of atherosclerotic lesions. Arterioscler Thromb Vasc Biol. 2013;33(8):1812–9.
Simon G, Bauer J, Saborovski O, Fu Y, Corot C, Wendland M, et al. T1 and T2 relaxivity of intracellular and extracellular USPIO at 1.5T and 3T clinical MR scanning. Eur Radiol. 2006;16(3):738–45.
Jaffer FA, Nahrendorf M, Sosnovik D, Kelly KA, Aikawa E, Weissleder R. Cellular imaging of inflammation in atherosclerosis using magnetofluorescent nanomaterials. Mol Imaging. 2006;5(2):85–92.
Sosnovik DE, Nahrendorf M, Deliolanis N, Novikov M, Aikawa E, Josephson L, et al. Fluorescence tomography and magnetic resonance imaging of myocardial macrophage infiltration in infarcted myocardium in vivo. Circulation. 2007;115(11):1384–91.
Trivedi RA, Mallawarachi C, U-King-Im JM, Graves MJ, Horsley J, Goddard MJ, et al. Identifying inflamed carotid plaques using in vivo USPIO-enhanced MR imaging to label plaque macrophages. Arterioscler Thromb Vasc Biol. 2006;26(7):1601–6.
Yilmaz A, Dengler MA, van der Kuip H, Yildiz H, Rösch S, Klumpp S, et al. Imaging of myocardial infarction using ultrasmall superparamagnetic iron oxide nanoparticles: a human study using a multi-parametric cardiovascular magnetic resonance imaging approach. Eur Heart J. 2013;34(6):462–75. In this clinical trial, authors compared ferumoxytol (Feraheme™, FH), an ultrasmall superparamagnetic iron oxide nanoparticle (USPIO), to conventional gadolinium based agents in patients with acute myocardial infarction. T2* contrast was recognized not only in the infarct core and peri-infarct tissue but also in the remote myocardium suggesting macrophage infiltration and possible remote tissue remodeling.
Alam SR, Shah AS, Richards J, Lang NN, Barnes G, Joshi N, et al. Ultrasmall superparamagnetic particles of iron oxide in patients with acute myocardial infarction: early clinical experience. Circ Cardiovasc Imaging. 2012;5(5):559–65.
Tang TY, Howarth SP, Miller SR, Graves MJ, Patterson AJ, U-King-Im JM, et al. The ATHEROMA (Atorvastatin Therapy: Effects on Reduction of Macrophage Activity) Study. Evaluation using ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging in carotid disease. J Am Coll Cardiol. 2009;53(22):2039–50. In this clinical trial, high and low dose atorvastatin treatment response was followed in patients with carotid atherosclerosis. Only high dose statin demonstrated measurable changes in carotid plaque inflammation as defined by the USPIO-enhanced MRI, within first 3 months of therapy. This study signifies USPIO based macrophage imaging as a useful tool for assessing therapeutic response.
Olzinski AR, Turner GH, Bernard RE, Karr H, Cornejo CA, Aravindhan K, et al. Pharmacological inhibition of C-C chemokine receptor 2 decreases macrophage infiltration in the aortic root of the human C-C chemokine receptor 2/apolipoprotein E-/- mouse: magnetic resonance imaging assessment. Arterioscler Thromb Vasc Biol. 2010;30(2):253–9.
Sigovan M, Kaye E, Lancelot E, Corot C, Provost N, Majd Z, et al. Anti-inflammatory drug evaluation in ApoE−/− mice by ultrasmall superparamagnetic iron oxide–enhanced magnetic resonance imaging. Investig Radiol. 2012;47(9):546–52. doi:10.1097/RLI.0b013e3182631e68.
Millon A, Dickson SD, Klink A, Izquierdo-Garcia D, Bini J, Lancelot E, et al. Monitoring plaque inflammation in atherosclerotic rabbits with an iron oxide (P904) and (18)F-FDG using a combined PET/MR scanner. Atherosclerosis. 2013;228(2):339–45. By using a combined PET/MRI scanner, authors compared (18)F-FDG PET and USPIO based MRI to assess plaque inflammation changes induced by atorvastatin and dietary change in a rabbit model of atherosclerosis. There was a decrease in the standard uptake value of (18)F-FDG after six months of treatment. Similar response was also measured in R2* with the help of USPIO imaging.
Wu YL, Ye Q, Sato K, Foley LM, Hitchens TK, Ho C. Noninvasive evaluation of cardiac allograft rejection by cellular and functional cardiac magnetic resonance. JACC Cardiovasc Imaging. 2009;2(6):731–41.
Yang CY, Tai MF, Lin CP, Lu CW, Wang JL, Hsiao JK, et al. Mechanism of cellular uptake and impact of ferucarbotran on macrophage physiology. PLoS One. 2011;6(9):e25524.
Naresh NK, Xu Y, Klibanov AL, Vandsburger MH, Meyer CH, Leor J, et al. Monocyte and/or macrophage infiltration of heart after myocardial infarction: MR imaging by using T1-shortening liposomes. Radiology. 2012;264(2):428–35.
Dellinger A, Olson J, Link K, Vance S, Sandros MG, Yang J, et al. Functionalization of gadolinium metallofullerenes for detecting atherosclerotic plaque lesions by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2013;15:7.
Lipinski MJ, Frias JC, Amirbekian V, Briley-Saebo KC, Mani V, Samber D, et al. Macrophage-specific lipid-based nanoparticles improve cardiac magnetic resonance detection and characterization of human atherosclerosis. JACC Cardiovasc Imaging. 2009;2(5):637–47.
Flögel U, Ding Z, Hardung H, Jander S, Reichmann G, Jacoby C, et al. In vivo monitoring of inflammation after cardiac and cerebral ischemia by fluorine magnetic resonance imaging. Circulation. 2008;118(2):140–8.
Flögel U, Su S, Kreideweiß I, Ding Z, Galbarz L, Fu J, et al. Noninvasive detection of graft rejection by in vivo 19F MRI in the early stage. Am J Transplant. 2011;11(2):235–44.
Panizzi P, Swirski FK, Figueiredo JL, Waterman P, Sosnovik DE, Aikawa E, et al. Impaired infarct healing in atherosclerotic mice with Ly-6C(hi) monocytosis. J Am Coll Cardiol. 2010;55(15):1629–38.
Vinegoni C, Botnaru I, Aikawa E, Calfon MA, Iwamoto Y, Folco EJ, et al. Indocyanine green enables near-infrared fluorescence imaging of lipid-rich, inflamed atherosclerotic plaques. Sci Transl Med. 2011;3(84):84ra45. This study explains that the indocyanin green is taken up by lipid rich foam cells and can be imaged with intravenous near infrared detection catheter in rabbit vessels. Being widely available and FDA approved, indocyanin has a promise for clinical macrophage imaging in human coronary disease as well.
Ogawa M, Nakamura S, Saito Y, Kosugi M, Magata Y. What can be seen by 18F-FDG PET in atherosclerosis imaging? The effect of foam cell formation on 18F-FDG uptake to macrophages in vitro. J Nucl Med. 2012;53(1):55–8.
Truijman MT, Kwee RM, van Hoof RH, Hermeling E, van Oostenbrugge RJ, Mess WH, et al. Combined 18F-FDG PET-CT and DCE-MRI to assess inflammation and microvascularization in atherosclerotic plaques. Stroke. 2013;44(12):3568–70.
Rudd JH, Myers KS, Bansilal S, Machac J, Rafique A, Farkouh M, et al. (18)Fluorodeoxyglucose positron emission tomography imaging of atherosclerotic plaque inflammation is highly reproducible: implications for atherosclerosis therapy trials. J Am Coll Cardiol. 2007;50(9):892–6.
Fayad ZA, Mani V, Woodward M, Kallend D, Abt M, Burgess T, et al. Safety and efficacy of dalcetrapib on atherosclerotic disease using novel non-invasive multimodality imaging (dal-PLAQUE): a randomised clinical trial. Lancet. 2011;378(9802):1547–59.
Tawakol A, Fayad ZA, Mogg R, Alon A, Klimas MT, Dansky H, et al. Intensification of statin therapy results in a rapid reduction in atherosclerotic inflammation: results of a multicenter fluorodeoxyglucose-positron emission tomography/computed tomography feasibility study. J Am Coll Cardiol. 2013;62(10):909–17. In this similar clinical trial, PET/CT imaging with (18)F-FDG was used to assess high and low dose atorvastatin treatment response in patients with carotid atherosclerosis. Again, high dose treatment produced significant reductions in FDG uptake that may represent changes in atherosclerotic plaque inflammation. This study signifies (18)F-FDG based macrophage imaging as an important tool for therapeutic response follow up.
Peterson LR, Gropler RJ. Radionuclide imaging of myocardial metabolism. Circ Cardiovasc Imaging. 2010;3(2):211–22.
Folco EJ, Sheikine Y, Rocha VZ, Christen T, Shvartz E, Sukhova GK, et al. Hypoxia but not inflammation augments glucose uptake in human macrophages implications for imaging atherosclerosis with 18fluorine-labeled 2-deoxy-D-glucose positron emission tomography. J Am Coll Cardiol. 2011;58(6):603–14.
Nahrendorf M, Zhang H, Hembrador S, Panizzi P, Sosnovik DE, Aikawa E, et al. Nanoparticle PET-CT imaging of macrophages in inflammatory atherosclerosis. Circulation. 2008;117(3):379–87.
Majmudar MD, Yoo J, Keliher EJ, Truelove JJ, Iwamoto Y, Sena B, et al. Polymeric nanoparticle PET/MR imaging allows macrophage detection in atherosclerotic plaques. Circ Res. 2013;112(5):755–61.
Nahrendorf M, Keliher E, Marinelli B, Leuschner F, Robbins CS, Gerszten RE, et al. Detection of macrophages in aortic aneurysms by nanoparticle positron emission tomography-computed tomography. Arterioscler Thromb Vasc Biol. 2011;31(4):750–7.
Ueno T, Dutta P, Keliher E, Leuschner F, Majmudar M, Marinelli B, et al. Nanoparticle PET-CT detects rejection and immunomodulation in cardiac allografts. Circ Cardiovasc Imaging. 2013;6(4):568–73. Trimodality contrats nanoagents have been used in the past as well. In this recent study, Ueno et al. reported use of a macrophage avid trimodality PET and magnetofluorescent nanoparticle in mouse model of cardiac transplant rejection. Additionally, immunosuppressive response with angiotensin converting enzyme inhibitor was also quantified with this novel imaging agent which resulted in better allograft survival.
Keliher EJ, Yoo J, Nahrendorf M, Lewis JS, Marinelli B, Newton A, et al. 89Zr-labeled dextran nanoparticles allow in vivo macrophage imaging. Bioconjug Chem. 2011;22(12):2383–9.
Settles M, Etzrodt M, Kosanke K, Schiemann M, Zimmermann A, Meier R, et al. Different capacity of monocyte subsets to phagocytose iron-oxide nanoparticles. PLoS One. 2011;6(10):e25197.
Dollery CM, McEwan JR, Henney AM. Matrix metalloproteinases and cardiovascular disease. Circ Res. 1995;77(5):863–8.
Lutgens SP, Cleutjens KB, Daemen MJ, Heeneman S. Cathepsin cysteine proteases in cardiovascular disease. FASEB J. 2007;21(12):3029–41.
Hermann S, Starsichova A, Waschkau B, Kuhlmann M, Wenning C, Schober O, et al. Non-FDG imaging of atherosclerosis: will imaging of MMPs assess plaque vulnerability? J Nucl Cardiol. 2012;19(3):609–17.
Razavian M, Tavakoli S, Zhang J, Nie L, Dobrucki LW, Sinusas AJ, et al. Atherosclerosis plaque heterogeneity and response to therapy detected by in vivo molecular imaging of matrix metalloproteinase activation. J Nucl Med. 2011;52(11):1795–802.
Razavian M, Zhang J, Nie L, Tavakoli S, Razavian N, Dobrucki LW, et al. Molecular imaging of matrix metalloproteinase activation to predict murine aneurysm expansion in vivo. J Nucl Med. 2010;51(7):1107–15.
Sahul ZH, Mukherjee R, Song J, McAteer J, Stroud RE, Dione DP, et al. Targeted imaging of the spatial and temporal variation of matrix metalloproteinase activity in a porcine model of postinfarct remodeling: relationship to myocardial dysfunction. Circ Cardiovasc Imaging. 2011;4(4):381–91.
Jaffer FA, Kim DE, Quinti L, Tung CH, Aikawa E, Pande AN, et al. Optical visualization of cathepsin K activity in atherosclerosis with a novel, protease-activatable fluorescence sensor. Circulation. 2007;115(17):2292–8.
Nahrendorf M, Waterman P, Thurber G, Groves K, Rajopadhye M, Panizzi P, et al. Hybrid in vivo FMT-CT imaging of protease activity in atherosclerosis with customized nanosensors. Arterioscler Thromb Vasc Biol. 2009;29(10):1444–51.
Sheth RA, Maricevich M, Mahmood U. In vivo optical molecular imaging of matrix metalloproteinase activity in abdominal aortic aneurysms correlates with treatment effects on growth rate. Atherosclerosis. 2010;212(1):181–7.
Nahrendorf M, Sosnovik DE, Waterman P, Swirski FK, Pande AN, Aikawa E, et al. Dual channel optical tomographic imaging of leukocyte recruitment and protease activity in the healing myocardial infarct. Circ Res. 2007;100(8):1218–25.
Jaffer FA, Vinegoni C, John MC, Aikawa E, Gold HK, Finn AV, et al. Real-time catheter molecular sensing of inflammation in proteolytically active atherosclerosis. Circulation. 2008;118(18):1802–9.
Jaffer FA, Calfon MA, Rosenthal A, Mallas G, Razansky RN, Mauskapf A, et al. Two-dimensional intravascular near-infrared fluorescence molecular imaging of inflammation in atherosclerosis and stent-induced vascular injury. J Am Coll Cardiol. 2011;57(25):2516–26.
Yoo H, Kim JW, Shishkov M, Namati E, Morse T, Shubochkin R, et al. Intra-arterial catheter for simultaneous microstructural and molecular imaging in vivo. Nat Med. 2011;17(12):1680–4. This study combines macrophage protease activity with high resolution structural imaging (optical frequency domain imaging) as imaged in rabbit vessels comparable in size to human coronary arteries. Both technologies were mounted on a same catheter and provided a powerful tool to image in vivo plaque inflammation superimposed on detailed vessel anatomy.
Bezerra HG, Costa MA, Guagliumi G, Rollins AM, Simon DI. Intracoronary optical coherence tomography: a comprehensive review clinical and research applications. JACC Cardiovasc Interv. 2009;2(11):1035–46.
van der Veen BS, de Winther MP, Heeringa P. Myeloperoxidase: molecular mechanisms of action and their relevance to human health and disease. Antioxid Redox Signal. 2009;11(11):2899–937.
Nicholls SJ, Hazen SL. Myeloperoxidase and cardiovascular disease. Arterioscler Thromb Vasc Biol. 2005;25(6):1102–11.
Vita JA, Brennan ML, Gokce N, Mann SA, Goormastic M, Shishehbor MH, et al. Serum myeloperoxidase levels independently predict endothelial dysfunction in humans. Circulation. 2004;110(9):1134–9.
Zheng L, Nukuna B, Brennan ML, Sun M, Goormastic M, Settle M, et al. Apolipoprotein A-I is a selective target for myeloperoxidase-catalyzed oxidation and functional impairment in subjects with cardiovascular disease. J Clin Invest. 2004;114(4):529–41.
Bergt C, Pennathur S, Fu X, Byun J, O'Brien K, McDonald TO, et al. The myeloperoxidase product hypochlorous acid oxidizes HDL in the human artery wall and impairs ABCA1-dependent cholesterol transport. Proc Natl Acad Sci U S A. 2004;101(35):13032–7.
Askari AT, Brennan ML, Zhou X, Drinko J, Morehead A, Thomas JD, et al. Myeloperoxidase and plasminogen activator inhibitor 1 play a central role in ventricular remodeling after myocardial infarction. J Exp Med. 2003;197(5):615–24.
Schindhelm RK, van der Zwan LP, Teerlink T, Scheffer PG. Myeloperoxidase: a useful biomarker for cardiovascular disease risk stratification? Clin Chem. 2009;55(8):1462–70.
Zhang R, Brennan M, Fu X, et al. ASsociation between myeloperoxidase levels and risk of coronary artery disease. JAMA. 2001;286(17):2136–42.
Baldus S, Heeschen C, Meinertz T, Zeiher AM, Eiserich JP, Munzel T, et al. Myeloperoxidase serum levels predict risk in patients with acute coronary syndromes. Circulation. 2003;108(12):1440–5.
Brennan ML, Penn MS, Van Lente F, Nambi V, Shishehbor MH, Aviles RJ, et al. Prognostic value of myeloperoxidase in patients with chest pain. N Engl J Med. 2003;349(17):1595–604.
Meuwese MC, Stroes ES, Hazen SL, van Miert JN, Kuivenhoven JA, Schaub RG, et al. Serum myeloperoxidase levels are associated with the future risk of coronary artery disease in apparently healthy individuals: the EPIC-Norfolk Prospective Population Study. J Am Coll Cardiol. 2007;50(2):159–65.
Chen JW, Pham W, Weissleder R, Bogdanov Jr A. Human myeloperoxidase: a potential target for molecular MR imaging in atherosclerosis. Magn Reson Med. 2004;52(5):1021–8.
Chen JW, Querol Sans M, Bogdanov Jr A, Weissleder R. Imaging of myeloperoxidase in mice by using novel amplifiable paramagnetic substrates. Radiology. 2006;240(2):473–81.
Pulli B, Ali M, Forghani R, Schob S, Hsieh KL, Wojtkiewicz G, et al. Measuring myeloperoxidase activity in biological samples. PLoS One. 2013;8(7):e67976.
Rodriguez E, Nilges M, Weissleder R, Chen JW. Activatable magnetic resonance imaging agents for myeloperoxidase sensing: mechanism of activation, stability, and toxicity. J Am Chem Soc. 2010;132(1):168–77.
Ronald JA, Chen JW, Chen Y, Hamilton AM, Rodriguez E, Reynolds F, et al. Enzyme-sensitive magnetic resonance imaging targeting myeloperoxidase identifies active inflammation in experimental rabbit atherosclerotic plaques. Circulation. 2009;120(7):592–9.
Nahrendorf M, Sosnovik D, Chen JW, Panizzi P, Figueiredo JL, Aikawa E, et al. Activatable magnetic resonance imaging agent reports myeloperoxidase activity in healing infarcts and noninvasively detects the antiinflammatory effects of atorvastatin on ischemia-reperfusion injury. Circulation. 2008;117(9):1153–60.
Breckwoldt MO, Chen JW, Stangenberg L, Aikawa E, Rodriguez E, Qiu S, et al. Tracking the inflammatory response in stroke in vivo by sensing the enzyme myeloperoxidase. Proc Natl Acad Sci U S A. 2008;105(47):18584–9.
Swirski FK, Wildgruber M, Ueno T, Figueiredo JL, Panizzi P, Iwamoto Y, et al. Myeloperoxidase-rich Ly-6C+ myeloid cells infiltrate allografts and contribute to an imaging signature of organ rejection in mice. J Clin Invest. 2010;120(7):2627–34. For cardiac transplant rejection, serial biopsy is the current standard, which is invasive and prone to sampling error. In this study, Swirski et al. reported use of a gadolinium based agent specific for enzyme myeloperoxidase (MPO-Gd), which can be used as an imaging biomarker for cardiac rejection. Additionally, MPO-Gd was also able to follow immunosuppressive response non-invasively.
Chen JW, Breckwoldt MO, Aikawa E, Chiang G, Weissleder R. Myeloperoxidase-targeted imaging of active inflammatory lesions in murine experimental autoimmune encephalomyelitis. Brain. 2008;131(Pt 4):1123–33.
Forghani R, Wojtkiewicz GR, Zhang Y, Seeburg D, Bautz BR, Pulli B, et al. Demyelinating diseases: myeloperoxidase as an imaging biomarker and therapeutic target. Radiology. 2012;263(2):451–60.
Pecoits-Filho R, Stenvinkel P, Marchlewska A, Heimburger O, Barany P, Hoff CM, et al. A functional variant of the myeloperoxidase gene is associated with cardiovascular disease in end-stage renal disease patients. Kidney Int Suppl. 2003;84:S172–6.
Nikpoor B, Turecki G, Fournier C, Théroux P, Rouleau GA. A functional myeloperoxidase polymorphic variant is associated with coronary artery disease in French-Canadians. Am Heart J. 2001;142(2):336–9.
Galis ZS, Khatri JJ. Matrix metalloproteinases in vascular remodeling and atherogenesis the good, the bad, and the ugly. Circ Res. 2002;90(3):251–62.
Nahrendorf M, Swirski FK. Monocyte and macrophage heterogeneity in the heart. Circ Res. 2013;112(12):1624–33.
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Muhammad Ali declares that he has no conflict of interest. Benjamin Pulli declares that he has no conflict of interest. John W. Chen declares that he has no conflict of interest.
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Ali, M., Pulli, B. & Chen, J.W. Molecular Imaging of Macrophage Enzyme Activity in Cardiac Inflammation. Curr Cardiovasc Imaging Rep 7, 9258 (2014). https://doi.org/10.1007/s12410-014-9258-0
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DOI: https://doi.org/10.1007/s12410-014-9258-0