Abstract

Central nervous system leukemia (CNS-L) is caused by leukemic cells infiltrating into the meninges or brain parenchyma and remains the main reason for disease relapse. Currently, it is hard to detect CNS-L accurately by clinically available imaging models due to the relatively low amount of tumor cells, confined blood supply, and the inferior glucose metabolism intensity. Recently, integrin α6-laminin interactions have been identified to mediate CNS-L, which suggests that integrin α6 may be a promising molecular imaging target for the detection of CNS-L. The acute lymphoblastic leukemia (ALL) cell line NALM6 stabled and transfected with luciferase was used to establish the CNS-L mouse model. CNS-L-bearing mice were monitored and confirmed by bioluminescence imaging. Three of our previously developed integrin α6-targeted peptide-based molecular imaging agents, Cy5-S5 for near-infrared fluorescence (NIRF), Gd-S5 for magnetic resonance (MR), and 18F-S5 for positron emission tomography (PET) imaging, were employed for the molecular imaging of these CNS-L-bearing mice. Bioluminescence imaging showed a local intensive signal in the heads among CNS-L-bearing mice; meanwhile, Cy5-S5/NIRF imaging produced intensive fluorescence intensity in the same head regions. Moreover, Gd-S5/MR imaging generated superior MR signal enhancement at the site of meninges, which were located between the skull bone and brain parenchyma. Comparatively, MR imaging with the clinically available MR enhancer Gd-DTPA did not produce the distinguishable MR signal in the same head regions. Additionally, 18F-S5/PET imaging also generated focal radio-concentration at the same head regions, which generated nearly 5-times tumor-to-background ratio compared to the clinically available PET radiotracer 18F-FDG. Finally, pathological examination identified layer-displayed leukemic cells in the superficial part of the brain parenchyma tissue, and immunohistochemical staining confirmed the overexpression of the integrin α6 within the lesion. These findings suggest the potential application of these integrin α6-targeted molecular imaging agents for the accurate detection of CNS-L.

Highlights

  • Acute lymphoblastic leukemia (ALL) is a malignant proliferation of lymphocytes that could invade the bone marrow, blood, and extramedullary tissues or organs, with an estimated incidence of about 157/100,000 and a distinctive prevalence in children, especially in those at 1–4 years old (Siegel et al, 2019; Malard and Mohty, 2020)

  • Pathological examination identified layer-displayed leukemic cells in the superficial part of the brain parenchyma tissue, and immunohistochemical staining confirmed the overexpression of the integrin α6 within the lesion. These findings suggest the potential application of these integrin α6-targeted molecular imaging agents for the accurate detection of central nervous system leukemia (CNS-L)

  • We further developed the targeted molecular imaging probes for near-infrared fluorescence (NIRF) imaging, magnetic resonance imaging (MRI), and positron emission tomography (PET) based on the S5 peptide, which is called Cy5-S5, Gd-S5, and 18F-S5 in short

Read more

Summary

Introduction

Acute lymphoblastic leukemia (ALL) is a malignant proliferation of lymphocytes that could invade the bone marrow, blood, and extramedullary tissues or organs, with an estimated incidence of about 157/100,000 and a distinctive prevalence in children, especially in those at 1–4 years old (Siegel et al, 2019; Malard and Mohty, 2020). Central nervous system involvement of ALL, caused by leukemic cells infiltrating into the meninges or brain parenchyma, which is called central nervous system leukemia (CNS-L), remains the main reason for disease relapse during the remission period. Because most chemotherapeutic drugs could not penetrate the blood–brain barrier, leukemic cells hidden in the central nervous system could not be effectively eliminated and become the origin of extramedullary leukemia recurrence (Pinnix et al, 2018; Zhang C et al, 2020). Patients evaluated at a high risk of CNS infiltration routinely received additional cranial irradiation, which could further exacerbate neurocognitive impairment and the risk of secondary malignancies (Zhou et al, 2020)

Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call