Hou Huagang, Khan Nadeem, O'Hara Julia A, Grinberg Oleg Y, Dunn Jeff F, Abajian Michelle A, Wilmot Carmen M, Makki Malek, Demidenko Eugene, Lu Shiyi, Steffen Robert P, Swartz Harold M
Department of Diagnostic Radiology, EPR Center for the Study of Viable Systems, Dartmouth Medical School, Hanover, NH 03755, USA.
Int J Radiat Oncol Biol Phys. 2004 Jul 1;59(3):834-43. doi: 10.1016/j.ijrobp.2004.02.039.
RSR13, an allosteric modifier of hemoglobin, reduces hemoglobin-oxygen binding affinity facilitating oxygen release from hemoglobin, resulting in increases in tissue pO(2). The purpose of this study was noninvasively to monitor the time course and effect of RSR13 on tumor oxygenation, directly using in vivo electron paramagnetic resonance (EPR oximetry), and indirectly using blood oxygen level dependent magnetic resonance imaging (BOLD MRI).
The study was performed in transplanted radiation-induced fibrosarcoma tumors (RIF-1) in 18 female C3H/HEJ mice, which had two lithium phthalocyanine (LiPc) deposits implanted in the tumor when the tumors reached about 200-600 mm(3). Baseline EPR measurements were made daily for 3 days. Then, for 6 consecutive days and after an initial baseline EPR measurement, RSR13 (150 mg/kg) or vehicle (same volume) was injected intraperitoneally, and measurements of intratumoral oxygen were made at 10-min intervals for the next 60 min. In each mouse, every third day, instead of EPR oximetry, BOLD MRI measurements were made for 60 min after administration of the RSR13.
Based on EPR measurements, RSR13 produced statistically significant temporal increases in tumor pO(2) over the 60-min time course, which reached a maximum at 35-43 min postdose. The average time required to return to the baseline pO(2) was 70-85 min. The maximum increase in tumor tissue pO(2) values after RSR13 treatment from Day 1 to Day 5 (8.3-12.4 mm Hg) was greater than the maximum tumor tissue pO(2) value for Day 6 (4.7 mm Hg, p < 0.01). The maximum increase in pO(2) occurred on Day 2 (12.4 mm Hg) after RSR13 treatment. There was little change in R(2)*, indicating that the RSR13 had minimal detectable effects on total deoxyhemoglobin and hemoglobin-oxygen saturation.
The extent of the increase in tumor pO(2) achieved by RSR13 would be expected to lead to a significant increase in the effectiveness of tumor radiotherapy. The lack of a change in the BOLD MRI signal suggests that the tumor physiology was largely unchanged by RSR13. These results illustrate a unique and useful capability of in vivo EPR oximetry and BOLD MRI to obtain repeated measurements of tumor oxygenation and physiology. The dynamics of tumor pO(2) after RSR13 administration may be useful for the design of clinical protocols using allosteric hemoglobin effectors.
RSR13是一种血红蛋白变构调节剂,可降低血红蛋白与氧的结合亲和力,促进氧从血红蛋白释放,从而使组织pO₂升高。本研究的目的是使用体内电子顺磁共振(EPR血氧测定法)直接和使用血氧水平依赖性功能磁共振成像(BOLD MRI)间接无创监测RSR13对肿瘤氧合的时间进程和影响。
本研究在18只雌性C3H/HEJ小鼠的移植性辐射诱导纤维肉瘤肿瘤(RIF-1)中进行,当肿瘤体积达到约200 - 600 mm³时,在肿瘤内植入两个锂酞菁(LiPc)沉积物。连续3天每天进行基线EPR测量。然后,在初始基线EPR测量后,连续6天腹腔注射RSR13(150 mg/kg)或赋形剂(相同体积),并在接下来的60分钟内每隔10分钟进行一次瘤内氧测量。在每只小鼠中,每隔三天,在注射RSR13后60分钟进行BOLD MRI测量,而不是EPR血氧测定。
基于EPR测量,RSR13在60分钟的时间进程中使肿瘤pO₂在统计学上有显著的时间依赖性升高,在给药后35 - 43分钟达到最大值。恢复到基线pO₂所需的平均时间为70 - 85分钟。RSR13治疗后第1天至第5天肿瘤组织pO₂值的最大升高(8.3 - 12.4 mmHg)大于第6天的最大肿瘤组织pO₂值(4.7 mmHg,p < 0.01)。pO₂的最大升高发生在RSR13治疗后的第2天(12.4 mmHg)。R₂*变化很小,表明RSR13对总脱氧血红蛋白和血红蛋白氧饱和度的可检测影响最小。
预计RSR13使肿瘤pO₂升高的程度会导致肿瘤放射治疗效果显著增加。BOLD MRI信号缺乏变化表明RSR13对肿瘤生理学的影响在很大程度上未改变。这些结果说明了体内EPR血氧测定法和BOLD MRI在重复测量肿瘤氧合和生理学方面的独特且有用的能力。RSR13给药后肿瘤pO₂的动态变化可能有助于设计使用变构血红蛋白效应剂的临床方案。