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一种用于克罗恩病纤维化分期的靶向I型胶原的磁共振成像探针。

A Type I Collagen-Targeted MR Imaging Probe for Staging Fibrosis in Crohn's Disease.

作者信息

Li Zhoulei, Lu Baolan, Lin Jinjiang, He Shaofu, Huang Li, Wang Yangdi, Meng Jixin, Li Ziping, Feng Shi-Ting, Lin Shaochun, Mao Ren, Li Xue-Hua

机构信息

Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

Front Mol Biosci. 2021 Nov 11;8:762355. doi: 10.3389/fmolb.2021.762355. eCollection 2021.

Abstract

Fibrostenosis is a serious complication of Crohn's disease (CD), affecting approximately one-half of all patients. Surgical resection is the typical clinical end due to ineffective antifibrotic therapy mainly through anti-inflammatory treatment and fibrosis can be reverted only at early stages. Mover, human fibrotic disorders is known to be associated with aging process. Thus, accurate monitoring of the progression of fibrosis is crucial for CD management as well as can be benefit to aging related fibrosis. The excessive deposition of type I collagen (ColI) is the core point in major complications of fibrosis, including that in patients with CD and aging related fibrosis. Therefore, a MR imaging probe (EP-3533) targeted ColI was employed to stage bowel fibrosis in CD using a rat model and to compare its efficiency with the common MR imaging contrast medium gadopentetatedimeglumine (Gd-DTPA). The bowel fibrotic rat model was established with different degrees of bowel fibrosis, were scanned using a 3.0-T MRI scanner with a specialized animal coil. MRI sequence including mapping and T1-weighed imaging were performed before and after injecting the MRI probe (EP-3533 or Gd-DTPA). The relaxation time ( value) and change in the contrast-to-noise ratio (ΔCNR) were measured to evaluate bowel fibrosis. Masson's trichrome staining was performed to determine the severity of fibrosis. EP-3533 offered a better longitudinal relaxivity (r) with 67.537 L/mmol·s, which was approximately 13 times that of Gd-DTPA. The value on bowel segments was reduced in the images from EP-3533 compared to that from Gd-DTPA (F = 16.478; < 0.001). Additionally, a better correlation between ΔCNR calculated from EP-3533 imaging and bowel fibrosis (AUC = 0.846) was determined 10 min after enhanced media administration than with Gd-DTPA (AUC = 0.532). The 10th-minute ΔCNR performed using the ColI probe showed the best correlation with the severity of bowel fibrosis ( = 0.538; = 0.021). Our results demonstrates that targeted MRI probe (EP-3533) supplies a better enhanced effect compared to Gd-DTPA and could be a promising method to evaluate the progression and monitor the therapeutic response of bowel fibrosis.

摘要

纤维狭窄是克罗恩病(CD)的一种严重并发症,影响约一半的患者。由于主要通过抗炎治疗的抗纤维化疗法无效,手术切除是典型的临床结局,且纤维化仅在早期阶段可逆转。此外,已知人类纤维化疾病与衰老过程相关。因此,准确监测纤维化进展对于CD的管理至关重要,并且可能有益于与衰老相关的纤维化。I型胶原蛋白(ColI)的过度沉积是纤维化主要并发症的核心点,包括CD患者和与衰老相关的纤维化患者。因此,使用大鼠模型,采用靶向ColI的磁共振成像探针(EP - 3533)对CD患者的肠道纤维化进行分期,并将其效率与常用的磁共振成像造影剂钆喷酸葡胺(Gd - DTPA)进行比较。建立具有不同程度肠道纤维化的肠道纤维化大鼠模型,使用带有专门动物线圈的3.0 - T磁共振成像扫描仪进行扫描。在注射磁共振成像探针(EP - 3533或Gd - DTPA)之前和之后进行磁共振成像序列,包括 映射和T1加权成像。测量 弛豫时间( 值)和对比噪声比变化(ΔCNR)以评估肠道纤维化。进行Masson三色染色以确定纤维化的严重程度。EP - 3533的纵向弛豫率(r)更好,为67.537 L/mmol·s,约为Gd - DTPA的13倍。与Gd - DTPA相比,EP - 3533图像中肠道节段的 值降低(F = 16.478; < 0.001)。此外,在增强介质给药10分钟后,由EP - 3533成像计算得到的ΔCNR与肠道纤维化之间的相关性更好(AUC = 0.846),优于Gd - DTPA(AUC = 0.532)。使用ColI探针进行的第10分钟ΔCNR与肠道纤维化严重程度的相关性最佳( = 0.538; = 0.021)。我们的结果表明,与Gd - DTPA相比,靶向磁共振成像探针(EP - 3533)提供了更好的增强效果,可能是评估肠道纤维化进展和监测治疗反应的一种有前景的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c66/8631902/714e084ae29c/fmolb-08-762355-g001.jpg

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