From the Department of Biomedical Engineering, Washington University in St Louis, 4511 Forest Park Ave, St Louis, MO 63108 (C.P.P., J.Y., Y.Y., E.C.L., H.C.); Department of Neurosurgery (E.C.L.), Mallinckrodt Institute of Radiology (T.L.S.B., A.N.), and Department of Radiation Oncology (H.C.), Washington University School of Medicine, St Louis, Mo.
Radiology. 2023 Apr;307(2):e220869. doi: 10.1148/radiol.220869. Epub 2023 Jan 31.
Background Neurodegenerative disorders (such as Alzheimer disease) characterized by the deposition of various pathogenic forms of tau protein in the brain are collectively referred to as tauopathies. Identification of the molecular drivers and pathways of neurodegeneration is critical to individualized targeted treatment of these disorders. However, despite important advances in fluid biomarker detection, characterization of these molecular subtypes is limited by the blood-brain barrier. Purpose To evaluate the feasibility and safety of focused ultrasound-mediated liquid biopsy (sonobiopsy) in the detection of brain-derived protein biomarkers in a transgenic mouse model of tauopathy (PS19 mice). Materials and Methods Sonobiopsy was performed by sonicating the cerebral hemisphere in 2-month-old PS19 and wild-type mice, followed by measurement of plasma phosphorylated tau (p-tau) species (30 minutes after sonication in the sonobiopsy group). Next, spatially targeted sonobiopsy was performed by sonicating either the cerebral cortex or the hippocampus in 6-month-old PS19 mice. To detect changes in plasma neurofilament light chain (a biomarker of neurodegeneration) levels, blood samples were collected before and after sonication (15 and 45-60 minutes after sonication). Histologic staining was performed to evaluate tissue damage after sonobiopsy. The Shapiro-Wilk test, unpaired and paired tests, and the Mann-Whitney test were used. Results In the 2-month-old mice, sonobiopsy significantly increased the normalized levels of plasma p-tau species compared with the conventional blood-based liquid biopsy (p-tau-181-to-mouse tau [m-tau] ratio: 1.7-fold increase, = .006; p-tau-231-to-m-tau ratio: 1.4-fold increase, = .048). In the 6-month-old PS19 mice, spatially targeted sonobiopsy resulted in a 2.3-fold increase in plasma neurofilament light chain after sonication of the hippocampus and cerebral cortex ( < .001). After optimization of the sonobiopsy parameters, no excess microhemorrhage was observed in the treated cerebral hemisphere compared with the contralateral side. Conclusion This study showed the feasibility of sonobiopsy to release phosphorylated tau species and neurofilament light chain to the blood circulation, potentially facilitating diagnosis of neurodegenerative disorders. © RSNA, 2023 See also the editorial by Fowlkes in this issue.
背景 以脑内各种致病性tau 蛋白形式沉积为特征的神经退行性疾病(如阿尔茨海默病)统称为tau 病。鉴定神经退行性变的分子驱动因素和途径对于这些疾病的个体化靶向治疗至关重要。然而,尽管在液体生物标志物检测方面取得了重要进展,但由于血脑屏障的存在,这些分子亚型的特征仍受到限制。 目的 在tau 病转基因小鼠模型(PS19 小鼠)中,评估聚焦超声介导的液体活检测(sonobiopsy)检测脑源性蛋白生物标志物的可行性和安全性。 材料与方法 在 2 月龄 PS19 和野生型小鼠的大脑半球行 sonobiopsy,sonobiopsy 组在 sonication 后 30 分钟测量血浆磷酸化 tau(p-tau)种类;然后,在 6 月龄 PS19 小鼠中通过 sonication 行空间靶向 sonobiopsy,分别作用于大脑皮层或海马。为了检测神经丝轻链(神经退行性变的生物标志物)水平的变化,在 sonication 前后(sonication 后 15 和 45-60 分钟)采集血液样本。行组织学染色评估 sonobiopsy 后的组织损伤。采用 Shapiro-Wilk 检验、非配对和配对 t 检验、Mann-Whitney U 检验。 结果 在 2 月龄小鼠中,sonobiopsy 与传统的基于血液的液体活检相比,显著增加了血浆 p-tau 种类的标准化水平(p-tau-181 与小鼠 tau[m-tau]的比值:增加 1.7 倍, =.006;p-tau-231 与 m-tau 的比值:增加 1.4 倍, =.048)。在 6 月龄 PS19 小鼠中,海马和大脑皮层 sonication 后,空间靶向 sonobiopsy 导致血浆神经丝轻链增加 2.3 倍( <.001)。在 sonobiopsy 参数优化后,与对侧相比,治疗侧大脑半球未见额外微出血。 结论 本研究表明 sonobiopsy 释放磷酸化 tau 种类和神经丝轻链进入血液循环具有可行性,可能有助于神经退行性疾病的诊断。 ® RSNA,2023 参见本期 Fowlkes 的社论。