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In vivo alpha-V beta-3 integrin expression in human aortic atherosclerosis.

Title: In vivo alpha-V beta-3 integrin expression in human aortic atherosclerosis.
Authors: Jenkins, WS; Vesey, AT; Vickers, A; Neale, A; Moles, C; Connell, M; Joshi, NV; Lucatelli, C; Fletcher, AM; Spratt, JC; Mirsadraee, S; van Beek, EJ; Rudd, JH; Newby, DE; Dweck, MR
Publisher Information: BMJ Publishing Group
Publication Year: 2019
Collection: St George's University of London: Repository
Description: OBJECTIVES: Intraplaque angiogenesis and inflammation are key promoters of atherosclerosis and are mediated by the alpha-V beta-3 (αvβ3) integrin pathway. We investigated the applicability of the αvβ3-integrin receptor-selective positron emission tomography (PET) radiotracer 18F-fluciclatide in assessing human aortic atherosclerosis. METHODS: Vascular 18F-fluciclatide binding was evaluated using ex vivo analysis of carotid endarterectomy samples with autoradiography and immunohistochemistry, and in vivo kinetic modelling following radiotracer administration. Forty-six subjects with a spectrum of atherosclerotic disease categorised as stable (n=27) or unstable (n=19; recent myocardial infarction) underwent PET and CT imaging of the thorax after administration of 229 (IQR 217-237) MBq 18F-fluciclatide. Thoracic aortic 18F-fluciclatide uptake was quantified on fused PET-CT images and corrected for blood-pool activity using the maximum tissue-to-background ratio (TBRmax). Aortic atherosclerotic burden was quantified by CT wall thickness, plaque volume and calcium scoring. RESULTS: 18F-Fluciclatide uptake co-localised with regions of increased αvβ3 integrin expression, and markers of inflammation and angiogenesis. 18F-Fluciclatide vascular uptake was confirmed in vivo using kinetic modelling, and on static imaging correlated with measures of aortic atherosclerotic burden: wall thickness (r=0.57, p=0.001), total plaque volume (r=0.56, p=0.001) and aortic CT calcium score (r=0.37, p=0.01). Patients with recent myocardial infarction had greater aortic 18F-fluciclatide uptake than those with stable disease (TBRmax 1.29 vs 1.21, p=0.02). CONCLUSIONS: In vivo expression of αvβ3 integrin in human aortic atheroma is associated with plaque burden and is increased in patients with recent myocardial infarction. Quantification of αvβ3 integrin expression with 18F-fluciclatide PET has potential to assess plaque vulnerability and disease activity in atherosclerosis.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1468-201X
Relation: https://openaccess.sgul.ac.uk/id/eprint/111777/1/1868.full.pdf; Jenkins, WS; Vesey, AT; Vickers, A; Neale, A; Moles, C; Connell, M; Joshi, NV; Lucatelli, C; Fletcher, AM; Spratt, JC; et al. Jenkins, WS; Vesey, AT; Vickers, A; Neale, A; Moles, C; Connell, M; Joshi, NV; Lucatelli, C; Fletcher, AM; Spratt, JC; Mirsadraee, S; van Beek, EJ; Rudd, JH; Newby, DE; Dweck, MR (2019) In vivo alpha-V beta-3 integrin expression in human aortic atherosclerosis. Heart, 105 (24). pp. 1868-1875. ISSN 1468-201X https://doi.org/10.1136/heartjnl-2019-315103 SGUL Authors: Spratt, James
Availability: https://openaccess.sgul.ac.uk/id/eprint/111777/; https://openaccess.sgul.ac.uk/id/eprint/111777/1/1868.full.pdf
Rights: cc_by_4
Accession Number: edsbas.B1F25BE7
Database: BASE