SV2A-PET обнаруживает кортикальную потерю синапса при множественном склерозе.
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Ullrich Gavilanes Emily M, Bartos Laura M, Gernert Jonathan A, Carral Carla Ares, Ruiz Navarro Diego, Havla Joachim, Gerdes Lisa-Ann, Gnörich Johannes S, Kunze Lea H, Dorneich Julia S, Pakula Vanessa, Tagnin Lisa, Zimmermann Hanna, Seelos Klaus, Franzmeier Nicolai, Frontzkowski Lukas, Pedrosa de Barros Nuno, Ribbens Annemie, Zwergal Rachel Maria, Zwergal Andreas, Vollmar Christian, Remi Jan, Picon Carmen, Reynolds Richard, Merkler Doron, Wattjes Mike P, Kümpfel Tania, Brendel Matthias, Kerschensteiner Martin
Аннотация
Оригинал публикации
SV2A-PET imaging uncovers cortical synapse loss in multiple sclerosis.
Gray matter pathology, including the formation of cortical lesions, predicts progression in people with multiple sclerosis (PwMS). Here, we investigated whether positron emission tomography (PET) imaging using the synaptic vesicle protein 2A (SV2A)-targeting radioligand [18F]UCB-H could help to detect and monitor synapse loss, an early feature of gray matter pathology in MS. First, we confirmed that SV2A is a suitable marker of synapse density in MS by analyzing SV2A mRNA and protein expression in cortical gray matter. We then used a mouse model of cortical MS pathology to demonstrate that SV2A-PET imaging can detect synapse loss in cortical lesions and that synapse densities measured by PET imaging correspond to the densities of genetically and immunohistochemically labeled synapses in the same lesions. Last, we performed SV2A-PET imaging in a total of 31 PwMS at different stages of the disease process, showing that PET imaging can detect synapse loss in cortical MS lesions in vivo. Moreover, we found that interhemispheric asymmetries in SV2A-PET tracer uptake can be leveraged to uncover further cortical alterations, the volume of which was more than 20-fold larger than the cortical lesion area detected by MRI. The extent of these PET-defined areas of cortical synapse pathology was larger in the progressive stage of the disease and correlated with the disability and cognitive performance of the same individuals. SV2A-PET imaging thus unmasked clinically relevant cortical pathology in MS thereby providing a promising tool to detect and monitor disease progression.