Background: Gliomas are the most frequent primary brain tumours in adults with two main histological subtypes: astrocytoma and oligodendroglioma. Translocator protein (TSPO) is a pro-inflammatory molecule over-expressed predominantly in activated microglia under pathological conditions. In astrocytoma samples, TSPO has also been found to be up-regulated and correlated with the malignancy of the tumours. [11C]-(R)PK11195 is a selective radioligand for the TSPO widely applied in clinical PET studies. We used [11C]-(R)PK11195 PET to investigate in vivo cerebral TSPO expression and microglial activation in patients with gliomas of different histological subtypes and grades. Methods: 24 glioma patients and 10 healthy volunteers underwent volumetric MRI and dynamic [11C]-(R)PK11195 PET scans. Tissue time-activity curves (TACs) were extracted from tumour regions and normal grey and white matter of the brains. Parametric maps of binding potential (BPND) were generated with the simplified reference tissue model. Co-registered MRI/PET was used to guide tumour biopsies. Tumour tissue was quantitatively assessed for TSPO expression and microglial infiltration by immunohistochemistry. Results: Three types of tumour TAC were observed in gliomas (grey matter-like kinetics, white matter-like kinetics and mixed kinetics), which differed between low-grade astrocytomas and low-grade oligodendrogliomas but were independent of the tumour grade. [11C]-(R)PK11195 BPND also differed between the two subtypes of low-grade gliomas, and low-grade gliomas demonstrated lower BPND than high-grade gliomas. 4 cases of high-grade glioma with minor or no contrast enhancement on MRI showed pronounced [11C]-(R)PK11195 binding. Immunohistochemistry confirmed that expression of TSPO correlated with [11C]-(R)PK11195 BPND of the tumour. It was related mainly to expression by neoplastic cells while the contribution from tumour-infiltrating microglia was minimal. When compared with control subjects, increased [11C]-(R)PK11195 BPND was found in patients’ normal appearing cerebral structures, being more prominent in the tumour-bearing than the tumour-free hemisphere. This extra-tumoral [11C]-(R)PK11195 binding was correlated with the duration of epileptic seizures, the symptom shared by the majority of our patients. Conclusions: Gliomas show differences in [11C]-(R)PK11195 kinetics and binding that are related to histological subtype and grade. Neoplastic cells rather than activated microglia are the main cellular sources expressing TSPO and determine the [11C]-(R)PK11195 binding within the tumours. [11C]-(R)PK11195 PET has the potential to detect malignant transformation of non-enhancing gliomas and facilitate the targeting of more aggressive areas in tumour biopsy. The high extra-tumoral [11C]-(R)PK11195 binding indicates widespread microglial activation in otherwise normal appearing cerebral structures of glioma patients. It is associated with epilepsy and could open up novel therapeutic perspectives for seizure control in this patient population.

Introdução: Esclerose múltipla (EM) é uma doença desmielinizante e inflamatória do sistema nervoso central. Seu diagnóstico é clínico, auxiliado pela imagem de ressonância magnética, mas essa imagem não diferencia processos de inflamação e desmielinização. A tomografia por emissão de pósitrons (PET), usando radiofármacos específicos, pode ser uma ferramenta para diferenciar esses processos. O radiofármaco [11C]PK11195 se liga na proteína translocadora 18 kDa (TSPO) presente nas mitocôndrias das células gliais. O radiofármaco [11C]PIB é utilizado para detecção de placa Beta-amiloide, mas tem sido utilizado também na análise do conteúdo de mielina. Esta nova aplicação foi fundamentada na captação deste radiofármaco em substância branca. A utilização em conjunto destes dois radiofármacos pode diferenciar processos de neuroinflamação, desmielinização e remielização através da imagem PET. Objetivo: O objetivo deste trabalho é validar o uso dos radiofármacos [11C]PK11195 e [11C]PIB para estudo pré-clínico para a quantificação de neuroinflamação e quantidade de mielina, respectivamente, na progressão da doença de modelos animais de esclerose múltipla, modelo de roedores, e em seguida realizar análise de lesões em substância cinzenta e substância branca em modelo de primatas não humanos. Material e Métodos Projeto aprovado pelo comitê de ética (UNIFESP 2628300415 e FMUSP 25/15 e 0556/15). O modelo de lisolecitina em ratos (Wistar, machos) foi induzido pela injeção estereotáxica de lisolecitina 1% em dois locais do estriado direito (2 + 2 microL) e no corpo caloso (3 microL). As imagens de PET com [11C]PK11195 e [11C]PIB foram adquiridas nos tempos basal, 3 dias, 1 semana e 4 semanas após a administração estereotáxica. O modelo de encefalomielite autoimune experimental (EAE) em saguis foi induzido por injeção de glicoproteína da mielina do oligodendrócito (MOG) emulsionada em Adjuvante Incompleto de Freund (IFA) ou em Adjuvante Completo de Freund (CFA). As imagens de PET foram adquiridas antes da imunização (basal) e ± 100 dias após a imunização (final). O tecido cerebral foi utilizado para análise imuno-histológica. Resultados: No modelo de lisolecitina em rato foi observado um aumento na captação de [11C]PK11145 no corpo caloso, 25 % (P = 0,002) e no estriado, 24 % (P < 0,05) uma semana após a imunização comparando com a imagem basal. Com o [11C]PIB não foram observadas diferenças significativas. No modelo de EAE em saguis, induzido com MOG/IFA, foi possível observar uma redução significativa da captação de [11C]PIB nas regiões do esplênio do corpo caloso direito de 38,17 % (P = 0,0365), globo pálido direito, 22,75 %, (P = 0,0355), núcleo caudado direito, 29,36 % (P = 0,0284) e córtex cingulado, 18,99 % (P = 0,0453), enquanto para o grupo MOG/CFA foi observada uma redução significativa para a região do córtex motor esquerdo, 9,51 % (P = 0,0083). Com o [11C]PK11195 foi observada uma redução significativa na captação do radiofármacos na imagem intermediária do grupo MOG/IFA comparada com a captação basal nas regiões do córtex somatossensorial direito, 22,8 % (P = 0,0041), córtex de associação direito, 18,98 % (P = 0,0228), córtex subpial direito, 23,37 % (P = 0,0006) e região do núcleo caudado inferior esquerdo, 18,97 % (P = 0,0233). Nos ensaios post mortem realizados com os ratos foi possível observar na imuno-histoquímica uma correlação, entre micróglia ativada (Iba-1) e [11C]PK11195, tanto no corpo caloso como no estriado. Para os saguis foi observado correlação entre [11C]PK11195 e Iba-1 e esta não foi observada para o [11C]PK11195 e GFAP. Na histologia, foi observada uma correlação entre os dados da imagem de [11C]PIB e a técnica de luxol fast blue. Conclusão: A imagem PET com [11C]PK11195 e [11C]PIB foi eficiente para as quantificações de neuroinflamação e mielina, respectivamente, na progressão da doença dos modelos animais (roedor e primata não humano) da EM / Introduction: Multiple sclerosis (MS) is a demyelinating and inflammatory disease of the central nervous system. Its diagnosis is clinical, helped by magnetic resonance imaging, but this image modality does not differentiate between inflammation and demyelination. Positron Emission Tomography (PET), using specific radiopharmaceuticals, can be a tool to differentiate these processes. The radiopharmaceutical [11C]PK11195 binds to the translocator protein 18 kDa (TSPO) present in the mitochondria of glial cells. [11C]PIB is a radiopharmaceutical used for detection of Beta-amyloid plaques, but has also been used in the analysis of myelin content. This new application was based on the white matter uptake of this radiopharmaceutical. The use of these two radiopharmaceuticals together can differentiate processes of neuroinflammation, demyelination and remyelination by the PET imaging. Objective: The objective of this work is to validate the use of tracers [11C]PK11195 and [11C]PIB for preclinical study for the qualification of neuroinflammation and amount of myelin, respectively, in the disease progression of animal models of multiple sclerosis, rodent model, and then perform analysis of grey matter and white matter lesions in non-human primate model. Material and Methods: Project approved by the ethics committee (UNIFESP 2628300415 and FMUSP 25/15 and 0556/15). The rat lysolecithin model (Wistar, male) was induced by stereotactic injection of lysolecithin 1% at two sites of the right striatum (2 + 2 microL) and in the corpus callosum (3 microL). PET images with [11C]PK11195 and [11C]PIB were acquired at baseline, 3 days, 1 week and 4 weeks after stereotactic injection. The experimental autoimmune encephalomyelitis (EAE) model in marmosets was induced by injection of myelin oligodendrocyte glycoprotein (MOG) emulsified in Incomplete Freund\'s Adjuvant (IFA) or Complete Freund\'s Adjuvant (CFA). PET images were acquired prior to immunization (baseline) and ± 100 days after immunization (end of experiment). Brain tissue was used for immunohistochemical analysis. Results: In the rat lysolecithin model, an increase in [11C]PK11145 uptake of 25% (P = 0.002) was observed in the corpus callosum and 24% (P < 0.05) in the striatum, one week after immunization compared to the baseline image. The IFA/MOG and CFA/MOG groups showed clinical signs in 100% of the animals. The comparison between baseline and symptoms time points showed in the CFA/MOG group a significant 11C-PIB uptake reduction only in the left motor cortex, 9.5 % (P = 0.0083). For the IFA/MOG group, a significant decrease in 11C-PIB uptake was observed in the splenium of corpus callosum, 38.4 % (P = 0.0365), globus pallidus, 22.9 % (P = 0.0355) and tail of caudate nucleus, 28.9 % (P = 0.0284), being these 3 regions in the right brain hemisphere, and also in the cingulate cortex (midline above corpus callosum), 19.5 % (P = 0.0453). 11C-PK11195 uptake was significantly decreased in IFA/MOG group in the intermediary time point in the right somatosensorial cortex, 22.08 % (P = 0.0041), right association cortex, 18.98 % (P = 0.0228), right subpial cortex, 23.37 % (P = 0.0006) and left tail of caudate nucleus, 18.97 % (P = 0.0233). In the post mortem analysis performed with rat tissue, a weak correlation between activated microglia (Iba-1) and [11C]PK11195 uptake was observed both in the corpus callosum and in the striatum. For the marmosets we observed correlation between [11C]PK11195 and Iba-1 but we didn\'t observed between [11C]PK11195 and GFAP. In histology, we observed correlation between [11C]PIB and luxol fast blue. Conclusion: The PET images with [11C]PK11195 and [11C]PIB were efficient for quantifying neuroinflammation and myelin content, respectively, in the disease progression of animal models (rodent and nonhuman primate) of MS

Traumatic brain injury (TBI) is a leading cause of death and long-term disability worldwide, and survivors are often left with cognitive deficits and significant problems with day to day tasks. To date, therapeutic pharmacological treatments of TBI remain elusive despite numerous clinical trials. An improved understanding of the molecular and cellular response to injury may help guide future treatment strategies. One promising marker for brain injury is the translocator protein (TSPO), which is normally expressed at a low level, but is highly expressed following brain damage and is associated with neuroinflammation. The isoquinoline carboxamide PK11195 binds selectively to the TSPO in many species, and has therefore become the most-studied TSPO ligand. To characterize the time-course of TSPO expression in the controlled cortical injury (CCI) model of TBI we subjected Sprague-Dawley rats to CCI and euthanatized them after 30 minutes, 12 hours, 1, 2, 4, or 6 days. Autoradiography with radiolabelled PK11195 was used to assess the time-course of TSPO binding following CCI. Autoradiographs were compared to adjacent tissue slices stained with the microglia/macrophage marker ED-1, with which a moderate positive correlation was discovered. PK11195 autoradiography was used as a tool with which to assess neuroinflammation following CCI and the administration of an α7 nAChR antagonist, methyllycaconitine (MLA). We hypothesized that blocking the calcium permeable α7 nAChR after brain injury would have a neuroprotective effect by attenuating excitotoxicity in the shortterm. Our study revealed clear dose-dependent tissue sparing in rats administered MLA after trauma and a modest improvement in functional outcome. The relatively modest recovery of function with MLA, which could be due to prolonged α7 nAChR blockade or downregulation lead us to explore the potential of α7 nAChR partial agonists in treating TBI. The α7 nAChR partial agonists tropisetron, ondansetron, and DMXB-A produced a moderate attenuation of cognitive deficits, but did not have a neuroprotective effect on tissue sparing. These studies show that following TBI, α7 nAChR modulation can have neuroprotective effects and attenuate cognitive deficits. Whether this modulation is best achieved through partial agonist treatment alone or a combination antagonist/agonist treatment remains to be determined.

Epilepsy is a common neurological disease affecting 6 million people in Europe. Early prevention and accurate diagnosis and treatment are of importance to obtain seizure freedom. In this thesis new applications of carbon-11-labelled tracers in PET and autoradiographic studies were explored in focal epilepsy. Patients with low-grade gliomas often experience epileptic seizures. A retrospective PET-study assessing seizure activity, metabolic rate measured with 11C-methionine and other known prognostic factors was performed in patients with glioma. No correlation was found between seizure activity and uptake of methionine. The presence and termination of early seizures was a favourable prognostic factor. Activation of the neurokinin-1 (NK1) receptor by substance P (SP) induces epileptic activity. PET with the NK1 receptor antagonist GR205171 was performed in patients with temporal lobe epilepsy (TLE) and healthy controls. In TLE patients an increased NK1 receptor availability was found in both hemispheres, most pronounced in anterior cingulate gyrus ipsilateral to seizure onset. A positive correlation between NK1 receptors and seizure frequency was observed in ipsilateral medial structures consistent with an intrinsic network using the NK1-SP receptor system for transmission of seizure activity. The uptake of 18F-fluoro-deoxy-glucose (FDG) is related to cerebral blood flow (CBF). Previously, methods to estimate blood flow from dynamic PET data have been described. A retrospective study was conducted in 15 patients undergoing epilepsy surgery investigation, including PET with 11C-FDG and 11C-Flumazenil (FMZ). The dynamic FMZ dataset and pharmacokinetic modeling with a multilinear reference tissue model were used to determine images of relative CBF. Agreement between data of FDG and CBF was analyzed showing a close association between interictal brain metabolism and relative CBF. Epilepsy often occurs after traumatic brain injuries. Changes in glia and inhibitory neuronal cells contribute to the chain of events leading to seizures. Autoradiography with 11C-PK11195, 11C-L-deprenyl and 11C-Flumazenil in an animal model of posttraumatic epilepsy studied the temporal and spatial distribution of microglia, astrocytes and GABAergic neurons. Results showed an instant increase in microglial activity that subsequently normalized, a late formation of astrogliosis and an instant and prolonged decease in GABA binding. The model can be used to visualize pathophysiological events during the epileptogenesis.

<p>This thesis describes the use of copper and palladium to mediate transformations of carboranes, especially <i>p</i>-carborane.</p><p>1-(1-<i>p</i>-carboranyl)-<i>N</i>-methyl-<i>N</i>-(2-butyl)-3-isoquinolinecarboxamide, a carborane containing analogue of the peripheral benzodiazepine receptor (PBR) ligand PK11195, has been synthesised. A key step in the reaction is the copper (I) mediated coupling of p-carborane with ethyl 1-bromo-isoquinoline-3-carboxylate. </p><p><i>p</i>-Carborane has been arylated on the 2-<i>B</i>-atom in high yields, using the Suzuki–Miyaura reaction. Thus the reaction between 2-I-<i>p</i>-carborane and various arylboronic acids [1-naphthyl-, phenyl-, 4-MeO-C₆H₄-, 3-CH₃CONH-C₆H₄-, 4-NC-C₆H₄-, 3-NO₂-C₆H₄-], gave the corresponding 2-aryl-<i>p</i>-carboranes in DME solution when reacted in the presence of cesium fluoride and the catalytic Pd₂(dba)₃–dppb system. Under the same conditions, the boron-boron bond forming reaction of two <i>p</i>-carboranylboronic esters (2-[(pinacolato)boron]-<i>p</i>-carborane and 2-[(neopentyl glycolato)boron]-p-carborane) was also shown feasible.</p><p><i>p</i>-Carborane has been vinylated on the 2-<i>B</i>-atom in high yields by use of the Heck reaction. The coupling between 2-I-<i>p</i>-carborane and various styrenes [4-H-, 4-C₆H₄-, 4-Cl , 4-Br-, 4-NO₂-, 4-CH3O- and 4 CH₃ ] resulted in the formation of the corresponding<i>trans</i>-β-(2-<i>B</i>-<i>p</i>-carboranyl) styrene in DMF solution when reacted in the presence of silver phosphate and the palladacycle Herrmann´s catalyst. The reaction was shown to proceed at higher rate with electron rich than with electron deficient olefins.</p><p>The feasibility of palladium-catalysed isotopic exchange of an iodinated closo-carborane with a radioisotope of iodine has been studied. 2-I-<i>p</i>-carborane was selected as a model compound. It was shown, that such isotopic exchange is possible and provides a high yield (83 ± 4.2 %) during 40 min long reaction. The reaction conditions were optimised, and it was demonstrated that presence of the tetra n-butylammonium hydrogensulphate is important in order to stabilise catalyst and provide reproducibility of labelling. In this work we have modified the methodology and extended the application to a wider range of iodinated carboranes. By the use of Herrmann’s catalyst in toluene at 100 °C this [¹²⁵I]-iodide labelling could be improved and extended. 2-I-<i>p</i>- 9-I-<i>m</i>-, 9-I-<i>o</i>-, 3-I-<i>o</i>-carborane, 1-phenyl-3-I-<i>o</i>-carborane and 1,2-diphenyl-3-I-<i>o</i>-carborane could be [¹²⁵I]-iodide labelled in high to excellent yields within 5 minutes.This reported palladium catalyzed radio-iodination of the uncharged closo-carboranes might find use in pharmacokinetic studies of carborane derivatives.</p>

This thesis describes the use of copper and palladium to mediate transformations of carboranes, especially p-carborane. 1-(1-p-carboranyl)-N-methyl-N-(2-butyl)-3-isoquinolinecarboxamide, a carborane containing analogue of the peripheral benzodiazepine receptor (PBR) ligand PK11195, has been synthesised. A key step in the reaction is the copper (I) mediated coupling of p-carborane with ethyl 1-bromo-isoquinoline-3-carboxylate. p-Carborane has been arylated on the 2-B-atom in high yields, using the Suzuki–Miyaura reaction. Thus the reaction between 2-I-p-carborane and various arylboronic acids [1-naphthyl-, phenyl-, 4-MeO-C6H4-, 3-CH3CONH-C6H4-, 4-NC-C6H4-, 3-NO2-C6H4-], gave the corresponding 2-aryl-p-carboranes in DME solution when reacted in the presence of cesium fluoride and the catalytic Pd2(dba)3–dppb system. Under the same conditions, the boron-boron bond forming reaction of two p-carboranylboronic esters (2-[(pinacolato)boron]-p-carborane and 2-[(neopentyl glycolato)boron]-p-carborane) was also shown feasible. p-Carborane has been vinylated on the 2-B-atom in high yields by use of the Heck reaction. The coupling between 2-I-p-carborane and various styrenes [4-H-, 4-C6H4-, 4-Cl , 4-Br-, 4-NO2-, 4-CH3O- and 4 CH3 ] resulted in the formation of the correspondingtrans-β-(2-B-p-carboranyl) styrene in DMF solution when reacted in the presence of silver phosphate and the palladacycle Herrmann´s catalyst. The reaction was shown to proceed at higher rate with electron rich than with electron deficient olefins. The feasibility of palladium-catalysed isotopic exchange of an iodinated closo-carborane with a radioisotope of iodine has been studied. 2-I-p-carborane was selected as a model compound. It was shown, that such isotopic exchange is possible and provides a high yield (83 ± 4.2 %) during 40 min long reaction. The reaction conditions were optimised, and it was demonstrated that presence of the tetra n-butylammonium hydrogensulphate is important in order to stabilise catalyst and provide reproducibility of labelling. In this work we have modified the methodology and extended the application to a wider range of iodinated carboranes. By the use of Herrmann’s catalyst in toluene at 100 °C this [125I]-iodide labelling could be improved and extended. 2-I-p- 9-I-m-, 9-I-o-, 3-I-o-carborane, 1-phenyl-3-I-o-carborane and 1,2-diphenyl-3-I-o-carborane could be [125I]-iodide labelled in high to excellent yields within 5 minutes.This reported palladium catalyzed radio-iodination of the uncharged closo-carboranes might find use in pharmacokinetic studies of carborane derivatives.

The pathological process behind abdominal aortic aneurysm (AAA) formation is poorly understood and difficult to study. The aim of the thesis was to study the pathophysiology of AAA formation with positron emission tomography (PET) technology, a molecular imaging technique, allowing in vivo studies of pathophysiological changes. In study I 18F-FDG, a glucose analogue, was tested. It had previously been reported as a useful tracer studying inflammation in AAAs. These studies included, however, foremost large, symptomatic, and inflammatory AAAs. In the present study on five small and seven large asymptomatic AAAs, no increase in 18F-FDG uptake could be revealed in vivo. In study II 11C-PK11195, a macrophage tracer, and 11C-D-deprenyl, an unspecific inflammatory tracer, previously never tested on asymptomatic AAAs, were tested in vivo on five and 10 AAA-patients respectively, without signs of increased levels of inflammatory activity in the aorta. In study III several tracers were screened in vitro through autoradiography on AAA tissue. [18F]fluciclatide, targeting the integrin αVβ3 receptor upregulated in angiogenesis, was the only tracer with an increased uptake. In study IV [18F]fluciclatide-autoradiography was performed on AAA tissue from five patients and non-aneurysmal aortic tissue obtained from five age and sex matched organ donors. The study showed a 56% increased specific uptake in AAA, although not significant (P=0.136). Immunohistochemical revealed inflammatory cell foci in close relation to the vessels. In conclusion, PET has potential to elucidate the pathophysiology of AAA formation. For the large group of small asymptomatic AAAs, 18F-FDG is not suitable, as the chronic inflammation in asymptomatic AAA is not sufficiently metabolically active. Furthermore, 11C-PK11195 and 11C-D-deprenyl were unable to show the chronic inflammation seen in asymptomatic AAA. The interesting finding with uptake of [18F]fluciclatide showed that angiogenesis may be imaged in large asymptomatic AAAs in vitro, through the integrin αVβ3 receptor. Thus, it is likely that future studies of the role of angiogenesis in AAA formation in vivo, in small AAAs, could use this target site. The development of an integrin αVβ3 receptor tracer, preferably with higher affinity, is in progress for further in vitro and in vivo studies.