The brain amyloid of Alzheimer disease (AD) may potentially be imaged in patients with AD by using neuroimaging technology and a radiolabeled form of the 40-residue 18-amyloid peptide A81-40 that is enabled to undergo transport through the brain capillary endothelial wall, which makes up the blood-brain barrier (BBB) in vivo.Transport of 125I-labeled A31-40 (125I-A31B-40) Alzheimer disease (AD) is a severe neurodegenerative disorder, and presently there is no premortem diagnostic test for this disease (1). The dementia of AD correlates with the deposition in brain of amyloid (2), which is principally composed of the 42-to 43-amino acid (3-amyloid peptide, A1(3'42/43 (3,4). One possible diagnostic approach to AD is the development of a premortem brain scan that would allow for semiquantitation of the AP3 amyloid burden in human brain. Previous studies have shown that 125I-labeled A(31-40 (125I-A3'-40) binds to preexisting amyloid plaques in frozen sections of AD brain (5). The delivery to brain of radiolabeled A,f1-40 in conjunction with the use of standard neuroimaging modalities such as single photon emission computed tomography (SPECT) may allow for quantitation of AB3 amyloid in AD brain. Therefore, the present studies examine whether 125I-A3l-40 undergoes significant transport through the brain capillary endothelial wall, which makes up the blood-brain barrier (BBB) in vivo, by using both intravenous/pharmacokinetic and internal carotid artery perfusion techniques. These studies then measure the extent to which BBB transport of 125I-AI3-40 is enhanced with the use of a vector-mediated drug delivery system (6). The latter is composed of a conjugate of streptavidin (SA) and the OX26 monoclonal antibody (mAb) to the transferrin receptor (7), which undergoes receptor-mediated transcytosis through the BBB (6); 125I-A31-40 is monobiotinylated (bio), and 125I,bio-Af140 is then conjugated to the SA-OX26 vector. Since conjugation of 125I-Af3'-40 to the vector-mediated delivery system may inhibit binding of A1'-40 to amyloid plaques, the present studies also examine the saturable binding of 125I-A31-40 to amyloid in AD brain after conjugation to the delivery system. Conjugate Synthesis. The OX26 was conjugated to SA by a thioether linkage as described previously (7,8 Abbreviations: Af31-40, 13-amyloid peptide residues 1-40; BBB, bloodbrain barrier; AD, Alzheimer disease; SA, streptavidin; mAb, monoclonal antibody; 0X26, murine mAb to the rat transferrin receptor; NHS, N-hydroxysuccinimide; SPECT, single photon emission computed tomography; bio, biotinylated; VD, brain volume of distribution; PS, permeability-surface area; AUC, area under the plasma concentration curve; TCA, trichloroacetic acid; TFA, trifluoroacetic acid; %ID, percent of the injected dose.
MATERIALS AND METHODS