Multi-targeted 1H/19F MRI unmasks specific danger patterns for emerging cardiovascular disorders

Relaxation-Based In Vivo Discrimination of Oxidized and Reduced States of a Redox-Switchable 19F MRI Probe

MRI assessment of the tissue redox state is important for revealing and understanding various pathologies, and redox-responsive imaging probes capable of generating discrete and quantifiable signals in both their reduced and oxidized forms can provide enhanced detection reliability. The small fluorinated, redox-active FeL1 chelate is a prototype of such agents. L1 forms stable and inert complexes with both Fe2+ and Fe3+ ions, and the redox potential of the Fe3+L1/Fe2+L1 couple (+240 mV vs NHE) is adapted to biological redox sensing. Fe2+L1 undergoes instantaneous oxidation in the presence of H2O2, and Fe3+L1 is reduced by cysteine, glutathione, and ascorbate. Fe2+L1 and Fe3+L1 have very different proton relaxivities (0.1 mM-1 s-1 and 2.83 mM-1 s-1, respectively, 60 MHz, 298 K), as well as 19F relaxation times (T1 = 71-130 ms; T2 = 60-117 ms and T1 = 2.43 ms; T2 = 1.81 ms, respectively, 400 MHz, 298 K), in accordance with the different paramagnetic relaxation enhancement capacity of the two iron redox states. Upon application of specific MRI pulse sequences adapted to the relaxation rate (RARE for Fe2+L1 and UTE for Fe3+L1, combined with appropriate acquisition parameters), both redox forms are detected in 19F MR phantom images with good sensitivity and signal-to-noise ratios linearly dependent on probe concentration. Fe2+L1 and Fe3+L1 can be readily visualized and unambiguously discriminated based on their 19F relaxation times in living mice, following intramuscular injection. The possibility of monitoring the redox switch in 1H MRI as well is an additional advantage of this bioresponsive probe.

Efficient Synthesis of Polymeric Fluorinated Nanoparticles with High Fluorine Content via Aqueous Photo-Polymerization-Induced Self-Assembly for 19F MRI Application

Polymeric fluorinated nanoparticles (PFNPs) are useful materials in many applications, especially in the field of 19F magnetic resonance imaging (MRI). Despite the development of numerous PFNPs with diverse chemical compositions and structures, those with high fluorine content and capable of highly sensitive 19F MRI remain scarce. Here we report an elegantly designed aqueous photo-polymerization-induced self-assembly (photo-PISA) system for the synthesis of PFNPs with high fluorine content for effective 19F MRI applications. This innovative photo-PISA system is enabled by two analogous fluorinated monomers, allowing efficient production of PFNPs with different morphologies and high fluorine content (25 wt %) in aqueous solution. These PFNPs exhibit favorable 19F MRI properties and morphology-dependent biological behavior, and have potential as advanced polymeric nanomaterials for imaging and drug delivery applications.

Super-multiplexed imaging and coding in the range of radio frequency

The era of the Internet has led to an information explosion, creating significant challenges for current techniques in information storage and access. High-performance strategies that expand existing methods offer a promising solution. Imaging-based approaches are vital for information perception but remain underexplored for information processing due to limited multiplexity. Here, we introduce 19F magnetic resonance imaging-Empowered information Assess and Storage Technique (FEAST), enabled by 22 fluorinated quaternary ammonium derivatives with distinct 19F chemical shifts. We developed three coding platforms for FEAST: fluorinated choline analog solutions, fluorinated deep eutectic solvents, and fluorinated ionogels. These platforms allow 2-spatial-dimensional applications, such as 16-bit encoding, "dual-color" watermarking, multiplexed Colorcodes, and encrypted QR codes, as well as 3-spatial-dimensional applications like "cubic" information storage, implanted anti-counterfeit labels, and FEAST-guided encryption. This work highlights FEAST's potential for advanced information storage and access, which is inspiring for further developments with versatile and robust coding platforms.

Imaging of Thromboinflammation by Multispectral 19F MRI

The close interplay between thrombotic and immunologic processes plays an important physiological role in the immune defence after tissue injury and has the aim to reduce damage and to prevent the spread of invading pathogens. However, the uncontrolled or exaggerated activation of these processes can lead to pathological thromboinflammation. Thromboinflammation has been shown to worsen the outcome of cardiovascular, autoinflammatory, or even infectious diseases. Imaging of thromboinflammation is difficult because many clinically relevant imaging techniques can only visualize either inflammatory or thrombotic processes. One interesting option for the noninvasive imaging of thromboinflammation is multispectral 19F magnetic resonance imaging (MRI). Due to the large chemical shift range of the 19F atoms, it is possible to simultaneously visualize immune cells as well as thrombus components with specific 19F tracer that have individual spectral 19F signatures. Of note, the 19F signal can be easily quantified and a merging of the 19F datasets with the anatomical 1H MRI images enables precise anatomical localization. In this review, we briefly summarize the background of 19F MRI for inflammation imaging, active targeting approaches to visualize thrombi and specific immune cells, introduce studies about multispectral 19F MRI, and summarize one study that imaged thromboinflammation by multispectral 19F MRI.

The Environmental Impact of Medical Imaging Agents and the Roadmap to Sustainable Medical Imaging

Medical imaging agents, i.e., contrast agents for magnetic resonance imaging (MRI) and radiopharmaceuticals, play a vital role in the diagnosis of diseases. Yet, they mostly contain harmful and non-biodegradable substances, such as per- and polyfluoroalkyl substances (PFAS), heavy metals or radionuclides. As a result of their increasing clinical use, these agents are entering various water bodies and soil, posing risks to environment and human health. Here, the environmental effects of the application of imaging agents are outlined for the major imaging modalities, and the respective chemistry of the contrast agents with environmental implications is linked. Recommendations are introduced for the design and application of contrast agents: the 3Cs of imaging agents: control, change, and combine; and recent approaches for more sustainable imaging strategies are highlighted. This combination of measures should engage an open discussion, inspire solutions to reduce pollution by imaging agents, and increase awareness for the impact of toxic waste related to imaging agents.

Design of Fluorinated Peptides as Biotransformed Urinalysis Biomarkers for Non-Invasive Diagnosis and Treatment of Liver Injury through Enzyme Directed Kinetics

Urinalysis, as a non-invasive and efficient diagnostic method, is very important but faces great challenges due to the complex compositions of urine and limited naturally occurring biomarkers for diseases. Herein, by leveraging the intrinsic absence of endogenous fluorinated interference, a strategy with the enzymatically activated assembly of synthetic fluorinated peptide for cholestatic liver injury (CLI) diagnosis and treatment through 19F nuclear magnetic resonance (NMR) urinalysis and efficient drug retention is developed. Specifically, alkaline phosphatase (ALP), overexpressed in the liver of CLI mice, triggers the assembly of fluorinated peptide, thus, directing the traffic and dynamic distribution of the synthetic biomarkers after administration, whereas CLI mice display much slower clearance of peptides through urine as compared with healthy counterparts. As such, it enables to transform pathophysiological information into exogenous signals via noninvasive urinary monitoring. Moreover, as a proof-of-concept, by grafting different functional groups to peptides, the theranostic platforms can be established to provide a new paradigm for the design of multifunctional peptides.

Core-Shell Magnetic Particles: Tailored Synthesis and Applications

Core-shell magnetic particles consisting of magnetic core and functional shells have aroused widespread attention in multidisciplinary fields spanning chemistry, materials science, physics, biomedicine, and bioengineering due to their distinctive magnetic properties, tunable interface features, and elaborately designed compositions. In recent decades, various surface engineering strategies have been developed to endow them desired properties (e.g., surface hydrophilicity, roughness, acidity, target recognition) for efficient applications in catalysis, optical modulation, environmental remediation, biomedicine, etc. Moreover, precise control over the shell structure features like thickness, porosity, crystallinity and compositions including metal oxides, carbon, silica, polymers, and metal-organic frameworks (MOFs) has been developed as the major method to exploit new functional materials. In this review, we highlight the synthesis methods, regulating strategies, interface engineering, and applications of core-shell magnetic particles over the past half-century. The fundamental methodologies for controllable synthesis of core-shell magnetic materials with diverse organic, inorganic, or hybrid compositions, surface morphology, and interface property are thoroughly elucidated and summarized. In addition, the influences of the synthesis conditions on the physicochemical properties (e.g., dispersibility, stability, stimulus-responsiveness, and surface functionality) are also discussed to provide constructive insight and guidelines for designing core-shell magnetic particles in specific applications. The brand-new concept of "core-shell assembly chemistry" holds great application potential in bioimaging, diagnosis, micro/nanorobots, and smart catalysis. Finally, the remaining challenges, future research directions and new applications for the core-shell magnetic particles are predicted and proposed.

Polydopamine Nanobowl-Armoured Perfluorocarbon Emulsions: Tracking Thermal- and Photothermal-Induced Phase Change through Neutron Scattering

Anisotropic polydopamine nanobowls (PDA NBs) show significant promise in biomedicine, distinguished by their unique optical properties and superior cellular uptake compared to spherical nanoparticles. This study presents a novel approach for creating multistimuli-activated PDA NB-armored emulsions, encapsulating perfluorohexane (NB-H) and perfluoropentane (NB-P) cores, with applications in controlled delivery and ultrasound imaging. Thermal and photothermal activation induced distinct responses in the emulsions, as evidenced by optical microscopy and thermogravimetric analysis. For the first time, neutron scattering techniques (SANS and USANS) under contrast matching conditions are applied to investigate these materials, revealing detailed droplet and microbubble structures and phase transition dynamics. These results show that NB-H droplets resist phase change under direct heating, whereas NB-P droplets respond more readily, exhibiting significant bubble formation. During photothermal activation with short near-infrared (NIR) exposure (15 min at 400 mW cm-2), SANS and USANS analyses reveal varying degrees of phase transition, proving this activation method to be more effective than direct heating. Importantly, NB-H and NB-P droplets have excellent ultrasound contrast enhancement and biocompatibility, indicating their potential for contrast-enhanced ultrasound imaging, theranostics, and photothermal applications. This comprehensive study advances the understanding of multifunctional colloidal materials in biomedicine, contributing essential knowledge to this rapidly evolving field.

Advances and future trends in the detection of beta-amyloid: A comprehensive review

The neurodegenerative condition known as Alzheimer's disease is typified by the build-up of beta-amyloid plaques within the brain. The timely and precise identification of beta-amyloid is essential for understanding disease progression and developing effective therapeutic interventions. This comprehensive review explores the diverse landscape of beta-amyloid detection methods, ranging from traditional immunoassays to cutting-edge technologies. The review critically examines the strengths and limitations of established techniques such as ELISA, PET, and MRI, providing insights into their roles in research and clinical settings. Emerging technologies, including electrochemical methods, nanotechnology, fluorescence techniques, point-of-care devices, and machine learning integration, are thoroughly discussed, emphasizing recent breakthroughs and their potential for revolutionizing beta-amyloid detection. Furthermore, the review delves into the challenges associated with current detection methods, such as sensitivity, specificity, and accessibility. By amalgamating knowledge from multidisciplinary approaches, this review aims to guide researchers, clinicians, and policymakers in navigating the complex landscape of beta-amyloid detection, ultimately contributing to advancements in Alzheimer's disease diagnostics and therapeutics.

Quantitative in Vivo Molecular MRI

Molecular magnetic resonance imaging (MRI) combines chemistry, chemical biology, and imaging techniques to track molecular events non-invasively. Quantitative molecular MRI aims to provide meaningful, reproducible numerical measurements of molecular processes or biochemical targets within the body. In this review, the classifications of molecular MRI probes based on their signal-generating mechanism and functionality are first described. From there, the primary considerations for in vitro characterization and in vivo validation of molecular MRI probes, including how to avoid pitfalls and biases are discussed. Then, recommendations on imaging acquisition protocols and analysis methods to establish quantitative relationships between MRI signal change induced by the probes and the molecular processes of interest are provided. Finally, several representative case studies are highlighted that incorporate these features. Quantitative molecular MRI is a multidisciplinary research area incorporating expertise in chemical biology, inorganic chemistry, molecular probes, imaging physics, drug development, pathobiology, and medicine. The purpose of this review is to provide guidance to chemists developing MR imaging probes and methods in terms of in vitro and in vivo validation to accelerate the translation of these new quantitative tools for non-invasive imaging of biological processes.

Nanoengineered Neutrophil as 19F-MRI Tracer for Alert Diagnosis and Severity Assessment of Acute Lung Injury

Acute lung injury (ALI) is a severe complication in clinical settings. Alert diagnosis and severity assessment of ALI is pivotal to ensure curative treatment and increase survival rates. However, the development of a precise ALI diagnostic strategy remains a pending task. Here, leveraging neutrophil's inflammation-homing and physiological barrier-navigating capability, a facile strategy is proposed for achieving targeted 19F-MRI detection of ALI based on the nanoengineered neutrophil internalized with perfluorocarbon nanoemulsion (Neu@PFC). The remodeling process poses a negligible impact on the neutrophil's inherent activation and transmigration functions. The migratory behavior of Neu@PFC toward pneumonia is confirmed in vivo using an LPS-induced ALI murine model. Direct intratracheal (i.t.) administration contributes to a vast deposition of Neu@PFC within the lung, allowing for real-time 19F-MRI visualization and the potential to predict progressive pneumonia. Furthermore, intravenous (i.v.) administration of Neu@PFC enables quantitative assessment of the extent of ALI due to the chemokine-guided neutrophil migration. This study not only provides a pathway to diagnose ALI, but also sheds light on the neutrophil recruitment and activation cues in different tissues and inflammatory conditions, which is a prerequisite for developing potential therapeutic approaches.

Small, Fluorinated Mn2+ Chelate as an Efficient 1H and 19F MRI Probe

We explore the potential of fluorine-containing small Mn2+ chelates as alternatives to perfluorinated nanoparticles, widely used as 19F MRI probes. In MnL1, the cyclohexanediamine skeleton and two piperidine rings, involving each a metal-coordinating amide group and an appended CF3 moiety, provide high rigidity to the complex. This allows for good control of the Mn-F distance (rMnF=8.2±0.2 Å determined from 19F relaxation data), as well as for high kinetic inertness (a dissociation half-life of 1285 h is estimated for physiological conditions). The paramagnetic Mn2+ leads to a ~150-fold acceleration of the longitudinal 19F relaxation, with moderate line-broadening effect, resulting in T2/T1 ratios of 0.8 (9.4 T). Owing to its inner sphere water molecule, MnL1 is a good 1H relaxation agent as well (r1=5.36 mM-1 s-1 at 298 K, 20 MHz). MnL1 could be readily visualized in 19F MRI by using fast acquisition techniques, both in phantom images and living mice following intramuscular injection, with remarkable signal-to-noise ratios and short acquisition times. While applications in targeted imaging or cell therapy monitoring require further optimisation of the molecular structure, these results argue for the potential of such small, monohydrated and fluorinated Mn2+ complexes for combined 19F and 1H MRI detection.

A polymeric 1H/19F dual-modal MRI contrast agent with a snowman-like Janus nanostructure

Magnetic resonance imaging (MRI) has emerged as a pivotal tool in contemporary medical diagnostics, offering non-invasive and high-resolution visualization of internal structures. Contrast agents are essential for enhancing MRI resolution, accurate lesion detection, and early pathology identification. While gadolinium-based contrast agents are widely used in clinics, safety concerns have prompted exploration of metal-free alternatives, including fluorine and nitroxide radical-based MRI contrast agents. Fluorine-containing compounds exhibit excellent MRI capabilities, with 19F MRI providing enhanced resolution and quantitative assessment. Nitroxide radicals, such as PROXYL and TEMPO, offer paramagnetic properties for MRI contrast. Despite their versatility, nitroxide radicals suffer from lower relaxivity values (r1) compared to gadolinium. Dual-modal imaging, combining 1H and 19F MRI, has gained prominence for its comprehensive insights into biological processes and disease states. However, existing dual-modal agents predominantly utilize gadolinium-organic ligands without incorporating nitroxide radicals. Here, we introduce a novel dual-modal MRI contrast agent (J-CA) featuring a Janus asymmetric nanostructure synthesized via seeded emulsion polymerization and post-modification. J-CA demonstrates excellent in vitro and in vivo performance in both 19F and 1H MRI, with a T2 relaxation time of 5 ms and an r1 value of 0.31 mM-1 s-1, ensuring dual-modal imaging capability. Moreover, J-CA exhibits superior biocompatibility and organ targeting, making it a promising candidate for precise lesion imaging and disease diagnosis. This work introduces a new avenue for metal-free dual-modal MRI, addressing safety concerns associated with traditional contrast agents.

Fluorinated 1,7-DO2A-Based Iron(II) Complexes as Sensitive 19F MRI Molecular Probes for Visualizing Renal Dysfunction in Living Mice

Kidney diseases have become an important global health concern due to their high incidence, inefficient diagnosis, and poor prognosis. Devising direct methods, especially imaging means, to assess renal function is the key for better understanding the mechanisms of various kidney diseases and subsequent development of effective treatment. Herein, we developed a fluorinated ferrous chelate-based sensitive probe, 1,7-DO2A-Fe(II)-F18 (Probe 1), for 19F magnetic resonance imaging (MRI). This highly fluorinated probe (containing 18 chemically equivalent 19F atoms with a fluorine content at 35 wt %) achieves a 15-time enhancement in signal intensity compared with the fluorine-containing ligand alone due to the appropriately regulated 19F relaxation times by the ferrous ion, which significantly increases imaging sensitivity and reduces acquisition time. Owing to its high aqueous solubility, biostability, and biocompatibility, this probe could be rapidly cleared by kidneys, which provides a means for monitoring renal dysfunction via 19F MRI. With this probe, we accomplish in vivo imaging of the impaired renal dysfunction caused by various kidney diseases including acute kidney injury, unilateral ureteral obstruction, and renal fibrosis at different stages. Our study illustrates the promising potential of Probe 1 for in vivo real-time visualization of kidney dysfunction, which is beneficial for the study, diagnosis, and even stratification of different kidney diseases. Furthermore, the design strategy of our probe is inspiring for the development of more high-performance 19F MRI probes for monitoring various biological processes.

Dissecting and Visualizing the Functional Diversity of Cardiac Macrophages

Cardiac macrophages represent a functionally diverse population of cells involved in cardiac homeostasis, repair, and remodeling. With recent advancements in single-cell technologies, it is possible to elucidate specific macrophage subsets based on transcriptional signatures and cell surface protein expression to gain a deep understanding of macrophage diversity in the heart. The use of fate-mapping technologies and parabiosis studies have provided insight into the ontogeny and dynamics of macrophages identifying subsets derived from embryonic and adult definitive hematopoietic progenitors that include tissue-resident and bone marrow monocyte-derived macrophages, respectively. Within the heart, these subsets have distinct tissue niches and functional roles in the setting of homeostasis and disease, with cardiac resident macrophages representing a protective cell population while bone marrow monocyte-derived cardiac macrophages have a context-dependent effect, triggering both proinflammatory tissue injury, but also promoting reparative functions. With the increased understanding of the clinical relevance of cardiac macrophage subsets, there has been an increasing need to detect and measure cardiac macrophage compositions in living animals and patients. New molecular tracers compatible with positron emission tomography/computerized tomography and positron emission tomography/ magnetic resonance imaging have enabled investigators to noninvasively and serially visualize cardiac macrophage subsets within the heart to define associations with disease and measure treatment responses. Today, advancements within this thriving field are poised to fuel an era of clinical translation.

Platelet-targeted thromboprophylaxis with a human serum albumin fusion drug: Preventing thrombosis and reducing cardiac ischemia/reperfusion injurywithout bleeding complications

Background: Myocardial infarction (MI) as a consequence of atherosclerosis-associated acute thrombosis is a leading cause of death and disability globally. Antiplatelet and anticoagulant drugs are standard therapies in preventing and treating MI. However, all clinically used drugs are associated with bleeding complications, which ultimately limits their use in patients with a high risk of bleeding. We have developed a new recombinant drug, targ-HSA-TAP, that combines targeting and specific inhibition of activated platelets as well as anticoagulation. This drug is designed and tested for a prolonged circulating half-life, enabling unique thromboprophylaxis without bleeding complications. Methods: Targ-HSA-TAP combines a single-chain antibody (scFv) that targets activated glycoprotein IIb/IIIa on activated platelets, human serum albumin (HSA) for prolonged circulation, and tick anticoagulant peptide (TAP) for coagulation FX inhibition. A non-binding scFv is employed as a non-targeting control (non-targ-HSA-TAP). Its efficacy was investigated in vivo using murine models of acute thrombosis and cardiac ischemia-reperfusion (I/R) injury. Results: Our experiments confirmed the targeting specificity of targ-HSA-TAP to activated platelets and demonstrated effective prevention of platelet aggregation and thrombus formation, as well as FXa inhibition in vitro. Thromboprophylactic administration of targ-HSA-TAP subcutaneously in mice prevented occlusion of the carotid artery after ferric chloride injury as compared to non-targ-HSA-TAP and PBS-control treated mice. By comparing the therapeutic outcomes between targ-TAP and targ-HSA-TAP, we demonstrate the significant improvements brought by the HSA fusion in extending the drug's half-life and enhancing its therapeutic window for up to 16 h post-administration. Importantly, tail bleeding time was not prolonged with targ-HSA-TAP in contrast to the clinically used anticoagulant enoxaparin. Furthermore, in a murine model of cardiac I/R injury, mice administered targ-HSA-TAP 10 h before injury demonstrated preserved cardiac function, with significantly higher ejection fraction and fractional shortening, as compared to the non-targ-HSA-TAP and PBS control groups. Advanced strain analysis revealed reduced myocardial deformation and histology confirmed a reduced infarct size in targ-HSA-TAP treated mice compared to control groups. Conclusion: The inclusion of HSA represents a significant advancement in the design of targeted therapeutic agents for thromboprophylaxis. Our activated platelet-targeted targ-HSA-TAP is a highly effective antithrombotic drug with both anticoagulant and antiplatelet effects while retaining normal hemostasis. The long half-life of targ-HSA-TAP provides the unique opportunity to use this antithrombotic drug for more effective, long-lasting and safer anti-thrombotic prophylaxis. In cases where MI occurs, this prophylactic strategy reduces thrombus burden and effectively reduces cardiac I/R injury.

In-vivo tracking of deuterium metabolism in mouse organs using LC-MS/MS

Mass spectrometry-based metabolomics with stable isotope labeling (SIL) is an established tool for sensitive and precise analyses of tissue metabolism, its flux, and pathway activities in diverse models of physiology and disease. Despite the simplicity and broad applicability of deuterium (2H)-labeled precursors for tracing metabolic pathways with minimal biological perturbations, they are rarely employed in LC-MS/MS-guided metabolomics. In this study, we have developed a LC-MS/MS-guided workflow to trace deuterium metabolism in mouse organs following 2H7 -glucose infusion. The workflow includes isotopically labeled glucose infusion, mouse organ isolation and metabolite extraction, zwitterion-based hydrophilic interaction liquid chromatography (HILIC) coupled to high-resolution tandem mass spectrometry, targeted data acquisition for sensitive detection of deuterated metabolites, a spectral library of over 400 metabolite standards, and multivariate data analysis with pathway mapping. The optimized method was validated for matrix effects, normalization, and quantification to provide both tissue metabolomics and tracking the in-vivo metabolic fate of deuterated glucose through key metabolic pathways. We quantified more than 100 metabolites in five major mouse organ tissues (liver, kidney, brain, brown adipose tissue, and heart). Furthermore, we mapped isotopologues of deuterated metabolites from glycolysis, tricarboxylic acid (TCA) cycle, and amino acid pathways, which are significant for studying both health and various diseases. This study will open new avenues in LC-MS based analysis of 2H-labeled tissue metabolism research in animal models and clinical settings.

Quantitative assessment of angioplasty-induced vascular inflammation with 19F cardiovascular magnetic resonance imaging

BACKGROUND

Macrophages play a pivotal role in vascular inflammation and predict cardiovascular complications. Fluorine-19 magnetic resonance imaging (19F MRI) with intravenously applied perfluorocarbon allows a background-free direct quantification of macrophage abundance in experimental vascular disease models in mice. Recently, perfluorooctyl bromide-nanoemulsion (PFOB-NE) was applied to effectively image macrophage infiltration in a pig model of myocardial infarction using clinical MRI scanners. In the present proof-of-concept approach, we aimed to non-invasively image monocyte/macrophage infiltration in response to carotid artery angioplasty in pigs using 19F MRI to assess early inflammatory response to mechanical injury.

METHODS

In eight minipigs, two different types of vascular injury were conducted: a mild injury employing balloon oversize angioplasty only (BA, n = 4) and a severe injury provoked by BA in combination with endothelial denudation (BA + ECDN, n = 4). PFOB-NE was administered intravenously three days after injury followed by 1H and 19F MRI to assess vascular inflammatory burden at day six. Vascular response to mechanical injury was validated using X-ray angiography, intravascular ultrasound and immunohistology in at least 10 segments per carotid artery.

RESULTS

Angioplasty was successfully induced in all eight pigs. Response to injury was characterized by positive remodeling with predominantly adventitial wall thickening and concomitant infiltration of monocytes/macrophages. No severe adverse reactions were observed following PFOB-NE administration. In vivo 19F signals were only detected in the four pigs following BA + ECDN with a robust signal-to-noise ratio (SNR) of 14.7 ± 4.8. Ex vivo analysis revealed a linear correlation of 19F SNR to local monocyte/macrophage cell density. Minimum detection limit of infiltrated monocytes/macrophages was estimated at approximately 410 cells/mm2.

CONCLUSIONS

In this proof-of-concept study, 19F MRI enabled quantification of monocyte/macrophage infiltration after vascular injury with sufficient sensitivity. This may provide the opportunity to non-invasively monitor vascular inflammation with MRI in patients after angioplasty or even in atherosclerotic plaques.

How to 19F MRI: applications, technique, and getting started

Magnetic resonance imaging (MRI) plays a significant role in the routine imaging workflow, providing both anatomical and functional information. 19F MRI is an evolving imaging modality where instead of 1H, 19F nuclei are excited. As the signal from endogenous 19F in the body is negligible, exogenous 19F signals obtained by 19F radiofrequency coils are exceptionally specific. Highly fluorinated agents targeting particular biological processes (i.e., the presence of immune cells) have been visualised using 19F MRI, highlighting its potential for non-invasive and longitudinal molecular imaging. This article aims to provide both a broad overview of the various applications of 19F MRI, with cancer imaging as a focus, as well as a practical guide to 19F imaging. We will discuss the essential elements of a 19F system and address common pitfalls during acquisition. Last but not least, we will highlight future perspectives that will enhance the role of this modality. While not an exhaustive exploration of all 19F literature, we endeavour to encapsulate the broad themes of the field and introduce the world of 19F molecular imaging to newcomers. 19F MRI bridges several domains, imaging, physics, chemistry, and biology, necessitating multidisciplinary teams to be able to harness this technology effectively. As further technical developments allow for greater sensitivity, we envision that 19F MRI can help unlock insight into biological processes non-invasively and longitudinally.

Cardiovascular Molecular Imaging With Fluorine-19 MRI: The Road to the Clinic

Fluorine-19 (19F) magnetic resonance imaging is a unique quantitative molecular imaging modality that makes use of an injectable fluorine-containing tracer that generates the only visible 19F signal in the body. This hot spot imaging technique has recently been used to characterize a wide array of cardiovascular diseases and seen a broad range of technical improvements. Concurrently, its potential to be translated to the clinical setting is being explored. This review provides an overview of this emerging field and demonstrates its diagnostic potential, which shows promise for clinical translation. We will describe 19F magnetic resonance imaging hardware, pulse sequences, and tracers, followed by an overview of cardiovascular applications. Finally, the challenges on the road to clinical translation are discussed.

Real-time 31P NMR reveals different gradient strengths in polyphosphoester copolymers as potential MRI-traceable nanomaterials

Polyphosphoesters (PPEs) are used in tissue engineering and drug delivery, as polyelectrolytes, and flame-retardants. Mostly polyphosphates have been investigated but copolymers involving different PPE subclasses have been rarely explored and the reactivity ratios of different cyclic phospholanes have not been reported. We synthesized binary and ternary PPE copolymers using cyclic comonomers, including side-chain phosphonates, phosphates, thiophosphate, and in-chain phosphonates, through organocatalyzed ring-opening copolymerization. Reactivity ratios were determined for all cases, including ternary PPE copolymers, using different nonterminal models. By combining different comonomers and organocatalysts, we created gradient copolymers with adjustable amphiphilicity and microstructure. Reactivity ratios ranging from 0.02 to 44 were observed for different comonomer sets. Statistical ring-opening copolymerization enabled the synthesis of amphiphilic gradient copolymers in a one-pot procedure, exhibiting tunable interfacial and magnetic resonance imaging (MRI) properties. These copolymers self-assembled in aqueous solutions, 31 P MRI imaging confirmed their potential as MRI-traceable nanostructures. This systematic study expands the possibilities of PPE-copolymers for drug delivery and theranostics.

Recent Research Progress of 19 F Magnetic Resonance Imaging Probes: Principle, Design, and Their Application

Visualization of biomolecules, cells, and tissues, as well as metabolic processes in vivo is significant for studying the associated biological activities. Fluorine magnetic resonance imaging (19 F MRI) holds potential among various imaging technologies thanks to its negligible background signal and deep tissue penetration in vivo. To achieve detection on the targets with high resolution and accuracy, requirements of high-performance 19 F MRI probes are demanding. An ideal 19 F MRI probe is thought to have, first, fluorine tags with magnetically equivalent 19 F nuclei, second, high fluorine content, third, adequate fluorine nuclei mobility, as well as excellent water solubility or dispersity, but not limited to. This review summarizes the research progresses of 19 F MRI probes and mainly discusses the impacts of structures on in vitro and in vivo imaging performances. Additionally, the applications of 19 F MRI probes in ions sensing, molecular structures analysis, cells tracking, and in vivo diagnosis of disease lesions are also covered in this article. From authors' perspectives, this review is able to provide inspirations for relevant researchers on designing and synthesizing advanced 19 F MRI probes.

Biodegradable polyphosphoester micelles act as both background-free 31P magnetic resonance imaging agents and drug nanocarriers

In vivo monitoring of polymers is crucial for drug delivery and tissue regeneration. Magnetic resonance imaging (MRI) is a whole-body imaging technique, and heteronuclear MRI allows quantitative imaging. However, MRI agents can result in environmental pollution and organ accumulation. To address this, we introduce biocompatible and biodegradable polyphosphoesters, as MRI-traceable polymers using the ³¹P centers in the polymer backbone. We overcome challenges in ³¹P MRI, including background interference and low sensitivity, by modifying the molecular environment of ³¹P, assembling polymers into colloids, and tailoring the polymers' microstructure to adjust MRI-relaxation times. Specifically, gradient-type polyphosphonate-copolymers demonstrate improved MRI-relaxation times compared to homo- and block copolymers, making them suitable for imaging. We validate background-free imaging and biodegradation in vivo using Manduca sexta. Furthermore, encapsulating the potent drug PROTAC allows using these amphiphilic copolymers to simultaneously deliver drugs, enabling theranostics. This first report paves the way for polyphosphoesters as background-free MRI-traceable polymers for theranostic applications.

Multicolor 19F magnetic resonance imaging: A promising medical technique for in vivo visualization of multiple biological targets

Driven by the needs of precision medicine, current imaging techniques are under continuous development to offer more accurate and comprehensive information beyond traditional macroscopic anatomical images. Multispectral color-coded (multicolor) 19F magnetic resonance imaging (MRI) is receiving increasing attention owing to its capability for visualizing quantitative and multiplexed molecular information during various biological processes. The chemical design and preparation of 19F probes lie at the core of multicolor 19F MRI since their performance dominates the accomplishment of this technique. Herein, the working principles of multicolor 19F MRI are briefly introduced. Recent progress on multicolor 19F MRI probes for simultaneous in vivo visualization of multiple biological targets is summarized. Finally, current challenges and potential solutions in this fast-developing field are discussed.

Outersphere Approach to Increasing the Persistance of Oxygen-Sensitive Europium(II)-Containing Contrast Agents for Magnetic Resonance Imaging with Perfluorocarbon Nanoemulsions toward Imaging of Hypoxia

Radiographic mapping of hypoxia is needed to study a wide range of diseases. Complexes of Eu(II) are a promising class of molecules to fit this need, but they are generally limited by their rapid oxidation rates in vivo. Here, a perfluorocarbon-nanoemulsion perfused with N2 , forms an interface with aqueous layers to hinder oxidation of a new perfluorocarbon-soluble complex of Eu(II). Conversion of the perfluorocarbon solution of Eu(II) into nanoemulsions results in observable differences between reduced and oxidized forms by magnetic resonance imaging both in vitro and in vivo. Oxidation in vivo occurrs over a period of ≈30 min compared to <5 min for a comparable Eu(II)-containing complex without nanoparticle interfaces. These results represent a critical step toward delivery of Eu(II)-containing complexes in vivo for the study of hypoxia.

Water-Soluble Chemically Precise Fluorinated Molecular Clusters for Interference-Free Multiplex 19F MRI in Living Mice

Fluorine-19 magnetic resonance imaging (¹⁹F MRI) is gaining widespread interest from the fields of biomolecule detection, cell tracking, and diagnosis, benefiting from its negligible background, deep tissue penetration, and multispectral capacity. However, a wide range of ¹⁹F MRI probes are in great demand for the development of multispectral ¹⁹F MRI due to the limited number of high-performance ¹⁹F MRI probes. Herein, we report a type of water-soluble molecular ¹⁹F MRI nanoprobe by conjugating fluorine-containing moieties with a polyhedral oligomeric silsesquioxane (POSS) cluster for multispectral color-coded ¹⁹F MRI. These chemically precise fluorinated molecular clusters are of excellent aqueous solubility with relatively high ¹⁹F contents and of single ¹⁹F resonance frequency with suitable longitudinal and transverse relaxation times for high-performance ¹⁹F MRI. We construct three POSS-based molecular nanoprobes with distinct ¹⁹F chemical shifts at -71.91, -123.23, and -60.18 ppm and achieve interference-free multispectral color-coded ¹⁹F MRI of labeled cells in vitro and in vivo. Moreover, in vivo ¹⁹F MRI reveals that these molecular nanoprobes could selectively accumulate in tumors and undergo rapid renal clearance afterward, illustrating their favorable in vivo behavior for biomedical applications. This study provides an efficient strategy to expand the ¹⁹F probe libraries for multispectral ¹⁹F MRI in biomedical research.

Non-invasive mapping of systemic neutrophil dynamics upon cardiovascular injury

Neutrophils play a complex role during onset of tissue injury and subsequent resolution and healing. To assess neutrophil dynamics upon cardiovascular injury, here we develop a non-invasive, background-free approach for specific mapping of neutrophil dynamics by whole-body magnetic resonance imaging using targeted multimodal fluorine-loaded nanotracers engineered with binding peptides specifically directed against murine or human neutrophils. Intravenous tracer application before injury allowed non-invasive three-dimensional visualization of neutrophils within their different hematopoietic niches over the entire body and subsequent monitoring of their egress into affected tissues. Stimulated murine and human neutrophils exhibited enhanced labeling due to upregulation of their target receptors, which could be exploited as an in vivo readout for their activation state in both sterile and nonsterile cardiovascular inflammation. This non-invasive approach will allow us to identify hidden origins of bacterial or sterile inflammation in patients and also to unravel cardiovascular disease states on the verge of severe aggravation due to enhanced neutrophil infiltration or activation.

Multispectral fluorine-19 MRI enables longitudinal and noninvasive monitoring of tumor-associated macrophages

High-grade gliomas, the most common and aggressive primary brain tumors, are characterized by a complex tumor microenvironment (TME). Among the immune cells infiltrating the glioma TME, tumor-associated microglia and macrophages (TAMs) constitute the major compartment. In patients with gliomas, increased TAM abundance is associated with more aggressive disease. Alterations in TAM phenotypes and functions have been reported in preclinical models of multiple cancers during tumor development and after therapeutic interventions, including radiotherapy and molecular targeted therapies. These findings indicate that it is crucial to evaluate TAM abundance and dynamics over time. Current techniques to quantify TAMs in patients rely mainly on histological staining of tumor biopsies. Although informative, these techniques require an invasive procedure to harvest the tissue sample and typically only result in a snapshot of a small region at a single point in time. Fluorine isotope 19 MRI (¹⁹F MRI) represents a powerful means to noninvasively and longitudinally monitor myeloid cells in pathological conditions by intravenously injecting perfluorocarbon-containing nanoparticles (PFC-NP). In this study, we demonstrated the feasibility and power of ¹⁹F MRI in preclinical models of gliomagenesis, breast-to-brain metastasis, and breast cancer and showed that the major cellular source of ¹⁹F signal consists of TAMs. Moreover, multispectral ¹⁹F MRI with two different PFC-NP allowed us to identify spatially and temporally distinct TAM niches in radiotherapy-recurrent murine gliomas. Together, we have imaged TAMs noninvasively and longitudinally with integrated cellular, spatial, and temporal resolution, thus revealing important biological insights into the critical functions of TAMs, including in disease recurrence.

Role of Cardiovascular Magnetic Resonance to Assess Cardiovascular Inflammation

Cardiovascular inflammatory diseases still represent a challenge for physicians. Inflammatory cardiomyopathy, pericarditis, and large vessels vasculitis can clinically mimic a wide spectrum of diseases. While the underlying etiologies are varied, the common physio-pathological process is characterized by vasodilation, exudation, leukocytes infiltration, cell damage, and fibrosis. Cardiovascular magnetic resonance (CMR) allows the visualization of some of these diagnostic targets. CMR provides not only morphological and functional assessment but also tissue catheterization revealing edema, hyperemia, tissue injury, and reparative fibrosis through T2 weighted images, early and late gadolinium enhancement, and parametric mapping techniques. Recent developments showed the role of CMR in the identification of ongoing inflammation also in other CV diseases like myocardial infarction, atherosclerosis, arrhythmogenic and hypertrophic cardiomyopathy. Future developments of CMR, aiming at the specific assessment of immune cell infiltration, will give deeper insight into cardiovascular inflammatory diseases.

Modulation of mTOR Signaling in Cardiovascular Disease to Target Acute and Chronic Inflammation

Inflammation is a key component in the pathogenesis of cardiovascular diseases causing a significant burden of morbidity and mortality worldwide. Recent research shows that mammalian target of rapamycin (mTOR) signaling plays an important role in the general and inflammation-driven mechanisms that underpin cardiovascular disease. mTOR kinase acts prominently in signaling pathways that govern essential cellular activities including growth, proliferation, motility, energy consumption, and survival. Since the development of drugs targeting mTOR, there is proven efficacy in terms of survival benefit in cancer and allograft rejection. This review presents current information and concepts of mTOR activity in myocardial infarction and atherosclerosis, two important instances of cardiovascular illness involving acute and chronic inflammation. In experimental models, inhibition of mTOR signaling reduces myocardial infarct size, enhances functional remodeling, and lowers the overall burden of atheroma. Aside from the well-known effects of mTOR inhibition, which are suppression of growth and general metabolic activity, mTOR also impacts on specific leukocyte subpopulations and inflammatory processes. Inflammatory cell abundance is decreased due to lower migratory capacity, decreased production of chemoattractants and cytokines, and attenuated proliferation. In contrast to the generally suppressed growth signals, anti-inflammatory cell types such as regulatory T cells and reparative macrophages are enriched and activated, promoting resolution of inflammation and tissue regeneration. Nonetheless, given its involvement in the control of major cellular pathways and the maintenance of a functional immune response, modification of this system necessitates a balanced and time-limited approach. Overall, this review will focus on the advancements, prospects, and limits of regulating mTOR signaling in cardiovascular disease.

A Toolbox to Investigate the Impact of Impaired Oxygen Delivery in Experimental Disease Models

Impaired oxygen utilization is the underlying pathophysiological process in different shock states. Clinically most important are septic and hemorrhagic shock, which comprise more than 75% of all clinical cases of shock. Both forms lead to severe dysfunction of the microcirculation and the mitochondria that can cause or further aggravate tissue damage and inflammation. However, the detailed mechanisms of acute and long-term effects of impaired oxygen utilization are still elusive. Importantly, a defective oxygen exploitation can impact multiple organs simultaneously and organ damage can be aggravated due to intense organ cross-talk or the presence of a systemic inflammatory response. Complexity is further increased through a large heterogeneity in the human population, differences in genetics, age and gender, comorbidities or disease history. To gain a deeper understanding of the principles, mechanisms, interconnections and consequences of impaired oxygen delivery and utilization, interdisciplinary preclinical as well as clinical research is required. In this review, we provide a "tool-box" that covers widely used animal disease models for septic and hemorrhagic shock and methods to determine the structure and function of the microcirculation as well as mitochondrial function. Furthermore, we suggest magnetic resonance imaging as a multimodal imaging platform to noninvasively assess the consequences of impaired oxygen delivery on organ function, cell metabolism, alterations in tissue textures or inflammation. Combining structural and functional analyses of oxygen delivery and utilization in animal models with additional data obtained by multiparametric MRI-based techniques can help to unravel mechanisms underlying immediate effects as well as long-term consequences of impaired oxygen delivery on multiple organs and may narrow the gap between experimental preclinical research and the human patient.

Fluorinated Ionic Liquid Based Multicolor 19 F MRI Nanoprobes for In Vivo Sensing of Multiple Biological Targets

Multicolor imaging, which maps the distribution of different targets, is important for in vivo molecular imaging and clinical diagnosis. Fluorine 19 magnetic resonance imaging (¹⁹ F MRI) is a promising technique because of unique insights without endogenous background or tissue penetration limit. Thus multicolor ¹⁹ F MRI probes, which can sense a wide variety of molecular species, are expected to help elucidate the biomolecular networks in complex biological systems. Here, a versatile model of activatable probes based on fluorinated ionic liquids (ILs) for multicolor ¹⁹ F MRI is reported. Three types of ILs at different chemical shifts are loaded in nanocarriers and sealed by three stimuli-sensitive copolymers, leading to "off" ¹⁹ F signals. The coating polymers specifically respond to their environmental stimuli, then degrade to release the loaded ILs, causing ¹⁹ F signals recovery. The nanoprobes are utilized for non-invasive detection of tumor hallmarks, which are distinguished by their individual colors in one living mouse, without interference between each other. This multicolor imaging strategy, which adopts modular construction of various ILs and stimuli-responsive polymers, will allow more comprehensive sensing of multiple biological targets, thus, opening a new realm in mechanistic understanding of complex pathophysiologic processes in vivo.

Nanobiotechnology approaches for cardiovascular diseases: site-specific targeting of drugs and nanoparticles for atherothrombosis

Atherosclerosis and atherothrombosis, the major contributors to cardiovascular diseases (CVDs), represent the leading cause of death worldwide. Current pharmacological therapies have been associated with side effects or are insufficient at halting atherosclerotic progression effectively. Pioneering work harnessing the passive diffusion or endocytosis properties of nanoparticles and advanced biotechnologies in creating recombinant proteins for site-specific delivery have been utilized to overcome these limitations. Since CVDs are complex diseases, the most challenging aspect of developing site-specific therapies is the identification of an individual and unique antigenic epitope that is only expressed in lesions or diseased areas. This review focuses on the pathological mechanism of atherothrombosis and discusses the unique targets that are important during disease progression. We review recent advances in site-specific therapy using novel targeted drug-delivery and nanoparticle-carrier systems. Furthermore, we explore the limitations and future perspectives of site-specific therapy for CVDs.

Regional analysis of inflammation and contractile function in reperfused acute myocardial infarction by in vivo 19F cardiovascular magnetic resonance in pigs

Inflammatory cell infiltration is central to healing after acute myocardial infarction (AMI). The relation of regional inflammation to edema, infarct size (IS), microvascular obstruction (MVO), intramyocardial hemorrhage (IMH), and regional and global LV function is not clear. Here we noninvasively characterized regional inflammation and contractile function in reperfused AMI in pigs using fluorine (¹⁹F) cardiovascular magnetic resonance (CMR). Adult anesthetized pigs underwent left anterior descending coronary artery instrumentation with either 90 min occlusion (n = 17) or without occlusion (sham, n = 5). After 3 days, in surviving animals a perfluorooctyl bromide nanoemulsion was infused intravenously to label monocytes/macrophages. At day 6, in vivo ¹H-CMR was performed with cine, T2 and T2* weighted imaging, T2 and T1 mapping, perfusion and late gadolinium enhancement followed by ¹⁹F-CMR. Pigs were sacrificed for subsequent ex vivo scans and histology. Edema extent was 35 ± 8% and IS was 22 ± 6% of LV mass. Six of ten surviving AMI animals displayed both MVO and IMH (3.3 ± 1.6% and 1.9 ± 0.8% of LV mass). The ¹⁹F signal, reflecting the presence and density of monocytes/macrophages, was consistently smaller than edema volume or IS and not apparent in remote areas. The ¹⁹F signal-to-noise ratio (SNR) > 8 in the infarct border zone was associated with impaired remote systolic wall thickening. A whole heart value of ¹⁹F integral (¹⁹F SNR × milliliter) > 200 was related to initial LV remodeling independently of edema, IS, MVO, and IMH. Thus, ¹⁹F-CMR quantitatively characterizes regional inflammation after AMI and its relation to edema, IS, MVO, IMH and regional and global LV function and remodeling.