99mTc-labeled Small Molecules for Diagnosis of Alzheimer’s Disease: Past, Recent and Future Perspectives

Medicinal (Radio) Chemistry: Building Radiopharmaceuticals for the Future

Radiopharmaceuticals are increasingly playing a leading role in diagnosing, monitoring, and treating disease. In comparison with conventional pharmaceuticals, the development of radiopharmaceuticals does follow the principles of medicinal chemistry in the context of imaging-altered physiological processes. The design of a novel radiopharmaceutical has several steps similar to conventional drug discovery and some particularity. In the present work, we revisited the insights of medicinal chemistry in the current radiopharmaceutical development giving examples in oncology, neurology, and cardiology. In this regard, we overviewed the literature on radiopharmaceutical development to study overexpressed targets such as prostate-specific membrane antigen and fibroblast activation protein in cancer; β-amyloid plaques and tau protein in brain disorders; and angiotensin II type 1 receptor in cardiac disease. The work addresses concepts in the field of radiopharmacy with a special focus on the potential use of radiopharmaceuticals for nuclear imaging and theranostics.

Two-Photon Fluorescent Probes for Amyloid-β Plaques Imaging In Vivo

Amyloid-β (Aβ) peptide deposition, hyperphosphorylated tau proteins, reactive astrocytes, high levels of metal ions, and upregulated monoamine oxidases are considered to be the primary pathological markers of Alzheimer's disease (AD). Among them, Aβ peptide deposition or Aβ plaques, is regarded as the initial factor in the pathogenesis of AD and a critical pathological hallmark in AD. This review highlights recently Aβ-specific fluorescent probes for two-photon imaging of Aβ plaques in vivo. It includes the synthesis and detection mechanism of probes, as well as their application to two-photon imaging of Aβ plaques in vivo.

Historical efforts to develop 99mTc-based amyloid plaque targeting radiotracers

Imaging biomarkers have changed the way we study Alzheimer's disease and related dementias, develop new therapeutics to treat the disease, and stratify patient populations in clinical trials. With respect to protein aggregates comprised of amyloid-β plaques and tau neurofibrillary tangles, Positron Emission Tomography (PET) has become the gold standard imaging modality for quantitative visualization. Due to high infrastructural costs, the availability of PET remains limited to large urban areas within high income nations. This limits access to leading edge medical imaging, and potentially access to new treatments, by millions of rural and remote residents in those regions as well as billions of people in middle- and low-income countries. Single Photon Emission Computed Tomography (SPECT) is a more widely available imaging alternative with lower infrastructural costs and decades of familiarity amongst nuclear medicine professionals. Recent technological advances have closed the gap in spatial resolution and quantitation between SPECT and PET. If effective SPECT radiotracers were available to visualize amyloid-β plaques, geographic barriers to imaging could be circumvented. In this review, we will discuss past efforts to develop SPECT radiotracers targeting amyloid-β plaques which incorporate the most used radionuclide in nuclear medicine: technetium-99m (99mTc; t 1/2 = 6.01 h; γ = 140 keV). While reviewing the various chemical scaffolds and chelates employed, the focus will be upon the impact to the pharmacological properties of putative 99mTc-based amyloid-targeting radiotracers.

Advances in fluorescent probes for detection and imaging of amyloid-β peptides in Alzheimer's disease

Amyloid plaques generated from the accumulation of amyloid-β peptides (Aβ) fibrils in the brain is one of the main hallmarks of Alzheimer's disease (AD), a most common neurodegenerative disorder. Aβ aggregation can produce neurotoxic oligomers and fibrils, which has been widely accepted as the causative factor in AD pathogenesis. Accordingly, both soluble oligomers and insoluble fibrils have been considered as diagnostic biomarkers for AD. Among the existing analytical methods, fluorometry using fluorescent probes has exhibited promising potential in quantitative detection and imaging of both soluble and insoluble Aβ species, providing a valuable approach for the diagnosis and drug development of AD. In this review, the most recent advances in the fluorescent probes for soluble or insoluble Aβ aggregates are discussed in terms of design strategy, probing mechanism, and potential applications. In the end, future research directions of fluorescent probes for Aβ species are also proposed.