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Schriftenreihe
Sonstige beteiligte Institutionen
- DFG Forschungsgruppe 2757 / Lokale Selbstregelungen im Kontext schwacher Staatlichkeit in Antike und Moderne (LoSAM) (2)
- Klinikum Fulda (2)
- Ökologische Station Fabrikschleichach (2)
- Airbus Defence and Space GmbH (1)
- Akademie der Wissenschaften und der Literatur, Mainz (1)
- Apotheke, Universitätsklinikum Würzburg (1)
- Biomedical Center Munich, Department of Physiological Chemistry, Ludwig-Maximilians-Universität München (1)
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany (1)
- Clinical Trial Center (CTC) / Zentrale für Klinische Studien Würzburg (ZKSW) (1)
- Cologne Game Lab (1)
Ein wesentliches Ziel dieser Arbeit war die Durchführung von regioselektiven Deborierungsreaktionen von 1,7-Dicarba-closo-dodecaboranen sowie die Herstellung von polyfunktionalisierten meta-Carboran-Derivaten. Die synthetisierten {nido-7,9-C2B9}- und {closo-1,7-C2B10}-Derivate und ausgewählte ortho-Carboran-Derivate wurden nach erfolgter Kumada-artiger Kreuzkupplungsreaktion bzgl. ihrer Koordinationschemie untersucht. Die ethinylfunktionalisierten Borcluster wurden als Edukte für die Herstellung von Gold(I)-Komplexen genutzt. Weitere Ziele dieser Arbeit waren außerdem die Synthese und umfassende Charakterisierung des gemischten Fluorohydridoborat-Anions [BHF3]− und der carboranylsubstituierten Borat-Anionen [1-HF2B-closo-1,2-C2B10H11]− und [1-HF2B-9,12-I2-closo-1,2-C2B10H9]− sowie die Untersuchung hinsichtlich ihrer Folgechemie.
Purpose
A neuropathological hallmark of Alzheimer's disease (AD) is the presence of amyloid-β (Aβ) plaques in the brain, which are observed in a significant number of cognitively normal, older adults as well. In AD, butyrylcholinesterase (BChE) becomes associated with A\(_{β}\) aggregates, making it a promising target for imaging probes to support diagnosis of AD. In this study, we present the synthesis, radiochemistry, in vitro and preliminary ex and in vivo investigations of a selective, reversible BChE inhibitor as PET-tracer for evaluation as an AD diagnostic.
Procedures
Radiolabeling of the inhibitor was achieved by fluorination of a respective tosylated precursor using K[\(^{18}\)F]. IC\(_{50}\) values of the fluorinated compound were obtained in a colorimetric assay using recombinant, human (h) BChE. Dissociation constants were determined by measuring hBChE activity in the presence of different concentrations of inhibitor.
Results
Radiofluorination of the tosylate precursor gave the desired radiotracer in an average radiochemical yield of 20 ± 3 %. Identity and > 95.5 % radiochemical purity were confirmed by HPLC and TLC autoradiography. The inhibitory potency determined in Ellman's assay gave an IC\(_{50}\) value of 118.3 ± 19.6 nM. Dissociation constants measured in kinetic experiments revealed lower affinity of the inhibitor for binding to the acylated enzyme (K2 = 68.0 nM) in comparison to the free enzyme (K\(_{1}\) = 32.9 nM).
Conclusions
The reversibly acting, selective radiotracer is synthetically easily accessible and retains promising activity and binding potential on hBChE. Radiosynthesis with \(^{18}\)F labeling of tosylates was feasible in a reasonable time frame and good radiochemical yield.
The enzyme butyrylcholinesterase (BChE) represents a promising target for imaging probes to potentially enable early diagnosis of neurodegenerative diseases like Alzheimer's disease (AD) and to monitor disease progression in some forms of cancer. In this study, we present the design, facile synthesis, in vitro and preliminary ex vivo and in vivo evaluation of a morpholine‐based, selective inhibitor of human BChE as a positron emission tomography (PET) tracer with a pseudo‐irreversible binding mode. We demonstrate a novel protecting group strategy for 18F radiolabeling of carbamate precursors and show that the inhibitory potency as well as kinetic properties of our unlabeled reference compound were retained in comparison to the parent compound. In particular, the prolonged duration of enzyme inhibition of such a morpholinocarbamate motivated us to design a PET tracer, possibly enabling a precise mapping of BChE distribution.
Bis(1-(4-tolyl)-carboran-2-yl)-(4-tolyl)-borane [(1-(4-MeC\(_{6}\)H\(_{4}\))-closo-1,2-C\(_{2}\)B\(_{10}\)H\(_{10}\)-2-)\(_{2}\)(4-MeC\(_{6}\)H\(_{4}\))B] (1), a new bis(o-carboranyl)-(R)-borane was synthesised by lithiation of the o-carboranyl precursor and subsequent salt metathesis reaction with (4-tolyl)BBr\(_{2}\). Cyclic voltammetry experiments on 1 show multiple distinct reduction events with a one-electron first reduction. In a selective reduction experiment the corresponding paramagnetic radical anion 1\(^{.−}\) was isolated and characterized. Single-crystal structure analyses allow an in-depth comparison of 1, 1\(^{.−}\), their calculated geometries, and the S\(_{1}\) excited state of 1. Photophysical studies of 1 show a charge transfer (CT) emission with low quantum yield in solution but a strong increase in the solid state. TD-DFT calculations were used to identify transition-relevant orbitals.
An N-heterocyclic-carbene-stabilized diboryne undergoes rapid, high-yielding and catalyst-free hydroamina- tion reactions with primary amines, yielding 1-amino-2-hydro- diborenes, which can be considered boron analogues of enamines. The electronics of the organic substituent at nitrogen influence the structure and further reactivity of the diborene product. With electron-rich anilines, a second hydroamination can occur at the diborene to generate 1,1-diamino-2,2-dihy- drodiboranes. With isopropylamine, the electronic influence of the alkyl substituent upon the diborene leads to an unprece- dented boron-mediated intramolecular N-dearylation reaction of an N-heterocyclic carbene unit.
A novel and convenient methodology for the one-pot synthesis of sterically congested triarylboranes by using bench-stable aryltrifluoroborates as the boron source is reported. This procedure gives systematic access to symmetrically and unsymmetrically substituted triarylboranes of the types BAr\(_{2}\)Ar’ and BArAr'Ar’’, respectively. Three unsymmetrically substituted triarylboranes as well as their iridium-catalyzed C−H borylation products are reported. These borylated triarylboranes contain one to three positions that can subsequently be orthogonally functionalized in follow-up reactions, such as Suzuki-Miyaura cross-couplings or Sonogashira couplings.
The first Borono-Strecker reaction has been developed to synthesize α-aminoboronates via a multicomponent reaction of readily available carbonyl compounds (aldehydes and ketones), amines and B2pin2. The preparation of α-amino cyclic boronates can be achieved via multicomponent coupling of salicylaldehydes, amines, and B2(OH)4. In addition, the diazaborole-based PBP pincer palladium chloride and the diazaborole-based PBP pincer palladium trifluoromethanesulfonate complexes were synthesized and fully characterized for the first time, and used as catalysts for Suzuki-Miyaura cross-coupling reactions.
In the course of this work, a total of three photocatalytically active dyads for proton reduction could be synthesized together with the associated individual components. Two of them, D1 and D2, comprised a [Ru(bpy)3]2+ photosensitizer and D3 an [Ir(ppy)2bpy]+ photosensitizer. A Ppyr3-substituted propyldithiolate [FeFe] complex was used as catalyst in all systems. The absorption spectroscopic and electrochemical investigations showed that an inner-dyadic electronic coupling is effectively prevented in the dyads due to conjugation blockers within the bridging units used. The photocatalytic investigations exhibited that all dyad containing two-component systems (2CS) showed a significantly worse performance than the corresponding bimolecular three-component systems (3CS). Transient absorption spectroscopy showed that the 2CS behave very similarly to the associated multicomponent systems during photocatalysis. The electron that was intended for the intramolecular transfer from the photosensitizer unit to the catalyst unit within the dyads remains at the photosensitizer for a relatively long time, analogous to the 3CS and despite the covalently bound catalyst. It is therefore assumed that this intramolecular electron transfer is likely to be hindered as a result of the weak electronic coupling caused by the bridge units used. Instead, the system bypasses this through an intermolecular transfer to other dyad molecules in the immediate vicinity. In addition, with the help of emission quenching experiments and electrochemical investigations, it could be clearly concluded that all investigated systems proceed via the reductive quenching mechanism during photocatalysis.
In recent years, research in the fields of optoelectronics, anion sensors and bioimaging agents have been greatly influenced by novel compounds containing triarylborane motifs. Such compounds possess an empty p‐orbital at boron which results in useful optical and electronic properties. Such a diversity of applications was not expected when the first triarylborane was reported in 1885. Synthetic approaches to triarylboranes underwent various changes over the following century, some of which are still used in the present day, such as the generally applicable routes developed by Krause et al. in 1922, or by Grisdale et al. in 1972 at Eastman Kodak. Some other developments were not pursued further after their initial reports, such as the synthesis of two triarylboranes bearing three different aromatic groups by Mikhailov et al. in 1958. This review summarizes the development of synthetic approaches to triarylboranes from their first report nearly 135 years ago to the present.
Fresh water is a vital natural resource. Earth observation time-series are well suited to monitor corresponding surface dynamics. The DLR-DFD Global WaterPack (GWP) provides daily information on globally distributed inland surface water based on MODIS (Moderate Resolution Imaging Spectroradiometer) images at 250 m spatial resolution. Operating on this spatiotemporal level comes with the drawback of moderate spatial resolution; only coarse pixel-based surface water quantification is possible. To enhance the quantitative capabilities of this dataset, we systematically access subpixel information on fractional water coverage. For this, a linear mixture model is employed, using classification probability and pure pixel reference information. Classification probability is derived from relative datapoint (pixel) locations in feature space. Pure water and non-water reference pixels are located by combining spatial and temporal information inherent to the time-series. Subsequently, the model is evaluated for different input sets to determine the optimal configuration for global processing and pixel coverage types. The performance of resulting water fraction estimates is evaluated on the pixel level in 32 regions of interest across the globe, by comparison to higher resolution reference data (Sentinel-2, Landsat 8). Results show that water fraction information is able to improve the product's performance regarding mixed water/non-water pixels by an average of 11.6% (RMSE). With a Nash-Sutcliffe efficiency of 0.61, the model shows good overall performance. The approach enables the systematic provision of water fraction estimates on a global and daily scale, using only the reflectance and temporal information contained in the input time-series.
Im Zuge der Erstdiagnostik einer Krankenhausaufnahme bei akuter Herzinsuffizienz ist die Röntgen-Thorax-Untersuchung fester Bestandteil. Ziel dieser Arbeit war es, ihren klinischen Stellenwert und die Aufnahmequalität systematisch zu untersuchen. In der AHF-Registerstudie wurden alle am Universitätsklinikum Würzburg vorstelligen Patienten mit akuter Herzinsuffizienz konsekutiv registriert und umfassend phänotypisiert. Die Röntgen-Thorax-Befunde wurden systematisch informationsextrahiert, auf Konsistenz überprüft, katalogisiert und klassifiziert.
Bisher gibt es nur wenige Forschungsarbeiten, die sich mit der videogestützten Analyse von Basketballverletzungen beschäftigen. In der vorliegenden Arbeit wurden Basketballverletzungen der ersten Basketballbundesliga und der zweiten Basketballbundesliga systematisch per Video analysiert, mit dem Ziel, Verletzungsmuster zu beschreiben und somit gegebenenfalls die Rate von Basketballverletzungen durch geeignete Präventionsansätze zu reduzieren. Hierbei wurden Daten hinsichtlich der Rahmenbedingungen, des Orts der Verletzung, der Spielsituation, der Auslöser und der Umstände der Verletzung an sich zu 215 Verletzungen mit Hilfe eines speziell für die videogestützte Analyse von Basketballverletzungen entwickelten Beobachtungsbogens erhoben.
Es zeigte sich in 38% der erhobenen Fälle das Bewegungsmuster Landung zum Verletzungszeitpunkt, was somit das häufigste zu Verletzungen führende Bewegungsmuster war. Oft waren gerade die die athletische Spielweise des Basketballs charakterisierenden Spielaktionen (z. B. Korbleger bzw. Dunking und Shotblock) Auslöser von Verletzungen. Zudem ereigneten sich die Verletzungen im zweiten Viertel 2,1-fach häufiger und im vierten Viertel 1,9-fach häufiger im Vergleich zu den anderen beiden Vierteln. Ein weiteres wichtiges Resultat war, dass die Verletzungen in der Mehrzahl der Fälle (80%) nicht auf ein Foulspiel zurückzuführen waren.
Insgesamt ergibt sich aus den Erkenntnissen die Empfehlung der Implementierung von neuromuskulären Präventionsprogrammen, welche die besonderen Verletzungsmechanismen des Basketballs miteinbeziehen. Bisherige Präventionsprogramme können aufgrund dieser Datenlage bezüglich der Bewegungsmuster, der Spielposition, des Verletzungszeitpunkts und des Kontaktmechanismus sowie der individuellen Voraussetzungen des jeweiligen Spielers verwendet werden. Die Umsetzung sollte von Trainern/-innen mitgetragen und überprüft werden.
Foulregeländerungen müssen gemäß der vorliegenden Untersuchung – in Hinblick auf die Verletzungsprävention nicht durchgeführt werden. Bezüglich der Resultate hinsichtlich des Verletzungszeitpunkts könnte nach Detektion der genauen Ursachen für eine gehäufte Anzahl an Verletzungen in bestimmten Spielabschnitten durch weitere Studien eine Regeländerung mit Verlängerung der Viertelpausen erwogen werden.
Systemic chemotherapy of pediatric recurrent ependymomas: results from the German HIT-REZ studies
(2021)
Purpose
Survival in recurrent ependymoma (EPN) depends mainly on the extent of resection achieved. When complete resection is not feasible, chemotherapy is often used to extend progression-free and overall survival. However, no consistent effect of chemotherapy on survival has been found in patients with recurrent EPN.
Methods
Systemic chemotherapeutic treatment of 138 patients enrolled in the German HIT-REZ-studies was analyzed. Survival depending on the use of chemotherapy, disease-stabilization rates (RR), duration of response (DOR) and time to progression (TTP) were estimated.
Results
Median age at first recurrence was 7.6 years (IQR: 4.0–13.6). At first recurrence, median PFS and OS were 15.3 (CI 13.3–20.0) and 36.9 months (CI 29.7–53.4), respectively. The Hazard Ratio for the use of chemotherapy in local recurrences in a time-dependent Cox-regression analysis was 0.99 (CI 0.74–1.33). Evaluable responses for 140 applied chemotherapies were analyzed, of which sirolimus showed the best RR (50%) and longest median TTP [11.51 (CI 3.98; 14.0) months] in nine patients, with the strongest impact found when sirolimus was used as a monotherapy. Seven patients with progression-free survival > 12 months after subtotal/no-resection facilitated by chemotherapy were found. No definitive survival advantage for any drug in a specific molecularly defined EPN type was found.
Conclusion
No survival advantage for the general use of chemotherapy in recurrent EPN was found. In cases with incomplete resection, chemotherapy was able to extend survival in individual cases. Sirolimus showed the best RR, DOR and TTP out of all drugs analyzed and may warrant further investigation.
High-resolution nuclear magnetic resonance (NMR) spectroscopy is used in structure elucidation and qualitative as well as quantitative examination of product components. Despite the worldwide development of numerous innovative NMR spectroscopic methods, several official methods that analyze specific substances and do not represent a holistic analysis, are still in use for the quality control of drugs, food and chemicals. Thus, counterfeit or contaminated products of inferior quality can be brought onto the market and distributed despite previous quality controls. To prevent this, three NMR spectroscopic methods have been developed within the scope of this work (1) to study the peroxide value in vegetable and animal oils, (2) for the qualitative and quantitative analysis of metal cations and (3) to determine the enantiomeric excess in chiral alcohols. In oil analysis, titration methods are used to determine the bulk quality parameters such as peroxide value, which represents the concentration of peroxides. Titrations show several drawbacks, such as the need of a large amount of sample and solvents, cross reactions and the low robustness. Thus, an alternative NMR spectroscopic method was developed to improve the peroxide analysis by using triphenylphosphine as a derivatization reagent, which reacts with peroxides in a stoichiometric ratio of 1:1 forming triphenylphosphine oxide. In the 1H-31P decoupled NMR spectrum, the signals of the unreacted triphenylphosphine and the reacted triphenylphosphine oxide are detected at 7.4 ppm and 7.8 ppm, respectively. The ratio of the two signals is used for the calculation of the peroxide concentration. 108 oil samples with a peroxide value between 1 meq/kg and 150 meq/kg were examined using the developed method. Oils with a very low peroxide value of less than 3 meq/kg showed a relative standard deviation of 4.9%, highly oxidized oils with a peroxide value of 150 meq/kg of 0.2%. The NMR method was demonstrated as a powerful technique for the analysis of vegetable and krill oils. Another 1H NMR spectroscopic method was developed for the qualitative determination of Be2+, Sr2+ and Cd2+, and for the qualitative and quantitative determination of Ca2+, Mg2+, Hg2+, Sn2+, Pb2+ and Zn2+ by using ethylenediamine tetraacetate (EDTA) as complexing agent. EDTA is a hexadentate ligand that forms stable chelate complexes with divalent cations. The known amount of added EDTA and the signal ratio of free and complexed EDTA are used to calculate the concentrations of the divalent cations, which makes the use of an internal standard obsolete. The use of EDTA with Be2+, Sr2+, Cd2+, Ca2+, Mg2+, Hg2+, Sn2+, Pb2+ and Zn2+ result in complexes whose signals are pH-independent, showing cation-specific chemical shifts and couplings in the 1H NMR spectrum that are used for identification and quantification. In the presented NMR method, the limit of quantification of the cations Ca2+, Mg2+, Hg2+, Sn2+, Pb2+, and Zn2+ was determined with 5-22 μg/mL. This method is applicable in the food and drug sectors. The third NMR spectroscopic method introduced an alternative determination of the enantiomer excess (ee) of the chiral alcohols menthol, borneol, 1-phenylethanol and linalool using phosgene as a derivatizing reagent. Phosgene reacts with a chiral alcohol to form carboxylic acid diesters, made of two identical (RR, SS) or two different enantiomers (RS, SR). These two different types of diastereomers can be examined by the difference of their chemical shifts. In the presented method, the integration values of the carbonyl signals in the 13C NMR spectrum are used for the determination of the enantiomer excess. The limit of quantification depends, among others, on the sample and on the non-labelled or 13C-labelled phosgene used for the analysis. In the case of menthol, a quantification limit of ee=99.1% was determined using non-labelled phosgene and ee=99.9% using 13C-labelled phosgene. The 13C NMR method was also applied for the quality control of the enantiomeric purity of borneol, 1-phenylethanol and linalool. The developed 13C NMR method represents a powerful alternative to Mosher’s reagent for investigating the enantiomeric excess in chiral alcohols. This work demonstrates the variety of possibilities of applications for the quantitative nuclear magnetic resonance spectroscopy in the chemical analysis of drugs, food and chemicals using tagging reactions such as derivatizations and complexations. The nuclear resonance spectroscopic methods developed in this research work represent powerful alternatives to the previously used quality control techniques.
The development of complexes featuring low-valent, multiply bonded metal centers is an exciting field with several potential applications. In this work, we describe the design principles and extensive computational investigation of new organometallic platforms featuring the elusive manganese-manganese bond stabilized by experimentally realized N-heterocyclic carbenes (NHCs). By using DFT computations benchmarked against multireference calculations, as well as MO- and VB-based bonding analyses, we could disentangle the various electronic and structural effects contributing to the thermodynamic and kinetic stability, as well as the experimental feasibility, of the systems. In particular, we explored the nature of the metal-carbene interaction and the role of the ancillary η\(^{6}\) coordination to the generation of Mn\(_{2}\) systems featuring ultrashort metal-metal bonds, closed-shell singlet multiplicities, and positive adiabatic singlet-triplet gaps. Our analysis identifies two distinct classes of viable synthetic targets, whose electrostructural properties are thoroughly investigated.
Cyanine dyes are exceptionally useful probes for a range of fluorescence-based applications, but their photon output can be limited by trans-to-cis photoisomerization. We recently demonstrated that appending a ring system to the pentamethine cyanine ring system improves the quantum yield and extends the fluorescence lifetime. Here, we report an optimized synthesis of persulfonated variants that enable efficient labeling of nucleic acids and proteins. We demonstrate that a bifunctional sulfonated tertiary amide significantly improves the optical properties of the resulting bioconjugates. These new conformationally restricted cyanines are compared to the parent cyanine derivatives in a range of contexts. These include their use in the plasmonic hotspot of a DNA-nanoantenna, in single-molecule Förster-resonance energy transfer (FRET) applications, far-red fluorescence-lifetime imaging microscopy (FLIM), and single-molecule localization microscopy (SMLM). These efforts define contexts in which eliminating cyanine isomerization provides meaningful benefits to imaging performance.
Introduction: Large-cell transformation (LCT) of mycosis fungoides (MF) has been associated with a higher risk of relapse and progression and, consequently, restricted prognosis. Its molecular pathogenesis has not been elucidated yet. Materials and Methods: In order to address molecular mechanisms of LCT, we performed hybrid capture panel-based sequencing of skin biopsies from 10 patients suffering from MF with LCT versus 17 patients without LCT including follow-up biopsies during clinical course, respectively (51 samples in total). The analyzed patients were attributed to three different groups based on the presence of LCT and clinical behavior. Results: While indolent MF cases without LCT did not show pathogenic driver mutations, a high rate of oncogenic alterations was detected in patients with LCT and aggressive clinical courses. Various genes of different oncogenic signaling pathways, including the MAPK and JAK-STAT signaling pathways, as well as epigenetic modifiers were affected. A high inter-individual and distinctive intra-individual mutation diversity was observed. Oncogenic RAS mutations were exclusively detected in patients with LCT. Conclusion: Our data demonstrate that LCT transition of MF is associated with increased frequency of somatic mutations in cancer-associated genes. In particular, the activation of RAS signaling — together with epigenetic dysregulation — may crucially contribute to the molecular pathogenesis of the LCT phenotype, thus conveying its adverse clinical behavior.
Revealing the molecular organization of anatomically precisely defined brain regions is necessary for refined understanding of synaptic plasticity. Although three-dimensional (3D) single-molecule localization microscopy can provide the required resolution, imaging more than a few micrometers deep into tissue remains challenging. To quantify presynaptic active zones (AZ) of entire, large, conditional detonator hippocampal mossy fiber (MF) boutons with diameters as large as 10 mu m, we developed a method for targeted volumetric direct stochastic optical reconstruction microscopy (dSTORM). An optimized protocol for fast repeated axial scanning and efficient sequential labeling of the AZ scaffold Bassoon and membrane bound GFP with Alexa Fluor 647 enabled 3D-dSTORM imaging of 25 mu m thick mouse brain sections and assignment of AZs to specific neuronal substructures. Quantitative data analysis revealed large differences in Bassoon cluster size and density for distinct hippocampal regions with largest clusters in MF boutons. Pauli et al. develop targeted volumetric dSTORM in order to image large hippocampal mossy fiber boutons (MFBs) in brain slices. They can identify synaptic targets of individual MFBs and measured size and density of Bassoon clusters within individual untruncated MFBs at nanoscopic resolution.
Purpose
While [\(^{18}\)F]-fluorodeoxyglucose ([\(^{18}\)F]FDG) is the standard for positron emission tomography/computed tomography (PET/CT) imaging of oral squamous cell carcinoma (OSCC), diagnostic specificity is hampered by uptake in inflammatory cells such as neutrophils or macrophages. Recently, molecular imaging probes targeting fibroblast activation protein α (FAP), which is overexpressed in a variety of cancer-associated fibroblasts, have become available and might constitute a feasible alternative to FDG PET/CT.
Methods
Ten consecutive, treatment-naïve patients (8 males, 2 females; mean age, 62 ± 9 years) with biopsy-proven OSCC underwent both whole-body [\(^{18}\)F]FDG and [\(^{68}\)Ga]FAPI-04 (FAP-directed) PET/CT for primary staging prior to tumor resection and cervical lymph node dissection. Detection of the primary tumor, as well as the presence and number of lymph node and distant metastases was analysed. Intensity of tracer accumulation was assessed by means of maximum (SUV\(_{max}\)) and peak (SUV\(_{peak}\) standardized uptake values. Histological work-up including immunohistochemical staining for FAP served as standard of reference.
Results
[\(^{18}\)F]FDG and FAP-directed PET/CT detected all primary tumors with a SUVmax of 25.5 ± 13.2 (FDG) and 20.5 ± 6.4 (FAP-directed) and a SUVpeak of 16.1 ± 10.3 ([\(^{18}\)F]FDG) and 13.8 ± 3.9 (FAP-directed), respectively. Regarding cervical lymph node metastases, FAP-directed PET/CT demonstrated comparable sensitivity (81.3% vs. 87.5%; P = 0.32) and specificity (93.3% vs. 81.3%; P = 0.16) to [\(^{18}\)F]FDG PET/CT. FAP expression on the cell surface of cancer-associated fibroblasts in both primary lesions as well as lymph nodes metastases was confirmed in all samples.
Conclusion
FAP-directed PET/CT in OSCC seems feasible. Future research to investigate its potential to improve patient staging is highly warranted.
The liver‐derived, circulating transport protein transthyretin (TTR) is the cause of systemic hereditary (ATTRv) and wild‐type (ATTRwt) amyloidosis. TTR stabilization and knockdown are approved therapies to mitigate the otherwise lethal disease course. To date, the variety in phenotypic penetrance is not fully understood. This systematic review summarizes the current literature on TTR pathophysiology with its therapeutic implications. Tetramer dissociation is the rate‐limiting step of amyloidogenesis. Besides destabilizing TTR mutations, other genetic (RBP4, APCS, AR, ATX2, C1q, C3) and external (extracellular matrix, Schwann cell interaction) factors influence the type of onset and organ tropism. The approved small molecule tafamidis stabilizes the tetramer and significantly decelerates the clinical course. By sequence‐specific mRNA knockdown, the approved small interfering RNA (siRNA) patisiran and antisense oligonucleotide (ASO) inotersen both significantly reduce plasma TTR levels and improve neuropathy and quality of life compared to placebo. With enhanced hepatic targeting capabilities, GalNac‐conjugated siRNA and ASOs have recently entered phase III clinical trials. Bivalent TTR stabilizers occupy both binding groves in vitro, but have not been tested in trials so far. Tolcapone is another stabilizer with the potential to cross the blood–brain barrier, but its half‐life is short and liver failure a potential side effect. Amyloid‐directed antibodies and substances like doxycycline aim at reducing the amyloid load, however, none of the yet developed antibodies has successfully passed clinical trials. ATTR‐amyloidosis has become a model disease for pathophysiology‐based treatment. Further understanding of disease mechanisms will help to overcome the remaining limitations, including application burden, side effects, and blood–brain barrier permeability.