This study tests the radiolabeled molecule ("tracer"), \[¹¹C\]HSP990, using positron emission tomography (PET) imaging to assess whether it can be used to measure levels of Heat Shock Protein 90 (Hsp90). The protein Hsp90 plays an important role in how proteins in the brain fold into their three-dimensional structure and how this protein helps maintain cellular homeostasis. Since neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS) are characterized by disrupted three-dimensional protein folding resulting in protein aggregation, we also aim to measure Hsp90 levels in patients with these conditions. \[¹¹C\]HSP990 is a promising tracer for this purpose and has already been extensively tested in animal models with safe and favorable results. The investigator now aims to evaluate this tracer in the human brain in healthy volunteers as well as in patients with Parkinson's disease, Alzheimer's disease and amyotrophic lateral sclerosis. The investigator expects that Hsp90 protein levels will be present at reduced concentrations in patients, possibly in different brain regions depending on the distribution of the disease-causing proteins associated with these disorders. Since the discovery of the important role of Hsp90 in neurodegenerative diseases, several candidate drugs targeting Hsp90 have been developed in recent years. The imaging method used in this study may support the development of Hsp90-targeting medications by enabling measurement of Hsp90 levels in the brain and assessment of the effects of these drugs.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
48
120 minute whole body PET/CT scan with \[11C\]HSP990 radiotracer
2 120-minute brain PET scan with \[11C\]HSP990 radiotracer
Simplified quantitative \[11C\]HSP990 PET scan as will be determined in part 2.
UZ Leuven
Leuven, Vlaam-Brabant, Belgium
RECRUITINGQuantification of HSP90 in the human brain
To quantify and compare Hsp90 levels in vivo in the human brain of healthy volunteers and patients with neurodegenerative disorders using the novel PET radioligand \[11C\]HSP990.
Time frame: This will be assessed right after each scan in cohort 2 and 3. (Estimated visit lenght in cohort 2 will be 4 hours for each scanning procedure. In cohort 3 this will be optimized based on the results of cohort 2.)
To assess the safety and clinical tolerance of [11C]HSP990 administration.
The impact of \[11C\]HSP990 administration on clinical symptoms and signs and biochemistry values will be evaluated. Baseline values will be recorded and subjects will be assessed clinically and with dual biochemical analysis (before PET and after PET). Adverse events will be scored as mild, moderate or severe. We hypothise that administration of \[11C\]HSP990 is safe and in view of the low mass dose (\< 10 µg) does not result in significant changes in vitals, clinical assessment or biochemistry, or subjective complaints other than those that may be related to the procedure (e.g., catheter placement).
Time frame: From enrollment until 1 week after completion of scan.
To determine the radiation dosimetry of [11C]HSP990 in humans.
Effective doses will be determined. The hypothesis is that in young healthy volunteers administration of \[11C\]HSP990 results in significant brain uptake and is partially hepatobiliary and renally cleared, and results in an effective dose between 3 to 8 microSv/MBq.
Time frame: This will be assessed right after each scan in cohort 1. (Estimated lenght of the scanning visit is 4 hours.)
To determine the optimal brain tracer kinetic modelling approach and test-retest variation (TRV) for [11C]HSP990 brain PET in humans.
Total distribution volume (VT) for \[11C\]HSP990 will be determined using the arterial brain input and response function. The hypothesis is that \[11C\]HSP990 PET allows for quantifying total Hsp90 distribution volume in the human brain with a 2TCM as the preferred quantitative approach. VT for \[11C\]HSP990 re-test scans will be determined and TRV will be calculated. The hypothesis is that the absolute short term test-retest will be acceptable (below 10 %).
Time frame: This will be assessed right after each scan in cohort 2. (Estimated lenght of each scanning visit is 4 hours.)
To determine the optimal imaging protocol for quantifying Hsp90 levels in human brain using [11C]HSP990 and develop if possible, a simplified imaging protocol or patient comfort.
It will be assessed if less invasive shorter imaging protocols can lead to equivalent outcome parameters in terms of VT. The hypothesis is that dynamic \[11C\]HSP990 PET combined with an image-derived input function and venous blood sampling based radiometabolite quantification can be used as a less invasive imaging protocol to quantify Hsp90 levels in human brain. Moreover, a shorter simplified coffeebreak protocol (e.g. 0-50 min p.i. dynamic imaging followed by 20 min break and 20 min dynamic imaging) can be used as a more patient friendly and shorter imaging protocol.
Time frame: This will be assessed right after each scan in cohort 2. (Estimated lenght of the scanning visit is 4 hours.)
To assess age-dependency of Hsp90 levels in healthy human brain using [11C]HSP990
The hypothesis is that compared to young healthy volunteers, \[11C\]HSP990 availability measured by VT is reduced upon healthy ageing and inversely related to age.
Time frame: This will be assessed right after each scan in cohort 2 and 3. (Estimated visit lenght in cohort 2 will be 4 hours for each scanning procedure. In cohort 3 this will be optimized based on the results of cohort 2.)
To compare Hsp90 levels in healthy human brain versus patients with neurodegeneration using [11C]HSP990
Based on preclinical findings, the hypothesis is that \[11C\]HSP990 VT in all forms of investigated neurodegeneration is globally lower than age-matched healthy volunteers and disease severity/duration is negatively correlated to the reduction of \[11C\]HSP990 VT.
Time frame: This will be assessed right after each scan in cohort 2 and 3. (Estimated visit lenght in cohort 2 will be 4 hours for each scanning procedure. In cohort 3 this will be optimized based on the results of cohort 2.)
To assess the regional brain pattern of [11C]HSP990 PET in neurodegeneration
The regional pattern of reduced \[11C\]HSP990 uptake (VT) will be assessed and correlated to DaT-scan in PD and amyloid PET in AD. The hypothesis is that in patients with neurodegeneration \[11C\]HSP990 VT is predominantly reduced in more affected brain regions.
Time frame: This will be assessed right after each scan in cohort 3. (Estimated scanning visit lenght in will be 3 hours.)
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