The design of a BFC for metal-based radiopharmaceuticals is largely influenced by the ability of the BFC to form a kinetically inert chelate with a metal radionuclide and the ease to covalently anchor a targeting vector. To date, both cyclic and acyclic BFCs containing coordinating atoms (e.g. nitrogen, oxygen and sulfur) have been reported for Ga(III) chelation.
35–38 For a BFC to be considered for nuclear imaging probe design, its complex with the metal ion of interest must have desirable thermodynamic and
in vivo kinetic stability, specifically resistance to trans-metalation with serum proteins. The most commonly used macrocyclic chelator, 1, 4, 7, 10-tetraazacyclododecanetetraacetic acid (DOTA), is a choice of convenience for
68Ga PET imaging design due to its commercial availability and the fact that it is in the composition of several FDA-approved agents. However, the DOTA complex with Ga(III) has a thermodynamic stability constant (log
K = 21.33)
39 comparable to that of the transferrin complex with Fe(III) (log
K = 20.3),
40 which may lead to in vivo transmetalation.
40 Also, the complexation kinetics of DOTA with Ga(III) often require an elevated temperature and a long reaction time, which could be detrimental to the activity of the biomolecule and not advantageous to
68Ga, a radionuclide with a decay half-life barely longer than one hour. Given the small ionic radius of Ga(III) (76 pm),
18 NOTA, a nine-membered triazamacrocyclic chelator, would provide a perfect cavity size match for Ga(III) coordination. Indeed, the thermodynamic stability constant of Ga(III)-NOTA complex (log
K = 30.98)
22, 24 is approximately 10 orders of magnitude higher than that of its DOTA counterpart. More impressively, the neutral Ga(III)-NOTA complex was reported to stay inert against the acid-catalyzed dissociation in 6N HNO
3 for 6 days.
20 When NOTA is used without modification as a BFC, however, one of its three pendent coordinating carboxylic acids would be consumed to form an amide linkage with the targeting vector. Although the coordinating atoms (N
3O
3) stay the same before and after the conjugation, the stability of the metal complex moiety is compromised due to the formation of an amide linkage.
41, 42 In order for NOTA to keep its three coordinating acetate arms intact for Ga(III) chelation, an additional functional group is necessary. Indeed, various C- or N-functionalized NOTA derivatives have been reported as modified NOTA for gallium radiopharmaceuticals.
23, 43–46 Of the reported methods, the N-functionalization of TACN provides a simple and versatile way of introducing additional functionalities to the triazamacrocyclic ring, which makes the NOTA derivatives bifunctional.
23, 24The multivalent effect is widely used to enhance the desired biological potency of a bioactive molecule.
47–50 For instance, the tumor targeting efficacy of a targeting vector can be enhanced by orders of magnitude through the strengthened specific ligand-receptor binding.
28, 34, 51–54 In principle, multimeric presentation of a ligand increases its local concentration on the cell surface thus increasing the probability of the specific ligand-receptor interaction, which results in enhanced target accumulation. Furthermore, the juxtaposition of the conjoined ligands can facilitate the desired ligand-receptor interaction. In the field of molecular imaging, multivalent effect can certainly be exploited to amplify the imaging signal in target organs or tissues in the same manner. Indeed, several groups have reported that imaging contrast can be significantly improved by taking advantage of multivalent effect in the imaging probe design.
27, 28, 32, 55–58 For instance, multivalent PET imaging probes featuring multimeric peptides have demonstrated better imaging properties than their monomeric counterpart.
32, 55, 59–64Recently, we reported a BFC scaffold design for
64Cu-based PET imaging probes, which provides multiple peripheral functional points for multi-presentation of targeting vectors in a BFC without compromising the metal chelate stability of the chelating core.
28 An important role of such a BFC scaffold is to provide PET signal enhancement through the resulted multivalent effect. Similarly, we designed a series of NOTA-based scaffolds for
68Ga PET imaging probes,
tBu
3-
1-Bn,23
tBu
3-
2-Bn
2 and
tBu
3-
3-Bn
3, which contain two orthogonally protected carboxylic acid groups on each side-arm. All three BFC scaffolds have three
t-butyl protected α-carboxylic acid groups intended for Ga(III) coordination, while the number of the terminal benzyl protected γ-carboxylic acid differs to systematically vary the valency of a targeting vector from 1 – 3. The orthogonality of the protecting groups on the side-arm enables the selective deprotection of the γcarboxylate and α-carboxylate groups by different procedures at the corresponding step. Further, the four-carbon alkyl chain is incorporated as a spacer between the NOTA core and the peripheral carboxylate groups so as to minimize the interference of the NOTA motif with the properties of the targeting vector. Indeed it was reported that replacing one of the acetic acid side arms of NOTA with succinic acid, a 4-carbon spacer, has a negligible effect on the geometry or the thermodynamic stability of the resulting Ga(III) complex (Ga-NODASA: log
K = 30.9; Ga-NOTA: log
K = 30.98).
24 Impressively, the exchange kinetics of
67Ga-NODASA with transferrin at the physiological pH and temperature showed no metal transchelation over the period of 5 days.
24 Therefore, we believe the replacement of the acetate side-arm with α-bromoglutaric acid 1-tert-butyl ester 5-benzyl ester (
4) would not adversely influence the structural integrity and thermodynamic stability of the resulting Ga-complexes.
The NOTA BFC scaffolds, tBu3-1-COOH, tBu3-2-(COOH)2 and tBu3-3-(COOH)3, were synthesized by alkylation of TACN using appropriate equivalents of 4. Synthesis of tBu3-1-COOH and tBu3-2-(COOH)2 was performed in a three-step route with the first step determining the overall yield. The alkylation of TACN with 4 afforded both 5 and 6. The subsequent two steps were quantitative. Synthesis of tBu3-3-(COOH)3 was straightforward, which can be scaled to produce grams of the product. The NOTA scaffolds (tBu3-1-COOH, tBu3-2-(COOH)2 and tBu3-3-(COOH)3) possess one, two and three peripheral catboxylate groups, respectively, for the covalent attachment of a targeting vector in a systematic fashion. For proof of concept, a well-validated integrin αvβ3 ligand, c(RGDyK), was conjugated to tBu3-1-COOH, tBu3-2-(COOH)2 and tBu3-3-(COOH)3 to yield tBu-protected monvalent, divalent, and trivalent peptide conjugates. The tBu-protected α-carboxylate was later deprotected in 95% TFA to give H31, H32, and H33 in quantitative yield as peptide conjugates ready for labeling with 68Ga.
Radiolabeling of the conjugates of H
31, H
32, and H
33 with
68Ga was tested by varying reaction conditions, such as pH, temperature, and time, in order to reach the highest achievable specific activity of the labeled tracers within a short time, given the 68-min half-life of
68Ga. Because radiolabeling of NOTA with
68Ga is pH sensitive, HEPES was used as the reaction buffer to provide the optimal labeling pH (3.0 – 3.5).
16 At room temperature, we were able to label the conjugates in high radiochemical yields (RCY > 95%) within 30 min. Comparatively speaking, the
68Ga labeling of multivalent conjugates (H
32, and H
33) was slower than that of the monvalent ones (H
31 and H
31a) in part due to the steric hindrance by the additional copies of c(RGDyK) peptide. However, the difference virtually disappeared when the radiolabeling was conducted at 70°C. One of the desired features of a PET imaging agent for clinical application is the ease of post-labeling purification. By a simple separation procedure through a C-18 cartridge, all the radiolabeled conjugates reached > 99% radiochemical purity as determined by radio-HPLC.
Both H
31 and H
31a have one copy of c(RGDyK) peptide while H
32 and H
33 have two and three copies of c(RGDyK), respectively. The multi-presentation of the c(RGDyK) peptide in H
32 and H
33 is expected to enhance the affinity of the receptor-ligand interaction through the phenomenon of multivalent effect. By a competitive cell-binding assay using
125I-echistatin as the integrin-specific radioligand,
32 multivalent effect, as measured by the enhanced specific ligand-receptor binding affinity was evaluated. The determined IC
50 values of monvalent H
31 (171 ± 60 nM), divalent H
32 (43.9 ± 16.1 nM), and trivalent H
33 (14.7 ± 5.0 nM) were found to be similar to the measurements reported for the monovalent (H
31a, 218 nM), divalent (60 nM) and tetravalent (16 nM) conjugates constructed from peptide multimerization of c(RGDyK).
26 The cell-binding assay clearly demonstrated the anticipated multivalent effect of H
32 and H
33 as compared to their monovalent counterpart (H
31). Of note, the multivalent effect resulted from the BFC scaffold-based multivalency (H
33, 13 nM) is similar to that resulted from the tetramerization of c(RGDyK) (NOTA-Bn-SCN–tetramer, 16 nM).
26The in vivo behavior of 68Ga-1, 68Ga-1a, 68Ga-2 and 68Ga-3, was evaluated in SCID mice bearing integrin αvβ3-positive PC-3 prostate cancer xenograft. Like other c(RGDyK) based agents, all the 68Ga-labeled conjugates were efficiently cleared from the kidneys, while the excretion through feces was negligible within 2 h p.i. The radio- HPLC analysis of collected urine demonstrated that the 68Ga-labeled conjugates stayed intact (> 99%) within 2 h p.i, which is roughly two times of the physical half-life of 68Ga. This high metabolic stability of the 68Ga-labeled conjugates likely resulted from the kinetic inertness of the Ga-NOTA complex.
The integrin α
vβ
3 positive PC-3 tumor was visualized with
68Ga-
1,
68Ga-
1a,
68Ga-
2, and
68Ga-
3 at 30 min and 2 h p.i. (). Irrespective of the valency, all the
68Ga-labeled conjugates showed similar tumor uptake with poor contrast at 30 min p.i. due to their relatively high level of presence in the non-target organs (e.g. blood and muscle.
Table S3). At 2 h p.i., the enhanced tumor uptake and retention of
68Ga-
2 and
68GA-
3 can be partially attributed to their increased binding affinities resulting from multivalent effect. Interestingly, the tumor PET signal amplification level by the multivalent effect (
68Ga-
3: 2.55 ± 0.50 %ID/g;
68Ga-
2: 1.90 ± 0.10 %ID/g;
68Ga-
1: 1.66 ± 0.15 %ID/g) is similar to that in a published work using peptide multimerization of c(RGDyK) as an approach to realize multivalent effect for PET probe design (tetramer: 2.1 %ID/g; dimer: 1.9 %ID/g; monomer: 1.1 %ID/g).
26 In addition to the increased binding affinity, the prolonged
in vivo half-life of multivalent conjugates, resulting from the molecule size increase, may also contribute to the enhanced tumor uptake over the time course. The prolonged
in vivo half-life of multivalent conjugate is believed to be able to sustain the desired tumor accumulation and retention.
26, 65 However, similar distribution and elimination half-lives were observed for all radiolabeled conjugates. Therefore we think that the observed tumor uptake increase and PET signal amplification was predominately caused by the multivalency of
68Ga-
2 and
68Ga-
3. It is important to note that the imaging specificity is not compromised because of the added multivalency as it is shown by the complete signal loss in the blockade experiment ( and
Table S2). The liver signal intensity difference between 2 h and 2 h blockade was likely caused by the diluting effect of the excess cold ligand. However, we acknowledge that the kidney uptake was also increased by the multivalent effect, which might affect how the peptide conjugates are handled in the proximal tubule and their binding to megalin. While the same phenomenon is common in peptide-based radiopharmaceuticals, the exact mechanism for such an increase is unknown. To evaluate the statistic correlation between the biodistribution and quantitative imaging data, we calculated the Pearson correlation coefficients for all four conjugates. The results (r:
68Ga-
1a > 0.77;
68Ga-
1 > 0.85;
68Ga-
2 > 0.90;
68Ga-
3 > 0.87) clearly demonstrate a strong correlation.