Amyloidosis is a devastating pathology associated with a growing number of diseases, including two of the most socio-economically impacting conditions of our time, Alzheimer's disease (Abeta amyloid) and type 2 diabetes (IAPP amyloid). Furthermore, cardiac amyloidosis in people over the age of 70 and in African American men is now recognized as a significant cause of morbidity. For these patients, there are few treatment options and no quantitative clinical imaging techniques for whole body detection of disease. Therefore, our long term goals are to develop amyloid-reactive peptides for the clinical detection and therapy of visceral amyloidosis in patients with these devastating conditions. During the first grant period it was shown that certain heparin-reactive small peptides specifically reacted with amyloid deposits but not with healthy tissues. This was demonstrated principally by using radioactively labeled peptides as imaging agents in mice with visceral AA amyloid as well as in mice with Abeta amyloid in the brain vasculature. Binding of peptides with amyloid was evidenced in SPECT images and micro-autoradiographs and was quantified by tissue biodistribution measurements. Recent data has now indicated that these peptides bind not only with highly-charged glycosaminoglycans that are present in all amyloid deposits but also the protein fibrils themselves, regardless of the precursor from which they are formed. We will leverage these novel findings to develop innovative molecular imaging agents and peptide therapeutics.
The aims of this 5 year renewal proposal are to:
Aim 1 : Characterize and develop amyloid-reactive peptides, based on the structure of our lead peptide, p5, by generating variants for the quantitative detection of visceral amyloidosis.
Aim 2 : Evaluate the therapeutic potential o amyloid-targeting peptides in vitro and in vivo for preventing and removing visceral AA, IAPP, and ApoA2c as well as Abeta-derived amyloid deposits.
Aim 3 : Examine the fundamental processes underlying the binding of amyloid-reactive peptides with Abeta (1-40) and IAPP synthetic fibrils, as well as AA and ApoA2c fibril extracts. This will enhance our rational design and optimization of amyloid-targeting and therapeutic peptides. To achieve these goals we will combine advanced small animal SPECT/CT imaging, micro- autoradiography and biodistribution measurements for testing new peptides in mice with amyloidosis. Additionally, we will use a battery of in vitro assays that we have established to measure the therapeutic potential of the peptides and investigate the fundamental processes governing the interactions of these reagents with amyloid. These studies will lead to improved and effective molecular imaging radiotracers and companion therapeutics that can be translated and evaluated clinically in patients with these devastating diseases.

Public Health Relevance

Peripheral amyloid is a devastating pathology associated with aging and inflammation as well as diseases such as multiple myeloma and type 2 diabetes. PET imaging of amyloid in patients could assist with diagnosis, prognostication, treatment planning, and monitoring response to therapy;however, this capability is not available in the US. We are developing a novel panel of small peptides that have been shown to be effective tracers for PET imaging of amyloid in mice and for detection of amyloid in tissues from patients;additionally, findings indicate that these peptides may also have therapeutic benefit for patients with these devastating disorders.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Clinical Molecular Imaging and Probe Development (CMIP)
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Laughlin, Maren R
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University of Tennessee Health Science Center
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United States
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Marin-Argany, Marta; Lin, Yi; Misra, Pinaki et al. (2016) Cell Damage in Light Chain Amyloidosis: FIBRIL INTERNALIZATION, TOXICITY AND CELL-MEDIATED SEEDING. J Biol Chem 291:19813-25
Martin, Emily B; Williams, Angela; Richey, Tina et al. (2016) Comparative evaluation of p5+14 with SAP and peptide p5 by dual-energy SPECT imaging of mice with AA amyloidosis. Sci Rep 6:22695
Pitt, Elisabeth A; Dogra, Pranay; Patel, Ravi S et al. (2016) The D-form of a novel heparan binding peptide decreases cytomegalovirus infection in vivo and in vitro. Antiviral Res 135:15-23
Kennel, Stephen J; Williams, Angela; Stuckey, Alan et al. (2016) The pattern recognition reagents RAGE VC1 and peptide p5 share common binding sites and exhibit specific reactivity with AA amyloid in mice. Amyloid 23:8-16
Kennel, Stephen J; Stuckey, Alan; McWilliams-Koeppen, Helen P et al. (2016) Tc-99m Radiolabeled Peptide p5 + 14 is an Effective Probe for SPECT Imaging of Systemic Amyloidosis. Mol Imaging Biol 18:483-9
Lee, Sanghyeb; Gregor, Jens; Kennel, Stephen J et al. (2015) GATE validation of standard dual energy corrections in small animal SPECT-CT. PLoS One 10:e0122780
McWilliams-Koeppen, Helen P; Foster, James S; Hackenbrack, Nicole et al. (2015) Light Chain Amyloid Fibrils Cause Metabolic Dysfunction in Human Cardiomyocytes. PLoS One 10:e0137716
Wall, Jonathan S; Martin, Emily B; Richey, Tina et al. (2015) Preclinical Validation of the Heparin-Reactive Peptide p5+14 as a Molecular Imaging Agent for Visceral Amyloidosis. Molecules 20:7657-82
Kennel, Stephen J; Macy, Sally; Wooliver, Craig et al. (2014) Phagocyte depletion inhibits AA amyloid accumulation in AEF-induced huIL-6 transgenic mice. Amyloid 21:45-53
Martin, Emily B; Kennel, Stephen J; Richey, Tina et al. (2014) Dynamic PET and SPECT imaging with radioiodinated, amyloid-reactive peptide p5 in mice: a positive role for peptide dehalogenation. Peptides 60:63-70

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