. Ligand-based design of [18F]OXD-2314 for PET imaging in non-Alzheimer's disease tauopathies. Nat Commun. 2024 Jun 14;15(1):5109. PubMed.

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  1. Mathis, Vasdev, and colleagues provide a model protocol for designing and evaluating PET radioligands based on chemical, pharmacokinetic, and pharmacodynamic properties. The validity of this approach will soon be examined by a clinical PET study for AD and non-AD tauopathy cases. The new tracer, 18F-OXD-2314, has a relatively long backbone structure (indol-pyridine-piperidin BBQ) similar to 18F-florzolotau, and presumably these compounds bind to hydrophobic grooves spanning stacked β-strands of tau molecules (Shi et al., 2021). As these groove-shaped binding pockets are present across the cross-beta motif of diverse tau fibril folds, such “long” chemicals are potentially reactive with a wide range of tau pathologies.

    The notable difference between OXD-2314 and florzolotau is that the former contains a pyridine ring instead of a butadiene linker to circumvent photoisomerization issues. I sense that the florzolotau backbone, including the slender linker portion in the middle, may show a lock-and-key fit to the wavy surface of the groove, but this view needs to be tested by in-depth molecular docking.

    Among various assessments in the current study, homogenate binding assays to determine the affinity of the compounds have illustrated the most intriguing features, as the dissociation constants (KDs) of OXD-2314 in PSP, CBD, and PiD were considerably lower than those of florzolotau. A slightly complicated issue is that the homologous blockade curves for OXD-2314 were well described by a two-site binding model, and KDs of this compound for the high-affinity binding site were compared to KDs of florzolotau.

    There is no information on whether a one- or two-binding model was employed for the fit to the florzolotau binding curves to determine KDs. It is also unclear whether the low-affinity, high-capacity binding of OXD-2314, which accounts for 20 percent to 30 percent of the total binding, reflects tau or non-tau pathologies. Another interesting point is the lack of displacement of 3H-OXD-2314 binding with florzolotau, contrary to the notion that both ligands could be docked with the grooves in the cross-beta spine of tau fibrils. The Bmax/KD values of OXD-2314 were also very high in a three-digit range and should be compared with those of florzolotau.

    Moreover, the Bmax/KD values of OXD-2314 were 550 in the AD cortex, 580 in the PSP cortex, and 1,000 in the PSP subcortex, indicating greater binding of this compound in PSP than in AD. This might not be consistent with autoradiographic findings since intense labeling was noted in AD rather than PSP slices. The Bmax/KD values of OXD-2314 were 371 in the CBD frontal cortex, while very strong displaceable binding was homogeneously observed in the autoradiography of a CBD frontal cortical sample.

    The rodent and monkey PET data revealed ideal pharmacokinetic and metabolic profiles of 18F-OXD-2314. This ligand was also shown to react with tau aggregates in transgenic mice, and it would be nice to demonstrate the in vivo labeling of tau deposits in rTg4510 mice with 18F-OXD-2314, which could be compared to the florzolotau data in the literature (Kimura et al., 2022). For the advancement of diagnostic technologies, it will be crucial to carry out comparative tests of different tau PET probes with proper methodologies in non-clinical and clinical settings.

    References:

    . Cryo-EM structures of tau filaments from Alzheimer's disease with PET ligand APN-1607. Acta Neuropathol. 2021 May;141(5):697-708. Epub 2021 Mar 16 PubMed. Correction.

    . A quantitative in vivo imaging platform for tracking pathological tau depositions and resultant neuronal death in a mouse model. Eur J Nucl Med Mol Imaging. 2022 Nov;49(13):4298-4311. Epub 2022 Jul 8 PubMed.

    View all comments by Makoto Higuchi
  2. The development of [18F]OXD-2314 heralds a promising advance in the imaging of tauopathies, particularly the non-Alzheimer's disease (non-AD) type. This new tracer, designed through a ligand-based approach, shows high affinity and selectivity for 4R-tau aggregates, characteristic of diseases such as progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). While [18F]OXD-2314 has shown promising preclinical results with higher binding affinity in PSP and CBD tissues and favorable pharmacokinetic properties, it has not yet been tested in human subjects.

    Therefore, it will be important to compare it clinically with [18F]PI-2620 and [18F]PM-PBB3, aka APN-1607, which have been established as reliable tracers for imaging tau pathology in both AD and non-AD tauopathies. [18F]PI-2620 and [18F]PM-PBB3 have been evaluated in patients and have shown the ability to image tau aggregates effectively in conditions such as PSP and corticobasal syndrome (CBS) (Brendel et al., 2020Palleis et al., 2021; Tagai et al., 2021). In addition, a small number of patients who have been imaged with [18F]PI-2620 and undergone autopsy upon death, corroborated the binding of the tracer to regions of the brain with 4R tau accumulation (Selmann et al., 2024). 

    The next steps for [18F]OXD-2314 involve crucial, human PET studies to validate its preclinical potential. If [18F]OXD-2314 can match or exceed the performance of [18F]PI-2620 or [18F]PM-PBB3 in clinical trials, it may become a valuable addition to the tool kit for imaging tau pathology. That [18F]OXD-2314 appears to have a unique binding site different than existing tau radiotracers is quite interesting. This may provide a different imaging profile, with respect to both on target and off target binding.

    The success of [18F]OXD-2314 in upcoming human studies will be eagerly anticipated, potentially enhancing the landscape of tau imaging in neurodegenerative diseases.

    References:

    . Assessment of 18F-PI-2620 as a Biomarker in Progressive Supranuclear Palsy. JAMA Neurol. 2020 Nov 1;77(11):1408-1419. PubMed.

    . In Vivo Assessment of Neuroinflammation in 4-Repeat Tauopathies. Mov Disord. 2021 Apr;36(4):883-894. Epub 2020 Nov 27 PubMed.

    . In Vivo Assessment of Neuroinflammation in 4-Repeat Tauopathies. Mov Disord. 2021 Apr;36(4):883-894. Epub 2020 Nov 27 PubMed.

    . Neuronal and oligodendroglial but not astroglial tau translates to in vivo tau-PET signals in primary tauopathies. 2024 May 07 10.1101/2024.05.04.592508 (version 1) bioRxiv.

    View all comments by Matthias Brendel

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