Glioblastoma (GBM) is the most malignant primary brain tumor in adults. Aberrant glucose metabolism is considered a hallmark of cancer, via the so called ‘Warburg Effect’. MRS gives the access to study tumor metabolism. 1H MRS enables to quantify the steady state pool size and 13C MRS of hyperpolarized (HP) endogenous compounds provides real time metabolic information which is related to enzymatic activity. The aim of the present study was to examine whether changes in lactate production through glycolysis can be characterized using HP [2H7,13C6]D-glucose MRS, and if those correspond to changes in lactate pool size.
Glioblastoma (GBM) is the most malignant primary brain tumor in adults. It exhibits high metabolic activity and is notorious for its resistance to multi-modal therapy, with a median survival of only 15 months. Hyperactive glucose metabolism is considered a hallmark of cancer, via the ‘Warburg Effect’ manifested by the switch of glucose metabolism and ATP production from oxidative phosphorylation to glycolysis, however recent ex vivo and in vivo studies show evidences for active glucose oxidation in human GBM1-3. Direct detection of tumor glycolysis can provide new evidences on this debate.
MRS gives the access to study tumor metabolism. 1H MRS enables to quantify the steady state pool size of about 20 metabolites4. 13C MRS of hyperpolarized (HP) endogenous compounds, using dissolution dynamic nuclear polarization (dDNP)5, provides real time metabolic information which is related to enzymatic activity6. It was recently reported that de novo synthesis of [1-13C]lactate can be monitored in vivo following the infusion of HP [2H7,13C6]D-glucose in the mouse brain7.
In the present study we addressed the question whether changes in lactate production in GBM can be characterized through glycolysis using HP [2H7,13C6]D-glucose MRS, and whether they correspond to deviations in lactate pool size as determined. The experiments were performed using an invasive patient-derived orthotopic xenograft GBM model, and taking advantage of the fact that metabolite ratios in HP 13C MRS are related to the flux through the up stream biochemical reactions8.
GBM mouse models: LN-3708GS spheroids (105 cells)9 were stereotactically injected into the left hemisphere of immunodeficient male mice (NSG). The control group was injected with 5 μL of the cell suspension solution solely ( n = 5 per group, 8 weeks of age at implantation, 20 ± 1 weeks at day of dDNP experiment).
Multimodal MR analysis was performed in a 9.4 T/31 cm actively shielded animal scanner (Varian/Magnex) and included the following steps: 1) To define structural changes T2 weighted (T2W) images were acquired. 2) To characterize the neurochemical profile of the tumor, single voxel 1H MRS measurements were carried out in the injected hemisphere. 3) Frozen droplets of a water solution containing [2H7,13C6]D-glucose (3M) and OX63 trityl radical (25 mM) were dynamically polarized in a custom designed 7T/1K DNP polarizer as previously described7,10. To monitor real-time de novo synthesis of [1-13C]lactate, a 540 μL of 56±13 mM HP [2H7,13C6]D-glucose was injected through the femoral vein. A series of pulse-acquire sequence was triggered 5.5s post injection with 20° frequency selective Gaussian pulse (250μs) centered at 182 ppm every 0.5s for 50 s. Lactate-to-glucose ratio (LGR) was calculated from the summed spectra. To minimize variation between individual animals, the ratio was corrected for the dose of 13C glucose at the time of injection, i.e. multiplying by the moles of [2H7,13C6]D-glucose injected, divided by the animal blood volume (cLGR). 4). The integrity of the blood brain barrier (BBB) was assessed by T1 weighted (T1W) images acquired after injection of gadolinium-contrast agent (Gadovist® 5uL/gr body weight),
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