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A protease-activated, near-infrared fluorescent probe for early endoscopic detection of premalignant gastrointestinal lesions.


ABSTRACT: Fluorescence imaging is currently being actively developed for surgical guidance; however, it remains underutilized for diagnostic and endoscopic surveillance of incipient colorectal cancer in high-risk patients. Here we demonstrate the utility and potential for clinical translation of a fluorescently labeled cathepsin-activated chemical probe to highlight gastrointestinal lesions. This probe stays optically dark until it is activated by proteases produced by tumor-associated macrophages and accumulates within the lesions, enabling their detection using an endoscope outfitted with a fluorescence detector. We evaluated the probe in multiple murine models and a human-scale porcine model of gastrointestinal carcinogenesis. The probe provides fluorescence-guided surveillance of gastrointestinal lesions and augments histopathological analysis by highlighting areas of dysplasia as small as 400 µm, which were visibly discernible with significant tumor-to-background ratios, even in tissues with a background of severe inflammation and ulceration. Given these results, we anticipate that this probe will enable sensitive fluorescence-guided biopsies, even in the presence of highly inflamed colorectal tissue, which will improve early diagnosis to prevent gastrointestinal cancers.

SUBMITTER: Yim JJ 

PROVIDER: S-EPMC7817203 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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A protease-activated, near-infrared fluorescent probe for early endoscopic detection of premalignant gastrointestinal lesions.

Yim Joshua J JJ   Harmsen Stefan S   Flisikowski Krzysztof K   Flisikowska Tatiana T   Namkoong Hong H   Garland Megan M   van den Berg Nynke S NS   Vilches-Moure José G JG   Schnieke Angelika A   Saur Dieter D   Glasl Sarah S   Gorpas Dimitris D   Habtezion Aida A   Ntziachristos Vasilis V   Contag Christopher H CH   Gambhir Sanjiv S SS   Bogyo Matthew M   Rogalla Stephan S  

Proceedings of the National Academy of Sciences of the United States of America 20210101 1


Fluorescence imaging is currently being actively developed for surgical guidance; however, it remains underutilized for diagnostic and endoscopic surveillance of incipient colorectal cancer in high-risk patients. Here we demonstrate the utility and potential for clinical translation of a fluorescently labeled cathepsin-activated chemical probe to highlight gastrointestinal lesions. This probe stays optically dark until it is activated by proteases produced by tumor-associated macrophages and acc  ...[more]

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