- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05374278
First-in-Human Evaluation of an Astrocytic Glutamate Transporter (EAAT2) PET Tracer in Dementia
First-in-Human Evaluation of an Astrocytic Glutamate Transporter (EAAT2) PET Tracer in the Brains of Healthy Controls and Patients With Dementia.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
AD and FTD are the two leading causes of dementia with tremendous impact on patients and their families. Early diagnosis of both AD and FTD is essential to increase patients' quality of life, identify and treat reversible causes, and enhance the development and effectiveness of treatments. However, no single diagnostic agent is currently available for either AD or FTD; instead, clinicians must rely on the patient's history and cognitive testing which often leads to delayed or incorrect diagnosis. Importantly AD and FTD have distinct regional patterns of neuronal loss and dysfunction in the brain; an agent that couldmdetect these regionally specific changes early in the course of the disease process could revolutionize diagnosis and treatment development for these conditions.
This study aims to develop a novel radiotracer to fill this unmet need. The excitatory amino acid transporter 2 (EAAT2) is the main transporter for glutamate in the brain and has been shown to be downregulated in the context of AD and other neurodegenerative conditions. EAAT2 is responsible for over 90% of glutamate uptake in the brain where it is primarily located on astrocytes and plays a key role in maintaining the homeostasis of the tripartite synapse. The goal of this study is to test the EAAT2 targeted positron emitting agent, [18F]RP-115, to evaluate early changes in astrocytes in healthy controls versus patients with AD and FTD by quantitative PET imaging of EAAT2. We have preclinical data that demonstrates that this agent is a good predictor of EAAT2 levels in animal models, hence, can potentially detect early signs of neurodegeneration. We now wish to test this agent in humans.
In summary, the primary objective of this study is to demonstrate human safety and measure the biodistribution of [18F]RP-115 in healthy controls as well as in age-matched patients with AD and FTD.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
- Name: David Wilson, MD, PhD
- Phone Number: 415-514-6229
- Email: david.m.wilson@ucsf.edu
Study Contact Backup
- Name: Henry Vanbrocklin, PhD
- Phone Number: 415-353-4569
- Email: henry.vanbrocklin@ucsf.edu
Study Locations
-
-
California
-
San Francisco, California, United States, 94107
- Recruiting
- China Basin, UCSF
-
Contact:
- David Wilson, MD, PhD
- Email: david.m.wilson@ucsf.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 40-75 years old
- BMI age-suitable
- Ability to provide written informed consent and willing to comply with protocol requirements, or has a legal authorized representative/guardian who provides surrogate informed consent.
- No apparent physical disorder.
- Radial, ulnar or brachial artery suitable for catheterization.
- Non- smoker, and not taking over the counter nicotine cessation- to limit peripheral metabolism events
Devoid of central nervous system prescription drugs for three weeks- to limit peripheral metabolism events.
For Cohort 2 part B only:
- Must have a study partner (informant) who spends a minimum average of 5 hours per week with the participant (e.g. family member, significant other, friend, caregiver), is generally aware of the participant's daily activities, can provide information about the participant's cognitive and functional performance
- Recent (within 6 mo.) mini mental examination clinical scores.
Exclusion Criteria:
- Unable to provide written informed consent and unwilling to comply with protocol requirements, or does not have a legal authorized representative/guardian who can provide surrogate informed consent.
- Inadequate arterial access.
- Receipt of radioisotope < 5 half-lives within [18F]RP-115 imaging- as to not confound any scans with radiation background for previous scanning, and unsuitable organ dosimetry thresholds from previous (> two weeks) PET scans.
- The performed [18F]RP-115 scan(s) must not represent > 3 PET studies total within one year.
- Contra-indication to magnetic resonance, including permanent pacemaker, implantable metallic device, etc.; or severe claustrophobia.
- Participants who are pregnant (female patients of childbearing age will be tested prior to injection of tracer- positive test excludes from the study)
- Participants who are breast-feeding.
- Have a medical condition or other circumstances that in the opinion of the project physicians would significantly decrease chances of obtaining reliable data, achieving the study objective or completing the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cohort 1 - dosimetry of [18F]RP-115 in healthy volunteers
Establish [18F]RP-115 safety in the clinic with male and female PET imaging.
|
An I.V. bolus injection of up to 10 millicurie (mCi) [18F]RP-115 will be administered, followed by a PET/MRI scan or by a combination of PET/CT and MRI
|
Experimental: Cohort 2B - [18F]RP-115 in patients with AD
Comparison of [18F]RP-115 PET binding between AD patients and age-matched cognitively normal controls and between AD and FTD
|
An I.V. bolus injection of up to 10 millicurie (mCi) [18F]RP-115 will be administered, followed by a PET/MRI scan or by a combination of PET/CT and MRI
|
Experimental: Cohort 2C - [18F]RP-115 in patients with FTD
Comparison of [18F]RP-115 PET binding between AD patients and age-matched cognitively normal controls and between AD and FTD
|
An I.V. bolus injection of up to 10 millicurie (mCi) [18F]RP-115 will be administered, followed by a PET/MRI scan or by a combination of PET/CT and MRI
|
Experimental: Cohort 2A - [18F]RP-115 in age-matched controls
Comparison of [18F]RP-115 PET binding between AD patients and age-matched cognitively normal controls and between AD and FTD
|
An I.V. bolus injection of up to 10 millicurie (mCi) [18F]RP-115 will be administered, followed by a PET/MRI scan or by a combination of PET/CT and MRI
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety of Administered dose
Time Frame: A year
|
Each study participant will undergo a physical examination, vital signs, and ECGs prior to and after the scan and will also be monitored during the scan for adverse events. Additionally, a follow-up with the subject will be conducted 24-48 hours after [18F]RP-115 administration. Outcome Measure: Any adverse events will be recorded and graded according to Common Terminology Criteria for Adverse Events. |
A year
|
Dosimetry of [18F]RP-115
Time Frame: A year
|
Whole-body PET/MRI scan will be conducted immediately after an [18F]RP-115 injection and last about 3.5 hours (including breaks) in 8 healthy volunteers (male and female). Equivalent organ radiation doses will be calculated in selected organs using the dynamic PET/MRI data in order to calculate the dosimetry of the tracer. Outcome Measure: Radiation exposure per organ as milliSievert/kg |
A year
|
Biodistribution of [18F]RP-115
Time Frame: A year
|
Whole-body PET/MRI scan will be conducted immediately after an [18F]RP-115 injection and last about 3.5 hours (including breaks) in 8 healthy volunteers (male and female). Percent injected activity (%IA) will be calculated in selected organs using the dynamic PET/MRI data in order to calculate the biodistribution of the tracer. Outcome Measure: Percent injected activity (%Injected radioactivity) in selected organs. |
A year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
[18F]RP-115 diagnostic performance
Time Frame: Three years
|
Sixty (90) subjects (subjects with AD, FTD, and healthy age-matched controls) will undergo a brain PET/MRI scan that will be start 30-90 minutes after an [18F]RP-115 injection and will last about 60-90 minutes. In selected subjects, blood sample collection via arterial catheter will be performed. Significant changes in the [18F]RP-115 cerebral tracer binding parameters will be used in order to identify the primary affected regions in patients with Alzheimer disease compared to healthy age-matched controls. Outcome Measure: Radioactivity distribution volume in select organs, mCi/L |
Three years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: David Wilson, MD, PhD, University of California, San Francisco
Publications and helpful links
General Publications
- Jack CR Jr, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, Holtzman DM, Jagust W, Jessen F, Karlawish J, Liu E, Molinuevo JL, Montine T, Phelps C, Rankin KP, Rowe CC, Scheltens P, Siemers E, Snyder HM, Sperling R; Contributors. NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018 Apr;14(4):535-562. doi: 10.1016/j.jalz.2018.02.018.
- Li S, Mallory M, Alford M, Tanaka S, Masliah E. Glutamate transporter alterations in Alzheimer disease are possibly associated with abnormal APP expression. J Neuropathol Exp Neurol. 1997 Aug;56(8):901-11. doi: 10.1097/00005072-199708000-00008.
- Innis RB, Cunningham VJ, Delforge J, Fujita M, Gjedde A, Gunn RN, Holden J, Houle S, Huang SC, Ichise M, Iida H, Ito H, Kimura Y, Koeppe RA, Knudsen GM, Knuuti J, Lammertsma AA, Laruelle M, Logan J, Maguire RP, Mintun MA, Morris ED, Parsey R, Price JC, Slifstein M, Sossi V, Suhara T, Votaw JR, Wong DF, Carson RE. Consensus nomenclature for in vivo imaging of reversibly binding radioligands. J Cereb Blood Flow Metab. 2007 Sep;27(9):1533-9. doi: 10.1038/sj.jcbfm.9600493. Epub 2007 May 9.
- Miller ZA, Sturm VE, Camsari GB, Karydas A, Yokoyama JS, Grinberg LT, Boxer AL, Rosen HJ, Rankin KP, Gorno-Tempini ML, Coppola G, Geschwind DH, Rademakers R, Seeley WW, Graff-Radford NR, Miller BL. Increased prevalence of autoimmune disease within C9 and FTD/MND cohorts: Completing the picture. Neurol Neuroimmunol Neuroinflamm. 2016 Oct 28;3(6):e301. doi: 10.1212/NXI.0000000000000301. eCollection 2016 Dec.
- Boche D, Gerhard A, Rodriguez-Vieitez E; MINC Faculty. Prospects and challenges of imaging neuroinflammation beyond TSPO in Alzheimer's disease. Eur J Nucl Med Mol Imaging. 2019 Dec;46(13):2831-2847. doi: 10.1007/s00259-019-04462-w. Epub 2019 Aug 8.
- Rice L, Bisdas S. The diagnostic value of FDG and amyloid PET in Alzheimer's disease-A systematic review. Eur J Radiol. 2017 Sep;94:16-24. doi: 10.1016/j.ejrad.2017.07.014. Epub 2017 Jul 20.
- Rodriguez-Vieitez E, Carter SF, Chiotis K, Saint-Aubert L, Leuzy A, Scholl M, Almkvist O, Wall A, Langstrom B, Nordberg A. Comparison of Early-Phase 11C-Deuterium-l-Deprenyl and 11C-Pittsburgh Compound B PET for Assessing Brain Perfusion in Alzheimer Disease. J Nucl Med. 2016 Jul;57(7):1071-7. doi: 10.2967/jnumed.115.168732. Epub 2016 Feb 16.
- Arakawa R, Stenkrona P, Takano A, Nag S, Maior RS, Halldin C. Test-retest reproducibility of [11C]-L-deprenyl-D2 binding to MAO-B in the human brain. EJNMMI Res. 2017 Dec;7(1):54. doi: 10.1186/s13550-017-0301-4. Epub 2017 Jun 20.
- Cowburn R, Hardy J, Roberts P, Briggs R. Presynaptic and postsynaptic glutamatergic function in Alzheimer's disease. Neurosci Lett. 1988 Mar 21;86(1):109-13. doi: 10.1016/0304-3940(88)90192-9.
- Scott HL, Tannenberg AE, Dodd PR. Variant forms of neuronal glutamate transporter sites in Alzheimer's disease cerebral cortex. J Neurochem. 1995 May;64(5):2193-202. doi: 10.1046/j.1471-4159.1995.64052193.x.
- Hoshi A, Tsunoda A, Yamamoto T, Tada M, Kakita A, Ugawa Y. Altered expression of glutamate transporter-1 and water channel protein aquaporin-4 in human temporal cortex with Alzheimer's disease. Neuropathol Appl Neurobiol. 2018 Oct;44(6):628-638. doi: 10.1111/nan.12475. Epub 2018 Mar 4.
- Pasqualetti G, Brooks DJ, Edison P. The role of neuroinflammation in dementias. Curr Neurol Neurosci Rep. 2015 Apr;15(4):17. doi: 10.1007/s11910-015-0531-7.
- Arnold SE, Han LY, Clark CM, Grossman M, Trojanowski JQ. Quantitative neurohistological features of frontotemporal degeneration. Neurobiol Aging. 2000 Nov-Dec;21(6):913-9. doi: 10.1016/s0197-4580(00)00173-1.
- Lui H, Zhang J, Makinson SR, Cahill MK, Kelley KW, Huang HY, Shang Y, Oldham MC, Martens LH, Gao F, Coppola G, Sloan SA, Hsieh CL, Kim CC, Bigio EH, Weintraub S, Mesulam MM, Rademakers R, Mackenzie IR, Seeley WW, Karydas A, Miller BL, Borroni B, Ghidoni R, Farese RV Jr, Paz JT, Barres BA, Huang EJ. Progranulin Deficiency Promotes Circuit-Specific Synaptic Pruning by Microglia via Complement Activation. Cell. 2016 May 5;165(4):921-35. doi: 10.1016/j.cell.2016.04.001. Epub 2016 Apr 21.
- Yin F, Banerjee R, Thomas B, Zhou P, Qian L, Jia T, Ma X, Ma Y, Iadecola C, Beal MF, Nathan C, Ding A. Exaggerated inflammation, impaired host defense, and neuropathology in progranulin-deficient mice. J Exp Med. 2010 Jan 18;207(1):117-28. doi: 10.1084/jem.20091568. Epub 2009 Dec 21.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mental Disorders
- Metabolic Diseases
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Neurologic Manifestations
- Neurobehavioral Manifestations
- Neurocognitive Disorders
- Neurodegenerative Diseases
- TDP-43 Proteinopathies
- Proteostasis Deficiencies
- Tauopathies
- Language Disorders
- Communication Disorders
- Speech Disorders
- Frontotemporal Lobar Degeneration
- Aphasia
- Dementia
- Alzheimer Disease
- Frontotemporal Dementia
- Aphasia, Primary Progressive
- Pick Disease of the Brain
Other Study ID Numbers
- 13180640
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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