Development of Receptor for Advanced Glycation End Products-Directed Imaging of Atherosclerotic Plaque in a Murine Model of Spontaneous Atherosclerosis

Background-The receptor for advanced glycation end products (RAGE) is implicated in the development and progression of atherosclerosis. We tested the hypothesis that Tc-99m-labeled anti-RAGE F(ab')(2) can be used as a noninvasive tool to image atherosclerotic lesions in apolipoprotein E-deficient (apoE(-/-)) mice. Methods and Results-A sequence in the V-type Ig extracellular domain of RAGE was used to develop a peptide injected into rabbits; serum was retrieved, IgG prepared and affinity-purified, and pepsin-digested into F(ab')(2). Thirteen 6-week apoE(-/-) mice were fed a Western diet. At 20 weeks, 6 were injected with 15.2 +/- 1.9 MBq (350 to 411 mu Ci) Tc-99m-labeled anti-RAGE F(ab')(2), 6 were injected with Tc-99m-labeled control nonspecific IgG F(ab')(2), and 1 was injected with dual-labeled Tc-99m and rhodamine anti-RAGE F(ab')(2). Four 20-week C57BL/6 mice were injected with Tc-99m-labeled anti-RAGE F(ab')(2). All mice were imaged on a high resolution mini-gamma camera 4 hours after injection and euthanized. The aortic tree was dissected and photographed, and the proximal aorta was sectioned for staining after gamma scintillation counting. All 6 apoE(-/-) mice injected with Tc-99m-labeled anti-RAGE F(ab')(2) fragments showed focal tracer uptake in the proximal aorta (mean %ID/g, 1.98%). Disease and antibody controls showed no focal tracer uptake in the thorax (%ID/g, < 1.0%). Histological sections of the proximal aorta showed American Heart Association class III lesions with lipid laden macrophages, smooth muscle cells, and positive staining for RAGE. On immunofluorescence, RAGE colocalized with macrophages. Conclusion-These data show the feasibility of noninvasively imaging RAGE in atherosclerotic lesions in a murine model and confirm levels of RAGE expression sufficient to allow detection on in vivo imaging. (Circ Cardiovasc Imaging. 2008;1:212-219.)