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Molecular imaging and disease theranostics with renal-clearable optical agents

Nature Reviews Materials volume 6, pages 1095–1113 (2021)Cite this article

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Abstract

Optical imaging in disease diagnosis and treatment benefits from high spatiotemporal resolution and the availability of numerous optical agents. However, many optical imaging probes are cleared by the reticuloendothelial system, which can lead to probe accumulation in the liver and spleen and hence organ toxicity. By contrast, renal-clearable optical agents (RCOAs) are rapidly excreted from the body via the kidneys, undergoing minimal metabolism. In this Review, we discuss the design principles of RCOAs, with a focus on imaging and disease theranostics (the combination of diagnosis and therapy). Renal excretion of RCOAs makes them intrinsically suitable for targeted kidney imaging, including passive monitoring of the glomerular filtration rate and detection of early kidney injury biomarkers. The pharmacokinetics of RCOAs can further be tailored to prolong their circulation in the blood, allowing deep tumour penetration and high-contrast tumour imaging. Finally, we discuss intraoperative image-guided surgery and optical urinalysis, and suggest future applications of RCOAs.

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Fig. 1: Timeline of major milestones and classifications of RCOAs.
Fig. 2: Clearance pathways of optical agents.
Fig. 3: RCOAs for monitoring the glomerular filtration rate.
Fig. 4: RCOAs for real-time kidney imaging.
Fig. 5: RCOAs for real-time cancer imaging.
Fig. 6: RCOAs for intraoperative fluorescence-guided surgery.
Fig. 7: RCOAs for optical urinalysis.

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Acknowledgements

K.P. thanks Nanyang Technological University (start-up grant M4081627) and Singapore Ministry of Education, Academic Research Fund Tier 1 (2019-T1-002-045, RG125/19), Academic Research Fund Tier 2 (MOE2018-T2-2-042) and the Agency for Science, Technology and Research (the AME Programmatic Grant SERC A18A8b0059) for the financial support.

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    Penghui Cheng & Kanyi Pu

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Cheng, P., Pu, K. Molecular imaging and disease theranostics with renal-clearable optical agents. Nat Rev Mater 6, 1095–1113 (2021). https://doi.org/10.1038/s41578-021-00328-6

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