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Keywords: mRNA
detection, Fluorescence, Diagnosis, Arthritis
INTRODUCTION
Arthritis is a term
used to indicate joint pain that are caused by inflammation of joints or joint
disease that occur commonly among older people. People of all ages, sexes and
race can and do have arthritis as well. There are different types of arthritis
with different causes and treatment methods but the most commonly known are the
Rheumatoid Arthritis (RA) and the Osteoarthritis (OA). The symptoms of
arthritis are joint pain, swelling, stiffness and decreased range of motion
which could develop over time or appear suddenly. These symptoms may or may not
exacerbate over time. As the disease get more severe, it could prevent patients
from doing daily activities such as walking up the stairs and experience
chronic pain [1].
There are multiple
approaches for diagnosing arthritis other than performing physical examinations
by the doctor or rheumatologists. Conventional radiography (CR) is one of the
many imaging methods for diagnosis. CR is cheap compared to the alternative,
magnetic resonance imaging (MRI) and faster than ultrasound. However, CR can
only be used towards the end of the disease process, where the bones have
eroded and joint spaces narrowing [1] and it does not show soft tissue
sufficiently [2]. Both ultrasound and MRI are not favorable due to the time it
takes for diagnosis with ultrasound and the high cost in exchange for high
sensitivity of MRI. Positron emission tomography (PET) has made its way into
diagnosing the disease for its high sensitivity detection and potential for
whole-body evaluation [3]. However, due to the short half-life of some isotopes
used for this technique, patients will mostly be subjected to radiation
exposure which may cause more health problems in the future. Optical imaging
(OI) have been around in the microscopic world is now making its way to the
macroscopic setting where this technique offers high sensitivity for detection
of inflammation [4,5], fast and inexpensive and most importantly do not expose
patients to ionizing radiation [3]. OI is perfect for detecting and diagnosing
rheumatoid arthritis that mainly affects small joints of hands and feet. Many
medical equipment, such as the X-ray radiography, computed tomography (X-RAY
CT), radionuclide imaging using single photons (Single Photon Emission Computer
Tomography SPECT) and positrons (Positron Emission Tomography PET), magnetic
resonance imaging (MRI), ultrasonography (US) and optical imaging require
‘contrast agents’ for the extraction of information of the human bodies [6,7].
Real-time PCR, fluorescence in situ
hybridization (FISH) analysis have been widely used at the cellular level to
detect expression levels and cell distribution of mRNA [8].
FLUORESCENCE-BASED
IMAGING TECHNIQUES
In the past few centuries, there was a surge
in the use of fluorescent dye in various areas. Special dyes are used for
printing valuable documents such as money, and certificates. Some dyes are used
to aid in leak detections of oils and fluids in vehicles. Because of its
distinct ability, the dyes are also used to assist in exploration of water
underground. Using similar concept in large scale, researchers started to apply
this approach in in vivo medical
imaging. Despite countless of organic dyes in the market for research, there
are only two fluorophores that’s approved by the US Food and Drug
Administration (FDA) for medical use, which are the fluorophores are
indocyanine green (ICG) and fluorescein [11-13]. ICG is used as an
ophthalmologic agent and as a hepatic functional agent while fluorescein is
used primarily in ophthalmology. These two agents, with no toxicity reported,
are primarily used to obtained retinal angiograms that require high dosage of
the agents. Even though fluorophores dyes in optical imaging have made great
strides in the imaging field, an ideal labeling reagent would be the ones that
remain non-fluorescent until bound to its target.
Fluorescence microscopy, providing real-time
visualization in the surgical field, has similar sensitivity to radionuclide
imaging, providing high resolution, high contrast, high specificity and
quantitative of the sample. The downside of optical imaging is that uncertainty
emerges as the scans get into deep tissue due to unpredictable light scattering
and absorption [14,15]. Hence, the best place to use optical imaging is on the
superficial tissue surfaces such as the breasts or the lymph nodes [16-20].
However, with the continued growth in the medical imaging techniques, dyes used
for contrast images have improved significantly.
To obtain a successful optical molecular
probe for medical imaging, the right wavelength must be employed to excite the
dye to obtain a unique emission wavelength. However, if the excitation
wavelength is near the ultraviolet region, the tissue will be damaged, while
excitation on at the infrared region will cause tissue heating. Absorbance and
auto fluorescence could be observed in any case when there is asymmetrical
stokes shift [12]. To prevent the auto fluorescence by the tissue under low
interference, many researchers and scientists have started applying light in
the near-infra red (NIR) wavelength (650-900 nm) as the excitation energy.
These NIR wavelengths are invisible to human eyes [21]. The incorporation of
NIR fluorophores with current optical imaging techniques provides an
intraoperative image-guided surgery that allows for target-specific imaging due
to ultralow background auto fluorescence [15].
Previous study of OI have shown promising
results after injection of fluorescent dyes for detection of arthritis
[4,5,22,23]. Another study has successfully shown that in vivo leukocyte cell can be tracked by using optical imaging
techniques. These in vivo leukocyte
cells are labeled with fluorescent dyes, which are suitable for the detection
of synovial inflammation in an antigen-induced arthritis model [3].
There are few available fluorescence-based
imaging techniques: fluorescence microscopy, flow cytometry, cell sorting
fluorescence correlation spectroscopy as well as particle tracking velocimetry
[7].
Visualization mRNA
with different hybridization methods
FIT: A different approach to increase
fluorescent signal upon bonding is to use forced intercalation (FIT) probes as
seen in Figure 1C. Like FISH, FIT
probes are made of peptide nucleic acid (PNA) or DNA single strands that only
fluoresce as soon as it hits the target DNA [31,32]. This is not covered in the
review.
QUANTUM DOTS: Quantum dots (QD) are a new class
of fluorescent probes starting to emerge in the past few decades. QDs also have
long lifetime increasing the probability of adsorption and producing broad
absorption spectrum. Other than being non-toxic to samples, one of the most
appreciated advantages of QD is their photostability or resistance to
photobleaching, which allows images to be recorded over a longer period
compared to conventional fluorescent dyes [7]. Other than in vivo targeting and imaging, QDs are also used in cellular
targeting and imaging, as well as fixed tissue analysis, optical encoding and
quantitative determination [33].
Size of the quantum dot nanoparticles in
bioimaging field generally falls within 2-10 nm in diameter. QDs have unique
optical and electronic properties, with molar extinction coefficients that are
10-50 times larger, making it much brighter than conventional dyes. The
emission wavelengths are size tunable depending on the radius of the QD. Larger
QDs were also synthesized to be used in other applications other than in vivo imaging. However, parameters
such as the distance between gold nanoparticle to optical absorbance and
scattering intensity of the inter-particle distance can be controlled,
resulting in a research group utilizing 20 nm Au nanoparticles QD to predict
the localized surface plasmon resonance (LSPR) of gold nanoparticles. They were
able to synthesize 20 nm AuNP monomers with zero LSPR background as probes with
only a single target molecule required to form a dimer with significant plasmon
resonance coupling effect, increasing the sensitivity of the LSPR sensor to
single cell level. In their study, they were able to present a smart single
mRNA imaging approach in living cells based on target-induced formation of
nanoparticle dimers. They concluded that with proper linker, these
nanoparticles could serve as a basis to many imaging techniques for
biomolecules and mRNA in living cells [34].
CONCLUSION
There are many restrictions obtaining
multicolor in vivo imaging mainly due
to overlapping fluorescence emissions. Different approaches have been executed,
including the recently developed 3’untranslated region (UTR)-based reported
gene imaging system to monitor the expression of patterns of mRNA. However,
with this approach, it is difficult to differentiate if the data obtained are
from the mRNA expression or from cell death in
vivo [44-47].
On the other hand, different fluorophores
with discernable emissions wavelength must be chosen for multicolor imaging.
The complications for the traditional dyes such as organic dyes and QDs are the
requirement to use UV or short-wavelength radiation for excitation of the
materials and their cytotoxicity in biological environment. Low light
penetration depth is observed due to the short wavelength excitation light or
low signal-to-noise ratio due to auto-fluorescence. Although fluorescence-based
imaging techniques have improved tremendously, there are still rooms to improve
the techniques or the probes. It is important to develop more efficient
bio-labels to overcome these limitations. NIR probes have gained its momentum
the past decades to overcome the shortcomings of the traditional probes when it
comes to monitoring the sample with higher depth. Few companies have developed
some NIR fluorophores with emission >800 nm, permitting NIR probes to be
used together with the original fluorescent organic dye [48]. With the
developments of new types of contrast agents together with improvement in
electronics and software in equipment, fluorescence-based imaging technique can
expand even more. In conjunction of NIR probes, quantum dots have also been an
interesting tool not only for imaging field, but for the computing as well as
the quantum dot displays for lightning up LCD displays in televisions. Many
researches could be done in terms of quantum dots in the field of
nanotechnology. Future work such as incorporating the reporter tag into
endogenous gene loci using CRISPR-Cas0 genome editing tools would proof to be
quite interesting [49].
The NIR dye, ICG, is already being used to
test for liver cancer during surgery, to identify small and unidentifiable
liver cancers in real time. ICG has also been used to identify lymph nodes in
real time in a small number of breast cancer patients [50]. Even though optical
imaging has yet to replace conventional imaging as a form of arthritis tool, OI
is a promising diagnostic tool for detecting early onset arthritis.
In summary, this review analysis on the
visualization of mRNA with different hybridization techniques. There were many
shortcomings since the development of fluorescence-based imaging techniques,
but scientists and researchers have all overcome the obstacles and improved
both the probes and instruments for a better future. The capability of
fluorescence-based imaging techniques is open to new possibilities for better
and faster diagnostic of joint diseases in the future.
CONFLICT OF INTEREST
Dr. Yupeng Chen is a co-founder of NanoDe
Therapeutics, Inc.
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