A method to detect and quantify aggregated α-synuclein
(αSYN)
fibrils in vivo would drastically impact the current
understanding of multiple neurodegenerative diseases, revolutionizing
their diagnosis and treatment. Several efforts have produced promising
scaffolds, but a notable challenge has hampered the establishment
of a clinically successful αSYN positron emission tomography
(PET) tracer: the requirement of high selectivity over the other misfolded
proteins amyloid β (Aβ) and tau. By designing and screening
a library of 2-styrylbenzothiazoles based on the selective fluorescent
probe RB1, this study aimed at developing a selective
αSYN PET tracer. [3H]PiB competition binding assays
identified PFSB (Ki
= 25.4
± 2.3 nM) and its less lipophilic analogue MFSB,
which exhibited enhanced affinity to αSYN (Ki
= 10.3 ± 4.7 nM) and preserved selectivity over Aβ.
The two lead compounds were labeled with fluorine-18 and evaluated
using in vitro autoradiography on human brain slices,
where they demonstrated up to 4-fold increased specific binding in
MSA cases compared to the corresponding control, reasonably reflecting
selective binding to αSYN pathology. In vivo PET imaging showed [18F]MFSB successfully
crosses the blood–brain barrier (BBB) and is taken up in the
brain (SUV = 1.79 ± 0.02). Although its pharmacokinetic profile
raises the need for additional structural optimization, [18F]MFSB represents a critical step forward in the development
of a successful αSYN PET tracer by overcoming the major challenge
of αSYN/Aβ selectivity.