Bexarotene (Targretin) is a retinoid X receptor (RXR) agonist that has applications for treatment of T cell lymphoma and proposed mechanisms of action in Alzheimer's disease that have been the subject of recent controversy. Carbon-11 labeled bexarotene ([ 11 Ccarbonyl]4- [1-(3,5,5,8,8-pentamethyltetralin-2-yl)ethenyl]benzoic acid) was synthesized using a Cu-mediated cross-coupling reaction employing an arylboronate precursor 1 and [ 11 C]carbon dioxide under atmospheric pressure in 15 Âą 2% uncorrected radiochemical yield (n = 3), based on [ 11 C]CO 2 . Judicious choice of solvents, catalysts, and additives, as well as precursor concentration and purity of [ 11 C]CO 2 , enabled the preparation of this 11 C-labeled carboxylic acid. Formulated [ 11 C]bexarotene was isolated (>37 mCi) with >99% radiochemical purity in 32 min. Preliminary positron emission tomographyâmagnetic resonance imaging revealed rapid brain uptake in nonhuman primate in the first 75 s following intravenous administration of the radiotracer (specific activity >0.3 Ci/Îźmol at time of injection), followed by slow clearance (Î = â43%) over 60 min. Modest uptake (SUV max = 0.8) was observed in whole brain and regions with high RXR expression. KEYWORDS: Bexarotene, targretin, positron emission tomography, carbon-11, carbon dioxide fixation, retinoid X receptor, Alzheimer's disease R etinoid X receptors (RXRs) function as key transcription factors inasmuch as they are the heterodimeric partners for most nuclear receptors, including retinoic acid receptors (RARs), peroxisome proliferator-activated receptors (PPARs), vitamin D receptor, and thyroid hormone receptor. 1 Retinoid X ligands (e.g., 9-cis retinoic acid, Figure 1) are small lipophilic hormones, which, when bound to a heterodimeric or a homodimeric (i.e., RXR-RXR fusion) receptor, cause it to bind a transcription complex on DNA and to promote expression of target genes. RXRs are found ubiquitously and differentially in mammalian cells, including in both glial and neuronal brain tissue. 2 Defective retinoid signaling and deficiency of apolipoprotein E (ApoE) are closely associated with Alzheimer's disease (AD). 3 Bexarotene (4-[1-(3,5,5,8,8-pentamethyltetralin-2-yl)ethenyl]benzoic acid, Figure 1), an FDA-approved selective RXR agonist, 4 has recently been demonstrated to induce clearance of β-amyloid from the brains of murine AD models through activation of the APOE gene, which is the most indicative genetic risk factor for late-onset AD. 5 In vitro and in vivo studies also suggest that bexarotene is acting on RXRs, and not directly on β-amyloid or by compromising the bloodâbrain barrier. 6 A transgenic mouse model of AD (Tg2576) exhibited reversal of cognitive and behavioral degradation with the administration of bexarotene. 5 These findings have proven to be controversial, however, as several laboratories have struggled to reproduce both the scope and magnitude of the in vivo results. 7â11 An additional caveat to these results is that the bexarotene dose used to achieve these effect...