Lead
While molecular imaging agents for positron emission tomography (PET) are essential tools for acquiring a better understanding of a disease, its severity and progression, PET has hardly been used in the current COVID-19 pandemic. We are therefore developing a PET tracer to study the expression dynamics of the virus entry receptor ACE2.

Lay summary

Background

The COVID-19 pandemic shows large variability in disease presentation, progression, and outcome. Until recently, the risk factors that determine disease severity and outcome have been scarcely investigated. Adequate early risk stratification will be essential to avoid overburdening hospitals and intensive care units in view of the current and future generations of SARS-CoV infections. Molecular imaging using PET may serve for risk stratification by assessing the expression and regulation of key disease factors, thereby providing personalised treatment options.

Research aims

It has been suggested that the virus entry receptor ACE2 is responsible for the individual’s susceptibility to infection and disease progression. The aim of this project is to develop a radioligand for non-invasive imaging of ACE2 using PET. It should provide clinicians with a tool to investigate the dynamics of ACE2 expression in relation to age, gender, pre-existing morbidity, medication and environmental factors, and thus enable (early) risk stratification.

Expected results and envisaged products

Successful completion of this research project will deliver a PET agent for non-invasive imaging of ACE2. Such radioligands will aid researchers and clinicians to better understand the expression pattern, function and regulation of ACE2 in the context of COVID-19. An understanding of the dynamics of ACE2 expression in relation to various endogenous and exogenous factors will be essential for the risk management of individual patients in the future. Ultimately, clinicians may thus profit from such a PET agent to assess COVID-19 patients and provide them with individual treatments to prevent severe disease progression and a fatal outcome.

Specific contribution to tackle the current pandemic

The specific contribution of this project to the current pandemic refers to the delivery of a tool that serves for a better understanding of risk factors for severe outcome of COVID-19. Only when we understand the role of ACE2 expression, its dynamics and regulation, will it be possible to address unfavourable conditions in certain population groups by specific interventions and to provide specific treatments for infected patients at risk. Certainly, the understanding of these mechanisms is not limited to SARS-CoV-2 but may also be of value to fight future generations of corona viral infection.