Magnetic Resonance in Medicine 51:938 –944 (2004) Improved Route for the Visualization of Stem Cells Labeled With a Gd-/Eu-Chelate as Dual (MRI and Fluorescence) Agent Simonetta Geninatti Crich,1 Luigi Biancone,2 Vincenzo Cantaluppi,2 Debora Duò,2 G. Esposito,1 Simona Russo,2 Giovanni Camussi,2 and Silvio Aime1* A simple labeling procedure of stem/progenitor cells based on the use of Gd-HPDO3A and Eu-HPDO3A, respectively, is described. The Gd-chelate acts as T1-agent for MRI visualization, whereas the corresponding Eu-chelate acts as reporter in fluorescence microscopy. Owing to their substantial chemical equivalence, the two chelates are equally internalized in EPCs (endothelial progenitor cells), thus allowing their visualization by both techniques. The lanthanide chelates are entrapped in endosomic vesicles and the labeled cells retain biological activity with preservation of viability and pro-angiogenesis capacity. Hyperintense spots in MR have been observed for Gd-labeled EPCs injected under mice kidney capsule or grafted on a subcutaneous Matrigel plug up to 14 days after transplantation. Magn Reson Med 51:938 –944, 2004. © 2004 Wiley-Liss, Inc. Key words: endothelial progenitor cells; magnetic resonance imaging; cell labeling; Gd/Eu-complexes; fluorescence microscopy Pluripotent stem cells hold a great therapeutic potential for their capacity of regenerating damaged tissues in the presence of a number of pathologies (1–3). In particular, several therapeutic applications have been envisaged for blood-derived endothelial progenitor cells (4 – 6) (EPCs). Infusion of ex vivo expanded EPCs may be used to increase neovascularization of ischemic sites. Moreover, EPCs may be used for in vitro tissue engineering of implantable devices such as valves, prostheses, or vascular stents. The possibility of their in vivo visualization will allow monitoring the fate of the transplanted cells. Radioactive labeling has allowed the assessment of tissue distribution of transplanted EPCs, but unfortunately displayed poor spatial resolution (7). Current MRI technology displays a superb spatial resolution (to ⬍100 m) and is the technique of choice for attaining the observation of a very small number of cells. However, the cells have to be labeled prior to transplantation with suitable relaxation agents. Up to now, of the two classes of MRI contrast agents (8), namely, paramagnetic Gd-chelates and iron-oxide particles, the labeling of cells has been pursued mainly using 1 Department of Chemistry IFM, University of Torino, and Center for Molecular Imaging (CIM), University of Torino, Torino, Italy. 2 Department of Internal Medicine and Research Center for Experimental Medicine (CeRMS) University of Torino, Torino, Italy. Grant sponsors: MIUR (PRIN and FIRB project), Associazione Italiana per la ricerca sul cancro (AIRC), Progetto S. Paolo (to G.C.), Bracco Imaging SpA. *Correspondence to: S. Aime, Department of Chemistry IFM, University of Torino, via P. Giuria 7, Torino, 10125, Italy. E-mail: [email protected] Received 28 August 2003; revised 15 December 2003; accepted 15 December 2003. DOI 10.1002/mrm.20072 Published online in Wiley InterScience (www.interscience.wiley.com). © 2004 Wiley-Liss, Inc. the latter class. Often, in order to pursue an efficient uptake in nonphagocytic cells, the outer surface of the ironoxide particles has to be substantially modified, making the labeling procedure quite cumbersome. For instance, successful uptakes have been obtained by targeting transferrin receptors with antibodies conjugated to the dextran cover of iron-oxide cores (9) or by using an HIV-Tat peptide derivative (10); this allows Tat-mediated internalization of the magnetic nanoparticles. Another approach is based on the use of DNA transfection reagents (11–16) such as lipofectamins that allow the internalization of enough iron-oxide particles for the visualization of the in vivo tracking of implanted embryonic stem cells in a rat model of ischemic stroke. The use of iron-oxide particles may have some drawbacks. First, since they act, primarily, as T2-(negative)agents producing dark spots in the MR images, they are particularly effective for applications dealing with anatomical districts (e.g., brain) characterized by an intense MR signal intensity. Therefore, problems might arise when the detection of grafted cells involves a region endowed with a low intrinsic MR signal. Although not yet fully addressed, there might be toxicological problems associated with the metabolic fate of iron-oxide particles. In a typical experiment the amount of cell-internalized iron may be as high as 10 times the amount of endogenous iron. Moreover, it has been recently shown that the distribution and morphology of endosomes filled with iron-oxide particles are highly sensitive to the effects of the external static magnetic field (17). In fact, such magnetic compartments are deformed along the field and attract each other to form chaplets within the cytoplasm. Until now, only one Gd-based agent has been used to label stem cells. It is a system containing a dextran polymer backbone which contains 9 –12 Gd-chelates per dextrane (18). It also bears a tetramethyl rhodamine functionality for fluorescence microscopy detection. Gd3⫹ ions inside such a large macromolecule (MW 16.6 kDa) appear to act essentially as T2 agents, thus compromising the basic advantage of T1-Gd agents, that is, to generate hyperintense spots in T1weighted images. For these reasons we thought to explore alternative routes to label stem cells based on the use of a welltolerated, small-sized paramagnetic Gd (III) chelate. Moreover, the close analogy between Gd3⫹ and Eu3⫹ ions suggests the development of a dual probe thanks to the fluorescent properties of the latter ion (19,20). Indeed, Gd3⫹ and Eu3⫹ chelated by the same ligand display the same chemical/biological behaviors and therefore they may be 938 Stem Cell Labeling With Gd/Eu Chelates used to detect the localization and migration of stem cells by both MRI and fluorescence microscopy, respectively. MATERIALS AND METHODS Gd-HPDO3A complex (white powder) and HPDO3A ligand were kindly provided by Bracco S.p.A. (Milano, Italy). Eu-HPDO3A was synthesized by adding Eu2O3 (1.5 mmol) to an aqueous solution of the ligand (3 mmol). The reaction mixture was stirred at 70°C for about 8 hr. Formation of the complex was followed by measuring 1H NMR-spectra up to the complete disappearance of the signals of the free ligand. The presence of an excess of free Eu2O3 ions can be easily removed by forming the insoluble hydroxide at basic pH followed by centrifugation and filtration of the resulting suspension. Physicochemical Characterization 1 H-NMR spectra were obtained on a Bruker 600 Avance spectrometer. The longitudinal water proton relaxation rate was measured on the Stelar Spinmaster spectrometer (Stelar, Mede (PV) Italy) operating at 20 MHz, by means of the standard inversion-recovery technique (16 experiments, 2 scans). A typical 90° pulse width was 3.5 s and the reproducibility of the T1 data was ⫾0.5%. Cell Lines EPCs were isolated from peripheral blood mononuclear cells from healthy donors as described by Vasa et al. (21). Cells were plated on culture flasks in endothelial cell basal medium-2 (Clonetics, Biowhittaker, Walkersville, MD) supplemented with EGM-2 MV single aliquots consisting of 5% FBS, VEGF, FGF-2, EGF, and insulin-like growth factor-1 (complete medium). The endothelial phenotype was confirmed by the expression of vWF, Tie-2, VEGFR-2, VEGFR-3, but not of VEGFR-1 by FACS, Western blot and by functional evaluation of in vitro and in vivo angiogenic properties in Matrigel (22). Cell Labeling EPCs were cultured in tissue culture flasks and allowed to grow to 60 –70% confluence. Then the cells were washed and incubated with the required amount of Gd-HPDO3A in the complete medium. At the end of the uptake experiments, the cells were washed five times with 50 ml RPMI, detached with trypsin/EDTA solution, and then washed three times by centrifugation at 1000g for 5 min. Determination of Gd3⫹ Content in Cells At the end of the uptake experiment (see above), labeled cells were collected in 250 l PBS and destroyed by adding the same volume of HCl 37% and left at 120°C overnight. Upon this treatment, all Gd3⫹ is solubilized as the free aquo-ion. Then the water proton T1 of these solutions was measured at 20 MHz and 25°C, and the Gd3⫹ concentrations determined from a standard curve obtained using standard GdCl3 solutions (0.01–2 mM). The method was double-checked by ICP measurements. 939 The protein concentration was determined from cell lysates by the method of Bradford (Sigma, St. Louis, MO) using bovine serum albumin as standard. One mg protein corresponds to about 4 ⫻ 106 cells. Determination of Intracellular Relaxivity At the end of the uptake (16 hr, 37°C), labeled cells (⬃2 million) were transferred to the NMR tube. The supernatant was carefully removed and the T1 of the intact cells was measured at 20 MHz and 25°C. Then the pellets were treated with HCl 37% (50:50) at 120°C overnight, in order to evaluate quantitatively the amount of Gd3⫹ as free aquoion. Intracellular relaxivity was determined using the following equation: r 1p (intracellular) ⫽ (R *1obs – R 1obsc)/[Gd 3⫹], where R*1obs are the observed relaxation rates (measured at c room temperature) for the Gd-containing cells, R1obs the observed relaxation rates for untreated cells, and [Gd3⫹] is the intracellular mM concentration of Gd3⫹. Cell Viability To evaluate cell viability, EPCs were cultured in 96-well flat-bottom microtiter plates (Falcon Labware, Oxnard, CA) at a concentration of 5 ⫻ 104 cells/well in DMEM/10% FBS in the presence of increasing concentrations of GdHPDO3A (10 –100 mM) for 24 hr at 37°C. The cell viability was evaluated using the sodium 3⬘-[1-(phenylaminocarbonyl)-3,4-tetrazolium]-bis(4-methoxy-6-nitro)benzene sulfonicacid hydrate (250 g/ml XTT)-based assay. The reduction of XTT was monitored by determination of the absorption values at 620 nm in an automated ELISA reader. The viability assay was performed by doublestaining the cells with 0.46 mM fluorescein diacetate (FDA) as an inclusion dye and 14.34 mM propidium iodide as an exclusion dye for living cells. Confocal Fluorescence Microscopy Uptake of Eu-HPDO3A was analyzed by confocal microscopy. Confocal microscopy was performed on a Leica TCS SP2 model confocal microscope (Heidelberg, Germany) using a 63⫻ magnification lens and excitation was obtained by an argon laser at 351 and 363 nm (20). Angiogenesis Assays In vitro formation of vessel-like tubular structures was studied on growth factor-reduced Matrigel (8.13 mg/ml; Becton Dickinson Labware, Bedford, MA) diluted 1:1 in ice-cold DMEM under a Nikon Diaphot inverted microscope in a Plexiglas Nikon NP-2 incubator at 37°C. Briefly, the 5 ⫻ 104/well cells were seeded onto Matrigel-coated wells in 10% FCS/DMEM. After the cells had attached, the FCS-containing media was removed and 0.5 ml serum-free DMEM was added. Image analysis was performed by digital saving of images at an interval of 30 min with a MicroImage analysis system (Casti Imaging srl, Venice Italy). In vivo, angiogenesis was assayed as blood vessel formation from 0.5 ⫻ 106 EPCs embedded into a solid gel of 940 Geninatti Crich et al. basement membrane (23). As standard procedure, EPCs were resuspended in 0.5 ml of Matrigel in liquid form at 4°C, and then injected into the dorsal subcutaneous tissue of 8-week-old SCID mice. For the kidney subcapsular implant, under general anesthesia induced by methoxyflurane (Metofane; ScheringPlough Animal Health, Atlanta, GA), a left lobotomy was performed, the right kidney was exposed, and 2 ⫻ 106 labeled EPCs were injected in the subcapsular space. The care of the animal was in accordance with institutional guidelines. MRI All MR images were acquired on a Bruker Avance 300 (7 T) equipped with a microimaging probe. The system is endowed with two birdcage resonators with 30 and 10 mm inner diameter, respectively. For MRI of cell pellets, cells were incubated with the contrast agent, extensively washed, detached, and again washed as described above. The cells were pelleted within a 200 l end-sealed plastic pipette tip that was then inserted in 2% agarose within a 50-ml tube. The imaging protocol consisted of a coronal T1-weighted spin echo (TR/TE/NEX 140/4.4/36, FOV 2.8 cm, 1 slice 1 mm). The ex vivo and in vivo imaging of Matrigel plugs was achieved with a T1-weighted spin echo (TR/TE/NEX 100/ 4.4/8, FOV 3.0 cm, 1 slice 1 mm and TR/TE/NEX 120/4.4/ 42, FOV 2.7 cm, 1 slice 1 mm, respectively). Imaging of mouse kidneys was performed using a T1-weighted spin echo protocol (TR/TE/NEX 180/4.4/56, FOV 2.6 cm, 1 slice 0.7 mm). After imaging, Matrigel plugs were excised and processed for optical microscopy. The care of the animal was in accordance with institutional guidelines. In vivo imaging was performed under general anesthesia induced by methoxyflurane (Metofane; Schering-Plough Animal Health). RESULTS AND DISCUSSION Gd-HPDO3A (Prohance, Bracco Imaging) (Fig. 1) is a commercially available, MRI nonspecific agent. Once administered intravenously, it quickly equilibrates between the intra- and extravascular compartments. It is a neutral, highly hydrophilic chelate endowed with a very high thermodynamic stability (log K⬃23.2) (24) which ensures against any release of harmful Gd3⫹ ions under in vivo conditions. Its relaxivity, r1p (where r1p is the relaxation enhancement of solvent water protons at 1 mM concentration of the paramagnetic chelate) is 4.2 mM-1s-1 in water at 25°C. From pharmacological studies, Gd-HPDO3A appears to be one of the best-tolerated xenobiotics, as it yielded an LD50 ⬎10 mmol/kg in rats (24). As anticipated above, the model system for the stem cells used in this work is represented by ex vivo expanded blood-derived human EPCs. In a typical experiment, 2 ⫻ 106 EPCs were incubated in media containing different concentrations of Gd-HPDO3A. As there is no specific mechanism available for the uptake of such neutral and highly hydrophilic molecules, their cell entrapment occurs mainly through pinocytosis. FIG. 1. The internalization of GdHPDO3A into EPCs. The uptake was carried out on ⬃2 million cells incubated in the presence of increasing concentrations of the complex at 37°C for 24 hr. The amount of internalized Gd-HPDO3A has been determined by measuring the relaxivity of the cytoplasmatic extracts mineralized at 120°C overnight, in the presence of HCl (6 M). From the known relaxivity of aquo-Gd3⫹ ion (r1p ⫽ 13.5 mM-1 s-1), one may easily determine the amount of total Gd taken up in a given experiment. In Fig. 1, the amount of internalized Gd (expressed in terms of 1 mg of total protein) is plotted against the concentration of Gd-HPDO3A in the incubation medium (incubation time ⫽ 24 hr). As expected for this type of internalization process, no saturation effect was detected and the amount of Gd3⫹ taken up is linearly proportional to the concentration of Gd-HPDO3A in the incubation medium. It is known that the pinocytosis process leads to the formation of small endosomes which may eventually fuse into larger lysosomes. In principle, one would expect that the relaxivity of Gd-HPDO3A inside the endosomes to be not too different from that shown in the incubation medium (⬃4.2 mM-1s-1 at 20 MHz, 298 K), as the endosome formation simply proceeds through the entrapment of a portion of the extracellular fluid. Against this expectation, the measure of r1p of internalized Gd-HPDO3A carried out on pellets of ⬃2⫻106 EPCs showed that the intracellular relaxivity is indeed dependent on the amount of Gd taken up by the cell (Fig. 2a). In fact, pellets obtained from incubation at low concentration yielded r1p values significantly higher than the relaxivity found in the incubation medium, whereas when the amount of internalized Gd is ⬎0.1 mol/mg of protein the observed relaxivity is “quenched” to a value of 1.0 mM-1 s-1. It is likely that, at low concentrations, this observed relaxation enhancement is the result of a decreased molecular mobility. Conversely, the decrease of the observed relaxivity, as the endosomic concentration of Gd-HPDO3A increases, may be attributed to different causes. One may think of a sort of shrinking effect inside endosomes for which the distances Stem Cell Labeling With Gd/Eu Chelates 941 FIG. 2. a: The relaxivity (r1p) of intracellular Gd-HPDO3A as a function of the amount of Gd internalized into EPCs/mg of proteins. One mg protein corresponds to about 4 ⫻ 106 cells. b: T1-weighted spin echo image (TR/TE/NEX (140/4.4/36), FOV 1.6 cm, 1 slice 0.5 mm) of an agar phantom containing EPCs labeled with increasing amounts of Gd-HPDO3A. Each pellet (⬃5 ⫻ 105 cells) contains: A) 5 (SI ⫽ 112), B) 8 (SI ⫽ 180), C) 11 (SI ⫽ 165), D) 14 (SI ⫽ 166), e) 20 (SI ⫽ 165) nmol of Gd-HPDO3A. SI is the corresponding signal intensity. SI measured for a corresponding number of unlabeled cells yielded a value of 43. between Gd-containing molecules becomes short enough to affect the electronic relaxation time. Such an effect has been recently shown to occur on the surface of micelles formed by Gd-chelates functionalized with a hydrophobic chain (25). Another cause may be the extensive broadening of the signal (mainly as the result of T*2 effects). Such a loss of signal intensity is expected to alter the assessment of proton T1 by the inversion recovery procedure in cell pellets. In order to assess the effect on signal intensity, associated with the changes in intracellular relaxivity, T1weighted MR images of a phantom, made up of pellets (5 ⫻ 105 cells) containing different amounts of internalized GdHPDO3A, were recorded (Fig. 2b). As expected from the results shown in Fig. 2a, the intensity of the signal (SI) decreases for higher intra-endosomic concentrations of the paramagnetic agent. Accordingly, T2 varies from 66 to about 25 ms on going from the lowest to the highest GdHPDO3A concentration in the pellets reported in Fig. 2b. However, the decrease of SI is not dramatic and it would not compromise the possibility of detecting the labeled cells over an extended range of Gd concentrations. All above considerations are based on the assumption that water molecules have free access to the compartment containing the paramagnetic agent. This seems a likely assumption, as the membrane delimiting the endosome vesicle should have maintained the same water permeability of the cellular membrane from which it derives. Next, the issue of the preservation of the chemical integrity of Ln(III)-HPDO3A upon cellular internalization was tackled. For this experiment, Gd-HPDO3A was replaced in the incubation medium with Eu-HPDO3A (50 mM, 16 hr, 2 ⫻ 106 cells). The latter complex displays relatively sharp lines in its high-resolution 1H-NMR spectrum. Although the assignment of all 1H resonances was not carried out, the lowest absorptions (at 32.5, 32.1, 27.4, and 22.1 ppm) are likely due to the four axial protons of the tetraazamacrocycle ring. This has been used as a reporter of the presence of Eu-HPDO3A in the cytoplasmatic extracts recovered by sonication of EPC pellets. To quantitate the amount of Eu-HPDO3A, a weighed amount of a related Eu(III)-complex (26) was added. The measurement of the relative ratios of the integrated areas of the signals of the two complexes allowed us to determine the actual amount of Eu-HPDO3A in the specimen. This should correspond to the amount of Gd-HPDO3A, as the two chelates have identical behavior in the internalization process. Interestingly, the obtained amounts of Eu-HPDO3A correspond nicely to those found for Gd, from relaxometric measurement after mineralizing the EPC pellet in related experiments. Thus, we may conclude that all entrapped Gd is present as Gd-HPDO3A. To determine the minimum number of Gd-HPDO3Alabeled cells detectable by MRI under in vitro conditions, six pellets containing different ratios of labeled/unlabeled cells were embedded in agar and their image detected by a T1-weighted sequence. We found that the minimum detectable number of labeled cells is on the order of 2–3 ⫻ 103 where each pellet contained ⬃250,000 cells. An important issue is the biological effect associated with the entrapment of Gd-HPDO3A in EPCs. The percentile viability of EPCs treated with Gd-HPDO3A, evaluated by the XTT-based assay, did not differ from that of the control for all concentrations tested (10, 25, 50, 100 mM in the incubation media) and was greater than 98%. Moreover, no difference in cell proliferation was detected at the scale of XTT reduction (Fig. 3a). The absence of dead cells was confirmed by the absence of nuclear staining by propidium iodide, which was less than 1% in both treated and untreated EPCs (not shown). Moreover, Gd-HPDO3Alabeled EPCs retained the functional ability to make vessel-like structures in vitro and in vivo Matrigel (Fig. 3b,c). Thus, we conclude that, also when internalized into cells, the lanthanide chelates of HPDO3A are an inert and welltolerated species. Gd-chelate distribution cannot be observed by the microscopic techniques currently used in cellular biology. However, its neighbor in the periodic table is Eu, which has excellent fluorescent properties. A characteristic feature of lanthanide(III) ions is their remarkably analogous chemistry. One would expect that Gd-HPDO3A and EuHPDO3A demonstrate identical behavior in the cell internalization process. Thus, the fluorescent response of EuHPDO3A can be exploited for histological confirmation of cell distribution. In Fig. 4, the image of EPCs incubated with Eu-HPDO3A obtained with a confocal microscope is shown. The endosomic vesicles containing Eu-HPDO3A 942 Geninatti Crich et al. FIG. 3. a: The proliferation assay of EPCs (labeled with Gd-HDO3A or unlabeled) detected by XTT-reduction assay. Data are the mean ⫾ SD of three independent experiments. b: Micrograph representative of in vitro angiogenesis assay on Matrigel. EPCs labeled with 25 mM Gd-HPDO3A form vessel-like tubular structures after 24 hr incubation at 37°C. c: Micrograph representative of in vivo angiogenesis induced by EPCs 1 week after subcutaneous implantation within Matrigel in SCID mice. Prior to injection the cells were labeled with 25 mM Gd-HPDO3A for 16 hr at 37°C. The same animals were subjected to MRI. Three experiments were performed with similar results. are clearly detected in the cytoplasmatic region, around the nucleus. Actually, EPCs can be incubated in a medium containing both Gd-HPDO3A and Eu-HPDO3A in order to have cells suitably labeled for the two imaging modalities. The proposed method is one of general applicability and is simpler than the use of the recently reported GRID (gadolinium rhodamine dextran) agent (18). High angiogenic potential represents the main feature of EPCs and holds promise for their use in therapeutic settings of local revascularization (1–5). In an in vivo mouse model of angiogenesis, we implanted EPCs subcutaneously within a Matrigel plug. After 7 days, Matrigel plugs were vascularized by a capillary network formed by EPCs and connected to the circulation. Our task was therefore the assessment of whether Gd-HPDO3A-labeled EPCs (5 ⫻ 105 cells) implanted within Matrigel (0.5 ml) were detectable under in vivo conditions. One day after implantation, hyperintense spots, well distributed in the Matrigel, were clearly detected in the resulting MR image (Fig. 5a). The histologic examination showed that the cells were dis- persed within the gel without evidence of capillary formation. In contrast, 7 days after implantation a fine network of bundles was seen in vivo within the Matrigel (Fig. 5b,c). The histologic examination showed large capillary structures transposing the gel plugs. Thus, MRI images parallel histologic findings: the hyperintense signal persisted for 14 days. As a control, Matrigel-embedded unlabeled cells were implanted under the same conditions and were always negative for an MRI signal. Moreover, 1 ⫻ 106 labeled or unlabeled EPCs were injected under the right kidney subcapsular space of SCID mice and images were taken after 24 hr. As shown in Fig. 6, labeled EPCs were visible at the site of injection. This result supports the view that the use of Gd-labeled cells may be particularly useful in organs, like the kidney, endowed with an intrinsic low MRI signal. In summary, the labeling procedure herein discussed for EPCs appears to be of general applicability, as all cell types tested to date showed an analogously efficient uptake of Gd(III)-chelates via the pynocytotic route, with no appar- FIG. 4. a: Micrograph representative of intracellular EPC uptake of Eu-HPDO3A after 16 hr of incubation at 37°C with 50 mM Eu-HPDO3A. b: Serial confocal optical sections of the cells showing that the fluorescent Eu-HPDO3A accumulates in the endosomal vesicles around nuclei. Stem Cell Labeling With Gd/Eu Chelates 943 FIG. 5. a: Ex vivo T1-weighted spin echo image (TR/TE/NEX 100/4.4/8, FOV 3.0 cm, 1 slice 1 mm) of Gd-labeled EPCs dispersed into a subcutaneous Matrigel plug excised one day after the implantation. b,c: In vivo T1-weighted spin echo image (TR/ TE/NEX 120/4.4/42, FOV 2.7 cm, 1 slice 1 mm) of Gd-labeled EPCs dispersed into a subcutaneous Matrigel plug 7 days after implantation. ent cytotoxicity. The compartmentalization of lanthanide(III)-HPDO3A complexes into membrane-bound cytoplasmatic perinuclear endosomes is likely to prevent any impact on relevant cellular processes, while maintaining an efficient accessibility to cytoplasmatic water molecules. Actually, the internalization of GdDTPA into tumor cells in culture was reported for human glioblastoma cells (27) and MCF7 (28). Consistent with our results, entrapment of GdDTPA in these cells takes place because of the high concentration of the paramagnetic agent in the incubation media. The detection of hyperintense spots in MR images of EPCs, 14 days after their grafting on Matrigel structures, shows that Gd-complexes can be competitive with iron-oxide particles for in vivo tracking of stem cells. Finally, it has been shown that the related Eu-HPDO3A complex is an excellent probe for fluorescence microscopy that allows a good match with the corresponding MR im- FIG. 6. T1-weighted spin echo image (TR/TE/NEX 180/4.4/56, FOV 2.6 cm, 1 slice 0.7 mm) of transplanted Gd-labeled EPCs (⬃1 million cells) under the right kidney capsula. The image was obtained 1 day after transplantation. ages based on the distribution of the Gd-chelate for an efficient localization of the transplanted cells. REFERENCES 1. Rafii S, Lyden D. Therapeutic stem and progenitor cell transplantation for organ vascularization and regeneration. Nat Med 2003;9:702–712. 2. McKay R. Stem cells— hype and hope. Nature 2000;406:361–364. 3. Pittenger MF, Mackay AM, Beck SC, Jaiswal RK, Douglas R, Mosca JD, Moorman MA, Simonetti DW, Craig S, Marshak DR. Multilineage potential of adult human mesenchymal stem cells. Science 1999;284:143– 147. 4. Quaini F, Urbanek K, Beltrami AP, Finato N, Beltrami CA, NadalGinard B, Kajstura J, Leri A, Anversa P. Chimerism of the transplanted heart. N Engl J Med 2002;346:5–15. 5. Hristov M, Erl W, Weber PC. Endothelial progenitors cells. 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