# Molecular Imaging CCR2 Lung Inflammation and Fibrosis

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2024 · $712,916

## Abstract

SUMMARY
Pulmonary fibrosis is the result of a poorly understood, dysregulated cellular response that is difficult to diagnose
and treat. A common form, idiopathic pulmonary fibrosis (IPF), has a progressive, downhill course. There are no
well-established molecular biomarkers for diagnosis, treatment, or disease activity. Clinicians currently depend
on changes in chest computed tomography (CT) and pulmonary function to monitor patients. Moreover, there
are only two approved drug therapies, and treatment is not guided by molecular biomarkers. Lung CCR2+ (C-C
motif chemokine receptor 2) inflammatory monocytes and their pathologic progeny, interstitial macrophages, are
strongly associated with the experimental development of lung fibrosis, elevated in the lungs of patients with
pulmonary fibrosis, and produce profibrotic factors. Fibrosis is significantly attenuated in Ccr2 null mice and by
deletion of CCR2+ progeny macrophages, strongly supporting a role for CCR2+ cells in human disease. This
proposal aims to utilize a molecular, positron-emission tomography (PET)-based diagnostic to detect CCR2-
mediated inflammation in the lungs of patients with fibrosis and to develop targeted therapies. Our
multidisciplinary group has established that a peptide-based radiotracer, 64Cu-DOTA-ECL1i, identifies CCR2+
monocytes in animal models and has acceptable dosimetry in our recent human Phase 0/1 trial of PET/CT
imaging. The known relationship of CCR2+ cells to pulmonary fibrosis and the clinical challenges of managing
patients with IPF, make this disease particularly suited for evaluating the radiotracer. Therefore, we have used
multiple mouse models of lung fibrosis to show that increased 64Cu-DOTA-ECL1i lung uptake correlates with
CCR2+ cell infiltration and fibrosis. Our data also show that the radiotracer detects decreases in lung uptake in
bleomycin-induced fibrosis after blockade of interleukin-1b, a mediator of fibrosis expressed in CCR2+ cells, and
treatment with anti-fibrotic drug, pirfenidone. Pilot CCR2-PET imaging of patients with IPF show increased lung
signal, particularly in regions of subpleural fibrosis. We propose to use 64Cu-DOTA-ECL1i PET imaging to
evaluate modulation of CCR2+-specific inflammation during the course of fibrotic lung disease in animal models,
validate the detection of CCR2 cells in human lung tissue, and assess the potential for monitoring patients. We
hypothesize that 64Cu-DOTA-ECL1i detects the CCR2+ cell inflammatory process associated with pulmonary
fibrosis and can be used to monitor disease activity. Specific aims are: (1) In mouse fibrosis models, assess the
change in the 64Cu-DOTA-ECL1i PET/CT uptake relative to inflammation and fibrosis upon treatment with clinical
anti-fibrotic drugs and following molecular targeting with CCR2 antagonists, and (2) In patients with IPF, assess
the relationship between PET uptake, CT imaging, and clinical status, then validate the relationship of PET
uptake with CCR2-mediated inflam...

## Key facts

- **NIH application ID:** 10753447
- **Project number:** 5R01HL151685-04
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Steven Brody
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $712,916
- **Award type:** 5
- **Project period:** 2021-02-05 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10753447

## Citation

> US National Institutes of Health, RePORTER application 10753447, Molecular Imaging CCR2 Lung Inflammation and Fibrosis (5R01HL151685-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10753447. Licensed CC0.

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