# Nerve-Specific Fluorophores for Improved Nerve Sparing during Prostatectomy using the Clinical Fluorescence Guided Surgery Infrastructure

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2024 · $601,985

## Abstract

PROJECT SUMMARY
Iatrogenic nerve injury represents one of the most feared surgical complications and remains a major morbidity
across all surgical specialties. Nerve-sparing radical prostatectomy is a compelling clinical example of significant
patient morbidity, where nerve damage is reported in up to 60% of patients resulting in incontinence and impo-
tence. Surprisingly, no clinically approved technology can enhance intraoperative nerve visualization, typically
performed through neuroanatomical knowledge and conventional white light visualization alone. Development
of a near infrared (NIR) fluorophore that specifically highlights nerve tissue in the operating room would have
direct clinical translation to nerve sparing prostatectomy through the FDA approved fluorescence channel in the
da Vinci surgical robotic system (Firefly, Intuitive Surgical, Inc.), which is used in >80% of prostatectomies per-
formed in the United States today. The proposed work will directly address this unmet clinical need. Fluorescence
Guided Surgery (FGS) has successfully integrated into clinical medicine with only two FDA-approved NIR fluor-
ophores (i.e., indocyanine green [ICG] and methylene blue). FGS systems operate almost exclusively in the NIR
(700-900 nm), where tissue chromophore absorbance, autofluorescence and scatter fall to local minima, allowing
high contrast and high resolution imaging at up to centimeter depths. All clinical FGS systems have an “800 nm”
channel designed to image ICG. To facilitate rapid clinical translation, the overall goal herein is to generate a
nerve-specific small molecule fluorophore with spectral properties matched to ICG, enabling both nerve imaging
at depth and future clinical translation using existing clinical FGS infrastructure. Design and development of a
small molecule nerve-specific fluorophore that can be imaged using FGS systems optimized for ICG has been
a significant challenge because these probes need to have a low enough molecular weight to cross the tight
blood nerve barrier junction with a sufficient degree of conjugation for NIR excitation and emission. In exciting
preliminary work, our team has synthesized first-in-class NIR nerve-specific small molecule fluorophores that
can be imaged with standard FGS systems optimized for ICG. Herein, these novel probes will be synthetically
tuned and validated for clinical utility through translation to swine and canine models using the da Vinci as well
as completion of preclinical pharmacology and toxicology (pharm/tox) studies, enabling a future IND application
to the FDA for clinical translation to robotic assisted radical prostatectomies (RARP). This goal will be accom-
plished through the following specific aims: Aim 1: Synthetic tuning and characterization of NIR nerve-specific
fluorophores for future clinical FGS. Aim 2: Demonstrate compatibility with the da Vinci Firefly and preclinical
pharm/tox suitable for clinical translation. Aim 3: Select the optimal 800 nm, ne...

## Key facts

- **NIH application ID:** 10832516
- **Project number:** 5R01EB032226-04
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Summer Lynne Gibbs
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $601,985
- **Award type:** 5
- **Project period:** 2021-08-05 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10832516

## Citation

> US National Institutes of Health, RePORTER application 10832516, Nerve-Specific Fluorophores for Improved Nerve Sparing during Prostatectomy using the Clinical Fluorescence Guided Surgery Infrastructure (5R01EB032226-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10832516. Licensed CC0.

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