Non-invasive in Vivo Assessment of 11β-hydroxysteroid Dehydrogenase type 1 Activity by 19 F-magnetic Resonance Spectroscopy

11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) amplifies tissue glucocorticoid levels and is a pharmaceutical target in diabetes and cognitive decline. Clinical translation of inhibitors is hampered by lack of in vivo pharmacodynamic biomarkers. Our goal was to monitor substrates and products of 11β-HSD1 non-invasively in liver via 19 Fluorine magnetic resonance spectroscopy (19 F-MRS). Interconversion of mono/poly-fluorinated substrate/product pairs was studied in Wistar rats (male, n=6) and healthy men (n=3) using 7 T and 3 T MRI scanners, respectively. Here we show that the limit of detection, as absolute fluorine content, was 0.625 μmol in blood. Mono-fluorinated steroids, dexamethasone and 11-dehydrodexamethasone, were detected in phantoms but not in vivo in human liver following oral dosing. A non-steroidal polyfluorinated tracer, 2-(phenylsulfonyl)-1-(4-(trifluoromethyl)phenyl)ethanone and its metabolic product were detected in vivo in rat liver after oral administration of the keto-substrate, giving a readout of reductase activity. Administration of a selective 11β-HSD1 inhibitor in vivo in rats altered total liver 19 F-MRS signal. We conclude that there is insufficient sensitivity to measure mono-fluorinated tracers in vivo in man with current dosage regimens and clinical scanners. However use of a poly-fluorinated tracer allowed detection of hepatic reductase activity in rats and could be developed for translation to man.