Molecular imaging allows for unique insights into specific disease mechanisms and holds great promise to change the practice of cardiovascular medicine by facilitating early disease detection, establishment of novel therapies, and selection of patients for treatment based on their individual disease biology (the paradigm of "personalized medicine").

Several different imaging techniques can be used for detection of molecular probes, including nuclear imaging, magnetic resonance imaging, ultrasound and optical imaging, although nuclear imaging techniques, and especially positron emission tomography (PET) are currently most promising because of their superior sensitivity for detection of small amounts of highly specific radioactive molecular probes in the body. The new generation of hybrid imaging system, which integrate PET with X-ray computed tomography (CT) will further refine the application of molecular imaging probes, because co registration with a high-resolution CT will allow for better localization of the specific molecular signal from PET.

Applications that are currently being tested in early clinical stages include the identification of individuals at risk for atherosclerotic plaque rupture, identification of risk for development of heart failure and/or fatal ventricular arrhythmia, and monitoring of novel therapies such as stem cell therapy or gene delivery.

The field is still in its infancy and strong translational efforts need to continue to make it a clinical reality in the next years. But there is a strong notion that, in the future era of personalized molecular medicine, molecular imaging will play a key role for guidance of clinical decision making based on individual disease biology.

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The study team also found an association between ulcerative colitis and genes on the major histocompatiblity complex (MHC) on chromosome 6. The MHC is a large group of genes with important roles in the immune system, and this finding may help refine diagnostic techniques that would allow physicians to administer more specific therapies to their patients.

The Center for Pediatric Inflammatory Bowel Disease at Children's Hospital currently treats 1,400 children annually for IBD, and has one of the world's largest clinical research programs for IBD. The Center for Applied Genomics, directed by Hakonarson, is currently the largest pediatric genotyping program in the world. The Center's highly automated analytic equipment scans each DNA sample for over half a million genetic markers.

Financial support for the study came from the National Institutes of Health, the IBD Family Research Council, the Crohn's and Colitis Foundation of America, the Koss Foundation, the NIH General Clinical Research Center of the Medical College of Wisconsin, the Primary Children's Medical Center Foundation, the Edmunds Fund, the Heineman Foundation, the Cotswold Foundation, and The Children's Hospital of Philadelphia, which funded all genotyping performed in the study.

Baldassano's and Hakonarson's co-authors included Struan Grant, Ph.D., Jonathan Bradfield, Ph.D., David A. Piccoli, M.D., Petar Mamula, M.D., Robert Grundmeier, M.D., and Dimitri Monos, Ph.D., all of Children's Hospital. Other co-authors were Subra Kugathasan, M.D. (formerly of the Medical College of Wisconsin and currently at Emory University), who is co-first author with Baldassano; Stephen Guthery, M.D., of the University of Utah; Gitit Tomer, M.D., and Lee Denson, M.D., of Cincinnati Children's Hospital Medical Center; Salvatore Cucchiara, M.D., Ph.D., of Sapienza University, Rome, Italy; and Vito Annese, M.D., of "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy.

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