Online Appendix for the following JACC article TITLE: In Vivo Characterization of a New Abdominal Aortic Aneurysm Mouse Model With Conventional and Molecular Magnetic Resonance Imaging AUTHORS: Ahmed Klink, Joeri Heynens, Beatriz Herranz, Mark E. Lobatto, Teresa Arias, Honorius M.H.F. Sanders, Gustav J. Strijkers, Maarten Merkx, Klaas Nicolay, Valentin Fuster, Alain Tedgui, Ziad Mallat, Willem J.M. Mulder, Zahi A. Fayad APPENDIX Supplementary Methods Synthesis of collagen-targeted multimodal nanoparticles The paramagnetic micelles were prepared by the lipid film hydration method as previously described1. Briefly, a lipid film was formed by rotary evaporation of GdDTPA-distearyl amide, DSPE-PEG2000, DSPE-PEG2000-maleimide, and Rhodamine-PE or Cy5.5-PEG-DSPE-lipid in a molar ratio 50:39:10:1, dissolved in a mixture of chloroform/methanol (4:1 v/v). After rotary evaporation to dryness, the lipid film was hydrated with HEPES buffered saline (HBS, pH 6.7), containing 20 mM HEPES (Sigma) and 135 mM NaCl (Sigma). The solution was slowly rotated at 65o C for 1 hour, which resulted in a clear solution, indicative of micelle formation. CNA-35 was then coupled to the micelles by a sulfhydrylmaleimide coupling method at a molar ratio of 1:50 (CNA-35: lipids). CNA-35 was reacted with N-succinimidyl S-acetylthioacetate (SATA) at a molar ratio of 1:10 for 1 hour in a NaHCO3 buffer at pH 8.0. Uncoupled SATA was removed using a centrifuge concentrator with a Molecular Weight Cut-off of 10 kDa (Sartorius). Subsequently, the thioacetate group is converted to a free thiol group by deacetylation with a hydroxylamine solution (0.5M hydroxyl amine, 1M HEPES, 32 mM EDTA, pH 7.0) for 1 hour. Modified CNA-35 was then allowed to react with preformed micelles at 4 ºC overnight in HBS (pH 6.7). The maleimide moiety reacts with free thiol groups of the protein to form a stable carbon-sulfur bond. Uncoupled CNA-35 was separated from CNA-35-functionalized micelles using centrifuge concentrators with a MWCO of 100 kDa (Sartorius), during the process the pH was increased to 7.4. Mutant-CNA-35 nanoparticles consisting micelles conjugated to a ‘nonbinding’ mutant CNA-35 protein were synthesized following the same procedure. Characterization and in-vitro binding experiment The mean hydrodynamic diameter of the particles was determined by dynamic light scattering, using a ZetaPALS (Brookhaven Instruments Corporation). The lipid composition of the final particles was determined by phosphate determination according to Rouser, and the amount of proteins was determined using a modified Lowry method. In this method, equal lipid concentration in both the calibration curve and actual samples were used, ensuring the same background signal of lipids. 1 H relaxivity measurements were performed to verify the expected relaxivity of the micelles. The longitudinal relaxation time (T1) of a concentration series was determined at 60 MHz and 37oC on a Bruker Minispec MQ60 (Bruker, Ettingen, Germany). The relaxivity (r1) of the micelles was then calculated. In order to check the binding of CNA-35 micelles to collagen, a fluorescence binding experiment was performed. Wells of 8-well strip plate were incubated overnight at 4° C with 50 μL of 55 μg/mL rat-tail collagen type I (C7661, Sigma-Aldrich) in HBS. Next, wells were rinsed 4 times with 300 μL HBS. Wells were then blocked with 250 μL of 5% (w/v) milk powder in HBS for 3 h at 20° C, aspirated and again rinsed 3 times with 300 μL HBS. 50 μL of a solution (concentration: 1 mM lipid) of targeted CNA micelles, mutant CNA micelles and untargeted micelles in HBS was added to each well and incubated for 3 h at 20 ° C. Wells were aspirated and washed 10 times with 300 μL HBS. The fluorescence intensities of Rhodamine were measured using a BioTek Synergy 2 microplate reader with Gen5TM software using a 540±20 nm excitation filter and a 590±20 nm emission filter. In the case of Cy5.5 micelles, an IVIS Imaging System 200 (Xenogen, Alameda, CA) was used to measure the fluorescence intensities of Cy5.5 using a 615–665 nm excitation filter and a 695–770 nm emission filter. Ex vivo near-infrared fluorescence imaging of AAA AAAs were induced in C57BL/6 mice according to the model described above. After aneurismal development, the animals were injected with Cy5.5 labeled CNA-35 micelles in order to visualize the spatial distribution of the nanoparticles throughout the aneurismal region. Animals with AAA that were not injected with micelles as well as healthy animals injected with Cy5.5 CNA-35 micelles served as controls. The animals were sacrificed 32 hours post injection and the aortas excised were imaged with the IVIS200 optical imaging system (Xenogen, Alameda, CA, USA) using a 615-667nm excitation filter and a 695-770nm emission filter. The photon count was quantified and compared between the two groups. MR imaging parameters for multi-contrast high-resolution in vivo MRI Repetition time/echo time [TR/TE] 800ms/8.6ms, 2500ms/30ms, 2500ms/10ms for T1Weighted (T1W), T2-Weighted (T2W) and Proton Density-Weighted (PDW) respectively; field of view 3.0 cm and 2.5 cm respectively for T1W and T2W/PDW; matrix size 256x256 and 192x256 respectively for T1W and T2W/PDW; voxel resolution 117μm and 130x97μm respectively for T1W and T2W/PDW; n=6 and n=8 excitations respectively for T1W and T2W/PDW; slice thickness 1mm for all the different sequences. Supplementary Figure 1 Figure 1 – (A) Illustration of CNA-35 or mutant CNA-35 micelles. Micelles are composed of gadolinium-DTPA (Gd-DTPA) and fluorescent lipids (rhodamine B or Cy5.5). Targeting proteins CNA-35 or the non-binding mutant CNA-35 are coupled to PEG-DSPE chains. (B) Results of the in vitro binding experiment performed with Gd-DTPA and rhodamine labeled CNA-35 micelles. CNA-35 micelles revealed a strong binding to collagen after extensive washing, while minor binding occurred for mutant CNA-35 or unconjugated micelles. (C) Results of the in vitro experiment performed with Gd-DTPA and Cy5.5 labeled CNA-35 micelles. Similarly to rhodamine labeled micelles, CNA-35 micelles showed a strong binding to collagen compared to minor binding for mutant CNA-35 and unconjugated micelles. Supplementary Figure 2 Figure 2 - Near infrared images of Ex-vivo aortas injected with Gd-DTPA/Cy5.5 CNA-35 micelles in healthy and aneurismal aortas. (A) A non-injected aneurismal aorta was used as a control and showed no near infrared fluorescent signal. (B) Aneurismal aorta injected with GdDTPA/Cy5.5 CNA-35 micelles. Cy5.5 labeled CNA-35 micelles were clearly appreciated in the AAA region compared to both the control aorta (A) and healthy animals injected with Cy5.5 CNA-35 micelles (C). Supplementary Figure 3 Figure 3 – Representative images obtained pre and post injection of CNA-35 micelles in healthy animals. No significant signal enhancement was observed. Supplementary Figure 4 Figure 4 – Diagram representing the region of interest traced around the aneurysms – excluding the lumen – in order to quantify the normalized signal enhancement percentage after the injection of CNA-35 micelles. Supplementary Figure 5 Figure 5 – Images from the 3 separate fluorescent channels of a representative AAA section injected with Gd-DTPA/rhodamine CNA-35 micelles, shown on a fluorescent confocal microscope. The section was stained with DAPI (A) and collagen-I (B). The fluorescent signal originating from the micelles is shown on the rhodamine channel (C). The overlay of the 3 channels (D) shows the precise colocalization of CNA-35 micelles and collagen-I therefore proving the specificity of the micelles for collagen. Supplementary Figure 6 Figure 6 - Images from the 3 separate fluorescent channels of a representative AAA section injected with Gd-DTPA/rhodamine mutant CNA-35 micelles, shown on a fluorescent confocal microscope. The section was stained with DAPI (A) and collagen-I (B). The fluorescent signal originating from the mutant CNA-35 micelles is shown on the rhodamine channel (C) and proves to be minor compared to CNA-35 micelles. (D) The overlay of the 3 channels showcases the absence of rhodamine signal in areas of collagen-I staining. 1. Mulder WJ, Koole R, Brandwijk RJ, Storm G, Chin PT, Strijkers GJ, de Mello Donegá C, Nicolay K, Griffioen AW. Quantum dots with a paramagnetic coating as a bimodal molecular imaging probe. Nano Lett. 2006;6:1-6.