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Lauri C, Varani M, Bentivoglio V, Capriotti G, Signore A. Present status and future trends in molecular imaging of lymphocytes. Semin Nucl Med 2023; 53:125-134. [PMID: 36150910 PMCID: PMC9489269 DOI: 10.1053/j.semnuclmed.2022.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 01/28/2023]
Abstract
Immune system is emerging as a crucial protagonist in a huge variety of oncologic and non-oncologic conditions including response to vaccines and viral infections (such as SARS-CoV-2). The increasing knowledge of molecular biology underlying these diseases allowed the identification of specific targets and the possibility to use tailored therapies against them. Immunotherapies and vaccines are, indeed, more and more used nowadays for treating infections, cancer and autoimmune diseases and, therefore, there is the need to identify, quantify and monitor immune cell trafficking before and after treatment. This approach will provide crucial information for therapy decision-making. Imaging of B and T-lymphocytes trafficking by using tailored radiopharmaceuticals proved to be a successful nuclear medicine tool. In this review, we will provide an overview of the state of art and future trends for "in vivo" imaging of lymphocyte trafficking and homing by mean of specific receptor-tailored radiopharmaceuticals.
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Affiliation(s)
- Chiara Lauri
- Nuclear Medicine Unit Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
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2
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Alexandre DJA, Carmo CCM, Romeiro LD, Gutfilen-Schlesinger G, Amarante JLM, de Souza SAL, Gutfilen B. 99mTc-antitumor necrosis factor-alpha scintigraphy for the detection of inflammatory activity in rheumatoid arthritis. Nucl Med Commun 2021; 42:389-395. [PMID: 33306625 DOI: 10.1097/mnm.0000000000001333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Tumor necrosis factor-alpha (TNF-α) is an important inflammatory cytokine. 99mTc-anti-TNF-α antibody scintigraphy has proven to be a viable alternative to MRI in specific cases. The objective of this study was to evaluate the performance of scintigraphy with 99mTc-anti-TNF-α in the identification of inflammatory foci in individuals diagnosed with rheumatoid arthritis using MRI as the gold standard. METHODS This cross-sectional, descriptive and analytical-qualitative clinical study compared the performance of 99mTc-anti-TNF-α scintigraphy with that of MRI with intravenous administration of gadolinium (used as the gold standard) and a clinical examination (Disease Activity Score 28) in 220 joints of 20 patients with a diagnosis of rheumatoid arthritis and one healthy control. RESULTS The concordance of scintigraphy with MRI in individuals with a diagnosis of rheumatoid arthritis was 79%. The accuracy, sensitivity and specificity of scintigraphy for distinguishing between inflammatory and noninflammatory sites were 92, 89, and 93%, respectively. No adverse reactions to the examinations were reported. CONCLUSIONS Scintigraphy with 99mTc-anti-TNF-α was well-tolerated and had a good ability to distinguish between inflammatory and noninflammatory lesions in patients with rheumatoid arthritis.
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Affiliation(s)
- Dângelo J A Alexandre
- Department of Radiology, School of Medicine, Federal University of Rio de Janeiro
- Physical Therapy Service, National Institute of Traumatology and Orthopedics
| | - Clarissa C M Carmo
- Department of Radiology, School of Medicine, Federal University of Rio de Janeiro
| | - Leonardo D Romeiro
- Rheumatology Service, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil
| | | | - José L M Amarante
- Department of Radiology, School of Medicine, Federal University of Rio de Janeiro
| | - Sergio A L de Souza
- Department of Radiology, School of Medicine, Federal University of Rio de Janeiro
| | - Bianca Gutfilen
- Department of Radiology, School of Medicine, Federal University of Rio de Janeiro
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3
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McCarthy CE, White JM, Viola NT, Gibson HM. In vivo Imaging Technologies to Monitor the Immune System. Front Immunol 2020; 11:1067. [PMID: 32582173 PMCID: PMC7280489 DOI: 10.3389/fimmu.2020.01067] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 05/04/2020] [Indexed: 12/13/2022] Open
Abstract
The past two decades have brought impressive advancements in immune modulation, particularly with the advent of both cancer immunotherapy and biologic therapeutics for inflammatory conditions. However, the dynamic nature of the immune response often complicates the assessment of therapeutic outcomes. Innovative imaging technologies are designed to bridge this gap and allow non-invasive visualization of immune cell presence and/or function in real time. A variety of anatomical and molecular imaging modalities have been applied for this purpose, with each option providing specific advantages and drawbacks. Anatomical methods including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound provide sharp tissue resolution, which can be further enhanced with contrast agents, including super paramagnetic ions (for MRI) or nanobubbles (for ultrasound). Conjugation of the contrast material to an antibody allows for specific targeting of a cell population or protein of interest. Protein platforms including antibodies, cytokines, and receptor ligands are also popular choices as molecular imaging agents for positron emission tomography (PET), single-photon emission computerized tomography (SPECT), scintigraphy, and optical imaging. These tracers are tagged with either a radioisotope or fluorescent molecule for detection of the target. During the design process for immune-monitoring imaging tracers, it is important to consider any potential downstream physiologic impact. Antibodies may deplete the target cell population, trigger or inhibit receptor signaling, or neutralize the normal function(s) of soluble proteins. Alternatively, the use of cytokines or other ligands as tracers may stimulate their respective signaling pathways, even in low concentrations. As in vivo immune imaging is still in its infancy, this review aims to describe the modalities and immunologic targets that have thus far been explored, with the goal of promoting and guiding the future development and application of novel imaging technologies.
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Affiliation(s)
- Claire E McCarthy
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Jordan M White
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Nerissa T Viola
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Heather M Gibson
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
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Lee HJ, Ehlerding EB, Cai W. Antibody-Based Tracers for PET/SPECT Imaging of Chronic Inflammatory Diseases. Chembiochem 2019; 20:422-436. [PMID: 30240550 PMCID: PMC6377337 DOI: 10.1002/cbic.201800429] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Indexed: 12/18/2022]
Abstract
Chronic inflammatory diseases are often progressive, resulting not only in physical damage to patients but also social and economic burdens, making early diagnosis of them critical. Nuclear medicine techniques can enhance the detection of inflammation by providing functional as well as anatomical information when combined with other modalities such as magnetic resonance imaging, computed tomography or ultrasonography. Although small molecules and peptides were mainly used for the treatment and imaging of chronic inflammatory diseases in the past, antibodies and their fragments have also been emerging for chronic inflammatory diseases as they show high specificity to their targets and can have various biological half-lives depending on how they are engineered. In addition, imaging with antibodies or their fragments can visualize the in vivo biodistribution of the probes or help monitor therapeutic responses, thereby providing physicians with a greater understanding of drug behavior in vivo and another means of monitoring their patients. In this review, we introduce various targets and radiolabeled antibody-based probes for the molecular imaging of chronic inflammatory diseases in preclinical and clinical studies. Targets can be classified into three different categories: 1) cell-adhesion molecules, 2) surface markers on immune cells, and 3) cytokines or enzymes. The limitations and future directions of using radiolabeled antibodies for imaging inflammatory diseases are also discussed.
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Affiliation(s)
- Hye Jin Lee
- Pharmaceutical Sciences Department, University of Wisconsin – Madison, Madison WI 53705, USA
| | - Emily B. Ehlerding
- Medical Physics Department, University of Wisconsin – Madison, Madison WI 53705, USA
| | - Weibo Cai
- Pharmaceutical Sciences Department, University of Wisconsin – Madison, Madison WI 53705, USA
- Medical Physics Department, University of Wisconsin – Madison, Madison WI 53705, USA
- Department of Radiology and Carbone Cancer Center, University of Wisconsin – Madison, Madison WI 53705, USA
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5
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Lopes FPPL, Souza SALD, Bica BERG, da Fonseca LMB, de Azevedo MNL, Gutfilen B. Reduced activation and CD3 lymphocyte recruitment after TNF-inhibitor use: evaluation of clinical and 99mTc-OKT3 scintigraphic response in a patient with juvenile idiopathic arthritis. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57:616-619. [PMID: 29173698 DOI: 10.1016/j.rbre.2015.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 03/01/2015] [Indexed: 06/07/2023] Open
Affiliation(s)
- Flavia Paiva Proença Lobo Lopes
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Departamento de Radiologia, Laboratório de Marcação de Células e Moléculas (LMCM), Rio de Janeiro, RJ, Brazil
| | - Sergio Augusto Lopes de Souza
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Departamento de Radiologia, Laboratório de Marcação de Células e Moléculas (LMCM), Rio de Janeiro, RJ, Brazil.
| | - Blanca Elena Rios Gomes Bica
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho, Serviço de Reumatologia, Rio de Janeiro, RJ, Brazil
| | - Lea Mirian Barbosa da Fonseca
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Departamento de Radiologia, Laboratório de Marcação de Células e Moléculas (LMCM), Rio de Janeiro, RJ, Brazil
| | - Mario Newton Leitão de Azevedo
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho, Serviço de Reumatologia, Rio de Janeiro, RJ, Brazil
| | - Bianca Gutfilen
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Departamento de Radiologia, Laboratório de Marcação de Células e Moléculas (LMCM), Rio de Janeiro, RJ, Brazil
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6
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Clementino A, Batger M, Garrastazu G, Pozzoli M, Del Favero E, Rondelli V, Gutfilen B, Barboza T, Sukkar MB, Souza SAL, Cantù L, Sonvico F. The nasal delivery of nanoencapsulated statins - an approach for brain delivery. Int J Nanomedicine 2016; 11:6575-6590. [PMID: 27994459 PMCID: PMC5153258 DOI: 10.2147/ijn.s119033] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose Along with their cholesterol-lowering effect, statins have shown a wide range of pleiotropic effects potentially beneficial to neurodegenerative diseases. However, such effects are extremely elusive via the conventional oral administration. The purpose of the present study was to prepare and characterize the physicochemical properties and the in vivo biodistribution of simvastatin-loaded lecithin/chitosan nanoparticles (SVT-LCNs) suitable for nasal administration in view of an improved delivery of the statins to the brain. Materials and methods Chitosan, lecithin, and different oil excipients were used to prepare nanocapsules loaded with simvastatin. Particle size distribution, surface charge, structure, simvastatin loading and release, and interaction with mucus of nanoparticles were determined. The nanoparticle nasal toxicity was evaluated in vitro using RPMI 2651 nasal cell lines. Finally, in vivo biodistribution was assessed by gamma scintigraphy via Tc99m labeling of the particles. Results Among the different types of nanoparticles produced, the SVT-LCN_MaiLab showed the most ideal physicochemical characteristics, with small diameter (200 nm), positive surface charge (+48 mV) and high encapsulation efficiency (EE; 98%). Size distribution was further confirmed by nanoparticle tracking analysis and electron microscopy. The particles showed a relatively fast release of simvastatin in vitro (35.6%±4.2% in 6 hours) in simulated nasal fluid. Blank nanoparticles did not show cytotoxicity, evidencing that the formulation is safe for nasal administration, while cytotoxicity of simvastatin-loaded nanoparticles (IC50) was found to be three times lower than the drug solution (9.92 vs 3.50 μM). In rats, a significantly higher radioactivity was evidenced in the brain after nasal delivery of simvastatin-loaded nanoparticles in comparison to the administration of a similar dose of simvastatin suspension. Conclusion The SVT-LCNs developed presented some of the most desirable characteristics for mucosal delivery, that is, small particle size, positive surface charge, long-term stability, high EE, and mucoadhesion. In addition, they displayed two exciting features: First was their biodegradability by enzymes present in the mucus layer, such as lysozyme. This indicates a new Trojan-horse strategy which may enhance drug release in the proximity of the nasal mucosa. Second was their ability to enhance the nose-to-brain transport as evidenced by preliminary gamma scintigraphy studies.
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Affiliation(s)
- Adryana Clementino
- Department of Pharmacy, University of Parma, Parma, Italy; National Council for Scientific and Technological Development - CNPq, Brasilia, Brazil
| | - Mellissa Batger
- Graduate School of Health - Pharmacy, University of Technology Sydney, Ultimo, NSW, Australia
| | - Gabriela Garrastazu
- National Council for Scientific and Technological Development - CNPq, Brasilia, Brazil; Graduate School of Health - Pharmacy, University of Technology Sydney, Ultimo, NSW, Australia
| | - Michele Pozzoli
- Graduate School of Health - Pharmacy, University of Technology Sydney, Ultimo, NSW, Australia
| | - Elena Del Favero
- Department of Medical Biotechnologies and Translational Medicine, LITA, University of Milan, Segrate, Italy
| | - Valeria Rondelli
- Department of Medical Biotechnologies and Translational Medicine, LITA, University of Milan, Segrate, Italy
| | - Bianca Gutfilen
- Laboratório de Marcação de Células e Moléculas, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thiago Barboza
- Laboratório de Marcação de Células e Moléculas, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria B Sukkar
- Graduate School of Health - Pharmacy, University of Technology Sydney, Ultimo, NSW, Australia
| | - Sergio A L Souza
- Laboratório de Marcação de Células e Moléculas, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Laura Cantù
- Department of Medical Biotechnologies and Translational Medicine, LITA, University of Milan, Segrate, Italy
| | - Fabio Sonvico
- Department of Pharmacy, University of Parma, Parma, Italy; Graduate School of Health - Pharmacy, University of Technology Sydney, Ultimo, NSW, Australia
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7
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Hammoud DA. Molecular Imaging of Inflammation: Current Status. J Nucl Med 2016; 57:1161-5. [PMID: 27173159 DOI: 10.2967/jnumed.115.161182] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/11/2016] [Indexed: 11/16/2022] Open
Abstract
The ability to image inflammation in vivo can improve our understanding of the pathophysiology underlying various disease etiologies, including cancer, atherosclerosis, and neurodegeneration. A great wealth of preclinical and translational research has been and is currently being developed to decipher the involvement of the immune system in disease pathophysiology, quantify the course of a disease, and visualize the potential detrimental effects of excessive inflammation. Down the road, the ultimate goal is to have clinical noninvasive in vivo imaging biomarkers of inflammation that will help diagnose disease, establish prognosis, and gauge response to preventative and therapeutic strategies.
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Affiliation(s)
- Dima A Hammoud
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland
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8
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Lopes FPPL, Souza SALD, Bica BERG, Fonseca LMBD, Azevedo MNLD, Gutfilen B. Reduced activation and CD3 lymphocyte recruitment after TNF-inhibitor use: evaluation of clinical and 99mTc-OKT3 scintigraphic response in a patient with juvenile idiopathic arthritis. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 57:S0482-5004(15)00077-7. [PMID: 26255077 DOI: 10.1016/j.rbr.2015.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 11/13/2014] [Accepted: 03/01/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Flavia Paiva Proença Lobo Lopes
- Laboratório de Marcação de Células e Moléculas (LMCM), Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Sergio Augusto Lopes de Souza
- Laboratório de Marcação de Células e Moléculas (LMCM), Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil.
| | - Blanca Elena Rios Gomes Bica
- Serviço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Lea Mirian Barbosa da Fonseca
- Laboratório de Marcação de Células e Moléculas (LMCM), Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Mario Newton Leitão de Azevedo
- Serviço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Bianca Gutfilen
- Laboratório de Marcação de Células e Moléculas (LMCM), Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
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9
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Barboza T, Gomes T, Mizurini DM, Monteiro RQ, König S, Francischetti IMB, Signoretti PVP, Ramos IP, Gutfilen B, Souza SAL. (99m)Tc-ixolaris targets glioblastoma-associated tissue factor: in vitro and pre-clinical applications. Thromb Res 2015; 136:432-9. [PMID: 26070446 DOI: 10.1016/j.thromres.2015.05.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 04/18/2015] [Accepted: 05/30/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND The clotting initiator protein tissue factor (TF) has recently been described as a potential target that can be exploited to image aggressive tumors. Ixolaris is a specific TF inhibitor that blocks tumor cell procoagulant activity and tumor growth. OBJECTIVE Herein we evaluated the ability of (99m)Tc-ixolaris to target tumor-derived TF using an orthotopic glioblastoma (GBM) model in mice. METHODS The right forebrains of Swiss mice were stereotactically inoculated with U87-MG human GBM cells. Histological and immunohistochemical analyses were performed on the resulting tumors after 35-45 days. The biodistribution of (99m)Tc-ixolaris was evaluated by semi-quantitative whole-body scintigraphy and a quantitative analysis of radioactivity in isolated organs. RESULTS No (99m)Tc-ixolaris uptake was observed in brain of tumor-free mice, independently of the integrity of brain-blood barrier. In contrast, the presence of TF-expressing brain tumor masses determined a significant (99m)Tc-ixolaris uptake. CONCLUSION (99m)Tc-ixolaris recognized TF-expressing GBM cells in vivo. Given the proposed role of TF in tumor progression, (99m)Tc-ixolaris is a promising radiopharmaceutical agent for quantifying cancer-associated TF in aggressive tumors, including GBM.
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Affiliation(s)
- Thiago Barboza
- Laboratório de Marcação de Células e Moléculas, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Tainá Gomes
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil; Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Daniella M Mizurini
- Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Robson Q Monteiro
- Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Sandra König
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Ivo M B Francischetti
- Vector Biology Section, Laboratory of Malaria and Vector Research, National Institutes of Health, Bethesda, MD, USA
| | - Paula V P Signoretti
- Laboratório de Físico-Química Biológica Aída Hassón Voloch e Laboratório Intermediário de Biomembranas, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Isalira P Ramos
- Laboratório de Cardiologia Celular e Molecular, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Bianca Gutfilen
- Laboratório de Marcação de Células e Moléculas, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Sergio A L Souza
- Laboratório de Marcação de Células e Moléculas, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.
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10
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de Andrade Alexandre DJ, de Souza SAL, Moraes do Carmo CC, Schau B, da Fonseca LMB, Roimicher L, Gutfilen B. Use of (99m)Tc-anti-TNF-α scintigraphy in a patient with non-radiographic axial spondyloarthritis. Ann Nucl Med 2014; 28:936-9. [PMID: 25052689 DOI: 10.1007/s12149-014-0886-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 07/10/2014] [Indexed: 11/30/2022]
Abstract
The aim of this study was to describe the use of (99m)Tc-anti-TNF-α scintigraphy for detecting inflammation of the sacroiliac joints in a patient with non-radiographic axial spondyloarthritis. A 47-year-old female patient, non-smoker and non-drinker, complained of a low back pain inflammation, which began 4 years before her condition have exacerbated to morning stiffness and anterior uveitis in the last 6 months. Initially diagnosed as mechanical low back pain, she irregularly took non-steroidal anti-inflammatory drugs and corticosteroids, without significant long-lasting results. Radiographic findings were negative. There was increased uptake of (99m)Tc-anti-TNF-α in an area corresponding to the topography of ileum and sacroiliac right joint upon (99m)Tc-anti-TNF-α scintigraphy. Magnetic resonance imaging (MRI), the most used image diagnosis tool, showed minimum impregnation of gadolinium in the right sacroiliac joint and at the iliac face of the inferior third of the right sacroiliac joint. We suggest that (99m)Tc-anti-TNF-α can facilitate early diagnosis of patients with non-radiographic axial spondyloarthritis. More studies are now ongoing.
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Rosado-de-Castro PH, Lopes de Souza SA, Alexandre D, Barbosa da Fonseca LM, Gutfilen B. Rheumatoid arthritis: Nuclear Medicine state-of-the-art imaging. World J Orthop 2014; 5:312-318. [PMID: 25035834 PMCID: PMC4095024 DOI: 10.5312/wjo.v5.i3.312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 04/04/2014] [Accepted: 04/29/2014] [Indexed: 02/06/2023] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease, which is associated with systemic and chronic inflammation of the joints, resulting in synovitis and pannus formation. For several decades, the assessment of RA has been limited to conventional radiography, assisting in the diagnosis and monitoring of disease. Nevertheless, conventional radiography has poor sensitivity in the detection of the inflammatory process that happens in the initial stages of RA. In the past years, new drugs that significantly decrease the progression of RA have allowed a more efficient treatment. Nuclear Medicine provides functional assessment of physiological processes and therefore has significant potential for timely diagnosis and adequate follow-up of RA. Several single photon emission computed tomography (SPECT) and positron emission tomography (PET) radiopharmaceuticals have been developed and applied in this field. The use of hybrid imaging, which permits computed tomography (CT) and nuclear medicine data to be acquired and fused, has increased even more the diagnostic accuracy of Nuclear Medicine by providing anatomical localization in SPECT/CT and PET/CT studies. More recently, fusion of PET with magnetic resonance imaging (PET/MRI) was introduced in some centers and demonstrated great potential. In this article, we will review studies that have been published using Nuclear Medicine for RA and examine key topics in the area.
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12
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Put S, Westhovens R, Lahoutte T, Matthys P. Molecular imaging of rheumatoid arthritis: emerging markers, tools, and techniques. Arthritis Res Ther 2014; 16:208. [PMID: 25099015 PMCID: PMC4061725 DOI: 10.1186/ar4542] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 04/08/2014] [Indexed: 12/18/2022] Open
Abstract
Early diagnosis and effective monitoring of rheumatoid arthritis (RA) are important for a positive outcome. Instant treatment often results in faster reduction of inflammation and, as a consequence, less structural damage. Anatomical imaging techniques have been in use for a long time, facilitating diagnosis and monitoring of RA. However, mere imaging of anatomical structures provides little information on the processes preceding changes in synovial tissue, cartilage, and bone. Molecular imaging might facilitate more effective diagnosis and monitoring in addition to providing new information on the disease pathogenesis. A limiting factor in the development of new molecular imaging techniques is the availability of suitable probes. Here, we review which cells and molecules can be targeted in the RA joint and discuss the advances that have been made in imaging of arthritis with a focus on such molecular targets as folate receptor, F4/80, macrophage mannose receptor, E-selectin, intercellular adhesion molecule-1, phosphatidylserine, and matrix metalloproteinases. In addition, we discuss a new tool that is being introduced in the field, namely the use of nanobodies as tracers. Finally, we describe additional molecules displaying specific features in joint inflammation and propose these as potential new molecular imaging targets, more specifically receptor activator of nuclear factor κB and its ligand, chemokine receptors, vascular cell adhesion molecule-1, αVβ₃ integrin, P2X7 receptor, suppression of tumorigenicity 2, dendritic cell-specific transmembrane protein, and osteoclast-stimulatory transmembrane protein.
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van der Laken CJ, Huisman MH, Voskuyl AE. Nuclear imaging of rheumatic diseases. Best Pract Res Clin Rheumatol 2013; 26:787-804. [PMID: 23273792 DOI: 10.1016/j.berh.2012.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 10/12/2012] [Indexed: 01/15/2023]
Abstract
Advanced imaging techniques are promising tools to assist in the early diagnosis and monitoring of therapy in various rheumatic diseases. As there is now increasing emphasis on diagnosing inflammatory rheumatic disease in the pre-clinical stages, so that treatment may be instituted early and ideally prevent irreversible tissue damage, highly sensitive techniques are needed to detect subclinical inflammation. Moreover, there is an increasing need to develop individualised treatment protocols at reasonable cost and with optimal therapeutic effect. Tools are required that can image the therapeutic target and sensitively trace changes in disease activity. Nuclear imaging techniques have the potential to fulfil these clinical needs. Positron emission tomography is emerging as an important modality as it provides highly sensitive, quantitative imaging at a molecular level, to reveal the important pathophysiological processes underlying inflammation. This chapter provides an overview of currently available nuclear imaging techniques, including recent technical developments, and discusses their role in the diagnosis and monitoring of rheumatic disease.
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Affiliation(s)
- Conny J van der Laken
- Department of Rheumatology, VU University Medical Center, HV Amsterdam, The Netherlands.
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Conti F, Malviya G, Ceccarelli F, Priori R, Iagnocco A, Valesini G, Signore A. Role of scintigraphy with 99mTc-infliximab in predicting the response of intraarticular infliximab treatment in patients with refractory monoarthritis. Eur J Nucl Med Mol Imaging 2012; 39:1339-47. [DOI: 10.1007/s00259-012-2133-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 03/28/2012] [Indexed: 10/28/2022]
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Fueldner C, Mittag A, Knauer J, Biskop M, Hepp P, Scholz R, Wagner U, Sack U, Emmrich F, Tárnok A, Lehmann J. Identification and evaluation of novel synovial tissue biomarkers in rheumatoid arthritis by laser scanning cytometry. Arthritis Res Ther 2012; 14:R8. [PMID: 22251373 PMCID: PMC3392796 DOI: 10.1186/ar3682] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 12/13/2011] [Accepted: 01/17/2012] [Indexed: 12/19/2022] Open
Abstract
Introduction Suitable biomarkers are essential for therapeutic strategies in personalized medicine in terms of diagnosis as well as of prognosis. With highly specific biomarkers, it is possible, for example, to identify patients with poor prognosis, which enables early intervention and intensive treatment. The aim of this study was to identify and validate biomarkers and possible combinations for a prospective use in immunoscintigraphy, which may improve diagnosis of rheumatoid arthritis (RA) patients with consideration of inflammatory activity in the affected joints. Therefore, we tested several monoclonal antibodies (mAbs) directed against cellular-surface molecules on cells likely to be involved in the pathogenesis of RA. Methods Synovial tissue from patients with long-standing RA (accompanied by synovitis with varying states of current activity) and patients with acute non-RA arthritis were stained for surface molecules on different cell types by using fluorochrome-labeled antibodies. Tissue analysis was done by laser scanning cytometry (LSC), and statistical evaluation, by discriminant analysis and ROC analysis. Results CD11b, HLA-DR, CD90, and CD64 revealed significant differences between tissues from patients with RA and acute non-RA arthritis. Especially with the expression of CD64, both patient cohorts could be discriminated with high sensitivity and specificity. RA classification was improved by simultaneously investigating the expression of two or three different surface proteins, such as HLA-DR, CD90, and CD29 in the tissue. The simultaneous analysis of CD64 together with CD304 or the combination of CD11b and CD38 was suitable for the identification of RA patients with high current activity in synovitis. Conclusions In this study, we showed that LSC is a novel reliable method in biomarker prevalidation in RA. Hence, identified mAbs in situ may allow their potential use in in vivo approaches. Moreover, we proved that biomarker-combination analysis resulted in better discrimination than did single-marker analysis. Combinations of these markers make a novel and reliable panel for the discrimination between RA and acute non-RA arthritis. In addition, further expedient combinations may be novel promising biomarker panels to identify current activity in synovitis in RA.
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Affiliation(s)
- Christiane Fueldner
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Cell Engineering/GLP, Perlickstr, 1, D-04103 Leipzig, Germany
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Roimicher L, Lopes FPPL, de Souza SAL, Mendes LF, Domingues RC, da Fonseca LMB, Gutfilen B. (99m)Tc-anti-TNF-α scintigraphy in RA: a comparison pilot study with MRI and clinical examination. Rheumatology (Oxford) 2011; 50:2044-50. [PMID: 21873267 DOI: 10.1093/rheumatology/ker234] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To compare the use of radiolabelled human monoclonal anti-TNF-α scintigraphy with clinical examination and MRI of hands and wrists joints in patients with active RA. METHODS Eight patients with active RA, 28-joint DAS (DAS-28) ≥ 3.2 and a healthy volunteer underwent whole body and hand/wrist scintigraphy after the administration of anti-human TNF-α labelled with technetium-99m ((99m)Tc). One hundred and ninety-eight joints were examined. Patients were also given clinical examinations in addition to MRI of the hands and wrists. RESULTS Of the 198 joints examined, signs of inflammation were detected by MRI in 49 (24.7%) and by scintigraphy in 48 (24.2%) joints, with agreement between the two methods in 44 joints. In five joints, MRI was positive and scintigraphy negative. In another four joints, scintigraphy was positive and MRI negative for signs of inflammation. MRI and scintigraphy were in agreement for negative results for 145 joints. The sensitivity and specificity of scintigraphy was 89.8 and 97.3%, respectively. When clinical parameters (presence of swelling and tenderness of joints) were compared with the MRI findings, lower correlation coefficients were observed (sensitivity of 59.2% and 65.3%, respectively). CONCLUSIONS Scintigraphy using (99m)Tc-anti-TNF-α showed high correlation with the presence of inflammatory signs detected by MRI in the hands and wrists of patients with active RA, and demonstrated a greater sensitivity than clinical examination. These results can assist in better understanding of anti-cytokine therapy and support the achievement of evidence-based biologic therapy.
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Affiliation(s)
- Luis Roimicher
- Departamento de Clínica Médica, Serviço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil.
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Gompels LL, Paleolog EM. A window on disease pathogenesis and potential therapeutic strategies: molecular imaging for arthritis. Arthritis Res Ther 2011; 13:201. [PMID: 21345267 PMCID: PMC3157632 DOI: 10.1186/ar3197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Novel molecular imaging techniques are at the forefront of both preclinical and clinical imaging strategies. They have significant potential to offer visualisation and quantification of molecular and cellular changes in health and disease. This will help to shed light on pathobiology and underlying disease processes and provide further information about the mechanisms of action of novel therapeutic strategies. This review explores currently available molecular imaging techniques that are available for preclinical studies with a focus on optical imaging techniques and discusses how current and future advances will enable translation into the clinic for patients with arthritis.
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Affiliation(s)
- Luke L Gompels
- Kennedy Institute of Rheumatology, Faculty of Medicine, Imperial College, Charing Cross Hospital Campus, 65 Aspenlea Road, London W68LH, UK.
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Garrood T. Comment on: use of 99mTc-anti-CD3 scintigraphy in the differential diagnosis of rheumatic diseases. Rheumatology (Oxford) 2010; 50:422-3; author reply 423. [PMID: 21047803 DOI: 10.1093/rheumatology/keq339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lopes FPPL, de Azevedo MNL, Marchiori E, da Fonseca LMB, de Souza SAL, Gutfilen B. Comment on: Use of 99mTc-anti-CD3 scintigraphy in the differential diagnosis of rheumatic diseases: reply. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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