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Maurya SD, Ballal S, Damle NA, Tiwari V, Bal CS. Tc-99m UBI Scintigraphy as a Cost-effective Alternative to Ga-68 NOTA-UBI PET/CT for Imaging Infections. Indian J Nucl Med 2024; 39:237-238. [PMID: 39291070 PMCID: PMC11404735 DOI: 10.4103/ijnm.ijnm_16_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/01/2024] [Accepted: 04/12/2024] [Indexed: 09/19/2024] Open
Affiliation(s)
| | | | | | - Varsha Tiwari
- Department of Nuclear Medicine, AIIMS, New Delhi, India
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2
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Bhatt Mitra J, Chatterjee S, Kumar A, Khatoon E, Chandak A, Rakshit S, Bandyopadhyay A, Mukherjee A. Expanding a peptide-covalent probe hybrid for PET imaging of S. aureus driven focal infections. EJNMMI Radiopharm Chem 2024; 9:25. [PMID: 38530487 DOI: 10.1186/s41181-024-00252-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The urgent demand for innovative theranostic strategies to combat bacterial resistance to antibiotics is evident, with substantial implications for global health. Rapid diagnosis of life-threatening infections can expedite treatment, improving patient outcomes. Leveraging diagnostic modalities i.e., positron emission tomography (PET) and single photon emission computed tomography (SPECT) for detecting focal infections has yielded promising results. Augmenting the sensitivity of current PET and SPECT tracers could enable effective imaging of pathogenic bacteria, including drug-resistant strains.UBI (29-41), an antimicrobial peptide (AMP) fragment recognizes the S. aureus membrane through electrostatic binding. Radiolabeled UBI (29-41) is a promising SPECT and PET-based tracer for detecting focal infections. 2-APBA (2-acetyl-phenyl-boronic acid), a non-natural amino acid, specifically targets lysyl-phosphatidyl-glycerol (lysyl-PG) on the S. aureus membranes, particularly in AMP-resistant strains. We propose that combining UBI with 2-APBA could enhance the diagnostic potential of radiolabeled UBI. RESULTS Present work aimed to compare the diagnostic potential of two radiolabeled peptides, namely UBI (29-41) and 2-APBA modified UBI (29-41), referred to as UBI and UBI-APBA. APBA modification imparted antibacterial activity to the initially non-bactericidal UBI against S. aureus by inducing a loss of membrane potential. The antibacterial activity demonstrated by UBI-APBA can be ascribed to the synergistic interaction of both UBI and UBI-APBA on the bacterial membrane. To enable PET imaging, we attached the chelator 1,4,7-triazacyclononane 1-glutaric acid 4,7-acetic acid (NODAGA) to the peptides for complexation with the positron emitter Gallium-68 (68Ga). Both NODAGA conjugates were radiolabeled with 68Ga with high radiochemical purity. The resultant 68Ga complexes were stable in phosphate-buffered saline and human serum. Uptake of these complexes was observed in S. aureus but not in mice splenocytes, indicating the selective nature of their interaction. Additionally, the APBA conjugate exhibited superior uptake in S. aureus while preserving the selectivity of the parent peptide. Furthermore, [68Ga]Ga-UBI-APBA demonstrated accumulation at the site of infection in rats, with an improved target-to-non-target ratio, as evidenced by ex-vivo biodistribution and PET imaging. CONCLUSIONS Our findings suggest that linking UBI, as well as AMPs in general, with APBA shows promise as a strategy to augment the theranostic potential of these molecules.
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Affiliation(s)
- Jyotsna Bhatt Mitra
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India
| | - Saurav Chatterjee
- Biomimetic Peptide Engineering Laboratory, Department of Chemistry, Indian Institute of Technology Ropar, Ropar, Punjab, India
| | - Anuj Kumar
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | - Elina Khatoon
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | - Ashok Chandak
- Board of Radiation and Isotope Technology, Navi Mumbai, India
| | | | - Anupam Bandyopadhyay
- Biomimetic Peptide Engineering Laboratory, Department of Chemistry, Indian Institute of Technology Ropar, Ropar, Punjab, India.
| | - Archana Mukherjee
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai, India.
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India.
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3
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Mendonça FF, Sobral DV, Durante ACR, Miranda ACC, Mejia J, de Paula Faria D, Marques FLN, de Barboza MF, Fuscaldi LL, Malavolta L. Assessment of bioactive peptides derived from laminin-111 as prospective breast cancer-targeting agents. Amino Acids 2024; 56:1. [PMID: 38285098 PMCID: PMC10824877 DOI: 10.1007/s00726-023-03379-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/24/2023] [Indexed: 01/30/2024]
Abstract
Breast cancer remains a pressing public health issue primarily affecting women. Recent research has spotlighted bioactive peptides derived from laminin-111, implicated in breast tumor development. Remarkably, the sequences IKVAV, YIGSR, and KAFDITYVRLKF from the α1, β1, and γ1 chains, respectively, have garnered significant attention. This study aims to assess the potential of these radiolabeled peptides as targeting agents for breast cancer. The three peptides were synthesized using the Fmoc strategy, purified via reversed-phase high-performance liquid chromatography (RP-HPLC), and characterized through mass spectrometry. Iodine-131 (131I) radiolabeling was performed using the chloramine T method, exhibiting high radiochemical yield and stability for [131I]I-YIKVAV and [131I]I-YIGSR. Conversely, [131I]I-KAFDITYVRLKF demonstrated low radiochemical yield and stability and was excluded from the biological studies. The lipophilicity of the compounds ranged from - 2.12 to - 1.10. Serum protein binding assay for [131I]I-YIKVAV and [131I]I-YIGSR reached ≅ 48% and ≅ 25%, respectively. Affinity for breast cancer cells was evaluated using MDA-MB-231 and MCF-7 tumor cell lines, indicating the affinity of the radiopeptides with these tumor cells. Ex vivo biodistribution profiles of the radiopeptides were assessed in the MDA-MB-231 breast tumor animal model, revealing tumor tissue accumulation, supported by a high tumor-to-contralateral muscle ratio and autoradiography. These results signify the effective penetration of YIKVAV and YIGSR into tumor tissue. Therefore, the synthesized α1 and β1 peptide fragments exhibit favorable characteristics as potential breast cancer-targeting agents, promising future exploration as radiopharmaceuticals for breast cancer.
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Affiliation(s)
- Fernanda Ferreira Mendonça
- Department of Physiological Sciences, Santa Casa de Sao Paulo School of Medical Sciences, Rua Dr. Cesareo Motta Jr. 61, Sao Paulo, CEP 01221-020, Brazil
| | - Danielle Vieira Sobral
- Department of Physiological Sciences, Santa Casa de Sao Paulo School of Medical Sciences, Rua Dr. Cesareo Motta Jr. 61, Sao Paulo, CEP 01221-020, Brazil
| | - Ana Claudia Ranucci Durante
- Department of Physiological Sciences, Santa Casa de Sao Paulo School of Medical Sciences, Rua Dr. Cesareo Motta Jr. 61, Sao Paulo, CEP 01221-020, Brazil
| | | | - Jorge Mejia
- Hospital Israelita Albert Einstein, Sao Paulo, 05521-200, Brazil
| | - Daniele de Paula Faria
- Laboratory of Nuclear Medicine (LIM-43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, 01246-903, Brazil
| | - Fabio Luiz Navarro Marques
- Laboratory of Nuclear Medicine (LIM-43), Department of Radiology and Oncology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, 01246-903, Brazil
| | | | - Leonardo Lima Fuscaldi
- Department of Physiological Sciences, Santa Casa de Sao Paulo School of Medical Sciences, Rua Dr. Cesareo Motta Jr. 61, Sao Paulo, CEP 01221-020, Brazil
| | - Luciana Malavolta
- Department of Physiological Sciences, Santa Casa de Sao Paulo School of Medical Sciences, Rua Dr. Cesareo Motta Jr. 61, Sao Paulo, CEP 01221-020, Brazil.
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4
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Dadachova E, Rangel DEN. Recent Advancements in Radiopharmaceuticals for Infection Imaging. Methods Mol Biol 2024; 2813:205-217. [PMID: 38888780 DOI: 10.1007/978-1-0716-3890-3_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
COVID-19 pandemic has heightened the interest toward diagnosis and treatment of infectious diseases. Nuclear medicine, with its powerful scintigraphic, single photon emission computer tomography (SPECT), and positron emission tomography (PET) imaging modalities, has always played an important role in diagnosis of infections and distinguishing them from the sterile inflammation. In addition to the clinically available radiopharmaceuticals, there has been a decades-long effort to develop more specific imaging agents with some examples being radiolabeled antibiotics and antimicrobial peptides for bacterial imaging, radiolabeled antifungals for fungal infections imaging, radiolabeled pathogen-specific antibodies, and molecular engineered constructs. In this chapter, we discuss some examples of the work published in the last decade on developing nuclear imaging agents for bacterial, fungal, and viral infections to generate more interest among nuclear medicine community toward conducting clinical trials of these novel probes, as well as toward developing novel radiotracers for imaging infections.
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Affiliation(s)
- Ekaterina Dadachova
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
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5
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Miranda ACC, Fuscaldi LL, Mejia J, da Silva FFA, Turato WM, Mendonça FF, Nogueira SA, Osawa A, Yamaga LYI, Malavolta L, de Barboza MF. Radiosynthesis Standardization and Preclinical Assessment of the [ 68Ga]Ga-DOTA-Ubiquicidin 29-41: A Translational Study Targeting Differential Diagnosis of Infectious Processes. Pharmaceuticals (Basel) 2023; 17:48. [PMID: 38256881 PMCID: PMC10821498 DOI: 10.3390/ph17010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 01/24/2024] Open
Abstract
Human bacterial infections significantly contribute to the increase in healthcare-related burdens. This scenario drives the study of novel techniques for the early and precise diagnosis of infectious processes. Some alternatives include Nuclear Medicine- and Molecular Imaging-based strategies. However, radiopharmaceuticals that are available for routine assessments are not specific to differentiating infectious from aseptic inflammatory processes. In this context, [68Ga]Ga-DOTA-Ubiquicidin29-41 was synthesized using an automated module and radiochemical; in vivo and in vitro studies were performed. The radiopharmaceutical remained stable in saline (up to 180 min) and in rodent serum (up to 120 min) with radiochemical purities > 99 and 95%, respectively. Partition coefficient and serum protein binding at 60 min were determined (-3.63 ± 0.17 and 44.06 ± 1.88%, respectively). Ex vivo biodistribution, as well as in vivo microPET/CT images in mice, showed rapid blood clearance with renal excretion and reduced uptake in other organs in Staphylococcus aureus-infected animals. Higher uptake was observed in the target as compared to the non-target tissue (p < 0.0001) at 60 min post administration. The presented in-human clinical case demonstrates uptake of the radiopharmaceutical by Staphyloccocus aureus bacteria. These results indicate the potential of [68Ga]Ga-DOTA-Ubiquicidin29-41 as a radiopharmaceutical that can be obtained in a hospital radiopharmacy for the diagnosis of infectious processes using PET/CT.
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Affiliation(s)
| | - Leonardo Lima Fuscaldi
- Department of Physiological Sciences, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo 01224-001, Brazil; (L.L.F.); (F.F.M.); (L.M.)
| | - Jorge Mejia
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (J.M.); (S.A.N.); (L.Y.I.Y.); (M.F.d.B.)
| | | | - Walter Miguel Turato
- School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo 05508-000, Brazil
| | - Fernanda Ferreira Mendonça
- Department of Physiological Sciences, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo 01224-001, Brazil; (L.L.F.); (F.F.M.); (L.M.)
| | - Solange Amorim Nogueira
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (J.M.); (S.A.N.); (L.Y.I.Y.); (M.F.d.B.)
| | - Akemi Osawa
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (J.M.); (S.A.N.); (L.Y.I.Y.); (M.F.d.B.)
| | - Lilian Yuri Itaya Yamaga
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (J.M.); (S.A.N.); (L.Y.I.Y.); (M.F.d.B.)
| | - Luciana Malavolta
- Department of Physiological Sciences, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo 01224-001, Brazil; (L.L.F.); (F.F.M.); (L.M.)
| | - Marycel Figols de Barboza
- Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil; (J.M.); (S.A.N.); (L.Y.I.Y.); (M.F.d.B.)
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6
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Nogueira SA, Barboza MRFFD, Bezerra RP, Cabeza JM, Dell'Aquila AM, Santos DDCB, Yamaga LYI, Osawa A. Antimicrobial peptide for bacterial infection imaging: first case reported in Brazil. EINSTEIN-SAO PAULO 2023; 21:eRC0621. [PMID: 38055555 DOI: 10.31744/einstein_journal/2023rc0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/14/2023] [Indexed: 12/08/2023] Open
Abstract
Molecular imaging markers can be used to differentiate between infection and aseptic inflammation, determine the severity of infection, and monitor treatment responses. One of these markers is ubiquicidin(29-41) (UBI), a cationic peptide fragment that binds to the bacterial membrane wall and is labeled with gallium-68 (68Ga), a positron emitter radioisotope. The use of UBI in positron emission tomography (PET)/computed tomography (CT) for improved detection of lesions has been receiving considerable attention recently. Herein, we report the first case of 68Ga-UBI PET/CT performed in Brazil. The patient was a 39-year-old woman referred for a scan to confirm a clinical suspicion of chronic osteomyelitis of her fractured left tibia. PET images revealed radiotracer uptake near the posterior contour of the tibial fracture focus and the fixation plate, in the soft tissue around the distal half of the tibia, and in the non-consolidated fracture of the left distal fibula. Surgery for local cleaning was performed, and culture of a specimen collected from the surgical site confirmed the presence of Staphylococcus aureus. In the present case, 68Ga-UBI PET/CT, a non-invasive imaging modality, identified the infection foci in vivo, indicating its potential for clinical use.
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Affiliation(s)
- Solange Amorim Nogueira
- Department of Radiology and Diagnostic Imaging, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Rosemeire Pereira Bezerra
- Department of Radiology and Diagnostic Imaging, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Jorge Mejia Cabeza
- Department of Radiology and Diagnostic Imaging, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Adriana Macedo Dell'Aquila
- Department of Medicine and Infectious Diseases, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil
| | | | - Lilian Yuri Itaya Yamaga
- Department of Radiology and Diagnostic Imaging, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Akemi Osawa
- Department of Radiology and Diagnostic Imaging, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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7
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Nogueira SA, de Barboza MF, Dell’Aquila AM, Santos DCB, Osawa A. Could 68 Ga-DOTA-UBI-29-41 Help Identify Chronic Osteomyelitis on PET/CT Images? A Pilot Study. Clin Nucl Med 2023; 48:982-984. [PMID: 37756436 PMCID: PMC10581417 DOI: 10.1097/rlu.0000000000004866] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/06/2023] [Indexed: 09/29/2023]
Abstract
ABSTRACT This pilot study aimed to confirm the presence of infectious agents in infection foci using PET/CT imaging with 68 Ga-DOTA-UBI (29-41) in 7 patients with chronic osteomyelitis and with indications for surgical cleaning at the site of the infection focus. The whole-body PET/CT was performed on Biograph mCT 40 PET/CT scanner (Siemens Healthineers); the image began 45-60 minutes postinjection of the radiotracer (148-260 MBq). This study demonstrated that, in 6 patients in whom the PET/CT was classified as positive for identified infectious foci, confirmed by culture of the secretion sample collected during surgery, only 1 patient in antibiotic therapy was negative.
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Affiliation(s)
| | | | - Adriana M. Dell’Aquila
- Department of Orthopedics and Traumatology–Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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8
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van Leer B, van Rijsewijk ND, Nijsten MWN, Slart RHJA, Pillay J, Glaudemans AWJM. Practice of 18F-FDG-PET/CT in ICU Patients: A Systematic Review. Semin Nucl Med 2023; 53:809-819. [PMID: 37258380 DOI: 10.1053/j.semnuclmed.2023.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/15/2023] [Accepted: 05/15/2023] [Indexed: 06/02/2023]
Abstract
18F-FDG-PET/CT imaging has become a key tool to evaluate infectious and inflammatory diseases. However, application of 18F-FDG-PET/CT in patients in the intensive care unit (ICU) is limited, which is remarkable since the development of critical illness is closely linked to infection and inflammation. This limited use is caused by perceived complexity and risk of planning and executing 18F-FDG-PET/CT in such patients. The aim of this systematic review was to investigate the feasibility of 18F-FDG-PET/CT in ICU patients with special emphasis on patient preparation, transport logistics and safety. Therefore, a systematic search was performed in PubMed, Embase, and Web of Science using the search terms: intensive care, critically ill, positron emission tomography and 18F-FDG or derivates. A total of 1183 articles were found of which 10 were included. Three studies evaluated the pathophysiology of acute respiratory distress syndrome, acute lung injury and acute chest syndrome. Three other studies applied 18F-FDG-PET/CT to increase understanding of pathophysiology after traumatic brain injury. The remaining four studies evaluated infection of unknown origin. These four studies showed a sensitivity and specificity between 85%-100% and 57%-88%, respectively. A remarkable low adverse event rate of 2% was found during the entire 18F-FDG-PET/CT procedure, including desaturation and hypotension. In all studies, a team consisting of an intensive care physician and nurse was present during transport to ensure continuation of necessary critical care. Full monitoring during transport was used in patients requiring mechanical ventilation or vasopressor support. None of the studies used specific patient preparation for ICU patients. However, one article described specific recommendations in their discussion. In conclusion, 18F-FDG-PET/CT has been shown to be feasible and safe in ICU patients, even when ventilated or requiring vasopressors. Specific recommendations regarding patient preparation, logistics and scanning are needed. Including 18F-FDG-PET/CT in routine workup of infection of unknown origin in ICU patients showed potential to identify source of infection and might improve outcome.
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Affiliation(s)
- Bram van Leer
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Nick D van Rijsewijk
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maarten W N Nijsten
- Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Riemer H J A Slart
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands
| | - Janesh Pillay
- Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Andor W J M Glaudemans
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Alberto S, Ordonez AA, Arjun C, Aulakh GK, Beziere N, Dadachova E, Ebenhan T, Granados U, Korde A, Jalilian A, Lestari W, Mukherjee A, Petrik M, Sakr T, Cuevas CLS, Welling MM, Zeevaart JR, Jain SK, Wilson DM. The Development and Validation of Radiopharmaceuticals Targeting Bacterial Infection. J Nucl Med 2023; 64:1676-1682. [PMID: 37770110 PMCID: PMC10626374 DOI: 10.2967/jnumed.123.265906] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/18/2023] [Indexed: 10/03/2023] Open
Abstract
The International Atomic Energy Agency organized a technical meeting at its headquarters in Vienna, Austria, in 2022 that included 17 experts representing 12 countries, whose research spanned the development and use of radiolabeled agents for imaging infection. The meeting focused largely on bacterial pathogens. The group discussed and evaluated the advantages and disadvantages of several radiopharmaceuticals, as well as the science driving various imaging approaches. The main objective was to understand why few infection-targeted radiotracers are used in clinical practice despite the urgent need to better characterize bacterial infections. This article summarizes the resulting consensus, at least among the included scientists and countries, on the current status of radiopharmaceutical development for infection imaging. Also included are opinions and recommendations regarding current research standards in this area. This and future International Atomic Energy Agency-sponsored collaborations will advance the goal of providing the medical community with innovative, practical tools for the specific image-based diagnosis of infection.
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Affiliation(s)
- Signore Alberto
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University of Rome "Sapienza," Rome, Italy
| | - Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Chanda Arjun
- Radiopharmaceutical Program, Board of Radiation and Isotope Technology, Mumbai, India
| | - Gurpreet Kaur Aulakh
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nicolas Beziere
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Ekaterina Dadachova
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Thomas Ebenhan
- Nuclear Medicine, University of Pretoria, and Radiochemistry, Applied Radiation, South African Nuclear Energy Corporation, Pelindaba, South Africa
| | - Ulises Granados
- Department of Nuclear Medicine, Hospital Internacional de Colombia-Fundación Cardiovascular de Colombia, Piedecuesta, Colombia
| | - Aruna Korde
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Amirreza Jalilian
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Wening Lestari
- National Nuclear Energy Agency, South Tangerang, Indonesia
| | - Archana Mukherjee
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Milos Petrik
- Institute of Molecular and Translational Medicine and Czech Advanced Technology and Research Institute, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Tamer Sakr
- Radioactive Isotopes and Generator Department, Hot Labs Center, Egyptian Atomic Energy Authority, Cairo, Egypt
| | | | - Mick M Welling
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; and
| | - Jan Rijn Zeevaart
- Nuclear Medicine, University of Pretoria, and Radiochemistry, Applied Radiation, South African Nuclear Energy Corporation, Pelindaba, South Africa
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David M Wilson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
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10
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Roll W, Faust A, Hermann S, Schäfers M. Infection Imaging: Focus on New Tracers? J Nucl Med 2023; 64:59S-67S. [PMID: 37918846 DOI: 10.2967/jnumed.122.264869] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/31/2023] [Indexed: 11/04/2023] Open
Abstract
Infections account for relevant morbidity and mortality, especially if the cardiovascular system is affected. Clinical manifestations are often unspecific, resulting in a challenging diagnostic work-up. The use of molecular imaging methods, namely [18F]FDG PET and leukocyte scintigraphy, is increasingly recognized in recently published international guidelines. However, these 2 established methods focus on the host's immune response to the pathogen and are therefore virtually unable to differentiate infection from inflammation. Targeting the microorganism responsible for the infection directly with novel imaging agents is a promising strategy to overcome these limitations. In this review, we discuss clinically approved [18F]FDG PET with its advantages and limitations in cardiovascular infections, followed by new PET-based approaches for the detection of cardiovascular infections by bacteria-specific molecular imaging methods. A multitude of different targeting options has already been preclinically evaluated, but most still lack clinical translation. We give an overview not only on promising tracer candidates for noninvasive molecular imaging of infections but also on issues hampering clinical translation.
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Affiliation(s)
- Wolfgang Roll
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany; and
| | - Andreas Faust
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany; and
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Sven Hermann
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany; and
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
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11
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Lai J, Wang B, Petrik M, Beziere N, Hammoud DA. Radiotracer Development for Fungal-Specific Imaging: Past, Present, and Future. J Infect Dis 2023; 228:S259-S269. [PMID: 37788500 PMCID: PMC10547453 DOI: 10.1093/infdis/jiad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Invasive fungal infections have become a major challenge for public health, mainly due to the growing numbers of immunocompromised patients, with high morbidity and mortality. Currently, conventional imaging modalities such as computed tomography and magnetic resonance imaging contribute largely to the noninvasive diagnosis and treatment evaluation of those infections. These techniques, however, often fall short when a fast, noninvasive and specific diagnosis of fungal infection is necessary. Molecular imaging, especially using nuclear medicine-based techniques, aims to develop fungal-specific radiotracers that can be tested in preclinical models and eventually translated to human applications. In the last few decades, multiple radioligands have been developed and tested as potential fungal-specific tracers. These include radiolabeled peptides, antifungal drugs, siderophores, fungal-specific antibodies, and sugars. In this review, we provide an overview of the pros and cons of the available radiotracers. We also address the future prospects of fungal-specific imaging.
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Affiliation(s)
- Jianhao Lai
- Center for Infectious Disease Imaging, Radiology, and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Benjamin Wang
- Center for Infectious Disease Imaging, Radiology, and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Milos Petrik
- Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University Olomouc, Olomouc, Czech Republic
- Czech Advanced Technology and Research Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Nicolas Beziere
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tübingen, Tübingen, Germany
- Cluster of Excellence EXC 2124 Controlling Microbes to Fight Infections, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Dima A Hammoud
- Center for Infectious Disease Imaging, Radiology, and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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Akter A, Lyons O, Mehra V, Isenman H, Abbate V. Radiometal chelators for infection diagnostics. FRONTIERS IN NUCLEAR MEDICINE (LAUSANNE, SWITZERLAND) 2023; 2:1058388. [PMID: 37388440 PMCID: PMC7614707 DOI: 10.3389/fnume.2022.1058388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Infection of native tissues or implanted devices is common, but clinical diagnosis is frequently difficult and currently available noninvasive tests perform poorly. Immunocompromised individuals (for example transplant recipients, or those with cancer) are at increased risk. No imaging test in clinical use can specifically identify infection, or accurately differentiate bacterial from fungal infections. Commonly used [18F]fluorodeoxyglucose (18FDG) positron emission computed tomography (PET/CT) is sensitive for infection, but limited by poor specificity because increased glucose uptake may also indicate inflammation or malignancy. Furthermore, this tracer provides no indication of the type of infective agent (bacterial, fungal, or parasitic). Imaging tools that directly and specifically target microbial pathogens are highly desirable to improve noninvasive infection diagnosis and localization. A growing field of research is exploring the utility of radiometals and their chelators (siderophores), which are small molecules that bind radiometals and form a stable complex allowing sequestration by microbes. This radiometal-chelator complex can be directed to a specific microbial target in vivo, facilitating anatomical localization by PET or single photon emission computed tomography. Additionally, bifunctional chelators can further conjugate therapeutic molecules (e.g., peptides, antibiotics, antibodies) while still bound to desired radiometals, combining specific imaging with highly targeted antimicrobial therapy. These novel therapeutics may prove a useful complement to the armamentarium in the global fight against antimicrobial resistance. This review will highlight current state of infection imaging diagnostics and their limitations, strategies to develop infection-specific diagnostics, recent advances in radiometal-based chelators for microbial infection imaging, challenges, and future directions to improve targeted diagnostics and/or therapeutics.
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Affiliation(s)
- Asma Akter
- Department of Analytical, Environmental and Forensic Sciences, King’s College London, London, United Kingdom
| | - Oliver Lyons
- Vascular Endovascular and Transplant Surgery, Christchurch Public Hospital, Christchurch, New Zealand
- Department of Surgery, University of Otago, Christchurch, New Zealand
| | - Varun Mehra
- Department of Hematology, King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Heather Isenman
- Department of Infectious Diseases, General Medicine, Christchurch Hospital, Christchurch, New Zealand
| | - Vincenzo Abbate
- Department of Analytical, Environmental and Forensic Sciences, King’s College London, London, United Kingdom
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Ankrah AO, Lawal IO, Dierckx RAJO, Sathekge MM, Glaudemans AWJM. Imaging of Invasive Fungal Infections- The Role of PET/CT. Semin Nucl Med 2023; 53:57-69. [PMID: 35933165 DOI: 10.1053/j.semnuclmed.2022.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 01/28/2023]
Abstract
Over the last decades, the population at risk for invasive fungal disease (IFD) has increased because of medical therapy advances and diseases compromising patients' immune systems. The high morbidity and mortality associated with invasive fungal disease in the immunocompromised present the challenge of early diagnosis of the IFD and the need to closely monitor the infection during treatment. The definitive diagnosis of invasive fungal disease based on culture or histopathological methods often has reduced diagnostic accuracy in the immunocompromised and may be very invasive. Less invasive and indirect evidence of the fungal infection by serology and imaging has been used for the early diagnosis of fungal infection before definitive results are available or when the definitive methods of diagnosis are suboptimal. Imaging in invasive fungal disease is a non-invasive biomarker that helps in the early diagnosis of invasive fungal disease but helps follow-up the infection during treatment. Different imaging modalities are used in the workup to evaluate fungal disease. The different imaging modalities have advantages and disadvantages at different sites in the body and may complement each other in the management of IFD. Positron emission tomography integrated with computed tomography with [18F]Fluorodeoxyglucose (FDG PET/CT) has helped manage IFD. The combined functional data from PET and anatomical data from the CT from almost the whole body allows noninvasive evaluation of IFD and provides a semiquantitative means of assessing therapy. FDG PET/CT adds value to anatomic-based only imaging modalities. The nonspecificity of FDG uptake has led to the evaluation of other tracers in the assessment of IFD. However, these are mainly still at the preclinical level and are yet to be translated to humans. FDG PET/CT remains the most widely evaluated radionuclide-based imaging modality in IFD management. The limitations of FDG PET/CT must be well understood, and more extensive prospective studies in uniform populations are needed to validate its role in the management of IFD that can be international guidelines.
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Affiliation(s)
- Alfred O Ankrah
- National Centre for Radiotherapy Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra GA, Ghana; Department of Nuclear Medicine, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa; Medical Imaging Center, University Medical Center Groningen, University of Groningen, RB Groningen, The Netherlands.
| | - Ismaheel O Lawal
- Department of Nuclear Medicine, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa; Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA
| | - Rudi A J O Dierckx
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, RB Groningen, The Netherlands
| | - Mike M Sathekge
- Department of Nuclear Medicine, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa
| | - Andor W J M Glaudemans
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, RB Groningen, The Netherlands
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Marjanovic-Painter B, Kleynhans J, Zeevaart JR, Rohwer E, Ebenhan T. A decade of ubiquicidin development for PET imaging of infection: A systematic review. Nucl Med Biol 2023; 116-117:108307. [PMID: 36435145 DOI: 10.1016/j.nucmedbio.2022.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/25/2022] [Accepted: 11/07/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ubiquicidin is a peptide fragment with selective binding to negatively charged bacterial cell membranes. Besides its earlier labelling with gamma emitting radionuclides, it has been labelled with Positron Emission Tomography (PET) radionuclides in the last decade for imaging infection and distinguishing infectious disease from sterile inflammation. This systematic review aims to evaluate the technology readiness level of PET based ubiquicidin radiopharmaceuticals. METHODS Two independent researchers reviewed all articles and abstracts pertaining ubiquicidin and PET imaging that are currently available. Scopus, Google Scholar and PubMed/Medline were used in the search. Upon completion of the literature search all articles and abstracts were evaluated and duplicates were excluded. All non-PET articles as well as review articles without new data were deemed ineligible. RESULTS From a total of 17 papers and 10 abstracts the studies were grouped into development, preclinical and clinical studies. Development was published in 15/17 (88%) publications and 6/10 (60%) abstracts, preclinical applications in 9/17 (53%) publications and 1/10 (10%) of abstracts. Finally, clinical studies made up 6/17 (35%) of full publications and 4/10 (40%) of the available abstracts. Development results were the most abundant. All the findings in the different areas of development of ubiquicidin as PET radiopharmaceutical are summarized in this paper. CONCLUSION Labelling procedures are generally uncomplicated and relatively fast and there are indications of adequate product stability. The production of PET radiopharmaceuticals based on UBI will therefore not be a barrier for clinical introduction of this technology. Systematization and unification of criteria for preclinical imaging and larger clinical trials are needed to ensure the translation of this radiopharmaceutical into the clinic. Therefore a conclusion with regards to the clinical relevance of ubiquicidin based PET is not yet possible.
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Affiliation(s)
| | - Janke Kleynhans
- Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa
| | - Jan Rijn Zeevaart
- Radiochemistry, The South African Nuclear Energy Corporation, Pelindaba, South Africa; Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa
| | - Egmont Rohwer
- Department of Chemistry, University of Pretoria, Pretoria, South Africa
| | - Thomas Ebenhan
- Radiochemistry, The South African Nuclear Energy Corporation, Pelindaba, South Africa; Department of Nuclear Medicine, University of Pretoria, Pretoria, South Africa; Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa.
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Bhatt Mitra J, Chatterjee S, Kumar A, Bandyopadhyay A, Mukherjee A. Integrating a covalent probe with ubiquicidin fragment enables effective bacterial infection imaging. RSC Med Chem 2022; 13:1239-1245. [PMID: 36325398 PMCID: PMC9579938 DOI: 10.1039/d2md00190j] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/25/2022] [Indexed: 08/03/2023] Open
Abstract
Developing potent and novel bacterial imaging agents remains formidable due to the rapid development of bacterial resistance. Ubiquicidin and its derivatives are the most studied antimicrobial peptides that bind to anionic membranes of a broad range of bacterial pathogens. Studies reveal that UBI (29-41) labeled with 99mTc and 68Ga could distinguish sterile inflammation from infection. A significant challenge that remains for cationic peptides is their poor salt tolerance. The present study deliberates the increment of UBI (29-41) peptide interaction with the bacterial membrane by incorporating 2-acetylphenylboronic acid (2-APBA) as a covalent probe and developing infection imaging probes with improved retention at the target. Given that both 99mTc-UBI (29-41) and 99mTc-UBI (29-41)-2-APBA peptide complexes are stable in serum over 16 h, 99mTc-UBI (29-41)-2-APBA shows enhanced uptake in S. aureus cells as compared to 99mTc-UBI (29-41). SPECT imaging in a mouse model of infection exhibited a higher target to non-target ratio after 2 h in the case of 99mTc-UBI (29-41)-2-APBA. The present study reveals a synergistic mechanism of target binding through covalent conjugation and non-covalent interaction, which could be a potential strategy for improving bacterial infection imaging. As a proof of concept, 99mTc-UBI (29-41)-2-APBA elicits our hypothesis by in vivo imaging of bacterial infection.
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Affiliation(s)
- Jyotsna Bhatt Mitra
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) Mumbai 400085 India
- Homi Bhabha National Institute Anushaktinagar Mumbai-400094 India
| | - Saurav Chatterjee
- Biomimetic Peptide Engineering Laboratory, Department of Chemistry, Indian Institute of Technology Ropar Rupnagar Punjab 140001 India
| | - Anuj Kumar
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) Mumbai 400085 India
| | - Anupam Bandyopadhyay
- Biomimetic Peptide Engineering Laboratory, Department of Chemistry, Indian Institute of Technology Ropar Rupnagar Punjab 140001 India
| | - Archana Mukherjee
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) Mumbai 400085 India
- Homi Bhabha National Institute Anushaktinagar Mumbai-400094 India
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Crișan G, Moldovean-Cioroianu NS, Timaru DG, Andrieș G, Căinap C, Chiș V. Radiopharmaceuticals for PET and SPECT Imaging: A Literature Review over the Last Decade. Int J Mol Sci 2022; 23:5023. [PMID: 35563414 PMCID: PMC9103893 DOI: 10.3390/ijms23095023] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/23/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023] Open
Abstract
Positron emission tomography (PET) uses radioactive tracers and enables the functional imaging of several metabolic processes, blood flow measurements, regional chemical composition, and/or chemical absorption. Depending on the targeted processes within the living organism, different tracers are used for various medical conditions, such as cancer, particular brain pathologies, cardiac events, and bone lesions, where the most commonly used tracers are radiolabeled with 18F (e.g., [18F]-FDG and NA [18F]). Oxygen-15 isotope is mostly involved in blood flow measurements, whereas a wide array of 11C-based compounds have also been developed for neuronal disorders according to the affected neuroreceptors, prostate cancer, and lung carcinomas. In contrast, the single-photon emission computed tomography (SPECT) technique uses gamma-emitting radioisotopes and can be used to diagnose strokes, seizures, bone illnesses, and infections by gauging the blood flow and radio distribution within tissues and organs. The radioisotopes typically used in SPECT imaging are iodine-123, technetium-99m, xenon-133, thallium-201, and indium-111. This systematic review article aims to clarify and disseminate the available scientific literature focused on PET/SPECT radiotracers and to provide an overview of the conducted research within the past decade, with an additional focus on the novel radiopharmaceuticals developed for medical imaging.
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Affiliation(s)
- George Crișan
- Faculty of Physics, Babeş-Bolyai University, Str. M. Kogălniceanu 1, 400084 Cluj-Napoca, Romania; (G.C.); (N.S.M.-C.); (D.-G.T.)
- Department of Nuclear Medicine, County Clinical Hospital, Clinicilor 3-5, 400006 Cluj-Napoca, Romania;
| | | | - Diana-Gabriela Timaru
- Faculty of Physics, Babeş-Bolyai University, Str. M. Kogălniceanu 1, 400084 Cluj-Napoca, Romania; (G.C.); (N.S.M.-C.); (D.-G.T.)
| | - Gabriel Andrieș
- Department of Nuclear Medicine, County Clinical Hospital, Clinicilor 3-5, 400006 Cluj-Napoca, Romania;
| | - Călin Căinap
- The Oncology Institute “Prof. Dr. Ion Chiricuţă”, Republicii 34-36, 400015 Cluj-Napoca, Romania;
| | - Vasile Chiș
- Faculty of Physics, Babeş-Bolyai University, Str. M. Kogălniceanu 1, 400084 Cluj-Napoca, Romania; (G.C.); (N.S.M.-C.); (D.-G.T.)
- Institute for Research, Development and Innovation in Applied Natural Sciences, Babeș-Bolyai University, Str. Fântânele 30, 400327 Cluj-Napoca, Romania
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Kaushik P, Maurya SD, Damle N, Ballal S, Kumar VS, Bal C, Tripathi M. Infected Lower Limb Megaprosthesis on 68Ga-NOTA-Ubiquicidin PET/CT Imaging. Nucl Med Mol Imaging 2022; 56:171-172. [DOI: 10.1007/s13139-022-00747-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 10/18/2022] Open
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Dadachova E, Rangel DEN. Highlights of the Latest Developments in Radiopharmaceuticals for Infection Imaging and Future Perspectives. Front Med (Lausanne) 2022; 9:819702. [PMID: 35223918 PMCID: PMC8873932 DOI: 10.3389/fmed.2022.819702] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
COVID-19 pandemic has heightened the interest toward diagnosis and treatment of infectious diseases. Nuclear medicine with its powerful scintigraphic, single photon emission computer tomography (SPECT) and positron emission tomography (PET) imaging modalities has always played an important role in diagnosis of infections and distinguishing them from the sterile inflammation. In addition to the clinically available radiopharmaceuticals there has been a decades-long effort to develop more specific imaging agents with some examples being radiolabeled antibiotics and antimicrobial peptides for bacterial imaging, radiolabeled anti-fungals for fungal infections imaging, radiolabeled pathogen-specific antibodies and molecular engineered constructs. In this opinion piece, we would like to discuss some examples of the work published in the last decade on developing nuclear imaging agents for bacterial, fungal, and viral infections in order to generate more interest among nuclear medicine community toward conducting clinical trials of these novel probes, as well as toward developing novel radiotracers for imaging infections.
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Affiliation(s)
- Ekaterina Dadachova
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
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Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised Hosts. Diagnostics (Basel) 2021; 11:diagnostics11112057. [PMID: 34829403 PMCID: PMC8620393 DOI: 10.3390/diagnostics11112057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022] Open
Abstract
Invasive fungal disease (IFD) leads to increased mortality, morbidity, and costs of treatment in patients with immunosuppressive conditions. The definitive diagnosis of IFD relies on the isolation of the causative fungal agents through microscopy, culture, or nucleic acid testing in tissue samples obtained from the sites of the disease. Biopsy is not always feasible or safe to be undertaken in immunocompromised hosts at risk of IFD. Noninvasive diagnostic techniques are, therefore, needed for the diagnosis and treatment response assessment of IFD. The available techniques that identify fungal-specific antigens in biological samples for diagnosing IFD have variable sensitivity and specificity. They also have limited utility in response assessment. Imaging has, therefore, been applied for the noninvasive detection of IFD. Morphologic imaging with computed tomography (CT) and magnetic resonance imaging (MRI) is the most applied technique. These techniques are neither sufficiently sensitive nor specific for the early diagnosis of IFD. Morphologic changes evaluated by CT and MRI occur later in the disease course and during recovery after successful treatment. These modalities may, therefore, not be ideal for early diagnosis and early response to therapy determination. Radionuclide imaging allows for targeting the host response to pathogenic fungi or specific structures of the pathogen itself. This makes radionuclide imaging techniques suitable for the early diagnosis and treatment response assessment of IFD. In this review, we aimed to discuss the interplay of host immunity, immunosuppression, and the occurrence of IFD. We also discuss the currently available radionuclide probes that have been evaluated in preclinical and clinical studies for their ability to detect IFD.
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20
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The utilization of positron emission tomography in the evaluation of renal health and disease. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00469-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Abstract
Purpose
Positron emission tomography (PET) is a nuclear imaging technique that uses radiotracers to visualize metabolic processes of interest across different organs, to diagnose and manage diseases, and monitor therapeutic response. This systematic review aimed to characterize the value of PET for the assessment of renal metabolism and function in subjects with non-oncological metabolic disorders.
Methods
This review was conducted and reported in accordance with the PRISMA statement. Research articles reporting “kidney” or “renal” metabolism evaluated with PET imaging between 1980 and 2021 were systematically searched in Medline/PubMed, Science Direct, and the Cochrane Library. Search results were exported and stored in RefWorks, the duplicates were removed, and eligible studies were identified, evaluated, and summarized.
Results
Thirty reports met the inclusion criteria. The majority of the studies were prospective (73.33%, n = 22) in nature. The most utilized PET radiotracers were 15O-labeled radio water (H215O, n = 14) and 18F-fluorodeoxyglucose (18F-FDG, n = 8). Other radiotracers used in at least one study were 14(R,S)-(18)F-fluoro-6-thia-heptadecanoic acid (18F-FTHA), 18F-Sodium Fluoride (18F-NaF), 11C-acetate, 68-Gallium (68Ga), 13N-ammonia (13N-NH3), Rubidium-82 (82Rb), radiolabeled cationic ferritin (RadioCF), 11C‐para-aminobenzoic acid (11C-PABA), Gallium-68 pentixafor (68Ga-Pentixafor), 2-deoxy-2-F-fluoro-d-sorbitol (F-FDS) and 55Co-ethylene diamine tetra acetic acid (55Co-EDTA).
Conclusion
PET imaging provides an effective modality for evaluating a range of metabolic functions including glucose and fatty acid uptake, oxygen consumption and renal perfusion. Multiple positron emitting radiolabeled racers can be used for renal imaging in clinical settings. PET imaging thus holds the potential to improve the diagnosis of renal disorders, and to monitor disease progression and treatment response.
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Tegge W, Guerra G, Höltke A, Schiller L, Beutling U, Harmrolfs K, Gröbe L, Wullenkord H, Xu C, Weich H, Brönstrup M. Selective Bacterial Targeting and Infection-Triggered Release of Antibiotic Colistin Conjugates. Angew Chem Int Ed Engl 2021; 60:17989-17997. [PMID: 34097810 PMCID: PMC8456958 DOI: 10.1002/anie.202104921] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/28/2021] [Indexed: 12/18/2022]
Abstract
In order to render potent, but toxic antibiotics more selective, we have explored a novel conjugation strategy that includes drug accumulation followed by infection-triggered release of the drug. Bacterial targeting was achieved using a modified fragment of the human antimicrobial peptide ubiquicidin, as demonstrated by fluorophore-tagged variants. To limit the release of the effector colistin only to infection-related situations, we introduced a linker that was cleaved by neutrophil elastase (NE), an enzyme secreted by neutrophil granulocytes at infection sites. The linker carried an optimized sequence of amino acids that was required to assure sufficient cleavage efficiency. The antibacterial activity of five regioisomeric conjugates prepared by total synthesis was masked, but was released upon exposure to recombinant NE when the linker was attached to amino acids at the 1- or the 3-position of colistin. A proof-of-concept was achieved in co-cultures of primary human neutrophils and Escherichia coli that induced the secretion of NE, the release of free colistin, and an antibacterial efficacy that was equal to that of free colistin.
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Affiliation(s)
- Werner Tegge
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Giulia Guerra
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Alexander Höltke
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Lauritz Schiller
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Ulrike Beutling
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Kirsten Harmrolfs
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Lothar Gröbe
- Flow Cytometry and Cell Sorting PlatformHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Hannah Wullenkord
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Chunfa Xu
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Herbert Weich
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Mark Brönstrup
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
- German Center for Infection Research (DZIF), SiteHannover-BraunschweigGermany
- Center of Biomolecular Drug Research (BMWZ)Leibniz Universität30167HannoverGermany
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22
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Tegge W, Guerra G, Höltke A, Schiller L, Beutling U, Harmrolfs K, Gröbe L, Wullenkord H, Xu C, Weich H, Brönstrup M. Zielgerichtete bakterielle Lokalisation und infektionsinduzierte Freisetzung von antibiotischen Colistin‐Konjugaten. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202104921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Werner Tegge
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Giulia Guerra
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Alexander Höltke
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Lauritz Schiller
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Ulrike Beutling
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Kirsten Harmrolfs
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Lothar Gröbe
- Flow Cytometry and Cell Sorting Platform Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Hannah Wullenkord
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Chunfa Xu
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Herbert Weich
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Mark Brönstrup
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
- Deutsches Zentrum für Infektionsforschung (DZIF), Standort Hannover-Braunschweig Deutschland
- Biomolekulares Wirkstoffzentrum (BMWZ) Leibniz Universität 30167 Hannover Deutschland
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Pijl JP, Nienhuis PH, Kwee TC, Glaudemans AWJM, Slart RHJA, Gormsen LC. Limitations and Pitfalls of FDG-PET/CT in Infection and Inflammation. Semin Nucl Med 2021; 51:633-645. [PMID: 34246448 DOI: 10.1053/j.semnuclmed.2021.06.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
White blood cells activated by either a pathogen or as part of a systemic inflammatory disease are characterized by high energy consumption and are therefore taking up the glucose analogue PET tracer FDG avidly. It is therefore not surprising that a steadily growing body of research and clinical reports now supports the use of FDG PET/CT to diagnose a wide range of patients with non-oncological diseases. However, using FDG PET/CT in patients with infectious or inflammatory diseases has some limitations and potential pitfalls that are not necessarily as pronounced in oncology FDG PET/CT. Some of these limitations are of a general nature and related to the laborious acquisition of PET images in patients that are often acutely ill, whereas others are more disease-specific and related to the particular metabolism in some of the organs most commonly affected by infections or inflammatory disease. Both inflammatory and infectious diseases are characterized by a more diffuse and less pathognomonic pattern of FDG uptake than oncology FDG PET/CT and the affected organs also typically have some physiological FDG uptake. In addition, patients referred to PET/CT with suspected infection or inflammation are rarely treatment naïve and may have received varying doses of antibiotics, corticosteroids or other immune-modulating drugs at the time of their examination. Combined, this results in a higher rate of false positive FDG findings and also in some cases a lower sensitivity to detect active disease. In this review, we therefore discuss the limitations and pitfalls of FDG PET/CT to diagnose infections and inflammation taking these issues into consideration. Our review encompasses the most commonly encountered inflammatory and infectious diseases in head and neck, in the cardiovascular system, in the abdominal organs and in the musculoskeletal system. Finally, new developments in the field of PET/CT that may help overcome some of these limitations are briefly highlighted.
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Affiliation(s)
- Jordy P Pijl
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen
| | - Pieter H Nienhuis
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen
| | - Thomas C Kwee
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen
| | - Andor W J M Glaudemans
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen
| | - Riemer H J A Slart
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen; Faculty of Science and Technology, Department of Biomedical Photonic Imaging, University of Twente, Enschede
| | - Lars C Gormsen
- Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus N.
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Jiang Y, Fang S, Zhang X, Feng J, Ruan Q, Zhang J. Radiolabeling and evaluation of a novel [ 99mTcN] 2+ complex with deferoxamine dithiocarbamate as a potential agent for bacterial infection imaging. Bioorg Med Chem Lett 2021; 43:128102. [PMID: 33984471 DOI: 10.1016/j.bmcl.2021.128102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 01/17/2023]
Abstract
In order to find a 99mTc-labeled deferoxamine radiotracer for bacterial infection imaging, deferoxamine dithiocarbamate (DFODTC) was successfully synthesized and it was radiolabeled with [99mTcN]2+ core to prepare the 99mTcN(DFODTC)2 complex. 99mTcN(DFODTC)2 was obtained with high radiochemical purity without further purification. The complex was lipophilic and exhibited good in vitro stability. According to the result of bacterial binding study, the binding of 99mTcN(DFODTC)2 to bacteria was specific. Biodistribution in mice study indicated that 99mTcN(DFODTC)2 had a higher uptake in bacterial infection tissues than in turpentine-induced abscesses at 120 min after injection, which showed that the radiotracer could differentiate between bacterial infection and sterile inflammation. SPECT/CT images showed that there was a clear accumulation in infection sites, suggesting that 99mTcN(DFODTC)2 could be a potential bacterial infection imaging radiotracer.
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Affiliation(s)
- Yuhao Jiang
- Key Laboratory of Radiopharmaceuticals of Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Si'an Fang
- Key Laboratory of Radiopharmaceuticals of Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Xuran Zhang
- Key Laboratory of Radiopharmaceuticals of Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Junhong Feng
- Key Laboratory of Radiopharmaceuticals of Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Qing Ruan
- Key Laboratory of Radiopharmaceuticals of Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Junbo Zhang
- Key Laboratory of Radiopharmaceuticals of Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, PR China.
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25
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Jødal L, Afzelius P, Alstrup AKO, Jensen SB. Radiotracers for Bone Marrow Infection Imaging. Molecules 2021; 26:3159. [PMID: 34070537 PMCID: PMC8198735 DOI: 10.3390/molecules26113159] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Radiotracers are widely used in medical imaging, using techniques of gamma-camera imaging (scintigraphy and SPECT) or positron emission tomography (PET). In bone marrow infection, there is no single routine test available that can detect infection with sufficiently high diagnostic accuracy. Here, we review radiotracers used for imaging of bone marrow infection, also known as osteomyelitis, with a focus on why these molecules are relevant for the task, based on their physiological uptake mechanisms. The review comprises [67Ga]Ga-citrate, radiolabelled leukocytes, radiolabelled nanocolloids (bone marrow) and radiolabelled phosphonates (bone structure), and [18F]FDG as established radiotracers for bone marrow infection imaging. Tracers that are under development or testing for this purpose include [68Ga]Ga-citrate, [18F]FDG, [18F]FDS and other non-glucose sugar analogues, [15O]water, [11C]methionine, [11C]donepezil, [99mTc]Tc-IL-8, [68Ga]Ga-Siglec-9, phage-display selected peptides, and the antimicrobial peptide [99mTc]Tc-UBI29-41 or [68Ga]Ga-NOTA-UBI29-41. CONCLUSION Molecular radiotracers allow studies of physiological processes such as infection. None of the reviewed molecules are ideal for the imaging of infections, whether bone marrow or otherwise, but each can give information about a separate aspect such as physiology or biochemistry. Knowledge of uptake mechanisms, pitfalls, and challenges is useful in both the use and development of medically relevant radioactive tracers.
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Affiliation(s)
- Lars Jødal
- Department of Nuclear Medicine, Aalborg University Hospital, DK-9000 Aalborg, Denmark;
| | - Pia Afzelius
- Zealand Hospital, Køge, Copenhagen University Hospital, DK-4600 Køge, Denmark;
| | - Aage Kristian Olsen Alstrup
- Department of Nuclear Medicine & PET, Aarhus University Hospital, DK-8200 Aarhus, Denmark;
- Department of Clinical Medicine, Aarhus University, DK-8000 Aarhus, Denmark
| | - Svend Borup Jensen
- Department of Nuclear Medicine, Aalborg University Hospital, DK-9000 Aalborg, Denmark;
- Department of Chemistry and Biosciences, Aalborg University, DK-9220 Aalborg, Denmark
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Ankrah AO, Sathekge MM, Dierckx RAJO, Glaudemans AWJM. Radionuclide Imaging of Fungal Infections and Correlation with the Host Defense Response. J Fungi (Basel) 2021; 7:jof7060407. [PMID: 34067410 PMCID: PMC8224611 DOI: 10.3390/jof7060407] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/10/2021] [Accepted: 05/21/2021] [Indexed: 12/19/2022] Open
Abstract
The human response to invading fungi includes a series of events that detect, kill, or clear the fungi. If the metabolic host response is unable to eliminate the fungi, an infection ensues. Some of the host response’s metabolic events to fungi can be imaged with molecules labelled with radionuclides. Several important clinical applications have been found with radiolabelled biomolecules of inflammation. 18F-fluorodeoxyglucose is the tracer that has been most widely investigated in the host defence of fungi. This tracer has added value in the early detection of infection, in staging and visualising dissemination of infection, and in monitoring antifungal treatment. Radiolabelled antimicrobial peptides showed promising results, but large prospective studies in fungal infection are lacking. Other tracers have also been used in imaging events of the host response, such as the migration of white blood cells at sites of infection, nutritional immunity in iron metabolism, and radiolabelled monoclonal antibodies. Many tracers are still at the preclinical stage. Some tracers require further studies before translation into clinical use. The application of therapeutic radionuclides offers a very promising clinical application of these tracers in managing drug-resistant fungi.
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Affiliation(s)
- Alfred O. Ankrah
- National Centre for Radiotherapy Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra GA-222 7974, Ghana;
- Department of Nuclear Medicine, University of Pretoria, Steve Biko Academic Hospital, Pretoria 0001, South Africa;
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;
| | - Mike M. Sathekge
- Department of Nuclear Medicine, University of Pretoria, Steve Biko Academic Hospital, Pretoria 0001, South Africa;
| | - Rudi A. J. O. Dierckx
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;
| | - Andor W. J. M. Glaudemans
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;
- Correspondence:
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Pijl JP, Kwee TC, Slart RHJA, Glaudemans AWJM. PET/CT Imaging for Personalized Management of Infectious Diseases. J Pers Med 2021; 11:133. [PMID: 33669375 PMCID: PMC7920259 DOI: 10.3390/jpm11020133] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/28/2022] Open
Abstract
Positron emission tomography combined with computed tomography (PET/CT) is a nuclear imaging technique which is increasingly being used in infectious diseases. Because infection foci often consume more glucose than surrounding tissue, most infections can be diagnosed with PET/CT using 2-deoxy-2-[18F]fluoro-D-glucose (FDG), an analogue of glucose labeled with Fluorine-18. In this review, we discuss common infectious diseases in which FDG-PET/CT is currently applied including bloodstream infection of unknown origin, infective endocarditis, vascular graft infection, spondylodiscitis, and cyst infections. Next, we highlight the latest developments within the field of PET/CT, including total body PET/CT, use of novel PET radiotracers, and potential future applications of PET/CT that will likely lead to increased capabilities for patient-tailored treatment of infectious diseases.
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Affiliation(s)
- Jordy P. Pijl
- Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, 9700 RB Groningen, The Netherlands; (T.C.K.); (R.H.J.A.S.); (A.W.J.M.G.)
| | - Thomas C. Kwee
- Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, 9700 RB Groningen, The Netherlands; (T.C.K.); (R.H.J.A.S.); (A.W.J.M.G.)
| | - Riemer H. J. A. Slart
- Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, 9700 RB Groningen, The Netherlands; (T.C.K.); (R.H.J.A.S.); (A.W.J.M.G.)
- Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, 7500 AE Enschede, The Netherlands
| | - Andor W. J. M. Glaudemans
- Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, 9700 RB Groningen, The Netherlands; (T.C.K.); (R.H.J.A.S.); (A.W.J.M.G.)
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In Vitro and In Vivo Evaluation of 99mTc-Polymyxin B for Specific Targeting of Gram-Bacteria. Biomolecules 2021; 11:biom11020232. [PMID: 33562877 PMCID: PMC7915610 DOI: 10.3390/biom11020232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023] Open
Abstract
Background: Infectious diseases are one of the main causes of morbidity and mortality worldwide. Nuclear molecular imaging would be of great help to non-invasively discriminate between septic and sterile inflammation through available radiopharmaceuticals, as none is currently available for clinical practice. Here, we describe the radiolabeling procedure and in vitro and in vivo studies of 99mTc-polymyxin B sulfate (PMB) as a new single photon emission imaging agent for the characterization of infections due to Gram-negative bacteria. Results: Labeling efficiency was 97 ± 2% with an average molar activity of 29.5 ± 0.6 MBq/nmol. The product was highly stable in saline and serum up to 6 h. In vitro binding assay showed significant displaceable binding to Gram-negative bacteria but not to Gram-positive controls. In mice, 99mTc-HYNIC-PMB was mainly taken up by liver and kidneys. Targeting studies confirmed the specificity of 99mTc-HYNIC-PMB obtained in vitro, showing significantly higher T/B ratios for Gram-negative bacteria than Gram-positive controls. Conclusions: In vitro and in vivo results suggest that 99mTc-HYNIC-PMB has a potential for in vivo identification of Gram-negative bacteria in patients with infections of unknown etiology. However, further investigations are needed to deeply understand the mechanism of action and behavior of 99mTc-HYNIC-PMB in other animal models and in humans.
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29
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Ordoñez AA, Jain SK. Imaging of Bacterial Infections. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00089-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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30
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Boaro A, Ageitos L, Torres M, Bartoloni FH, de la Fuente-Nunez C. Light-Emitting Probes for Labeling Peptides. CELL REPORTS. PHYSICAL SCIENCE 2020; 1:100257. [PMID: 34396352 PMCID: PMC8360326 DOI: 10.1016/j.xcrp.2020.100257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Peptides are versatile biopolymers composed of 2-100 amino acid residues that present a wide range of biological functions and constitute potential therapies for numerous diseases, partly due to their ability to penetrate cell membranes. However, their mechanisms of action have not been fully elucidated due to the lack of appropriate tools. Existing light-emitting probes are limited by their cytotoxicity and large size, which can alter peptide structure and function. Here, we describe the available fluorescent, bioluminescent, and chemiluminescent probes for labeling peptides, with a focus on minimalistic options.
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Affiliation(s)
- Andreia Boaro
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, and Department of Bioengineering, University of Pennsylvania, 3610 Hamilton Walk, Philadelphia, PA 19104, USA
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Avenida dos Estados, 5001, Santo André, São Paulo 09210-580, Brazil
| | - Lucía Ageitos
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, and Department of Bioengineering, University of Pennsylvania, 3610 Hamilton Walk, Philadelphia, PA 19104, USA
- Centro de Investigacións Científicas Avanzadas (CICA) e Departamento de Química, Facultade de Ciencias, Universidade da Coruña, Calle de la Maestranza, 9, A Coruña 15071, Spain
| | - Marcelo Torres
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, and Department of Bioengineering, University of Pennsylvania, 3610 Hamilton Walk, Philadelphia, PA 19104, USA
| | - Fernando Heering Bartoloni
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Avenida dos Estados, 5001, Santo André, São Paulo 09210-580, Brazil
| | - Cesar de la Fuente-Nunez
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, and Department of Bioengineering, University of Pennsylvania, 3610 Hamilton Walk, Philadelphia, PA 19104, USA
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31
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le Roux J, Rubow S, Ebenhan T. A comparison of labelling characteristics of manual and automated synthesis methods for gallium-68 labelled ubiquicidin. Appl Radiat Isot 2020; 168:109452. [PMID: 33127245 DOI: 10.1016/j.apradiso.2020.109452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/10/2020] [Accepted: 09/25/2020] [Indexed: 11/27/2022]
Abstract
Gallium-68 labelled 1,4,7-triazacyclononane-1,4,7-triacetic acid ubiquicidin (NOTA-UBI) is currently investigated as a PET radiopharmaceutical for the imaging of infections. The aim of this study was to compare the labelling characteristics of an optimized manual radiosynthesis method with those of optimized automated synthesis methods. Data from this study suggest that automated radiosynthesis of [68Ga]Ga-NOTA-UBI provides a higher degree of robustness and repeatability than the manual method. Our results also suggest that for our full-scale automated synthesis, radical scavengers should be considered to reduce radiolysis. Automated synthesis methods have the advantage of markedly reducing radiation exposure to operators. Standardised automation also makes the synthesis more reliably compliant with Good Manufacturing Practice guidelines.
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Affiliation(s)
- Jannie le Roux
- Nuclear Medicine Research Infrastructure, Node for Infection Imaging, Central Analytical Facilities, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, South Africa; Nuclear Medicine Division, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, South Africa.
| | - Sietske Rubow
- Nuclear Medicine Division, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, South Africa
| | - Thomas Ebenhan
- Department of Nuclear Medicine, University of Pretoria, cnr Malherbe and Steve Biko Rd, Pretoria, 0001, South Africa; Nuclear Medicine Research Infrastructure, Preclinical Imaging Facility, cnr Malherbe and Steve Biko Rd, Pretoria, 0001, South Africa
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32
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Mota F, Ordonez AA, Firth G, Ruiz-Bedoya CA, Ma MT, Jain SK. Radiotracer Development for Bacterial Imaging. J Med Chem 2020; 63:1964-1977. [PMID: 32048838 DOI: 10.1021/acs.jmedchem.9b01623] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Bacterial infections remain a major threat to humanity and are a leading cause of death and disability. Antimicrobial resistance has been declared as one of the top ten threats to human health by the World Health Organization, and new technologies are urgently needed for the early diagnosis and monitoring of deep-seated and complicated infections in hospitalized patients. This review summarizes the radiotracers as applied to imaging of bacterial infections. We summarize the recent progress in the development of pathogen-specific imaging and the application of radiotracers in understanding drug pharmacokinetics as well as the local biology at the infection sites. We also highlight the opportunities for medicinal chemists in radiotracer development for bacterial infections, with an emphasis on target selection and radiosynthetic approaches. Imaging of infections is an emerging field. Beyond clinical applications, these technologies could provide unique insights into disease pathogenesis and expedite bench-to-bedside translation of new therapeutics.
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Affiliation(s)
- Filipa Mota
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
| | - Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
| | - George Firth
- School of Biomedical Engineering and Imaging Sciences, St. Thomas' Hospital, King's College London, London SE1 7EH, United Kingdom
| | - Camilo A Ruiz-Bedoya
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
| | - Michelle T Ma
- School of Biomedical Engineering and Imaging Sciences, St. Thomas' Hospital, King's College London, London SE1 7EH, United Kingdom
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, United States
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Ruiz-Bedoya CA, Gordon O, Mota F, Abhishek S, Tucker EW, Ordonez AA, Jain SK. Molecular Imaging of Diabetic Foot Infections: New Tools for Old Questions. Int J Mol Sci 2019; 20:E5984. [PMID: 31795077 PMCID: PMC6928969 DOI: 10.3390/ijms20235984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 02/07/2023] Open
Abstract
Diabetic foot infections (DFIs) are a common, complex, and costly medical problem with increasing prevalence. Diagnosing DFIs is a clinical challenge due to the poor specificity of the available methods to accurately determine the presence of infection in these patients. However, failure to perform an opportune diagnosis and provide optimal antibiotic therapy can lead to higher morbidity for the patient, unnecessary amputations, and increased healthcare costs. Novel developments in bacteria-specific molecular imaging can provide a non-invasive assessment of the infection site to support diagnosis, determine the extension and location of the infection, guide the selection of antibiotics, and monitor the response to treatment. This is a review of recent research in molecular imaging of infections in the context of DFI. We summarize different clinical and preclinical methods and the translational implications aimed to improve the care of patients with DFI.
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Affiliation(s)
- Camilo A. Ruiz-Bedoya
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (C.A.R.-B.); (O.G.); (F.M.); (S.A.); (E.W.T.); (A.A.O.)
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Oren Gordon
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (C.A.R.-B.); (O.G.); (F.M.); (S.A.); (E.W.T.); (A.A.O.)
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Filipa Mota
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (C.A.R.-B.); (O.G.); (F.M.); (S.A.); (E.W.T.); (A.A.O.)
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Sudhanshu Abhishek
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (C.A.R.-B.); (O.G.); (F.M.); (S.A.); (E.W.T.); (A.A.O.)
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Elizabeth W. Tucker
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (C.A.R.-B.); (O.G.); (F.M.); (S.A.); (E.W.T.); (A.A.O.)
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Division of Pediatric Critical Care, Johns Hopkins All Children’s Hospital, St. Petersburg, FL 33701, USA
| | - Alvaro A. Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (C.A.R.-B.); (O.G.); (F.M.); (S.A.); (E.W.T.); (A.A.O.)
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Sanjay K. Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (C.A.R.-B.); (O.G.); (F.M.); (S.A.); (E.W.T.); (A.A.O.)
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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34
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Comparison of DOTA and NODAGA as chelates for 68Ga-labelled CDP1 as novel infection PET imaging agents. J Radioanal Nucl Chem 2019. [DOI: 10.1007/s10967-019-06693-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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35
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Vatsa R, Shukla J, Kumar S, Chakraboarty S, Dash A, Singh G, Mittal BR. Effect of Macro-Cyclic Bifunctional Chelators DOTA and NODAGA on Radiolabeling and In Vivo Biodistribution of Ga-68 Cyclic RGD Dimer. Cancer Biother Radiopharm 2019; 34:427-435. [DOI: 10.1089/cbr.2019.2811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rakhee Vatsa
- Department of Nuclear Medicine and PET, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaya Shukla
- Department of Nuclear Medicine and PET, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Kumar
- Department of Nuclear Medicine and PET, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Ashutosh Dash
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Gurpreet Singh
- Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine and PET, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Chopra S, Singh B, Koul A, Mishra AK, Robu S, Kaur A, Ghai A, Caplash N, Wester HJ. Radiosynthesis and pre-clinical evaluation of [ 68Ga] labeled antimicrobial peptide fragment GF-17 as a potential infection imaging PET radiotracer. Appl Radiat Isot 2019; 149:9-21. [PMID: 31003040 DOI: 10.1016/j.apradiso.2019.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 12/18/2022]
Abstract
The antimicrobial peptide fragment GF-17 was synthesized in-house and conjugated with DOTA and measured molecular mass of DOTA-GF-17 conjugate was 2489 Da. The peptide conjugate was purified and labeled with [68Ga]. The best radiolabeling efficiency (95.0%) of [68Ga]DOTA-GF-17 was achieved at pH 4 with peptide conjugate amount of 20.0 nmol with 30 min of heating at 95 °C. The product remained stable for up to 3 h. The plasma protein binding and lipophilicity for [68Ga]DOTA-GF-17 were 80.98% and -3.12 respectively. The uptake studies with [68Ga]DOTA- GF-17 in S.aureus and P.aeruginosa bacterial strains demonstrated binding of 69.08% and 43.69% respectively. The animal bio-distribution and PET imaging studies were in agreement showing similar pattern for organs' tracer distribution and renal excretion. The tracer had rapid blood clearance and uptake in bone marrow and muscles was very low. The highest uptake of [68Ga]DOTA-GF-17 was observed at 45 min and 120 min in S.aureus and P.aeruginosa infections respectively. [68Ga]DOTA-GF-17 could be a promising PET tracer and holds a great scope for taking the product further to perform extensive PET studies in animal infection (using gram negative/positive strains) models to prove the diagnostic utility of this novel PET tracer for futuristic clinical applications.
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Affiliation(s)
- Shalini Chopra
- Department of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Baljinder Singh
- Department of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
| | - Ashwani Koul
- Department of Biophysics, Panjab University, Sector 25, Chandigarh, 160014, India
| | - Anil K Mishra
- Division of Cyclotron and Radiopharmaceutical Sciences, Institute of Nuclear Medicine and Allied Sciences, DRDO, Brig. S.K. Mazumdar Road, Timarpur, Delhi, 110054, India
| | - Stephanie Robu
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Amritjyot Kaur
- Department of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Anchal Ghai
- Department of Radiology, School of Medicine, Washington University, 510 South Kingshighway Boulevard, St. Louis, Missouri, 63110-107, USA
| | - Neena Caplash
- Department of Biotechnology, Panjab University, Sector 25, Chandigarh, 160014, India
| | - Hans-Jürgen Wester
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
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38
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PET Radiopharmaceuticals for Specific Bacteria Imaging: A Systematic Review. J Clin Med 2019; 8:jcm8020197. [PMID: 30736324 PMCID: PMC6406348 DOI: 10.3390/jcm8020197] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 01/30/2019] [Accepted: 02/04/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Bacterial infections are still one of the main factors associated with mortality worldwide. Many radiopharmaceuticals were developed for bacterial imaging, both with single photon emission computed tomography (SPECT) and positron emission tomography (PET) isotopes. This review focuses on PET radiopharmaceuticals, performing a systematic literature review of published studies between 2005 and 2018. Methods: A systematic review of published studies between 2005 and 2018 was performed. A team of reviewers independently screened for eligible studies. Because of differences between studies, we pooled the data where possible, otherwise, we described separately. Quality of evidence was assessed by Quality Assessment of Diagnostic Accuracy Studies (QUADAS) approach. Results: Eligible papers included 35 published studies. Because of the heterogeneity of animal models and bacterial strains, we classified studies in relation to the type of bacterium: Gram-positive, Gram-negative, Gram-positive and negative, others. Conclusions: Results highlighted the availability of many promising PET radiopharmaceuticals for bacterial imaging, despite some bias related to animal selection and index test, but few have been translated to human subjects. Results showed a lack of standardized infection models and experimental settings.
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Selectivity of Antimicrobial Peptides: A Complex Interplay of Multiple Equilibria. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1117:175-214. [DOI: 10.1007/978-981-13-3588-4_11] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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40
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Zhao C, Mendive-Tapia L, Vendrell M. Fluorescent peptides for imaging of fungal cells. Arch Biochem Biophys 2018; 661:187-195. [PMID: 30465736 DOI: 10.1016/j.abb.2018.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 11/06/2018] [Accepted: 11/16/2018] [Indexed: 12/17/2022]
Abstract
Fungal infections, especially with the advent of antimicrobial resistance, represent a major burden to our society. As a result, there has been an increasing interest in the development of new probes that accelerate the study of fungi-related biological processes and facilitate novel clinical diagnostic and treatment strategies. Fluorescence-based reporters can provide dynamic information at the molecular level with high spatial resolution. However, conventional fluorescent probes for microbes often suffer from low specificity. In the last decade, numerous studies have been reported on the chemical design and application of fluorescent peptides for both in vitro and in vivo imaging of fungal cells. In this article, we review different strategies used in the preparation of fluorescent peptides for pathogenic fungi as well as some of their applications in medical imaging and in mode-of-action mechanistic studies.
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Affiliation(s)
- Can Zhao
- Manchester Fungal Infection Group, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, M13 9NT, United Kingdom
| | - Lorena Mendive-Tapia
- Centre for Inflammation Research, The University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom
| | - Marc Vendrell
- Centre for Inflammation Research, The University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom.
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Mukherjee A, Bhatt J, Shinto A, Korde A, Kumar M, Kamaleshwaran K, Joseph J, Sarma HD, Dash A. 68Ga-NOTA-ubiquicidin fragment for PET imaging of infection: From bench to bedside. J Pharm Biomed Anal 2018; 159:245-251. [PMID: 29990892 DOI: 10.1016/j.jpba.2018.06.064] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022]
Abstract
This study explores the possibility of formulation of a cold kit for fast and easy preparation of a PET radiopharmaceutical, 68Ga-NOTA-UBI (29-41) for clinical translation. In this study, Circular dichroism (CD) spectroscopy to study conformation of NOTA-UBI (29-41) and its comparison with conformation of UBI (29-41) was done. Pharmaceutical grade cold kits of NOTA-UBI (29-41) were formulated for radiolabeling with 68Ga and necessary quality control tests were carried out. 68Ga-NOTA-UBI (29-41) could be prepared in >90% radiochemical yield and radiochemical purity using cold kits of NOTA-UBI (29-41). In vitro and in vivo evaluation of 68Ga-NOTA-UBI (29-41) was done to demonstrate specificity of the agent for imaging infection. Kits were utilized for preparation of patient dose of 68Ga-NOTA-UBI (29-41). Simple instant thin layer chromatography (ITLC) method for estimating radiolabeling yield of 68Ga-NOTA-UBI (29-41) at hospital radiopharmacy was demonstrated. Clinical evaluation was done in patients with suspected infection. 148-185 MBq of 68Ga-NOTA-UBI (29-41) was injected intravenously in three patients. 68Ga-NOTA-UBI (29-41) uptake could clearly delineate infection foci from non target normal tissues. This is the first report on formulation of a cold kit of NOTA-UBI (29-41) for preparation of 68Ga labeled NOTA-UBI(29-41) at hospital radiopharmacy for infection imaging. Initial clinical evaluation reveal it to be a prospective agent for imaging infection.
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Affiliation(s)
- Archana Mukherjee
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai 400085, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India.
| | - Jyotsna Bhatt
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai 400085, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India
| | - Ajit Shinto
- Kovai Medical Center and Hospital Limited, Coimbatore, India
| | - Aruna Korde
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai 400085, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India
| | - Mukesh Kumar
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre (BARC), Mumbai 400085, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India
| | - K Kamaleshwaran
- Kovai Medical Center and Hospital Limited, Coimbatore, India
| | - Jephy Joseph
- Kovai Medical Center and Hospital Limited, Coimbatore, India
| | - Haladhar Dev Sarma
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre (BARC), Mumbai 400085, India
| | - Ashutosh Dash
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai 400085, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India
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Abstract
When serious infections are suspected, patients are often treated empirically with broad-spectrum antibiotics while awaiting results that provide information on the bacterial class and species causing the infection, as well as drug susceptibilities. For deep-seated infections, these traditional diagnostic techniques often rely on tissue biopsies to obtain clinical samples which can be expensive, dangerous, and has the potential of sampling bias. Moreover, these procedures and results can take several days and may not always provide reliable information. This combination of time and effort required for proper antibiotic selection has become a barrier leading to indiscriminate broad-spectrum antibiotic use. Exposure to nosocomial infections and indiscriminate use of broad-spectrum antibiotics are responsible for promoting bacterial drug-resistance leading to substantial morbidity and mortality, especially in hospitalized and immunosuppressed patients. Therefore, early diagnosis of infection and targeted antibiotic treatments are urgently needed to reduce morbidity and mortality caused by bacterial infections worldwide. Reliable pathogen-specific bacterial imaging techniques have the potential to provide early diagnosis and guide antibiotic treatments.
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Affiliation(s)
- Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
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