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Létang JM, Allegrini O, Testa É. Prompt-gamma track-length estimator with time tagging from proton tracking. Phys Med Biol 2024; 69:115052. [PMID: 38729180 DOI: 10.1088/1361-6560/ad4a01] [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] [Received: 12/30/2023] [Accepted: 05/10/2024] [Indexed: 05/12/2024]
Abstract
The design of prompt-gamma detectors necessitates numerous Monte Carlo simulations to precisely develop and optimize the detection stages in proton therapy. Alongside the advancement of MC simulations, various variance reduction methods have been explored to speed-up calculations. Among these techniques, track-length estimators are interesting scoring methods for achieving both speed and accuracy in Monte Carlo simulations of rare events. This paper introduces an extension of the GATE vpgTLE module that incorporates the prompt-gamma emission time, which is tagged from the proton tracking, enhancing its utility for studies focused on detector design and optimization that rely on time measurements. The results obtained from a clinical radiotherapy plan are presented. We demonstrate that the new vpgTLE tally with time tagging is accurate, except for certain prompt-gamma lines corresponding to long mean-life nuclei.
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Affiliation(s)
- Jean M Létang
- INSA-Lyon, Universite Claude Bernard Lyon 1, CNRS UMR5220, Inserm U1294, Centre Léon Bérard, CREATIS, F-69373 Lyon, France
| | - Oreste Allegrini
- Universite Claude Bernard Lyon 1, CNRS/IN2P3 UMR5822, IP2I, F-69622 Villeurbanne, France
| | - Étienne Testa
- Universite Claude Bernard Lyon 1, CNRS/IN2P3 UMR5822, IP2I, F-69622 Villeurbanne, France
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2
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Wu C, Tan Y, Wei X, Li X, Sun S, Lyu B, Shen Z, Wei X, Xiao S, Ruan Y, Yu J, He G, Zheng W, Li J. Bayesian analysis of physiologically based toxicokinetic (PBTK) modeling for pentachlorophenol exposure in pregnant women. Toxicol In Vitro 2024; 99:105853. [PMID: 38806067 DOI: 10.1016/j.tiv.2024.105853] [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: 02/23/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 05/30/2024]
Abstract
Pentachlorophenol (PCP) is a persistent organic compound that is widely present in the environment. The estimation of internal exposure levels for a given external exposure using toxicokinetic models is key to the human health risk assessment of PCP. The present study developed a physiologically based multicompartmental pharmacokinetic (PBTK) model to describe and predict the behavior of pentachlorophenol (PCP) in an organism. The model consists of stomach, intestines, adipose tissue, kidneys and fast- and poorly perfused tissues that are interconnected via blood circulation. We constructed a PBTK model of PCP in rats and extrapolated it to human dietary PCP exposure. The toxicokinetic data of PCP in human tissues and excreta were obtained from the published literature. Based on the collected PCP dietary survey and internal exposure data of pregnant women in Shanghai, Bayesian statistical analysis was performed for the model using Markov chain Monte Carlo (MCMC) simulation. The posterior distributions of the sensitive parameters were estimated, and the model was parameter optimized and validated using the pregnant women's test dataset. The results showed that the root mean square error (RMSE) improved 37.3% compared to the original model, and a systematic literature search revealed that the optimized model achieved acceptable prediction results for other datasets in China. A PCP metabolism model based on the exposure characteristics of pregnant women in China was constructed in the present study. The model provides a theoretical basis for the study of PCP toxicity and risk assessment.
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Affiliation(s)
- Chunfeng Wu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Yajiao Tan
- Key Laboratory of Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xiaoyi Wei
- Department of Food Science, College of Hospitality of Management, Shanghai Business School, Shanghai 200235, PR China
| | - Xun Li
- School of Public Health/Key Laboratory of Public Health Safety, Ministry of Education, Department of Nutrition and Food Science, Fudan University, Shanghai 200032, China
| | - Sifei Sun
- Community Health Service Center of Jiangqiao Town, Jiading District, Shanghai, China
| | - Bing Lyu
- Research Unit of Food Safety, Chinese Academy of Medical Sciences (No. 2019RU014); NHC Key Lab of Food Safety Risk Assessment; China National Center for Food Safety Risk Assessment, Beijing 100021, PR China
| | - Zhen Shen
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Xiao Wei
- Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Shuo Xiao
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ 08854, USA
| | - Yuanyuan Ruan
- Department of Biochemistry and Molecular Biology Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Jun Yu
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
| | - Gengsheng He
- School of Public Health/Key Laboratory of Public Health Safety, Ministry of Education, Department of Nutrition and Food Science, Fudan University, Shanghai 200032, China.
| | - Weiwei Zheng
- Key Laboratory of Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.
| | - Jingguang Li
- China National Center for Food Safety Risk Assessment, Beijing 100021, PR China
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Zhao R, Ke M, Lv J, Liu S, Liu Y, Zhang J, Xu L, Gu D, Li M, Cai C, Liu Y, Zeng G, Alexoff D, Ploessl K, Zhu L, Kung HF, Wang X. First-in-human study of PSMA-targeting agent, [ 18F]AlF-P16-093: dosimetry and initial evaluation in prostate cancer patients. Eur J Nucl Med Mol Imaging 2024; 51:1753-1762. [PMID: 38212531 DOI: 10.1007/s00259-024-06596-y] [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: 10/19/2023] [Accepted: 01/01/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE This is a first-in-human study to evaluate the radiation dosimetry of a new prostate-specific membrane antigen (PSMA)-targeted radiopharmaceutical, [18F]AlF-P16-093, and also initial investigation of its ability to detect PSMA-positive tumors using PET scans in a cohort of prostate cancer (PCa) patients. METHODS The [18F]AlF-P16-093 was automatically synthesized with a GE TRACERlab. A total of 23 patients with histopathologically proven PCa were prospectively enrolled. Dosimetry and biodistribution study investigations were carried out on a subset of six (6) PCa patients, involving multiple time-point scanning. The mean absorbed doses were estimated with PMOD and OLINDA software. RESULTS [18F]AlF-P16-093 was successfully synthesized, and radiochemical purity was > 95%, and average labeling yield was 36.5 ± 8.3% (decay correction, n = 12). The highest tracer uptake was observed in the kidneys, spleen, and liver, contributing to an effective dose of 16.8 ± 1.3 μSv/MBq, which was ~ 30% lower than that of [68Ga]Ga-P16-093. All subjects tolerated the PET examination well, and no reportable side-effects were observed. The PSMA-positive tumors displayed rapid uptake, and they were all detectable within 10 min, and no additional lesions were observed in the following multi-time points scanning. Each patient had at least one detectable tumor lesion, and a total of 356 tumor lesions were observed, including intraprostatic, lymph node metastases, bone metastases, and other soft tissue metastases. CONCLUSIONS We report herein a streamlined method for high yield synthesis of [18F]AlF-P16-093. Preliminary study in PCa patients has demonstrated its safety and acceptable radiation dosimetry. The initial diagnostic study indicated that [18F]AlF-P16-093 PET/CT is efficacious and potentially useful for a widespread application in the diagnosis of PCa patients.
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Affiliation(s)
- Ruiyue Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Miao Ke
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jie Lv
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Shaoyu Liu
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Yuheng Liu
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jing Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Lifu Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Di Gu
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China
| | - Mingzhao Li
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China
| | - Chao Cai
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China
| | - Yongda Liu
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China
| | - Guohua Zeng
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China
| | - David Alexoff
- Five Eleven Pharma Inc, 3700 Market St, Philadelphia, PA, 19104, USA
| | - Karl Ploessl
- Five Eleven Pharma Inc, 3700 Market St, Philadelphia, PA, 19104, USA
| | - Lin Zhu
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
- College of Chemistry, Beijing Normal University, Beijing, 100875, China.
| | - Hank F Kung
- Five Eleven Pharma Inc, 3700 Market St, Philadelphia, PA, 19104, USA.
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Xinlu Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
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Younes M, Aquilina G, Castle L, Degen G, Engel K, Fowler PJ, Frutos Fernandez MJ, Fürst P, Gundert‐Remy U, Gürtler R, Husøy T, Manco M, Moldeus P, Passamonti S, Shah R, Waalkens‐Berendsen I, Wright M, Benigni R, Bolognesi C, Chipman K, Cordelli E, Nørby K, Svendsen C, Carfí M, Dino B, Gagliardi G, Mech A, Multari S, Mennes W. Flavouring Group Evaluation 413 (FGE.413): Naringenin. EFSA J 2024; 22:e8747. [PMID: 38751504 PMCID: PMC11094580 DOI: 10.2903/j.efsa.2024.8747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
The EFSA Panel on Food Additives and Flavourings (FAF) was requested to evaluate the safety of naringenin [FL-no: 16.132] as a new flavouring substance, in accordance with Regulation (EC) No 1331/2008. No other substances with sufficient structural similarity have been identified in existing FGEs that could be used to support a read-across approach. The information provided on the manufacturing process, the composition and the stability of [FL-no: 16.132] was considered sufficient. From studies carried out with naringenin, the Panel concluded that there is no concern with respect to genotoxicity. The use of naringenin as a flavouring substance at added portions exposure technique (APET) exposure levels is unlikely to pose a risk for drug interaction. For the toxicological evaluation of naringenin, the Panel requested an extended one-generation toxicity study on naringenin, in line with the requirements of the Procedure and to investigate the consequence of a possible endocrine-disrupting activity. The Panel considered that changes in thymus weight, litter size, post-implantation loss and a consistent reduced pup weight in the high-dose F2 generation could not be dismissed and selected therefore, the mid-dose of 1320 mg/kg body weight (bw) per day for the parental males as the no observed adverse effect level (NOAEL) of the study. The exposure estimates for [FL-no: 16.132] (31,500 and 50,000 μg/person per day for children and adults, respectively) were above the threshold of toxicological of concern (TTC) for its structural class (III). Using the NOAEL of 1320 mg/kg bw per day at step A4 of the procedure, margins of exposure (MoE) of 1590 and 630 could be calculated for adults and children, respectively. Based on the calculated MoEs, the Panel concluded that the use of naringenin as a flavouring substance does not raise a safety concern.
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Kovar C, Loer HLH, Rüdesheim S, Fuhr LM, Marok FZ, Selzer D, Schwab M, Lehr T. A physiologically-based pharmacokinetic precision dosing approach to manage dasatinib drug-drug interactions. CPT Pharmacometrics Syst Pharmacol 2024. [PMID: 38693610 DOI: 10.1002/psp4.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/28/2024] [Accepted: 04/02/2024] [Indexed: 05/03/2024] Open
Abstract
Dasatinib, a second-generation tyrosine kinase inhibitor, is approved for treating chronic myeloid and acute lymphoblastic leukemia. As a sensitive cytochrome P450 (CYP) 3A4 substrate and weak base with strong pH-sensitive solubility, dasatinib is susceptible to enzyme-mediated drug-drug interactions (DDIs) with CYP3A4 perpetrators and pH-dependent DDIs with acid-reducing agents. This work aimed to develop a whole-body physiologically-based pharmacokinetic (PBPK) model of dasatinib to describe and predict enzyme-mediated and pH-dependent DDIs, to evaluate the impact of strong and moderate CYP3A4 inhibitors and inducers on dasatinib exposure and to support optimized dasatinib dosing. Overall, 63 plasma profiles from perorally administered dasatinib in healthy volunteers and cancer patients were used for model development. The model accurately described and predicted plasma profiles with geometric mean fold errors (GMFEs) for area under the concentration-time curve from the first to the last timepoint of measurement (AUClast) and maximum plasma concentration (Cmax) of 1.27 and 1.29, respectively. Regarding the DDI studies used for model development, all (8/8) predicted AUClast and Cmax ratios were within twofold of observed ratios. Application of the PBPK model for dose adaptations within various DDIs revealed dasatinib dose reductions of 50%-80% for strong and 0%-70% for moderate CYP3A4 inhibitors and a 2.3-3.1-fold increase of the daily dasatinib dose for CYP3A4 inducers to match the exposure of dasatinib administered alone. The developed model can be further employed to personalize dasatinib therapy, thereby help coping with clinical challenges resulting from DDIs and patient-related factors, such as elevated gastric pH.
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Affiliation(s)
- Christina Kovar
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | - Simeon Rüdesheim
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | | | | | - Dominik Selzer
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | - Matthias Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- Departments of Clinical Pharmacology, and Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany
- Cluster of Excellence iFIT (EXC2180), Image-Guided and Functionally Instructed Tumor Therapies, University of Tübingen, Tübingen, Germany
| | - Thorsten Lehr
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
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Grob D, Privé BM, Muselaers CHJ, Mehra N, Nagarajah J, Konijnenberg MW, Peters SMB. Bone marrow dosimetry in low volume mHSPC patients receiving Lu-177-PSMA therapy using SPECT/CT. EJNMMI Phys 2024; 11:34. [PMID: 38568428 PMCID: PMC10991600 DOI: 10.1186/s40658-024-00636-0] [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: 10/16/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Bone marrow toxicity in advanced prostate cancer patients who receive [177Lu]Lu-PSMA-617 is a well-known concern. In early stage patients; e.g. low volume metastatic hormone sensitive prostate cancer (mHSPC) patients, prevention of late bone marrow toxicity is even more crucial due to longer life expectancy. To date, bone marrow dosimetry is primarily performed using blood sampling. This method is time consuming and does not account for possible active bone marrow uptake. Therefore other methodologies are investigated. We calculated the bone marrow absorbed dose for [177Lu]Lu-PSMA-617 in mHSPC patients using SPECT/CT imaging and compared it to the blood sampling method as reference. METHODS Eight mHSPC patients underwent two cycles (3 and 6 GBq) of [177Lu]Lu-PSMA-617 therapy. After each cycle, five time point (1 h, 1 day, 2 days, 3 days, 7 days) SPECT/CT was performed at kidney level. Bone marrow dosimetry was performed using commercial software by drawing ten 1.5 cm diameter spheres in the lowest ten vertebrae to determine the time-integrated activity. Simplified protocols using only 2 imaging time points and 3 vertebrae were also compared. Blood-based dosimetry was based on the blood sampling method according to the EANM guideline. RESULTS Mean bone marrow absorbed dose was significantly different (p < 0.01) for the imaging based method (25.4 ± 8.7 mGy/GBq) and the blood based method (17.2 ± 3.4 mGy/GBq), with an increasing absorbed dose ratio between both methods over time. Bland Altman analysis of both simplification steps showed that differences in absorbed dose were all within the 95% limits of agreement. CONCLUSION This study showed that bone marrow absorbed dose after [177Lu]Lu-PSMA-617 can be determined using an imaging-based method of the lower vertebrae, and simplified using 2 time points (1 and 7 days) and 3 vertebrae. An increasing absorbed dose ratio over time between the imaging-based method and blood-based method suggests that there might be specific bone marrow binding of [177Lu]Lu-PSMA-617.
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Affiliation(s)
- Dagmar Grob
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Healthcare and Information Technology, Slingeland Hospital, Doetinchem, The Netherlands
| | - Bastiaan M Privé
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - James Nagarajah
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Mark W Konijnenberg
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Steffie M B Peters
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Lin KJ, Huang SY, Huang KL, Huang CC, Hsiao IT. Human biodistribution and radiation dosimetry for the tau tracer [ 18F]Florzolotau in healthy subjects. EJNMMI Radiopharm Chem 2024; 9:27. [PMID: 38563872 PMCID: PMC10987466 DOI: 10.1186/s41181-024-00259-x] [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: 01/25/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Tau pathology plays a crucial role in neurodegeneration diseases including Alzheimer's disease (AD) and non-AD diseases such as progressive supranuclear palsy. Tau positron emission tomography (PET) is an in-vivo and non-invasive medical imaging technique for detecting and visualizing tau deposition within a human brain. In this work, we aim to investigate the biodistribution of the dosimetry in the whole body and various organs for the [18F]Florzolotau tau-PET tracer. A total of 12 healthy controls (HCs) were enrolled at Chang Gung Memorial Hospital. All subjects were injected with approximately 379.03 ± 7.03 MBq of [18F]Florzolotau intravenously, and a whole-body PET/CT scan was performed for each subject. For image processing, the VOI for each organ was delineated manually by using the PMOD 3.7 software. Then, the time-activity curve of each organ was acquired by optimally fitting an exponential uptake and clearance model using the least squares method implemented in OLINDA/EXM 2.1 software. The absorbed dose for each target organ and the effective dose were finally calculated. RESULTS From the biodistribution results, the elimination of [18F]Florzolotau is observed mainly from the liver to the intestine and partially through the kidneys. The highest organ-absorbed dose occurred in the right colon wall (255.83 μSv/MBq), and then in the small intestine (218.67 μSv/MBq), gallbladder wall (151.42 μSv/MBq), left colon wall (93.31 μSv/MBq), and liver (84.15 μSv/MBq). Based on the ICRP103, the final computed effective dose was 34.9 μSv/MBq with CV of 10.07%. CONCLUSIONS The biodistribution study of [18F]Florzolotau demonstrated that the excretion of [18F]Florzolotau are mainly through the hepatobiliary and gastrointestinal pathways. Therefore, a routine injection of 370 MBq or 185 MBq of [18F]Florzolotau leads to an estimated effective dose of 12.92 or 6.46 mSv, and as a result, the radiation exposure to the whole-body and each organ remains within acceptable limits and adheres to established constraints. TRIAL REGISTRATION Retrospectively Registered at Clinicaltrials.gov (NCT03625128) on 12 July, 2018, https://clinicaltrials.gov/study/NCT03625128 .
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Affiliation(s)
- Kun-Ju Lin
- Department of Nuclear Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, No. 259, Wen-Hua 1St Road, Guishan Dist., Taoyuan City, 333, Taiwan
| | - Shao-Yi Huang
- Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, No. 259, Wen-Hua 1St Road, Guishan Dist., Taoyuan City, 333, Taiwan
| | - Kuo-Lun Huang
- Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chin-Chang Huang
- Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Ing-Tsung Hsiao
- Department of Nuclear Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
- Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, No. 259, Wen-Hua 1St Road, Guishan Dist., Taoyuan City, 333, Taiwan.
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Stokke C, Gnesin S, Tran-Gia J, Cicone F, Holm S, Cremonesi M, Blakkisrud J, Wendler T, Gillings N, Herrmann K, Mottaghy FM, Gear J. EANM guidance document: dosimetry for first-in-human studies and early phase clinical trials. Eur J Nucl Med Mol Imaging 2024; 51:1268-1286. [PMID: 38366197 PMCID: PMC10957710 DOI: 10.1007/s00259-024-06640-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: 11/29/2023] [Accepted: 02/04/2024] [Indexed: 02/18/2024]
Abstract
The numbers of diagnostic and therapeutic nuclear medicine agents under investigation are rapidly increasing. Both novel emitters and novel carrier molecules require careful selection of measurement procedures. This document provides guidance relevant to dosimetry for first-in human and early phase clinical trials of such novel agents. The guideline includes a short introduction to different emitters and carrier molecules, followed by recommendations on the methods for activity measurement, pharmacokinetic analyses, as well as absorbed dose calculations and uncertainty analyses. The optimal use of preclinical information and studies involving diagnostic analogues is discussed. Good practice reporting is emphasised, and relevant dosimetry parameters and method descriptions to be included are listed. Three examples of first-in-human dosimetry studies, both for diagnostic tracers and radionuclide therapies, are given.
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Affiliation(s)
- Caroline Stokke
- Department of Diagnostic Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
- Department of Physics, University of Oslo, Oslo, Norway.
| | - Silvano Gnesin
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Johannes Tran-Gia
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Francesco Cicone
- Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Søren Holm
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Marta Cremonesi
- Department of Medical Imaging and Radiation Sciences, European Institute of Oncology, IRCCS, Milan, Italy
| | - Johan Blakkisrud
- Department of Diagnostic Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Thomas Wendler
- Computer-Aided Medical Procedures and Augmented Reality, Technische Universität München, Munich, Germany
- Clinical Computational Medical Imaging Research, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Nic Gillings
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
- National Center for Tumor Diseases (NCT), NCT West, Heidelberg, Germany
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Jonathan Gear
- Joint Department of Physics, Royal Marsden NHSFT & Institute of Cancer Research, Sutton, UK
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Hermans E, Meersschaut J, Van Herteryck I, Devreese M, Walle JV, De Paepe P, De Cock PA. Have We Neglected to Study Target-Site Drug Exposure in Children? A Systematic Review of the Literature. Clin Pharmacokinet 2024; 63:439-468. [PMID: 38551787 DOI: 10.1007/s40262-024-01364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND AND OBJECTIVE Drug dosing should ideally be based on the drug concentrations at the target site, which, for most drugs, corresponds to the tissue. The exact influence of growth and development on drug tissue distribution is unclear. This systematic review compiles the current knowledge on the tissue distribution of systemically applied drugs in children, with the aim to identify priorities in tissue pharmacokinetic (PK) research in this population. METHODS A systematic literature search was performed in the MEDLINE and Embase databases. RESULTS Forty-two relevant articles were identified, of which 71% investigated antibiotics, while drug classes from the other studies were anticancer drugs, antifungals, anthelmintics, sedatives, thyreostatics, immunomodulators, antiarrhythmics, and exon skipping therapy. The majority of studies (83%) applied tissue biopsy as the sampling technique. Tonsil and/or adenoid tissue was most frequently examined (70% of all included patients). The majority of studies had a small sample size (median 9, range 1-93), did not include the youngest age categories (neonates and infants), and were of low reporting quality. Due to the heterogeneous data from different study compounds, dosing schedules, populations, and target tissues, the possibility for comparison of PK data between studies was limited. CONCLUSION The influence of growth and development on drug tissue distribution continues to be a knowledge gap, due to the paucity of tissue PK data in children, especially in the younger age categories. Future research in this field should be encouraged as techniques to safely investigate drug tissue disposition in children are available.
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Affiliation(s)
- Eline Hermans
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium.
- Department of Pediatrics, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Jozefien Meersschaut
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Isis Van Herteryck
- Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Mathias Devreese
- Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Johan Vande Walle
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
- Department of Pediatric Nephrology, SafePeDrug, Erknet Center, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Peter De Paepe
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
- Department of Emergency Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Pieter A De Cock
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Department of Pharmacy, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Department of Pediatric Intensive Care, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
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10
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Tamura K, Nishii R, Tani K, Hashimoto H, Kawamura K, Zhang MR, Maeda T, Yamazaki K, Higashi T, Jinzaki M. A first-in-man study of [ 18F] FEDAC: a novel PET tracer for the 18-kDa translocator protein. Ann Nucl Med 2024; 38:264-271. [PMID: 38285284 PMCID: PMC10954948 DOI: 10.1007/s12149-023-01895-0] [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] [Received: 10/12/2023] [Accepted: 12/10/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE N-benzyl-N-methyl-2-[7, 8-dihydro-7-(2-[18F] fluoroethyl) -8-oxo-2-phenyl-9H-purin-9-yl] acetamide ([18F] FEDAC) is a novel positron emission tomography (PET) tracer that targets the translocator protein (TSPO; 18 kDa) in the mitochondrial outer membrane, which is known to be upregulated in various diseases such as malignant tumors, neurodegenerative diseases, and neuroinflammation. This study presents the first attempt to use [18F]FEDAC PET/CT and evaluate its biodistribution as well as the systemic radiation exposure to the radiotracer in humans. MATERIALS AND METHODS Seventeen whole-body [18F]FEDAC PET/CT (injected dose, 209.1 ± 6.2 MBq) scans with a dynamic scan of the upper abdomen were performed in seven participants. Volumes of interest were assigned to each organ, and a time-activity curve was created to evaluate the biodistribution of the radiotracer. The effective dose was calculated using IDAC-Dose 2.1. RESULTS Immediately after the intravenous injection, the radiotracer accumulated significantly in the liver and was subsequently excreted into the gastrointestinal tract through the biliary tract. It also showed high levels of accumulation in the kidneys, but showed minimal migration to the urinary bladder. Thus, the liver was the principal organ that eliminated [18F] FEDAC. Accumulation in the normal brain tissue was minimal. The effective dose estimated from biodistribution in humans was 19.47 ± 1.08 µSv/MBq, and was 3.60 mSV for 185 MBq dose. CONCLUSION [18F]FEDAC PET/CT provided adequate image quality at an acceptable effective dose with no adverse effects. Therefore, [18F]FEDAC may be useful in human TSPO-PET imaging.
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Affiliation(s)
- Kentaro Tamura
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan.
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Ryuichi Nishii
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan.
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daiko Minami, Higashi-ku, Nagoya, 461-8673, Japan.
| | - Kotaro Tani
- Department of Radiation Measurement and Dose Assessment, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Hiroki Hashimoto
- Department of Advanced Nuclear Medicine Sciences, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Kazunori Kawamura
- Department of Advanced Nuclear Medicine Sciences, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Ming-Rong Zhang
- Department of Advanced Nuclear Medicine Sciences, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Takamasa Maeda
- Department of Medical Technology, Quantum Life and Medical Science Directorate, QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Kana Yamazaki
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan
| | - Tatsuya Higashi
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
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11
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Westerhout J, den Heijer-Jordaan A, Princen HMG, Stierum R. A systems toxicology approach for identification of disruptions in cholesterol homeostasis after aggregated exposure to mixtures of perfluorinated compounds in humans. Toxicol Sci 2024; 198:191-209. [PMID: 38243716 DOI: 10.1093/toxsci/kfae006] [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: 01/21/2024] Open
Abstract
Per- and polyfluoroalkyl substances (PFAS) are used in various household and industrial products. In humans, positive associations were reported between PFAS, including perfluorsulfonic acid and perfluorooctanoic acid, and cholesterol, a cardiometabolic risk factor. Animal studies show the opposite. Human-centered approaches are needed to better understand the effects of PFAS mixtures on cholesterol. Here, a systems toxicology approach is described, using a gene-centered cholesterol biokinetic model. PFAS exposure-gene expression relations from published data were introduced into the model. An existing PFAS physiologically based kinetic model was augmented with lung and dermal compartments and integrated with the cholesterol model to enable exposure-effect modeling. The final model was populated with data reflecting lifetime mixture exposure from: tolerable weekly intake values; the environment; high occupational exposures (ski waxing, PFAS industry). Results indicate that low level exposures (tolerable weekly intake, environmental) did not change cholesterol. In contrast, occupational exposures clearly resulted in internal PFAS exposure and disruption of cholesterol homeostasis, largely in line with epidemiological observations. Despite model limitations (eg, dynamic range, directionality), changes in cholesterol homeostasis were predicted for ski waxers, hitherto unknown from epidemiological studies. Here, future studies involving lipid metabolism could improve risk assessment.
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Affiliation(s)
- Joost Westerhout
- TNO Risk Analysis for Products in Development, 3584 CB Utrecht, The Netherlands
| | | | | | - Rob Stierum
- TNO Risk Analysis for Products in Development, 3584 CB Utrecht, The Netherlands
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12
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Li H, Pei W, Yang X, Qu G, Hua Q, Liu L, Wang Y, Xu T, Chen Y. Biodistribution and dosimetry of 177Lu-DOTA-IBA for therapy of bone metastases. EJNMMI Res 2024; 14:30. [PMID: 38517637 PMCID: PMC10959900 DOI: 10.1186/s13550-024-01094-6] [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: 12/13/2023] [Accepted: 03/12/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND We designed and synthesized a novel bisphosphonate radiopharmaceutical (68 Ga- or 177Lu-labeled DOTA-ibandronate [68 Ga/177Lu-DOTA-IBA]) for the targeted diagnosis and treatment of bone metastases. The biodistribution and internal dosimetry of a single therapeutic dose of 177Lu-DOTA-IBA were evaluated using a series of single-photon emission computerized tomography (SPECT) images and blood samples. Five patients with multiple bone metastases were included in this prospective study. After receiving 1110 MBq 177Lu-DOTA-IBA, patients underwent whole-body planar, SPECT/CT imaging and venous blood sampling over 7 days. Dosimetric evaluation was performed for the main organs and tumor lesions. Safety was assessed using blood biomarkers. RESULTS 177Lu-DOTA-IBA showed fast uptake, high retention in bone lesions, and rapid clearance from the bloodstream in all patients. In this cohort, the average absorbed doses (ADs) in the bone tumor lesions, kidneys, liver, spleen, red marrow, bladder-wall, and osteogenic cells were 5.740, 0.114, 0.095, 0.121, 0.095, and 0.333 Gy/GBq, respectively. Although no patient reached the predetermined dose thresholds, the red marrow will be the dose-limiting organ. There were no adverse reactions recorded after the administration of 1110 MBq 177Lu-DOTA-IBA. CONCLUSION Dosimetric results show that the ADs for critical organs and total body are within the safety limit and with high bone retention. It is a promising radiopharmaceutical alternative for the targeted treatment of bone metastases, controlling its progression, and improving the survival and quality of life of patients with advanced bone metastasis.
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Affiliation(s)
- Hongmei Li
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Wenjie Pei
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Xiqun Yang
- Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Gengcuo Qu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Qingchu Hua
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Lin Liu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Yudi Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Tingting Xu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China.
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China.
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China.
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China.
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China.
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China.
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13
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Versluis DM, Schoemaker R, Looijesteijn E, Geurts JM, Merks RM. 2'-Fucosyllactose helps butyrate producers outgrow competitors in infant gut microbiota simulations. iScience 2024; 27:109085. [PMID: 38380251 PMCID: PMC10877688 DOI: 10.1016/j.isci.2024.109085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/16/2023] [Accepted: 01/29/2024] [Indexed: 02/22/2024] Open
Abstract
A reduced capacity for butyrate production by the early infant gut microbiota is associated with negative health effects, such as inflammation and the development of allergies. Here, we develop new hypotheses on the effect of the prebiotic galacto-oligosaccharides (GOS) or 2'-fucosyllactose (2'-FL) on butyrate production by the infant gut microbiota using a multiscale, spatiotemporal mathematical model of the infant gut. The model simulates a community of cross-feeding gut bacteria in metabolic detail. It represents the community as a grid of bacterial populations that exchange metabolites, using 20 different subspecies-specific metabolic networks taken from the AGORA database. The simulations predict that both GOS and 2'-FL promote the growth of Bifidobacterium, whereas butyrate producing bacteria are only consistently abundant in the presence of propane-1,2-diol, a product of 2'-FL metabolism. In absence of prebiotics or in presence of only GOS, however, Bacteroides vulgatus and Cutibacterium acnes outcompete butyrate producers by consuming intermediate metabolites.
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Affiliation(s)
- David M. Versluis
- Leiden University, Institute of Biology, 2300 RA Leiden, the Netherlands
| | | | | | | | - Roeland M.H. Merks
- Leiden University, Institute of Biology, 2300 RA Leiden, the Netherlands
- Leiden University, Mathematical Institute, 2300 RA Leiden, the Netherlands
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14
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Hiller MM, Veinot KG, Hertel NE. Influence of neutron cross-section resonances on organ/tissue equivalent and effective dose coefficients for the ICRP voxel phantoms. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2024; 63:143-164. [PMID: 38310599 DOI: 10.1007/s00411-023-01058-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 12/27/2023] [Indexed: 02/06/2024]
Abstract
The materials which compose the ICRP Voxel phantoms used in the computation of conversion coefficients involve neutron interaction cross-sections that have resonances at specific energies. Depending on the energy bin structure used in the computations, these cross-section resonances may occur at energies that fall between energies at which dose coefficients are computed, thus their effects may not be completely accounted for in the reported coefficients. In the present study, a highly refined energy grid that closely follows the resonance structure in the phantom material cross-sections was identified and used to calculate dose coefficients. Both the equivalent organ/tissue doses for male and female voxel phantoms were computed as well as their summation to obtain the effective dose coefficients. The used refined energy grid tracks very closely the cross-sections in the vicinity of the resonances. The resulting refined energy grid coefficients are compared to coefficients for the coarser energy grid used in ICRP Publication 116. Additionally, reference spectra have been folded with both the fine and coarse sets of conversion coefficients. The resulting total effective doses for these reference spectra are used to assess the adequacy of the dose coefficients calculated on the original ICRP 116 energy grid. The dose coefficients were similarly computed for the local skin dose on the trunk of the body using the ICRU Report 95 phantom. The overall impact of the resonances on the organ/tissue equivalent dose, the effective dose, and the local skin dose are presented and discussed. In general, it was found that resonances can impact neutron dose coefficients, but in most cases the wide range of neutron energies encountered minimized this effect. The impact of resonances was further limited when computing effective dose due to organ/tissue summing and sex-averaging. For the neutron fields studied here, the impact was below 5%.
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Affiliation(s)
| | - Ken G Veinot
- Y-12 National Security Complex, Oak Ridge, TN, USA
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15
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Tolmachev SY, Avtandilashvili M. Long-term retention and distribution of highly enriched uranium in an occupationally exposed female. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2024; 63:109-123. [PMID: 38197921 DOI: 10.1007/s00411-023-01053-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/08/2023] [Indexed: 01/11/2024]
Abstract
The United States Transuranium and Uranium Registries' (USTUR) female whole body tissue donor studied here was occupationally exposed to highly enriched uranium for 17 years. One hundred and twenty-nine tissue samples were collected at the time of death, 31 years post-exposure. These samples were radiochemically analyzed for uranium. The highest uranium concentration of 16.5 ± 2.0 µg kg-1 was measured in the lungs, and the lowest concentration of 0.11 ± 0.01 µg kg-1 in the liver. The thyroid had the highest concentration of 6.3 ± 2.9 µg kg-1 among systemic tissues. Mass-weighted average concentration in the entire skeleton was estimated to be 1.60 ± 0.19 µg kg-1. In the skeleton, uranium was non-uniformly distributed among different bones. Thirty-one years after the intake, approximately 40% of occupational uranium was still retained in the skeleton, followed by the kidneys (~ 30%), and the brain and liver (~ 10%). Systemic uranium was equally distributed between the skeleton and soft tissues. Uranium content in systemic organs followed the pattern: skeleton > > brain ≈ kidneys > heart ≈ liver > thyroid ≈ spleen. Uranium distribution in this female was compared to previously published USTUR data for male tissue donors. It is concluded that no difference in uranium systemic distribution was observed between female and male individuals. It is demonstrated that dose assessment based on the current ICRP biokinetic model overestimated the dose to the brain by 20%.
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Affiliation(s)
- Sergey Y Tolmachev
- United States Transuranium and Uranium Registries, College of Pharmacy and Pharmaceutical Sciences, Washington State University, 1845 Terminal Drive, Suite 201, Richland, WA, 99354-4959, USA.
| | - Maia Avtandilashvili
- United States Transuranium and Uranium Registries, College of Pharmacy and Pharmaceutical Sciences, Washington State University, 1845 Terminal Drive, Suite 201, Richland, WA, 99354-4959, USA
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16
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Kahma H, Paludetto MN, Neuvonen M, Kurkela M, Filppula AM, Niemi M, Backman JT. Screening of 16 major drug glucuronides for time-dependent inhibition of nine drug-metabolizing CYP enzymes - detailed studies on CYP3A inhibitors. Eur J Pharm Sci 2024; 198:106735. [PMID: 38423227 DOI: 10.1016/j.ejps.2024.106735] [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: 08/30/2023] [Revised: 01/24/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
Time-dependent inhibition of cytochrome P450 (CYP) enzymes has been observed for a few glucuronide metabolites of clinically used drugs. Here, we investigated the inhibitory potential of 16 glucuronide metabolites towards nine major CYP enzymes in vitro. Automated substrate cocktail methods were used to screen time-dependent inhibition of CYP1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2J2 and 3A in human liver microsomes. Seven glucuronides (carvedilol β-D-glucuronide, diclofenac acyl-β-D-glucuronide, 4-hydroxyduloxetine β-D-glucuronide, ezetimibe phenoxy-β-D-glucuronide, raloxifene 4'-glucuronide, repaglinide acyl-β-D-glucuronide and valproic acid β-D-glucuronide) caused NADPH- and time-dependent inhibition of at least one of the CYPs investigated, including CYP2A6, CYP2C19 and CYP3A. In more detailed experiments, we focused on the glucuronides of carvedilol and diclofenac, which inhibited CYP3A. Carvedilol β-D-glucuronide showed weak time-dependent inhibition of CYP3A, but the parent drug carvedilol was found to be a more potent inhibitor of CYP3A, with the half-maximal inhibitor concentration (IC50) decreasing from 7.0 to 1.1 µM after a 30-min preincubation with NADPH. The maximal inactivation constant (kinact) and the inhibitor concentration causing half of kinact (KI) for CYP3A inactivation by carvedilol were 0.051 1/min and 1.8 µM, respectively. Diclofenac acyl-β-D-glucuronide caused time-dependent inactivation of CYP3A at high concentrations, with a 4-fold IC50 shift (from 400 to 98 µM after a 30-min preincubation with NADPH) and KI and kinact values of >2,000 µM and >0.16 1/min. In static predictions, carvedilol caused significant (>1.25-fold) increase in the exposure of the CYP3A substrates midazolam and simvastatin. In conclusion, we identified several glucuronide metabolites with CYP inhibitory properties. Based on detailed experiments, the inactivation of CYP3A by carvedilol may cause clinically significant drug-drug interactions.
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Affiliation(s)
- Helinä Kahma
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marie-Noëlle Paludetto
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Mikko Neuvonen
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Mika Kurkela
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne M Filppula
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Pharmaceutical Sciences Laboratory, Faculty of Science and Engineering, Åbo Akademi University, Turku, Finland
| | - Mikko Niemi
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Clinical Pharmacology, HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland
| | - Janne T Backman
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Clinical Pharmacology, HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland.
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17
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Sender R, Noor E, Milo R, Dor Y. What fraction of cellular DNA turnover becomes cfDNA? eLife 2024; 12:RP89321. [PMID: 38407214 PMCID: PMC10942627 DOI: 10.7554/elife.89321] [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: 02/27/2024] Open
Abstract
Cell-free DNA (cfDNA) tests use small amounts of DNA in the bloodstream as biomarkers. While it is thought that cfDNA is largely released by dying cells, the proportion of dying cells' DNA that reaches the bloodstream is unknown. Here, we integrate estimates of cellular turnover rates to calculate the expected amount of cfDNA. By comparing this to the actual amount of cell type-specific cfDNA, we estimate the proportion of DNA reaching plasma as cfDNA. We demonstrate that <10% of the DNA from dying cells is detectable in plasma, and the ratios of measured to expected cfDNA levels vary a thousand-fold among cell types, often reaching well below 0.1%. The analysis suggests that local clearance, presumably via phagocytosis, takes up most of the dying cells' DNA. Insights into the underlying mechanism may help to understand the physiological significance of cfDNA and improve the sensitivity of liquid biopsies.
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Affiliation(s)
- Ron Sender
- Weizmann Institute of ScienceRehovotIsrael
| | - Elad Noor
- Weizmann Institute of ScienceRehovotIsrael
| | - Ron Milo
- Weizmann Institute of ScienceRehovotIsrael
| | - Yuval Dor
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel Canada, the Hebrew University-Hadassah Medical SchoolJerusalemIsrael
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18
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Miodownik D, Bierman D, Thornton C, Moo T, Feigin K, Damato A, Le T, Williamson M, Prasad K, Chu B, Dauer L, Saphier N, Zanzonico P, Morrow M, Bellamy M. Radioactive seed localization is a safe and effective tool for breast cancer surgery: an evaluation of over 25,000 cases. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:011511. [PMID: 38295404 DOI: 10.1088/1361-6498/ad246a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/31/2024] [Indexed: 02/02/2024]
Abstract
Radioactive seed localization (RSL) provides a precise and efficient method for removing non-palpable breast lesions. It has proven to be a valuable addition to breast surgery, improving perioperative logistics and patient satisfaction. This retrospective review examines the lessons learned from a high-volume cancer center's RSL program after 10 years of practice and over 25 000 cases. We provide an updated model for assessing the patient's radiation dose from RSL seed implantation and demonstrate the safety of RSL to staff members. Additionally, we emphasize the importance of various aspects of presurgical evaluation, surgical techniques, post-surgical management, and regulatory compliance for a successful RSL program. Notably, the program has reduced radiation exposure for patients and medical staff.
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Affiliation(s)
- D Miodownik
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - D Bierman
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - C Thornton
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - T Moo
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - K Feigin
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - A Damato
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - T Le
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - M Williamson
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - K Prasad
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - B Chu
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - L Dauer
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - N Saphier
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - P Zanzonico
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - M Morrow
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - M Bellamy
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
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Kwon TE, Kitahara CM, Lee C. Absorbed dose coefficients for pediatric differentiated thyroid cancer patients undergoing radioiodine therapy. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:011509. [PMID: 38232407 DOI: 10.1088/1361-6498/ad1fdc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/17/2024] [Indexed: 01/19/2024]
Abstract
The escalating incidence of differentiated thyroid cancer (DTC) in pediatric patients and the resultant growing use of radioactive iodine (RAI) reinforce the need to evaluate radiation exposure to normal tissues and radiation-induced health risks in pediatric patients undergoing RAI therapy. In the current study, we calculated absorbed dose coefficients (i.e. absorbed dose per unit activity administered, mGy MBq-1) specific for pediatric patients with localized DTC undergoing RAI therapy following total thyroidectomy for use in epidemiological studies. We first modified previously-published biokinetic models for adult thyroid cancer patients to achieve a reasonable agreement with iodine biokinetics observed in pediatric patients or design principles addressed in the International Commission on Radiological Protection (ICRP) reference age-specific biokinetic models. We then combined the biokinetic models in conjunction withSvalues derived from ICRP reference pediatric voxel phantoms. The absorbed dose coefficients for pediatric patients were overall greater than those for adults with a ratio (pediatric/adult) up to 11.6 and rapidly decreased with increasing age. The sensitivity analysis showed that the renal clearance rate andSvalues may have the greatest impact on the absorbed dose coefficients with the rank correlation coefficients ranging from -0.53 to -0.82 (negative correlations) and from 0.51 to 0.80 (positive correlations), respectively. The results of the current study may be utilized in clinical or epidemiological studies to estimate organ-specific radiation absorbed doses and radiation-associated health risks among pediatric thyroid cancer patients.
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Affiliation(s)
- Tae-Eun Kwon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, United States of America
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, United States of America
| | - Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, United States of America
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20
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Benabdallah N, Lu P, Abou DS, Zhang H, Ulmert D, Hobbs RF, Gay HA, Simons BW, Saeed MA, Rogers BE, Jha AK, Tai YC, Malone CD, Ippolito JE, Michalski J, Jennings JW, Baumann BC, Pachynski RK, Thorek DLJ. Beyond Average: α-Particle Distribution and Dose Heterogeneity in Bone Metastatic Prostate Cancer. J Nucl Med 2024; 65:245-251. [PMID: 38124163 PMCID: PMC10858382 DOI: 10.2967/jnumed.123.266571] [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: 08/22/2023] [Revised: 10/23/2023] [Indexed: 12/23/2023] Open
Abstract
α-particle emitters are emerging as a potent modality for disseminated cancer therapy because of their high linear energy transfer and localized absorbed dose profile. Despite great interest and pharmaceutical development, there is scant information on the distribution of these agents at the scale of the α-particle pathlength. We sought to determine the distribution of clinically approved [223Ra]RaCl2 in bone metastatic castration-resistant prostate cancer at this resolution, for the first time to our knowledge, to inform activity distribution and dose at the near-cell scale. Methods: Biopsy specimens and blood were collected from 7 patients 24 h after administration. 223Ra activity in each sample was recorded, and the microstructure of biopsy specimens was analyzed by micro-CT. Quantitative autoradiography and histopathology were segmented and registered with an automated procedure. Activity distributions by tissue compartment and dosimetry calculations based on the MIRD formalism were performed. Results: We revealed the activity distribution differences across and within patient samples at the macro- and microscopic scales. Microdistribution analysis confirmed localized high-activity regions in a background of low-activity tissue. We evaluated heterogeneous α-particle emission distribution concentrated at bone-tissue interfaces and calculated spatially nonuniform absorbed-dose profiles. Conclusion: Primary patient data of radiopharmaceutical therapy distribution at the small scale revealed that 223Ra uptake is nonuniform. Dose estimates present both opportunities and challenges to enhance patient outcomes and are a first step toward personalized treatment approaches and improved understanding of α-particle radiopharmaceutical therapies.
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Affiliation(s)
- Nadia Benabdallah
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Peng Lu
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri
| | - Diane S Abou
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Hanwen Zhang
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - David Ulmert
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Robert F Hobbs
- Department of Radiation Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Hiram A Gay
- Department of Radiation Oncology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Brian W Simons
- Center for Comparative Medicine, Baylor University, Houston, Texas
| | - Muhammad A Saeed
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Buck E Rogers
- Department of Radiation Oncology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Abhinav K Jha
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri
| | - Yuan-Chuan Tai
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Christopher D Malone
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Joseph E Ippolito
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Jeff Michalski
- Department of Radiation Oncology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Jack W Jennings
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Brian C Baumann
- Department of Radiation Oncology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
- Department of Radiation Oncology, Springfield Clinic, Springfield, Illinois; and
| | - Russell K Pachynski
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Daniel L J Thorek
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri;
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri
- Oncologic Imaging Program, Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, Missouri
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21
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Siebinga H, Hendrikx JJMA, de Vries-Huizing DMV, Huitema ADR, de Wit-van der Veen BJ. The cycle effect quantified: reduced tumour uptake in subsequent cycles of [ 177Lu]Lu-HA-DOTATATE during peptide receptor radionuclide therapy. Eur J Nucl Med Mol Imaging 2024; 51:820-827. [PMID: 37843598 DOI: 10.1007/s00259-023-06463-2] [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: 06/01/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Clear evidence regarding the effect of reduced tumour accumulation in later peptide receptor radionuclide therapy (PRRT) cycles is lacking. Therefore, we aimed to quantify potential cycle effects for patients treated with [177Lu]Lu-HA-DOTATATE using a population pharmacokinetic (PK) modelling approach. METHODS A population PK model was developed using imaging data from 48 patients who received multiple cycles of [177Lu]Lu-HA-DOTATATE. The five-compartment model included a central, kidney, spleen, tumour and lumped rest compartment. Tumour volume and continued use of long-acting somatostatin analogues (SSAs) were tested as covariates in the model. In addition, the presence of a cycle effect was evaluated by relating the uptake rate in a specific cycle as a fraction of the (tumour or organ) uptake rate in the first cycle. RESULTS The final PK model adequately captured observed radioactivity accumulation in kidney, spleen and tumour. A higher tumour volume was identified to increase the tumour uptake rate, where a twofold increase in tumour volume resulted in a 2.3-fold higher uptake rate. Also, continued use of long-acting SSAs significantly reduced the spleen uptake rate (68.4% uptake compared to SSA withdrawal (10.5% RSE)). Lastly, a cycle effect was significantly identified, where tumour uptake rate decreased to 86.9% (5.3% RSE) in the second cycle and even further to 79.7% (5.6% RSE) and 77.6% (6.2% RSE) in the third and fourth cycle, respectively, compared to cycle one. CONCLUSIONS Using a population PK modelling approach, the cycle effect of reduced tumour uptake in subsequent PRRT cycles was quantified. Our findings implied that downregulation of target receptors is probably not the major cause of the cycle effect, due to a plateau in the decrease of tumour uptake in the fourth cycle.
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Affiliation(s)
- H Siebinga
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - J J M A Hendrikx
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D M V de Vries-Huizing
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A D R Huitema
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Pharmacology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - B J de Wit-van der Veen
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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22
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Moraitis A, Jentzen W, Reiter G, Schmitz J, Pöppel TD, Weber M, Herrmann K, Fendler WP, Fragoso Costa P, Bockisch A, Kersting D. Biodistribution and radiation dosimetry of 124I-mIBG in adult patients with neural crest tumours and extrapolation to paediatric models. EJNMMI Phys 2024; 11:3. [PMID: 38167953 PMCID: PMC10761661 DOI: 10.1186/s40658-023-00604-0] [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: 07/25/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
AIM Positron emission tomography (PET) using 124I-mIBG has been established for imaging and pretherapeutic dosimetry. Here, we report the first systematic analysis of the biodistribution and radiation dosimetry of 124I-mIBG in patients with neural crest tumours and project the results to paediatric patient models. METHODS Adult patients with neural crest tumours who underwent sequential 124I-mIBG PET were included in this retrospective single-center analysis. PET data were acquired 4, 24, 48, and/or 120 h after administration of a mean of 43 MBq 124I-mIBG. Whole-body counting and blood sampling were performed at 2, 4, 24, 48 and 120 h after administration. Absorbed organ dose and effective dose coefficients were estimated in OLINDA/EXM 2.2 according to the MIRD formalism. Extrapolation to paediatric models was performed based on mass-fraction scaling of the organ-specific residence times. Biodistribution data for adults were also projected to 123I-mIBG and 131I-mIBG. RESULTS Twenty-one patients (11 females, 10 males) were evaluated. For adults, the organs exposed to the highest dose per unit administered activity were urinary bladder (1.54 ± 0.40 mGy/MBq), salivary glands (0.77 ± 0.28 mGy/MBq) and liver (0.65 ± 0.22 mGy/MBq). Mean effective dose coefficient for adults was 0.25 ± 0.04 mSv/MBq (male: 0.24 ± 0.03 mSv/MBq, female: 0.26 ± 0.06 mSv/MBq), and increased gradually to 0.29, 0.44, 0.69, 1.21, and 2.94 mSv/MBq for the 15-, 10-, 5-, 1-years-old, and newborn paediatric reference patients. Projected mean effective dose coefficients for 123I-mIBG and 131I-mIBG for adults were 0.014 ± 0.002 mSv/MBq and 0.18 ± 0.04 mSv/MBq, respectively. CONCLUSION PET-based derived radiation dosimetry data for 124I-mIBG from this study agreed well with historical projected data from ICRP 53. The effective dose coefficients presented here may aid in guidance for establishing weight-based activity administration protocols.
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Affiliation(s)
- Alexandros Moraitis
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
| | - Walter Jentzen
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Gloria Reiter
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Jochen Schmitz
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Thorsten Dirk Pöppel
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Manuel Weber
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Wolfgang Peter Fendler
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Pedro Fragoso Costa
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Andreas Bockisch
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - David Kersting
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
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Cella L, Monti S, Pacelli R, Palma G. Modeling frameworks for radiation induced lymphopenia: A critical review. Radiother Oncol 2024; 190:110041. [PMID: 38042499 DOI: 10.1016/j.radonc.2023.110041] [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] [Received: 09/11/2023] [Revised: 11/17/2023] [Accepted: 11/25/2023] [Indexed: 12/04/2023]
Abstract
Radiation-induced lymphopenia (RIL) is a frequent, and often considered unavoidable, side effect of radiation therapy (RT), whether or not chemotherapy is included. However, in the last few years several studies have demonstrated the detrimental effect of RIL on therapeutic outcomes, with conflicting findings concerning possible inferior patient survival. In addition, since immunotherapeutic treatment has become an integral part of cancer therapy, preserving the immune system is recognized as crucial. Given this background, various research groups have reported on different frameworks for modelling RIL, frequently based on different definitions of RIL itself, and discordant results have been reported. Our aim is to critically review the current literature on RIL modelling and summarize the different approaches recently proposed to improve the prediction of RIL after RT and aimed at immunity-sparing RT. A detailed description of these approaches will be outlined and illustrated through their applications as found in the literature from the last five years. Such a critical analysis represents the necessary starting step to develop an effective strategy that ultimately could harmonize the diverse modelling methods.
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Affiliation(s)
- Laura Cella
- Institute of Biostructures and Bioimaging, National Research Council, Naples, Italy.
| | - Serena Monti
- Institute of Biostructures and Bioimaging, National Research Council, Naples, Italy
| | - Roberto Pacelli
- Department of Advanced Biomedical Sciences, Federico II School of Medicine, Naples, Italy
| | - Giuseppe Palma
- Institute of Nanotechnology, National Research Council, Lecce, Italy
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24
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Castillo SP, Rebolledo RA, Arim M, Hochberg ME, Marquet PA. Metastatic cells exploit their stoichiometric niche in the network of cancer ecosystems. SCIENCE ADVANCES 2023; 9:eadi7902. [PMID: 38091399 PMCID: PMC10848726 DOI: 10.1126/sciadv.adi7902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/10/2023] [Indexed: 12/18/2023]
Abstract
Metastasis is a nonrandom process with varying degrees of organotropism-specific source-acceptor seeding. Understanding how patterns between source and acceptor tumors emerge remains a challenge in oncology. We hypothesize that organotropism results from the macronutrient niche of cells in source and acceptor organs. To test this, we constructed and analyzed a metastatic network based on 9303 records across 28 tissue types. We found that the topology of the network is nested and modular with scale-free degree distributions, reflecting organotropism along a specificity/generality continuum. The variation in topology is significantly explained by the matching of metastatic cells to their stoichiometric niche. Specifically, successful metastases are associated with higher phosphorus content in the acceptor compared to the source organ, due to metabolic constraints in proliferation crucial to the invasion of new tissues. We conclude that metastases are codetermined by processes at source and acceptor organs, where phosphorus content is a limiting factor orchestrating tumor ecology.
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Affiliation(s)
- Simon P. Castillo
- Departamento de Ecología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, C.P. 8331150, Santiago, Chile
| | - Rolando A. Rebolledo
- Instituto de Ingeniería Biológica y Médica (IIBM), Pontificia Universidad Católica de Chile, Santiago, Chile
- Hepato-Pancreato-Biliary Surgery Unit, Surgery Service, Complejo Asistencial Dr. Sótero Del Río, Santiago, Chile
| | - Matías Arim
- Departamento de Ecologia y Gestion Ambiental, Centro Universitario Regional Este (CURE), Universidad de la República, Maldonado, Uruguay
| | - Michael E. Hochberg
- ISEM, University of Montpellier, Montpellier, France
- Santa Fe Institute, Santa Fe, NM 87501, USA
| | - Pablo A. Marquet
- Departamento de Ecología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, C.P. 8331150, Santiago, Chile
- Santa Fe Institute, Santa Fe, NM 87501, USA
- Centro de Modelamiento Matemático, Universidad de Chile, International Research Laboratory 2807, CNRS, C.P. 8370456, Santiago, Chile
- Instituto de Sistemas Complejos de Valparaíso (ISCV), Valparaíso, Chile
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Yan M, Zhu H, Luo H, Zhang T, Sun H, Kannan K. Daily Exposure to Environmental Volatile Organic Compounds Triggers Oxidative Damage: Evidence from a Large-Scale Survey in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:20501-20509. [PMID: 38033144 DOI: 10.1021/acs.est.3c06055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Volatile organic compounds (VOCs) are ubiquitous environmental pollutants and have been implicated in adverse health outcomes. In this study, concentrations of 11 VOC metabolites (mVOCs) and three oxidative stress biomarkers (8-oxo-7,8-dihydro-2'-deoxyguanosine, 8-oxo-7,8-dihydro-guanosine, and dityrosine) were determined in 205 urine samples collected from 12 cities across mainland China. Urinary ∑11mVOC concentrations ranged from 498 to 1660 ng/mL, with a geometric mean (GM) value of 1070 ng/mL. The factorial analysis revealed that cooking, solvents, and vehicle emissions were the three primary sources of VOC exposure. A significant regional variation was clearly found in ∑11mVOC concentrations across four regions in China, with high urine VOC concentrations found in North and South China (GM: 1450 and 1340 ng/mL). The multiple linear regression model revealed that most mVOCs were significantly positively correlated with three oxidative stress markers (β range: 0.06-0.22). Mixture effect regression showed that isoprene, crotonaldehyde, acrolein, and benzene were the strongest contributors to oxidative stress. Approximately 80% of the participants have HQ values greater than 1.0 for 1,3-butadiene and benzene, suggesting that their exposure doses were close to potential adverse health effects. Our findings provide comprehensive information on human exposure and potential health risks of VOCs in China.
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Affiliation(s)
- Mengqi Yan
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
| | - Hongkai Zhu
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
| | - Haining Luo
- Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300100, China
| | - Tao Zhang
- School of Environmental Science and Engineering, Sun Yat-Sen University, Guangzhou 510275, China
| | - Hongwen Sun
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health, Albany, New York 12237, United States
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Kim S, Byun HK, Shin J, Lee IJ, Sung W. Normal Tissue Complication Probability Modeling of Severe Radiation-Induced Lymphopenia Using Blood Dose for Patients With Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2023:S0360-3016(23)08186-5. [PMID: 38056776 DOI: 10.1016/j.ijrobp.2023.11.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/24/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE This study aimed to develop a normal tissue complication probability (NTCP) model to estimate the risk of severe radiation-induced lymphopenia (SRIL; absolute lymphocyte count [ALC] < 500/μL) by using the blood dose of patients with hepatocellular carcinoma (HCC). METHODS AND MATERIALS We retrospectively collected data from 75 patients with HCC who received radiation therapy (RT) between 2015 and 2018. The hematological dose framework calculated blood dose-volume histograms (DVHs) using a predefined blood flow model, organ DVHs, the number of treatment fractions, and beam delivery time. A Lyman-Kutcher-Burman model with a generalized equivalent dose was used to establish the NTCP model, reflecting the whole-blood DVHs. Optimization of the Lyman-Kutcher-Burman parameters was conducted by minimizing a negative log-likelihood function. RESULTS There were 6, 4, 18, 33, and 14 patients in the groups with radiation-induced lymphopenia grades 0, 1, 2, 3, and 4, respectively. The median pre- and post-RT ALC values were 1410/μL (range, 520-3710/μL) and 470/μL (range, 60-1760/μL), respectively. There was a correlation between mean blood dose and ALC depletion (Pearson r = -0.664; P < .001). The average mean blood doses in each radiation-induced lymphopenia group were 2.90 Gy (95% CI, 1.96-3.85 Gy) for grade 0 to 1, 5.29 Gy (95% CI, 4.12-6.45 Gy) for grade 2, 8.81 Gy (95% CI, 7.55-10.07 Gy) for grade 3, and 11.69 Gy (95% CI, 9.82-17.57 Gy) for grade 4. When applying the developed NTCP model to predict SRIL, the area under the receiver operating characteristic curve and Brier score values were 0.89 and 0.12, respectively. CONCLUSIONS We developed the first NTCP model based on whole-blood DVHs for estimating SRIL after abdominal RT in patients with HCC. Our results showed a strong correlation between blood dose and ALC depletion, suggesting the potential to predict the risk of SRIL occurrence using blood dose.
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Affiliation(s)
- Seohan Kim
- Deparments of Biomedical Engineering and Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hwa Kyung Byun
- Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Jungwook Shin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Ik Jae Lee
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
| | - Wonmo Sung
- Deparments of Biomedical Engineering and Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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El-Khateeb E, Chinnadurai R, Al Qassabi J, Scotcher D, Darwich AS, Kalra PA, Rostami-Hodjegan A. Using Prior Knowledge on Systems Through PBPK to Gain Further Insight into Routine Clinical Data on Trough Concentrations: The Case of Tacrolimus in Chronic Kidney Disease. Ther Drug Monit 2023; 45:743-753. [PMID: 37315152 PMCID: PMC10635338 DOI: 10.1097/ftd.0000000000001108] [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] [Received: 01/11/2023] [Accepted: 03/23/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Routine therapeutic drug monitoring (TDM) relies heavily on measuring trough drug concentrations. Trough concentrations are affected not only by drug bioavailability and clearance, but also by various patient and disease factors and the volume of distribution. This often makes interpreting differences in drug exposure from trough data challenging. This study aimed to combine the advantages of top-down analysis of therapeutic drug monitoring data with bottom-up physiologically-based pharmacokinetic (PBPK) modeling to investigate the effect of declining renal function in chronic kidney disease (CKD) on the nonrenal intrinsic metabolic clearance ( CLint ) of tacrolimus as a case example. METHODS Data on biochemistry, demographics, and kidney function, along with 1167 tacrolimus trough concentrations for 40 renal transplant patients, were collected from the Salford Royal Hospital's database. A reduced PBPK model was developed to estimate CLint for each patient. Personalized unbound fractions, blood-to-plasma ratios, and drug affinities for various tissues were used as priors to estimate the apparent volume of distribution. Kidney function based on the estimated glomerular filtration rate ( eGFR ) was assessed as a covariate for CLint using the stochastic approximation of expectation and maximization method. RESULTS At baseline, the median (interquartile range) eGFR was 45 (34.5-55.5) mL/min/1.73 m 2 . A significant but weak correlation was observed between tacrolimus CLint and eGFR (r = 0.2, P < 0.001). The CLint declined gradually (up to 36%) with CKD progression. Tacrolimus CLint did not differ significantly between stable and failing transplant patients. CONCLUSIONS Kidney function deterioration in CKD can affect nonrenal CLint for drugs that undergo extensive hepatic metabolism, such as tacrolimus, with critical implications in clinical practice. This study demonstrates the advantages of combining prior system information (via PBPK) to investigate covariate effects in sparse real-world datasets.
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Affiliation(s)
- Eman El-Khateeb
- Certara UK Limited (Simcyp Division), Sheffield, United Kingdom
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Rajkumar Chinnadurai
- Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Jokha Al Qassabi
- Centre for Applied Pharmacokinetic Research, University of Manchester, Manchester, United Kingdom
- University of Technology and Applied Sciences, Muscat, Oman; and
| | - Daniel Scotcher
- Centre for Applied Pharmacokinetic Research, University of Manchester, Manchester, United Kingdom
| | - Adam S. Darwich
- Logistics and Informatics in Health Care, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Philip A. Kalra
- Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Amin Rostami-Hodjegan
- Certara UK Limited (Simcyp Division), Sheffield, United Kingdom
- Centre for Applied Pharmacokinetic Research, University of Manchester, Manchester, United Kingdom
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28
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Dinh J, Johnson TN, Grimstein M, Lewis T. Physiologically Based Pharmacokinetics Modeling in the Neonatal Population-Current Advances, Challenges, and Opportunities. Pharmaceutics 2023; 15:2579. [PMID: 38004559 PMCID: PMC10675397 DOI: 10.3390/pharmaceutics15112579] [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: 09/26/2023] [Revised: 10/24/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Physiologically based pharmacokinetic (PBPK) modeling is an approach to predicting drug pharmacokinetics, using knowledge of the human physiology involved and drug physiochemical properties. This approach is useful when predicting drug pharmacokinetics in under-studied populations, such as pediatrics. PBPK modeling is a particularly important tool for dose optimization for the neonatal population, given that clinical trials rarely include this patient population. However, important knowledge gaps exist for neonates, resulting in uncertainty with the model predictions. This review aims to outline the sources of variability that should be considered with developing a neonatal PBPK model, the data that are currently available for the neonatal ontogeny, and lastly to highlight the data gaps where further research would be needed.
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Affiliation(s)
- Jean Dinh
- Certara UK Limited, Sheffield S1 2BJ, UK; (J.D.); (T.N.J.)
| | | | - Manuela Grimstein
- Office of Clinical Pharmacology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20903, USA
| | - Tamorah Lewis
- Pediatric Clinical Pharmacology & Toxicology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
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29
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Singh PK, Patni HK, Roy R, Akar DK, Sawant PD. 131I dose coefficients for a reference population using age-specific models. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:041508. [PMID: 37857280 DOI: 10.1088/1361-6498/ad04ef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/19/2023] [Indexed: 10/21/2023]
Abstract
Age-specific dose coefficients are required to assess internal exposure to the general public. This study utilizes reference age-specific biokinetic models of iodine to estimate the total number of nuclear disintegrations ã(rS,τ) occurring in source regions (rS) during the commitment time (τ). Age-specific S values are estimated for 35 target regions due to131I present in 22rSusing data from 10 paediatric reference computational phantoms (representing five ages for both sexes) published recently by the International Commission of Radiation Protection (ICRP). Monte Carlo transport simulations are performed in FLUKA code. The estimated ã(rS,τ) and S values are then used to compute the committed tissue equivalent dose HT(τ) for 27 radiosensitive tissues and dose coefficients e(τ) for all five ages due to inhalation and ingestion of131I. The derived ã(rS,τ) values in the thyroid source are observed to increase with age due to the increased retention of iodine in the thyroid. S values are found to decrease with age, mainly due to an increase in target masses. Generally, HT(τ) values are observed to decrease with age, indicating the predominant behaviour of S values over ã(rS,τ). On average, ingestion dose coefficients are 63% higher than for inhalation in all ages. The maximum contribution to dose coefficients is from the thyroid, accounting for 96% in the case of newborns and 98%-99% for all other ages. Furthermore, the estimated e(τ) values for the reference population are observed to be lower than previously published reference values from the ICRP. The estimated S, HT(τ) and e(τ) values can be used to improve estimations of internal doses to organs/whole body for members of the public in cases of131I exposure. The estimated dose coefficients can also be interpolated for other ages to accurately evaluate the doses received by the general public during131I therapy or during a radiological emergency.
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Affiliation(s)
- Pradeep Kumar Singh
- Internal Dosimetry Section, Radiation Safety Systems Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - Hemant Kumar Patni
- Internal Dosimetry Section, Radiation Safety Systems Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - Rahul Roy
- Internal Dosimetry Section, Radiation Safety Systems Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - Deepak Kumar Akar
- Internal Dosimetry Section, Radiation Safety Systems Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - Pramilla D Sawant
- Internal Dosimetry Section, Radiation Safety Systems Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
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30
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Ayala Alvarez DS, Watson PGF, Popovic M, Heng VJ, Evans MDC, Panet-Raymond V, Seuntjens J. Evaluation of Dosimetry Formalisms in Intraoperative Radiation Therapy of Glioblastoma. Int J Radiat Oncol Biol Phys 2023; 117:763-773. [PMID: 37150259 DOI: 10.1016/j.ijrobp.2023.04.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/21/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
PURPOSE The intraoperative radiotherapy in newly diagnosed glioblastoma multiforme (INTRAGO) clinical trial assesses survival in patients with glioblastoma treated with intraoperative radiation therapy (IORT) using the INTRABEAM. Treatment planning for INTRABEAM relies on vendor-provided in-water depth dose curves obtained according to the TARGeted Intraoperative radioTherapy (TARGIT) dosimetry protocol. However, recent studies have shown discrepancies between the estimated TARGIT and delivered doses. This work evaluates the effect of the choice of dosimetry formalism on organs at risk (OAR) doses. METHODS AND MATERIALS A treatment planning framework for INTRABEAM was developed to retrospectively calculate the IORT dose in 8 INTRAGO patients. These patients received an IORT prescription dose of 20 to 30 Gy in addition to external beam radiation therapy. The IORT dose was obtained using (1) the TARGIT method; (2) the manufacturer's V4.0 method; (3) the CQ method, which uses an ionization chamber Monte Carlo (MC) calculated factor; (4) MC dose-to-water; and (5) MC dose-to-tissue. The IORT dose was converted to 2 Gy fractions equivalent dose. RESULTS According to the TARGIT method, the OAR dose constraints were respected in all cases. However, the other formalisms estimated a higher mean dose to OARs and revealed 1 case where the constraint for the brain stem was exceeded. The addition of the external beam radiation therapy and TARGIT IORT doses resulted in 10 cases of OARs exceeding the dose constraints. The more accurate MC calculation of dose-to-tissue led to the highest dosimetric differences, with 3, 3, 2, and 2 cases (out of 8) exceeding the dose constraint to the brain stem, optic chiasm, optic nerves, and lenses, respectively. Moreover, the mean cumulative dose to brain stem exceeded its constraint of 66 Gy with the MC dose-to-tissue method, which was not evident with the current INTRAGO clinical practice. CONCLUSIONS The current clinical approach of calculating the IORT dose with the TARGIT method may considerably underestimate doses to nearby OARs. In practice, OAR dose constraints may have been exceeded, as revealed by more accurate methods.
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Affiliation(s)
| | | | | | - Veng Jean Heng
- Department of Physics and Medical Physics Unit, McGill University, Montreal, QC, Canada
| | | | - Valerie Panet-Raymond
- Department of Radiation Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Jan Seuntjens
- Medical Physics Unit and; Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON, Canada
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31
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Shenkoya B, Yellepeddi V, Mark K, Gopalakrishnan M. Predicting Maternal and Infant Tetrahydrocannabinol Exposure in Lactating Cannabis Users: A Physiologically Based Pharmacokinetic Modeling Approach. Pharmaceutics 2023; 15:2467. [PMID: 37896227 PMCID: PMC10610403 DOI: 10.3390/pharmaceutics15102467] [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: 09/12/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
A knowledge gap exists in infant tetrahydrocannabinol (THC) data to guide breastfeeding recommendations for mothers who use cannabis. In the present study, a paired lactation and infant physiologically based pharmacokinetic (PBPK) model was developed and verified. The verified model was used to simulate one hundred virtual lactating mothers (mean age: 28 years, body weight: 78 kg) who smoked 0.32 g of cannabis containing 14.14% THC, either once or multiple times. The simulated breastfeeding conditions included one-hour post smoking and subsequently every three hours. The mean peak concentration (Cmax) and area under the concentration-time curve (AUC(0-24 h)) for breastmilk were higher than in plasma (Cmax: 155 vs. 69.9 ng/mL; AUC(0-24 h): 924.9 vs. 273.4 ng·hr/mL) with a milk-to-plasma AUC ratio of 3.3. The predicted relative infant dose ranged from 0.34% to 0.88% for infants consuming THC-containing breastmilk between birth and 12 months. However, the mother-to-infant plasma AUC(0-24 h) ratio increased up to three-fold (3.4-3.6) with increased maternal cannabis smoking up to six times. Our study demonstrated the successful development and application of a lactation and infant PBPK model for exploring THC exposure in infants, and the results can potentially inform breastfeeding recommendations.
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Affiliation(s)
- Babajide Shenkoya
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
| | - Venkata Yellepeddi
- Division of Clinical Pharmacology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84112, USA
- Department of Molecular Pharmaceutics, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Katrina Mark
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, 11 S Paca, Suite 400, Baltimore, MD 21042, USA
| | - Mathangi Gopalakrishnan
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA
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32
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Rodriguez Martin L, Gilles L, Helte E, Åkesson A, Tägt J, Covaci A, Sakhi AK, Van Nieuwenhuyse A, Katsonouri A, Andersson AM, Gutleb AC, Janasik B, Appenzeller B, Gabriel C, Thomsen C, Mazej D, Sarigiannis D, Anastasi E, Barbone F, Tolonen H, Frederiksen H, Klanova J, Koponen J, Tratnik JS, Pack K, Gudrun K, Ólafsdóttir K, Knudsen LE, Rambaud L, Strumylaite L, Murinova LP, Fabelova L, Riou M, Berglund M, Szabados M, Imboden M, Laeremans M, Eštóková M, Janev Holcer N, Probst-Hensch N, Vodrazkova N, Vogel N, Piler P, Schmidt P, Lange R, Namorado S, Kozepesy S, Szigeti T, Halldorsson TI, Weber T, Jensen TK, Rosolen V, Puklova V, Wasowicz W, Sepai O, Stewart L, Kolossa-Gehring M, Esteban-López M, Castaño A, Bessems J, Schoeters G, Govarts E. Time Patterns in Internal Human Exposure Data to Bisphenols, Phthalates, DINCH, Organophosphate Flame Retardants, Cadmium and Polyaromatic Hydrocarbons in Europe. TOXICS 2023; 11:819. [PMID: 37888670 PMCID: PMC10610666 DOI: 10.3390/toxics11100819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023]
Abstract
Human biomonitoring (HBM) data in Europe are often fragmented and collected in different EU countries and sampling periods. Exposure levels for children and adult women in Europe were evaluated over time. For the period 2000-2010, literature and aggregated data were collected in a harmonized way across studies. Between 2011-2012, biobanked samples from the DEMOCOPHES project were used. For 2014-2021, HBM data were generated within the HBM4EU Aligned Studies. Time patterns on internal exposure were evaluated visually and statistically using the 50th and 90th percentiles (P50/P90) for phthalates/DINCH and organophosphorus flame retardants (OPFRs) in children (5-12 years), and cadmium, bisphenols and polycyclic aromatic hydrocarbons (PAHs) in women (24-52 years). Restricted phthalate metabolites show decreasing patterns for children. Phthalate substitute, DINCH, shows a non-significant increasing pattern. For OPFRs, no trends were statistically significant. For women, BPA shows a clear decreasing pattern, while substitutes BPF and BPS show an increasing pattern coinciding with the BPA restrictions introduced. No clear patterns are observed for PAHs or cadmium. Although the causal relations were not studied as such, exposure levels to chemicals restricted at EU level visually decreased, while the levels for some of their substitutes increased. The results support policy efficacy monitoring and the policy-supportive role played by HBM.
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Affiliation(s)
- Laura Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (K.G.); (M.L.); (J.B.); (G.S.); (E.G.)
| | - Liese Gilles
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (K.G.); (M.L.); (J.B.); (G.S.); (E.G.)
| | - Emilie Helte
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.H.); (A.Å.); (J.T.); (M.B.)
| | - Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.H.); (A.Å.); (J.T.); (M.B.)
| | - Jonas Tägt
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.H.); (A.Å.); (J.T.); (M.B.)
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium;
| | - Amrit K. Sakhi
- Norwegian Institute of Public Health, 0456 Oslo, Norway; (A.K.S.); (C.T.)
| | - An Van Nieuwenhuyse
- Laboratoire National de Santé (LNS), Rue Louis Rech 1, 3555 Dudelange, Luxembourg;
| | | | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (A.-M.A.); (H.F.)
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), University of Copenhagen, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Arno C. Gutleb
- Luxembourg Institute of Science and Technology (LIST), 4362 Esch-sur-Alzette, Luxembourg;
| | - Beata Janasik
- Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland; (B.J.); (W.W.)
| | | | - Catherine Gabriel
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.G.); (D.S.)
- HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Bldg. B, 10th km Thessaloniki-Thermi Road, 57001 Thessaloniki, Greece
| | - Cathrine Thomsen
- Norwegian Institute of Public Health, 0456 Oslo, Norway; (A.K.S.); (C.T.)
| | - Darja Mazej
- Jožef Stefan Institute, 1000 Ljubljana, Slovenia; (D.M.); (J.S.T.)
| | - Denis Sarigiannis
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.G.); (D.S.)
- HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Bldg. B, 10th km Thessaloniki-Thermi Road, 57001 Thessaloniki, Greece
- Environmental Health Engineering, Institute of Advanced Study, Palazzo del Broletto–Piazza Della Vittoria 15, 27100 Pavia, Italy
| | - Elena Anastasi
- State General Laboratory, Ministry of Health, 2081 Nicosia, Cyprus; (A.K.); (E.A.)
| | - Fabio Barbone
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy;
| | - Hanna Tolonen
- Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (H.T.); (J.K.)
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (A.-M.A.); (H.F.)
| | - Jana Klanova
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 625 00 Brno, Czech Republic; (J.K.); (P.P.)
| | - Jani Koponen
- Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (H.T.); (J.K.)
| | | | - Kim Pack
- Department of Toxicology, Health-Related Environmental Monitoring, German Environment Agency (UBA), 14195 Berlin, Germany; (K.P.); (N.V.); (P.S.); (R.L.); (T.W.)
| | - Koppen Gudrun
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (K.G.); (M.L.); (J.B.); (G.S.); (E.G.)
| | - Kristin Ólafsdóttir
- Faculty of Food Science and Nutrition, University of Iceland, Hofsvallagata 53, 107 Reykjavik, Iceland; (K.Ó.); (T.I.H.)
| | - Lisbeth E. Knudsen
- Section of Environmental Health, University of Copenhagen, 1165 Copenhagen, Denmark;
| | - Loïc Rambaud
- Department of Environmental and Occupational Health, Santé Publique France, 94410 Saint Maurice, France (M.R.)
| | - Loreta Strumylaite
- Neuroscience Institute, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania;
| | - Lubica Palkovicova Murinova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 833 03 Bratislava, Slovakia; (L.P.M.)
| | - Lucia Fabelova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 833 03 Bratislava, Slovakia; (L.P.M.)
| | - Margaux Riou
- Department of Environmental and Occupational Health, Santé Publique France, 94410 Saint Maurice, France (M.R.)
| | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (E.H.); (A.Å.); (J.T.); (M.B.)
| | - Maté Szabados
- National Public Health Center, Albert Florian 2-6, 1097 Budapest, Hungary; (M.S.); (S.K.); (T.S.)
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; (M.I.); (N.P.-H.)
| | - Michelle Laeremans
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (K.G.); (M.L.); (J.B.); (G.S.); (E.G.)
| | - Milada Eštóková
- Department of Environment and Health, Public Health Authority, 83105 Bratislava, Slovakia;
| | - Natasa Janev Holcer
- Division for Environmental Health, Croatian Institute of Public Health, Rockefellerova 7, 10000 Zagreb, Croatia;
- Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka, Bráce Branchetta 20/1, 51000 Rijeka, Croatia
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; (M.I.); (N.P.-H.)
| | - Nicole Vodrazkova
- Centre for Health and Environment, National Institute of Public Health, 100 00 Prague, Czech Republic; (N.V.); (V.P.)
| | - Nina Vogel
- Department of Toxicology, Health-Related Environmental Monitoring, German Environment Agency (UBA), 14195 Berlin, Germany; (K.P.); (N.V.); (P.S.); (R.L.); (T.W.)
| | - Pavel Piler
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 625 00 Brno, Czech Republic; (J.K.); (P.P.)
| | - Phillipp Schmidt
- Department of Toxicology, Health-Related Environmental Monitoring, German Environment Agency (UBA), 14195 Berlin, Germany; (K.P.); (N.V.); (P.S.); (R.L.); (T.W.)
| | - Rosa Lange
- Department of Toxicology, Health-Related Environmental Monitoring, German Environment Agency (UBA), 14195 Berlin, Germany; (K.P.); (N.V.); (P.S.); (R.L.); (T.W.)
| | - Sónia Namorado
- Department of Epidemiology, National Institute of Health Doctor Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal;
| | - Szilvia Kozepesy
- National Public Health Center, Albert Florian 2-6, 1097 Budapest, Hungary; (M.S.); (S.K.); (T.S.)
| | - Tamás Szigeti
- National Public Health Center, Albert Florian 2-6, 1097 Budapest, Hungary; (M.S.); (S.K.); (T.S.)
| | - Thorhallur I. Halldorsson
- Faculty of Food Science and Nutrition, University of Iceland, Hofsvallagata 53, 107 Reykjavik, Iceland; (K.Ó.); (T.I.H.)
| | - Till Weber
- Department of Toxicology, Health-Related Environmental Monitoring, German Environment Agency (UBA), 14195 Berlin, Germany; (K.P.); (N.V.); (P.S.); (R.L.); (T.W.)
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, 5000 Odense, Denmark;
| | - Valentina Rosolen
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Via Cassa di Risparmio 10, 34121 Trieste, Italy;
| | - Vladimira Puklova
- Centre for Health and Environment, National Institute of Public Health, 100 00 Prague, Czech Republic; (N.V.); (V.P.)
| | - Wojciech Wasowicz
- Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland; (B.J.); (W.W.)
| | - Ovnair Sepai
- UKHSA UK Health Security Agency, Harwell Science Park, Chilton OX11 0RQ, UK; (O.S.); (L.S.)
| | - Lorraine Stewart
- UKHSA UK Health Security Agency, Harwell Science Park, Chilton OX11 0RQ, UK; (O.S.); (L.S.)
| | - Marike Kolossa-Gehring
- Department of Toxicology, Health-Related Environmental Monitoring, German Environment Agency (UBA), 14195 Berlin, Germany; (K.P.); (N.V.); (P.S.); (R.L.); (T.W.)
| | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Majadahonda, Spain; (M.E.-L.); (A.C.)
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28220 Majadahonda, Spain; (M.E.-L.); (A.C.)
| | - Jos Bessems
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (K.G.); (M.L.); (J.B.); (G.S.); (E.G.)
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (K.G.); (M.L.); (J.B.); (G.S.); (E.G.)
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium;
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; (L.G.); (K.G.); (M.L.); (J.B.); (G.S.); (E.G.)
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Dengel DR, Evanoff NG. Positional Differences in Muscle-to-bone Ratio in National Football League Players. Int J Sports Med 2023; 44:720-727. [PMID: 37160263 DOI: 10.1055/a-2089-8068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The purpose of the present study was to examine the muscle-to-bone ratio (MBR) in National Football League (NFL) players. Three hundred and forty-six NFL players had their total body lean, fat and bone masses determined using dual X-ray absorptiometry and were compared to 228 age-matched, healthy male controls. Compared to the control group, NFL players had a significantly lower percent total body fat (17.90±6.92 vs. 22.93±8.96%, p=0.053), but significantly greater total fat mass (19.76±11.29 vs. 17.84±12.11 kg, p<0.0001), lean mass (84.55±8.75 vs. 55.3±11.79 kg, p<0.0001), bone mineral content (4.58±0.45 vs. 2.91±0.67 kg, p<0.0001), and bone mineral density (1.61±0.11 vs. 1.26±0.21 g/cm2, p<0.0001). NFL players had greater arm MBR (17.70±1.47 vs. 16.48±1.88, p<0.0001) than controls; however, both trunk (26.62±2.55 vs. 31.56±4.19, p<0.0001) and total (18.50±1.31 vs. 19.12±1.88, p<0.001) MBR were lower in NFL players. Leg MBR was not significantly different between NFL players and controls (16.72±1.53 vs. 16.85±1.87, p=0.34). When NFL players were categorized by their offensive or defensive position for comparison, no differences in total MBR were observed. However, leg MBR varied greatly among NFL players by position. It is possible that regional differences in MBR in the NFL players may be related to the demands of that position.
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Affiliation(s)
- Donald R Dengel
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, United States
| | - Nicholas G Evanoff
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, United States
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34
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Yu X, Sun H, Xu L, Han Y, Wang C, Li L, Ng YL, Shi F, Qiu J, Huang G, Zhou Y, Chen Y, Liu J. Improved accuracy of the biodistribution and internal radiation dosimetry of 13 N-ammonia using a total-body PET/CT scanner. Med Phys 2023; 50:5865-5874. [PMID: 37177847 DOI: 10.1002/mp.16450] [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: 07/05/2022] [Revised: 04/23/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Conventional short-axis PET typically utilizes multi-bed multi-pass acquisition to produce quantitative whole-body dynamic images and cannot record all the uptake information simultaneously, resulting in errors when fitting the time-activity curves (TACs) and calculating radiation doses. PURPOSE The aim of this study is to evaluate the 13 N-ammonia biodistribution and the internal radiation doses using a 194 cm long total-body PET/CT scanner (uEXPLORER), and make a comparison with the previous short-axis PET results. METHODS Ten subjects (age 40-74 years) received 13 N-NH3 injection (418.1-670.81 MBq) and were under a dynamic scan for about 60 min with using a 3-dimensional whole-body protocol. ROIs were drawn visually on 11 major organs (brain, thyroid, gallbladder, heart wall, kidneys, liver, pancreas, spleen, lungs, bone marrow, and urinary bladder content) for each subject. TACs were generated using Pmod and the absorbed radiation doses were calculated using Olinda 2.2. To compare with the conventional PET/CT, five points were sampled on uEXPLORER's TACs to mimic the result of a short-axis PET/CT (15 cm axial FOV, consisted of 9 or 10 bed positions). Then the TACs were obtained using the multi-exponential fitting method, and the residence time and radiation dose were also calculated and compared with uEXPLORER. RESULTS The highest absorbed organ doses were the pancreas, thyroid, spleen, heart wall, and kidneys for the male. For the female, the first five highest absorbed organ dose coefficients were the pancreas, heart wall, spleen, lungs, and kidneys. The lowest absorbed dose was found in red marrow both for male and female. The simulated short-axis PET can fit TACs well for the gradually-changed uptake organs but typically underestimated for the rapid-uptake organs during the first-10 min, resulting in errors in the calculated radiation dose. CONCLUSION uEXPLORER PET/CT can measure 13 N-ammonia's TACs simultaneously in all organs of the whole body, which can provide more accurate biodistribution and radiation dose estimation compared with the conventional short-axis scanners.
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Affiliation(s)
- Xiaofeng Yu
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Hongyan Sun
- Central Research Institute, United Imaging Healthcare, Shanghai, People's Republic of China
| | - Lian Xu
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yuan Han
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Cheng Wang
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Lianghua Li
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yee Ling Ng
- Central Research Institute, United Imaging Healthcare, Shanghai, People's Republic of China
| | - Fuxiao Shi
- Central Research Institute, United Imaging Healthcare, Shanghai, People's Republic of China
| | - Ju Qiu
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Gang Huang
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare, Shanghai, People's Republic of China
| | - Yumei Chen
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Jianjun Liu
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Pepin XJH, Grant I, Wood JM. SubQ-Sim: A Subcutaneous Physiologically Based Biopharmaceutics Model. Part 1: The Injection and System Parameters. Pharm Res 2023; 40:2195-2214. [PMID: 37634241 PMCID: PMC10547635 DOI: 10.1007/s11095-023-03567-0] [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] [Received: 05/03/2023] [Accepted: 07/13/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE To construct a detailed mechanistic and physiologically based biopharmaceutics model capable of predicting 1) device-formulation-tissue interaction during the injection process and 2) binding, degradation, local distribution, diffusion, and drug absorption, following subcutaneous injection. This paper is part of a series and focusses on the first aspect. METHODS A mathematical model, SubQ-Sim, was developed incorporating the details of the various substructures within the subcutaneous environment together with the calculation of dynamic drug disposition towards the lymph ducts and venous capillaries. Literature was searched to derive key model parameters in healthy and diseased subjects. External factors such as body temperature, exercise, body position, food or stress provide a means to calculate the impact of "life events" on the pharmacokinetics of subcutaneously administered drugs. RESULTS The model predicts the tissue backpressure time profile during the injection as a function of injection rate, volume injected, solution viscosity, and interstitial fluid viscosity. The shape of the depot and the concentrations of the formulation and proteins in the depot are described. The model enables prediction of formulation backflow following premature needle removal and the resulting formulation losses. Finally, the effect of disease (type 2 diabetes) or the presence of recombinant human hyaluronidase in the formulation on the injection pressure, are explored. CONCLUSIONS This novel model can successfully predict tissue back pressure, depot dimensions, drug and protein concentration and formulation losses due to incorrect injection, which are all important starting conditions for predicting drug absorption from a subcutaneous dose. The next article will describe the absorption model and validation against clinical data.
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Affiliation(s)
| | - Iain Grant
- Innovation Strategy & External Liaison, Pharmaceutical Technology & Development, Operations, AstraZeneca, Charter Way, Macclesfield, SK10 2NA, UK.
| | - J Matthew Wood
- New Modalities and Parenteral Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Macclesfield, UK
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Hoffman SLV, Mixdorf JC, Kwon O, Johnson TR, Makvandi M, Lee H, Aluicio-Sarduy E, Barnhart TE, Jeffery JJ, Patankar MS, Engle JW, Bednarz BP, Ellison PA. Preclinical studies of a PARP targeted, Meitner-Auger emitting, theranostic radiopharmaceutical for metastatic ovarian cancer. Nucl Med Biol 2023; 122-123:108368. [PMID: 37490805 PMCID: PMC10529069 DOI: 10.1016/j.nucmedbio.2023.108368] [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: 05/09/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Abstract
Advanced ovarian cancer currently has few therapeutic options. Poly(ADP-ribose) polymerase (PARP) inhibitors bind to nuclear PARP and trap the protein-inhibitor complex to DNA. This work investigates a theranostic PARP inhibitor for targeted radiopharmaceutical therapy of ovarian cancer in vitro and PET imaging of healthy mice in vivo. METHODS [77Br]RD1 was synthesized and assessed for pharmacokinetics and cytotoxicity in human and murine ovarian cancer cell lines. [76Br]RD1 biodistribution and organ uptake in healthy mice were quantified through longitudinal PET/CT imaging and ex vivo radioactivity measurements. Organ-level dosimetry following [76/77Br]RD1 administration was calculated using RAPID, an in-house platform for absorbed dose in mice, and OLINDA for equivalent and effective dose in human. RESULTS The maximum specific binding (Bmax), equilibrium dissociation constant (Kd), and nonspecific binding slope (NS) were calculated for each cell line. These values were used to calculate the cell specific activity uptake for cell viability studies. The half maximal effective concentration (EC50) was measured as 0.17 (95 % CI: 0.13-0.24) nM and 0.46 (0.13-0.24) nM for PARP(+) and PARP(-) expressing cell lines, respectively. The EC50 was 0.27 (0.21-0.36) nM and 0.30 (0.22-0.41) nM for BRCA1(-) and BRCA1(+) expressing cell lines, respectively. When measuring the EC50 as a function of cellular activity uptake and nuclear dose, the EC50 ranges from 0.020 to 0.039 Bq/cell and 3.3-9.2 Gy, respectively. Excretion through the hepatobiliary and renal pathways were observed in mice, with liver uptake of 2.3 ± 0.4 %ID/g after 48 h, contributing to estimated absorbed dose values in mice of 19.3 ± 0.3 mGy/MBq and 290 ± 10 mGy/MBq for [77Br]RD1 and [76Br]RD1, respectively. CONCLUSION [77Br]RD1 cytotoxicity was dependent on PARP expression and independent of BRCA1 status. The in vitro results suggest that [77Br]RD1 cytotoxicity is driven by the targeted Meitner-Auger electron (MAe) radiotherapeutic effect of the agent. Further studies investigating the theranostic potential, organ dose, and tumor uptake of [76/77Br]RD1 are warranted.
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Affiliation(s)
- S L V Hoffman
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J C Mixdorf
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - O Kwon
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - T R Johnson
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - M Makvandi
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - H Lee
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - E Aluicio-Sarduy
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - T E Barnhart
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J J Jeffery
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - M S Patankar
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J W Engle
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - B P Bednarz
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - P A Ellison
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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Scarinci I, Valente M, Pérez P. A machine learning-based model for a dose point kernel calculation. EJNMMI Phys 2023; 10:41. [PMID: 37358735 DOI: 10.1186/s40658-023-00560-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 06/13/2023] [Indexed: 06/27/2023] Open
Abstract
PURPOSE Absorbed dose calculation by kernel convolution requires the prior determination of dose point kernels (DPK). This study reports on the design, implementation, and test of a multi-target regressor approach to generate the DPKs for monoenergetic sources and a model to obtain DPKs for beta emitters. METHODS DPK for monoenergetic electron sources were calculated using the FLUKA Monte Carlo (MC) code for many materials of clinical interest and initial energies ranging from 10 to 3000 keV. Regressor Chains (RC) with three different coefficients regularization/shrinkage models were used as base regressors. Electron monoenergetic scaled DPKs (sDPKs) were used to assess the corresponding sDPKs for beta emitters typically used in nuclear medicine, which were compared against reference published data. Finally, the beta emitters sDPK were applied to a patient-specific case calculating the Voxel Dose Kernel (VDK) for a hepatic radioembolization treatment with [Formula: see text]Y. RESULTS The three trained machine learning models demonstrated a promising capacity to predict the sDPK for both monoenergetic emissions and beta emitters of clinical interest attaining differences lower than [Formula: see text] in the mean average percentage error (MAPE) as compared with previous studies. Furthermore, differences lower than [Formula: see text] were obtained for the absorbed dose in patient-specific dosimetry comparing against full stochastic MC calculations. CONCLUSION An ML model was developed to assess dosimetry calculations in nuclear medicine. The implemented approach has shown the capacity to accurately predict the sDPK for monoenergetic beta sources in a wide range of energy in different materials. The ML model to calculate the sDPK for beta-emitting radionuclides allowed to obtain VDK useful to achieve reliable patient-specific absorbed dose distributions required short computation times.
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Affiliation(s)
- Ignacio Scarinci
- Instituto de Física Enrique Gaviola (IFEG), CONICET, Av. Medina Allende s/n, 5000, Córdoba, Argentina
- Laboratorio de Investigación e Instrumentación en Física Aplicada a la Medicina e Imágenes de Rayos X (LIIFAMIRx), Facultad de Matemática, Astronomía, Física y Computación, Universidad Nacional de Córdoba, Av. Medina Allende s/n, 5000, Córdoba, Argentina
| | - Mauro Valente
- Instituto de Física Enrique Gaviola (IFEG), CONICET, Av. Medina Allende s/n, 5000, Córdoba, Argentina.
- Laboratorio de Investigación e Instrumentación en Física Aplicada a la Medicina e Imágenes de Rayos X (LIIFAMIRx), Facultad de Matemática, Astronomía, Física y Computación, Universidad Nacional de Córdoba, Av. Medina Allende s/n, 5000, Córdoba, Argentina.
- Centro de Excelencia en Física e Ingeniería en Salud (CFIS) & Departamento de Ciencias Físicas, Universidad de la Frontera, Avenida Francisco Salazar 01145, 4811230, Temuco, Cautín, Chile.
| | - Pedro Pérez
- Instituto de Física Enrique Gaviola (IFEG), CONICET, Av. Medina Allende s/n, 5000, Córdoba, Argentina
- Laboratorio de Investigación e Instrumentación en Física Aplicada a la Medicina e Imágenes de Rayos X (LIIFAMIRx), Facultad de Matemática, Astronomía, Física y Computación, Universidad Nacional de Córdoba, Av. Medina Allende s/n, 5000, Córdoba, Argentina
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Gnesin S, Chouin N, Cherel M, Dunn SM, Schaefer N, Faivre-Chauvet A, Prior JO, Delage JA. From bench to bedside: 64Cu/ 177Lu 1C1m-Fc anti TEM-1: mice-to-human dosimetry extrapolations for future theranostic applications. EJNMMI Res 2023; 13:59. [PMID: 37314509 DOI: 10.1186/s13550-023-01010-4] [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: 04/24/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023] Open
Abstract
The development of diagnostic and therapeutic radiopharmaceuticals is an hot topic in nuclear medicine. Several radiolabeled antibodies are under development necessitating both biokinetic and dosimetry extrapolations for effective human translation. The validation of different animal-to-human dosimetry extrapolation methods still is an open issue. This study reports the mice-to-human dosimetry extrapolation of 64Cu/177Lu 1C1m-Fc anti-TEM-1 for theranostic application in soft-tissue sarcomas. We adopt four methods; direct mice-to-human extrapolation (M1); dosimetry extrapolation considering a relative mass scaling factor (M2), application of a metabolic scaling factor (M3) and combination of M2 and M3 (M4). Predicted in-human dosimetry for the [64Cu]Cu-1C1m-Fc resulted in an effective dose of 0.05 mSv/MBq. Absorbed dose (AD) extrapolation for the [177Lu]Lu-1C1m-Fc indicated that the AD of 2 Gy and 4 Gy to the red-marrow and total-body can be reached with 5-10 GBq and 25-30 GBq of therapeutic activity administration respectively depending on applied dosimetry method. Dosimetry extrapolation methods provided significantly different absorbed doses in organs. Dosimetry properties for the [64Cu]Cu-1C1m-Fc are suitable for a diagnostic in-human use. The therapeutic application of [177Lu]Lu-1C1m-Fc presents challenges and would benefit from further assessments in animals' models such as dogs before moving into the clinic.
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Affiliation(s)
- Silvano Gnesin
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Nicolas Chouin
- Inserm, CNRS, University of Angers, Oniris, CRCI2NA, University of Nantes, Nantes, France
| | - Michel Cherel
- CHU Nantes, CNRS, Inserm, CRCINA, University of Nantes, 44000, Nantes, France
| | - Steven Mark Dunn
- LAbCore, Ludwig Institute for Cancer Research, Lausanne University Hospital and University of Lausanne, 1066, Epalinges, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | | | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| | - Judith Anna Delage
- Radiopharmacy Unit, Department of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
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Chen FS, Chen CC, Tsai CC, Lu JH, You HL, Chen CM, Huang WT, Tsai KF, Cheng FJ, Kung CT, Li SH, Wang CC, Ou YC, Lee WC, Chang YT, Hashim F, Chao HR, Wang LJ. Urinary levels of organophosphate flame retardants metabolites in a young population from Southern Taiwan and potential health effects. Front Endocrinol (Lausanne) 2023; 14:1173449. [PMID: 37334296 PMCID: PMC10272846 DOI: 10.3389/fendo.2023.1173449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023] Open
Abstract
Background Organophosphate flame retardants (OPFRs) are widely distributed in the environment and their metabolites are observed in urine, but little is known regarding OPFRs in a broad-spectrum young population from newborns to those aged 18 years. Objectives Investigate urinary levels of OPFRs and OPFR metabolites in Taiwanese infants, young children, schoolchildren, and adolescents within the general population. Methods Different age groups of subjects (n=136) were recruited from southern Taiwan to detect 10 OPFR metabolites in urine samples. Associations between urinary OPFRs and their corresponding metabolites and potential health status were also examined. Results The mean level of urinary Σ10 OPFR in this broad-spectrum young population is 2.25 μg/L (standard deviation (SD) of 1.91 μg/L). Σ10 OPFR metabolites in urine are 3.25 ± 2.84, 3.06 ± 2.21, 1.75 ± 1.10, and 2.32 ± 2.29 μg/L in the age groups comprising of newborns, 1-5 year-olds, 6-10 year-olds, and 11-18 year-olds, respectively, and borderline significant differences were found in the different age groups (p=0.125). The OPFR metabolites of TCEP, BCEP, DPHP, TBEP, DBEP, and BDCPP predominate in urine and comprise more than 90% of the total. TBEP was highly correlated with DBEP in this population (r=0.845, p<0.001). The estimated daily intake (EDI) of Σ5OPFRs (TDCPP, TCEP, TBEP, TNBP, and TPHP) was 2,230, 461, 130, and 184 ng/kg bw/day for newborns, 1-5 yr children, 6-10 yr children, and 11-17 yr adolescents, respectively. The EDI of Σ5OPFRs for newborns was 4.83-17.2 times higher than the other age groups. Urinary OPFR metabolites are significantly correlated with birth length and chest circumference in newborns. Conclusion To our knowledge, this is the first investigation of urinary OPFR metabolite levels in a broad-spectrum young population. There tended to be higher exposure rates in both newborns and pre-schoolers, though little is known about their exposure levels or factors leading to exposure in the young population. Further studies should clarify the exposure levels and factor relationships.
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Affiliation(s)
- Feng-Shun Chen
- Section of Neonatology, Department of Pediatrics, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chih-Cheng Chen
- Section of Neonatology, Department of Pediatrics, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Early Childhood Care and Education, Cheng-Shiu University, Kaohsiung, Taiwan
| | - Ching-Chang Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jian-He Lu
- Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Neipu, Taiwan
| | - Huey-Ling You
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Mei Chen
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wan-Ting Huang
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kai-Fan Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Jen Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chia-Te Kung
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chin-Chou Wang
- Department of Occupational Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Che Ou
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Chin Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ting Chang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fahimah Hashim
- Universiti Malaysia Terengganu, Kuala Terengganu, Malaysia
| | - How-Ran Chao
- Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Neipu, Taiwan
- Institute of Food Safety Management, College of Agriculture, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Abalo KD, Malekzadeh-Milani S, Hascoët S, Dreuil S, Feuillet T, Damon C, Bouvaist H, Bouzguenda I, Cohen S, Dauphin C, Di Filippo S, Douchin S, Godart F, Guérin P, Helms P, Karsenty C, Lefort B, Mauran P, Ovaert C, Piéchaud JF, Thambo JB, Lee C, Little MP, Bonnet D, Bernier MO, Rage E. Lympho-hematopoietic malignancies risk after exposure to low dose ionizing radiation during cardiac catheterization in childhood. Eur J Epidemiol 2023:10.1007/s10654-023-01010-7. [PMID: 37191831 DOI: 10.1007/s10654-023-01010-7] [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: 10/03/2022] [Accepted: 04/16/2023] [Indexed: 05/17/2023]
Abstract
Pediatric patients with congenital heart disease (CHD) often undergo low dose ionizing radiation (LDIR) from cardiac catheterization (CC) for the diagnosis and/or treatment of their disease. Although radiation doses from a single CC are usually low, less is known about the long-term radiation associated cancer risks. We aimed to assess the risk of lympho-hematopoietic malignancies in pediatric CHD patients diagnosed or treated with CC. A French cohort of 17,104 children free of cancer who had undergone a first CC from 01/01/2000 to 31/12/2013, before the age of 16 was set up. The follow-up started at the date of the first recorded CC until the exit date, i.e., the date of death, the date of first cancer diagnosis, the date of the 18th birthday, or the 31/12/2015, whichever occurred first. Poisson regression was used to estimate the LDIR associated cancer risk. The median follow-up was 5.9 years, with 110,335 person-years. There were 22,227 CC procedures, yielding an individual active bone marrow (ABM) mean cumulative dose of 3.0 milligray (mGy). Thirty-eight incident lympho-hematopoietic malignancies were observed. When adjusting for attained age, gender and predisposing factors to cancer status, no increased risk was observed for lympho-hematopoietic malignancies RR/mGy = 1.00 (95% CI: 0.88; 1.10). In summary, the risk of lympho-hematopoietic malignancies and lymphoma was not associated to LDIR in pediatric patients with CHD who undergo CC. Further epidemiological studies with greater statistical power are needed to improve the assessment of the dose-risk relationship.
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Affiliation(s)
- Kossi D Abalo
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE/SESANE/Laboratory of Epidemiology, BP 17, Fontenay-aux-Roses, 92262, France
| | - Sophie Malekzadeh-Milani
- M3C-Necker, Hôpital universitaire Necker-Enfants malades, Université de Paris Cité, Paris, France
| | - Sébastien Hascoët
- Cardiology department, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Serge Dreuil
- Institute for Radiological Protection and Nuclear Safety, (IRSN), PSE-SANTE/SER/UEM, BP 17, Fontenay-aux-Roses, 92262, France
| | | | - Cecilia Damon
- Institute for Radiological Protection and Nuclear Safety, (IRSN), DTR/D3NSI/SVDDA/CVD, BP 17, Fontenay-aux-Roses, 92262, France
| | - Hélène Bouvaist
- Cardiopédiatrie, hôpital couple enfant, CHU Grenoble Alpes, Grenoble cedex 9, 38043, France
| | - Ivan Bouzguenda
- Pediatric and congenital cardiology, Interventional cardiology, INTERCARD Clinique La Louvière, Lille, France
| | - Sarah Cohen
- Cardiology department, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Claire Dauphin
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Sylvie Di Filippo
- Paediatric and Congential Cardiology Department, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Stéphanie Douchin
- Cardiopédiatrie, hôpital couple enfant, CHU Grenoble Alpes, Grenoble cedex 9, 38043, France
| | - François Godart
- Service de Cardiologie Infantile et Congénitale, Institut Coeur Poumon, Lille Cedex, 59037, France
| | - Patrice Guérin
- CHU Nantes, INSERM, Nantes Université, Clinique Cardiologique et des Maladies Vasculaires, Institut du Thorax, Nantes, 1413, CIC, France
| | - Pauline Helms
- Unit of Cardiopediatrics, University Hospital of Strasbourg, Strasbourg, France
| | - Clément Karsenty
- Pediatric and Congenital Cardiology, Institut des Maladies Métaboliques et Cardiovasculaires, Children's Hospital, INSERM U1048, Université de Toulouse, Toulouse, I2MC, France
| | - Bruno Lefort
- Institut des Cardiopathies Congénitales, CHRU Tours, 49 boulevard Béranger, Tours, 37000, France
| | - Pierre Mauran
- Unité de cardiologie pédiatrique et congénitale, American Memorial Hospital, CHU de Reims, 47 rue Cognacq-Jay, Reims Cedex, 51092, France
| | - Caroline Ovaert
- Cardiologie pédiatrique et congénitale, AP-HM et INSERM 1251, Aix-Marseille Université, Timone enfants, Marseille, France
| | | | - Jean-Benoît Thambo
- Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), Pessac, 33600, France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Damien Bonnet
- M3C-Necker, Hôpital universitaire Necker-Enfants malades, Université de Paris Cité, Paris, France
| | - Marie-Odile Bernier
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE/SESANE/Laboratory of Epidemiology, BP 17, Fontenay-aux-Roses, 92262, France
| | - Estelle Rage
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE/SESANE/Laboratory of Epidemiology, BP 17, Fontenay-aux-Roses, 92262, France.
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Kidney absorbed radiation doses for [ 177 Lu]Lu-PSMA-617 and [ 177 Lu]Lu-PSMA-I&T determined by 3D clinical dosimetry. Nucl Med Commun 2023; 44:270-275. [PMID: 36597884 PMCID: PMC9994818 DOI: 10.1097/mnm.0000000000001658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE For prostate-specific membrane antigen-directed radioligand therapy (PSMA-RLT), [ 177 Lu]Lu-PSMA-617 and [ 177 Lu]Lu-PSMA-I&T are the currently preferred compounds. Recent preclinical studies suggested ~30x higher kidney absorbed dose for [ 177 Lu]Lu-PSMA-I&T compared to [ 177 Lu]Lu-PSMA-617, which may lead to an increased risk of kidney toxicity. We performed two single-centre, prospective dosimetry studies with either [ 177 Lu]Lu-PSMA-617 or [ 177 Lu]Lu-PSMA-I&T, using an identical dosimetry protocol. We evaluated the absorbed doses of both 177 Lu-labelled radioligands in human kidneys. METHODS 3D SPECT/computed tomography (CT) imaging of the kidneys was performed after PSMA-RLT in cancer patients with PSMA-positive disease and an adequate glomerular filtration rate (≥50 mL/min). Ten metastatic hormone-sensitive prostate cancer patients (mHSPC) were treated with [ 177 Lu]Lu-PSMA-617 and 10 advanced salivary gland cancer (SGC) patients were treated with [ 177 Lu]Lu-PSMA-I&T. SPECT/CT imaging was performed at five timepoints (1 h, 24 h, 48 h, 72 h, and 168 h post-injection). In mHSPC patients, SPECT/CT imaging was performed after cycles 1 and 2 (cumulative activity: 9 GBq) and in SGC patients only after cycle 1 (activity: 7.4 GBq). Kidney absorbed dose was calculated using organ-based dosimetry. RESULTS The median kidney absorbed dose was 0.49 Gy/GBq (range: 0.34-0.66) and 0.73 Gy/GBq (range: 0.42-1.31) for [ 177 Lu]Lu-PSMA-617 and [ 177 Lu]Lu-PSMA-I&T, respectively (independent samples t test; P = 0.010). CONCLUSION This study shows that the kidney absorbed dose for [ 177 Lu]Lu-PSMA-617 and [ 177 Lu]Lu-PSMA-I&T differs, with a ~1.5x higher median kidney absorbed dose for [ 177 Lu]Lu-PSMA-I&T. This difference in the clinical setting is considerably smaller than observed in preclinical studies and may not hamper treatments with [ 177 Lu]Lu-PSMA-I&T.
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42
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Scholten B, Westerhout J, Pronk A, Stierum R, Vlaanderen J, Vermeulen R, Jones K, Santonen T, Portengen L. A physiologically-based kinetic (PBK) model for work-related diisocyanate exposure: Relevance for the design and reporting of biomonitoring studies. ENVIRONMENT INTERNATIONAL 2023; 174:107917. [PMID: 37062159 DOI: 10.1016/j.envint.2023.107917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/05/2023] [Accepted: 04/02/2023] [Indexed: 06/19/2023]
Abstract
Diisocyanates are highly reactive substances and known causes of occupational asthma. Exposure occurs mainly in the occupational setting and can be assessed through biomonitoring which accounts for inhalation and dermal exposure and potential effects of protective equipment. However the interpretation of biomonitoring data can be challenging for chemicals with complex kinetic behavior and multiple exposure routes, as is the case for diisocyanates. To better understand the relation between external exposure and urinary concentrations of metabolites of diisocyanates, we developed a physiologically based kinetic (PBK) model for methylene bisphenyl isocyanate (MDI) and toluene di-isocyanate (TDI). The PBK model covers both inhalation and dermal exposure, and can be used to estimate biomarker levels after either single or chronic exposures. Key parameters such as absorption and elimination rates of diisocyanates were based on results from human controlled exposure studies. A global sensitivity analysis was performed on model predictions after assigning distributions reflecting a mixture of parameter uncertainty and population variability. Although model-based predictions of urinary concentrations of the degradation products of MDI and TDI for longer-term exposure scenarios compared relatively well to empirical results for a limited set of biomonitoring studies in the peer-reviewed literature, validation of model predictions was difficult because of the many uncertainties regarding the precise exposure scenarios that were used. Sensitivity analyses indicated that parameters with a relatively large impact on model estimates included the fraction of diisocyanates absorbed and the binding rate of diisocyanates to albumin relative to other macro molecules.We additionally investigated the effects of timing of exposure and intermittent urination, and found that both had a considerable impact on estimated urinary biomarker levels. This suggests that these factors should be taken into account when interpreting biomonitoring data and included in the standard reporting of isocyanate biomonitoring studies.
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Affiliation(s)
- B Scholten
- Risk Assessment for Products in Development, TNO Quality of Life, the Netherlands.
| | - J Westerhout
- Risk Assessment for Products in Development, TNO Quality of Life, the Netherlands
| | - A Pronk
- Risk Assessment for Products in Development, TNO Quality of Life, the Netherlands
| | - R Stierum
- Risk Assessment for Products in Development, TNO Quality of Life, the Netherlands
| | - J Vlaanderen
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - R Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - K Jones
- Health and Safety Executive (HSE), Harpur Hill, Buxton, UK
| | - T Santonen
- Finnish Institute of Occupational Health (FIOH), Finland
| | - L Portengen
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
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Lyu Q, Neph R, Sheng K. Tomographic detection of photon pairs produced from high-energy X-rays for the monitoring of radiotherapy dosing. Nat Biomed Eng 2023; 7:323-334. [PMID: 36280738 PMCID: PMC10038801 DOI: 10.1038/s41551-022-00953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/14/2022] [Indexed: 01/07/2023]
Abstract
Measuring the radiation dose reaching a patient's body is difficult. Here we report a technique for the tomographic reconstruction of the location of photon pairs originating from the annihilation of positron-electron pairs produced by high-energy X-rays travelling through tissue. We used Monte Carlo simulations on pre-recorded data from tissue-mimicking phantoms and from a patient with a brain tumour to show the feasibility of this imaging modality, which we named 'pair-production tomography', for the monitoring of radiotherapy dosing. We simulated three image-reconstruction methods, one applicable to a pencil X-ray beam scanning through a region of interest, and two applicable to the excitation of tissue volumes via broad beams (with temporal resolution sufficient to identify coincident photon pairs via filtered back projection, or with higher temporal resolution sufficient for the estimation of a photon's time-of-flight). In addition to the monitoring of radiotherapy dosing, we show that image contrast resulting from pair-production tomography is highly proportional to the material's atomic number. The technique may thus also allow for element mapping and for soft-tissue differentiation.
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Affiliation(s)
- Qihui Lyu
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Ryan Neph
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Ke Sheng
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
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44
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Sun Y, Liu Z, Xia W, He Z, Wan Y. Urinary pentachlorophenol in general population of central China: reproducibility, predictors, and associations with oxidative stress biomarkers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:37598-37606. [PMID: 36574129 DOI: 10.1007/s11356-022-24802-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/13/2022] [Indexed: 06/18/2023]
Abstract
Pentachlorophenol (PCP) is a ubiquitous environmental persistent organic pollutant and a Group 1 carcinogen. Human exposure level of PCP was reported to be relatively higher in China than in many other countries, because sodium pentachlorophenate was abused as molluscicide in China. PCP can induce oxidative stress; however, the relationship of PCP exposure with oxidative stress biomarkers (OSBs) in human beings has rarely been documented. In this study, 404 first-morning urine samples (including repeated samples in three days donated by 74 participants) were collected from 128 healthy adults (general population without occupational exposure to PCP) in autumn and winter of 2018, respectively, in Wuhan, central China. Urinary concentrations of PCP and three select OSBs [including 8-OHG (abbreviation of 8-hydroxy-guanosine), 8-OHdG (8-hydroxy-2'-deoxyguanosine), and 4-HNEMA (4-hydroxy-2-nonenal mercapturic acid), which reflect oxidative damage of RNA, DNA, and lipid, respectively] were determined. PCP was detectable in 100% of the urine samples (specific gravity-adjusted median concentration: 0.44 ng/mL; range: 0.02-14.2 ng/mL). Interday reproducibility of urinary PCP concentrations was excellent (intraclass correlation coefficient: 0.88) in three days. Significant differences in PCP concentrations were found among different age groups; the group of participants aged 20-45 y (median: 0.72 ng/mL) had higher concentrations than those in the elders (aged 45-60 y and > 60 y). Spatial disparity was observed in autumn, and urban residents had higher PCP concentrations than rural residents (median: 0.60 vs. 0.31 ng/mL), whereas such disparity was not found in winter. There were no season-, sex-, or BMI-related differences between the corresponding subgroups. The urinary PCP concentrations were found to be associated with increases in 8-OHdG and 8-OHG rather than 4-HNEMA. An interquartile range increase in urinary PCP concentration was associated with a 23.5% (95% CI: 9.18-39.6) increase in 8-OHdG and a 21.3% (95% CI: 9.18-32.4) increase in 8-OHG, implied that PCP exposure at environmental relevant dose might be associated with nucleic acid oxidative damage in the general population. This pilot study reported associations between PCP exposure and OSBs in human beings. Future studies are needed to elucidate the mediating roles of OSBs in the association between PCP exposure and certain adverse health outcomes.
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Affiliation(s)
- Yanfeng Sun
- Institute of Environmental Health, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, 430024, People's Republic of China
| | - Zhi Liu
- Jiangxia District Centers for Disease Control and Prevention, Wuhan, Hubei, 430200, People's Republic of China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Zhenyu He
- Institute of Environmental Health, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, 430024, People's Republic of China
| | - Yanjian Wan
- Institute of Environmental Health, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, 430024, People's Republic of China.
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45
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Sex-based differences in nuclear medicine imaging and therapy. Eur J Nucl Med Mol Imaging 2023; 50:971-974. [PMID: 36633615 DOI: 10.1007/s00259-023-06113-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 01/08/2023] [Indexed: 01/13/2023]
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46
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Yau E, Olivares-Morales A, Ogungbenro K, Aarons L, Gertz M. Investigation of simplified physiologically-based pharmacokinetic models in rat and human. CPT Pharmacometrics Syst Pharmacol 2023; 12:333-345. [PMID: 36754967 PMCID: PMC10014059 DOI: 10.1002/psp4.12911] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/03/2022] [Accepted: 12/12/2022] [Indexed: 02/10/2023] Open
Abstract
Whole-body physiologically-based pharmacokinetic (PBPK) models have many applications in drug research and development. It is often necessary to inform these models with animal or clinical data, updating model parameters, and making the model more predictive for future applications. This provides an opportunity and a challenge given the large number of parameters of such models. The aim of this work was to propose new mechanistic model structures with reduced complexity allowing for parameter optimization. These models were evaluated for their ability to estimate realistic values for unbound tissue to plasma partition coefficients (Kpu) and simulate observed pharmacokinetic (PK) data. Two approaches are presented: using either established kinetic lumping methods based on tissue time constants (drug-dependent) or a novel clustering analysis to identify tissues sharing common Kpu values or Kpu scalars based on similarities of tissue composition (drug-independent). PBPK models derived from these approaches were assessed using PK data of diazepam in rats and humans. Although the clustering analysis produced minor differences in tissue grouping depending on the method used, two larger groups of tissues emerged. One including the kidneys, liver, spleen, gut, heart, and lungs, and another including bone, brain, muscle, and pancreas whereas adipose and skin were generally considered distinct. Overall, a subdivision into four tissue groups appeared most physiologically relevant in terms of tissue composition. Several models were found to have similar abilities to describe diazepam i.v. data as empirical models. Comparability of estimated Kpus to experimental Kpu values for diazepam was one criterion for selecting the appropriate PK model structure.
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Affiliation(s)
- Estelle Yau
- Centre for Applied Pharmacokinetic Research (CAPKR), The University of Manchester, Manchester, UK.,Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland.,Sanofi R&D, DMPK France, Paris, France
| | - Andrés Olivares-Morales
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Kayode Ogungbenro
- Centre for Applied Pharmacokinetic Research (CAPKR), The University of Manchester, Manchester, UK
| | - Leon Aarons
- Centre for Applied Pharmacokinetic Research (CAPKR), The University of Manchester, Manchester, UK
| | - Michael Gertz
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
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47
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McCullum L, Shin J, Xing S, Beekman C, Schuemann J, Hong T, Duda D, Mohan R, Lin S, Correa-Alfonso CM, Domal S, Withrow J, Bolch W, Paganetti H, Grassberger C. Predicting Severity of Radiation Induced Lymphopenia in Individual Proton Therapy Patients for Varying Dose Rate and Fractionation Using Dynamic 4-Dimensional Blood Flow Simulations. Int J Radiat Oncol Biol Phys 2023:S0360-3016(23)00105-0. [PMID: 36739919 PMCID: PMC10363211 DOI: 10.1016/j.ijrobp.2023.01.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/11/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE Radiation-induced lymphopenia has gained attention recently as the result of its correlation with survival in a range of indications, particularly when combining radiation therapy (RT) with immunotherapy. The purpose of this study is to use a dynamic blood circulation model combined with observed lymphocyte depletion in patients to derive the in vivo radiosensitivity of circulating lymphocytes and study the effect of RT delivery parameters. METHODS AND MATERIALS We assembled a cohort of 17 patients with hepatocellular carcinoma treated with proton RT alone in 15 fractions (fx) using conventional dose rates (beam-on time [BOT], 120 seconds) for whom weekly absolute lymphocyte counts (ALCs) during RT and follow-up were available. We used HEDOS, a time-dependent, whole-body, blood flow computational framework, in combination with explicit liver blood flow modeling, to calculate the dose volume histograms for circulating lymphocytes for changing BOTs (1 second-300 seconds) and fractionations (5 fx, 15 fx). From this, we used the linear cell survival model and an exponential model to determine patient-specific lymphocyte radiation sensitivity, α, and recovery, σ, respectively. RESULTS The in vivo-derived patient-specific α had a median of 0.65 Gy-1 (range, 0.30-1.38). Decreasing BOT to 1 second led to an increased average end-of-treatment ALC of 27.5%, increasing to 60.3% when combined with the 5-fx regimen. Decreasing to 5 fx at the conventional dose rate led to an increase of 17.0% on average. The benefit of both increasing dose rate and reducing the number of fractions was patient specificࣧpatients with highly sensitive lymphocytes benefited most from decreasing BOT, whereas patients with slow lymphocyte recovery benefited most from the shorter fractionation regimen. CONCLUSIONS We observed that increasing dose rate at the same fractionation reduced ALC depletion more significantly than reducing the number of fractions. High-dose-rates led to an increased sparing of lymphocytes when shortening the fractionation regimen, particularly for patients with radiosensitive lymphocytes at elevated risk.
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Affiliation(s)
- Lucas McCullum
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
| | - Jungwook Shin
- Radiation Epidemiology Branch, National Cancer Institute, Rockville, Maryland
| | - Stella Xing
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Chris Beekman
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jan Schuemann
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Theodore Hong
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dan Duda
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Radhe Mohan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Camilo M Correa-Alfonso
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Sean Domal
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Julia Withrow
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Wesley Bolch
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Harald Paganetti
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Clemens Grassberger
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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48
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Vork KL, Brown JP, Carlisle JC. Evaluation and updates to the Leggett model for pharmacokinetic modeling of exposure to lead in the workplace - Part II adjustments to the adult exposure model, confirmation of Leggett+, and modeling of workplace exposure. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:55-83. [PMID: 36459063 DOI: 10.1080/15459624.2022.2150767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
California's Office of Environmental Health Hazard Assessment has updated the comprehensive age-specific model of lead metabolism in humans published by Richard W. Leggett in 1993. The updated model, called Leggett+, was introduced in a peer-reviewed report in 2013. The Leggett + model simulates the relationship between blood lead and exposure in the workplace. Leggett + includes a workplace exposure model comprising respiratory tract intake (workplace lead inhaled by a worker) and uptake (lead absorbed into the blood from the respiratory tract plus uptake from ambient air and diet). The latter is calculated as intake times an inhalation transfer coefficient plus background uptake. An adjusted adult systemic model describes the metabolism of the absorbed lead. This paper provides details about the workplace exposure and uptake elements of Leggett+, an updated approach to calibrating an inhalation transfer coefficient, confirmation of the model's performance in predicting blood lead levels from workplace studies, and predictions of blood lead levels from simulated exposures to workplace airborne lead over a working lifetime. Blood lead relative to airborne lead concentrations in a standard workplace scenario predicted by Leggett + was similar to corresponding relationships from four published workplace studies. Leggett + predictions displayed a good fit to regression equations when other key factors were considered such as pre-employment blood lead and ongoing background intake of lead, workplace air concentration, lead aerosol characteristics, and worker activity levels. The comprehensive Leggett + model can simulate plausible workplace air-blood lead relationships from a broad range of worker exposures. The inhalation transfer coefficient of 0.30, derived from empirical data described in the 2013 report has been reexamined. The original estimate continues to represent a plausible mid-point for a coefficient derived from an expanded range of theoretical particle size distributions deposited in the upper and lower regions of the respiratory tract considering intake during sedentary and outdoor activity breathing scenarios. This coefficient is slightly lower than the value of 0.35 estimated for unknown forms of lead by Leggett in 1993.
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Affiliation(s)
- Kathleen L Vork
- Air and Site Assessment and Climate Indicators Branch, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California
| | - Joseph P Brown
- Division of Scientific Programs, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California
| | - James C Carlisle
- Air and Site Assessment and Climate Indicators Branch, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Sacramento, California
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49
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Sun Y, Huang C, Jiang Y, Wan Y. Urinary concentrations of fungicide carbendazim's metabolite and associations with oxidative stress biomarkers in young children. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:18408-18418. [PMID: 36215016 DOI: 10.1007/s11356-022-23311-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Carbendazim (CBDZ) is the most widely used fungicide in China. It is ubiquitous in environment and can induce oxidative stress in mammals, while data on occurrence of its metabolite in human urine are scarce, and the relationship between CBDZ and oxidative stress biomarkers (OSBs) in young children has not been examined. The aim of this study was to measure the concentrations of methyl 5-hydroxy-2-benzimidazolecarbamate (5-HBC, the main metabolite of CBDZ in urine) in 390 urine samples collected from 130 healthy young (< 6.6 years old) children from Shenzhen and Wuhan, in south and central China, respectively, and to evaluate the associations of 5-HBC with three selected OSBs (4-HNEMA, 8-OHG, and 8-OHdG, for lipid, RNA, and DNA, respectively). 5-HBC was found in 99.2% of the urine samples at concentrations ranging from below the method detection limit (< 0.005 ng/mL) to 10.9 ng/mL (median: 0.11 ng/mL). Moderate inter-day reproducibility was found for specific gravity-adjusted 5-HBC concentrations (intraclass correlation coefficient: 0.50). The urinary 5-HBC concentrations were significantly and positively associated with 4-HNEMA (p < 0.01). An interquartile range increase in urinary 5-HBC concentrations was associated with a 42.1% increase in 4-HNEMA, which implied that CBDZ exposure might be associated with lipid peroxidation in young children without occupational exposure. As far as we know, this pilot study is the first to report urinary 5-HBC and its associations with OSBs in children.
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Affiliation(s)
- Yanfeng Sun
- Wuhan Centers for Disease Control and Prevention, Institute of Environmental Health, Wuhan, Hubei, 430024, People's Republic of China
| | - Changgang Huang
- Wuhan Centers for Disease Control and Prevention, Institute of Environmental Health, Wuhan, Hubei, 430024, People's Republic of China
| | - Ying Jiang
- Nanshan District Centers for Disease Control and Prevention, Shenzhen, Guangdong, 518054, People's Republic of China
| | - Yanjian Wan
- Wuhan Centers for Disease Control and Prevention, Institute of Environmental Health, Wuhan, Hubei, 430024, People's Republic of China.
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50
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Peters SMB, Mink MCT, Privé BM, de Bakker M, de Lange F, Muselaers CHJ, Mehra N, Witjes JA, Gotthardt M, Nagarajah J, Konijnenberg MW. Optimization of the radiation dosimetry protocol in Lutetium-177-PSMA therapy: toward clinical implementation. EJNMMI Res 2023; 13:6. [PMID: 36692682 PMCID: PMC9873880 DOI: 10.1186/s13550-023-00952-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Dosimetry in [177Lu]Lu-PSMA therapy is a valuable tool to assess treatment efficacy and toxicity. This study aims to develop a clinically implementable protocol to determine the absorbed dose in organs and tumor lesions after [177Lu]Lu-PSMA-617 therapy, by reducing the imaging time points and utilizing population-based kinetics with a single scan, with evaluation of its influence on the uncertainty in absorbed dose. METHODS Ten patients with metastatic hormone-sensitive prostate cancer received two cycles of [177Lu]Lu-PSMA-617. Post-treatment imaging was performed at 1 h, 24 h, 48 h, 72 h and 168 h, consisting of three-bed positions SPECT/CT and a whole-body planar scan. Five-time point SPECT dosimetry was performed for lesions and organs with physiological uptake (kidneys, liver and salivary glands) and used as the reference standard. Absorbed dose values for various simplified protocols were compared to the reference standard. RESULTS Accurate lesion dosimetry is possible using one-time point SPECT imaging at 168 h, with an increase in uncertainty (20% vs. 14% for the reference standard). By including a second time point, uncertainty was comparable to the reference standard (13%). Organ dosimetry can be performed using a single SPECT at 24 h or 48 h. Dosimetry based on planar scans did not provide accurate dose estimations. CONCLUSION Accurate lesion dosimetry in [177Lu]Lu-PSMA therapy can be performed using a one- or two-time point protocol, making dosimetry assessments more suitable for routine clinical implementation, although dosimetry based om multiple time points is more accurate. Clinical trial registration This study was approved by the Medical Review Ethics Committee Region Arnhem-Nijmegen on January 23, 2018 and was registered on clinicaltrials.gov (NCT03828838).
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Affiliation(s)
- Steffie M B Peters
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Maaike C T Mink
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Department of Physics and Astronomy, Radboud University, Nijmegen, The Netherlands
| | - Bastiaan M Privé
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Maarten de Bakker
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Frank de Lange
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | | | - Niven Mehra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Alfred Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martin Gotthardt
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - James Nagarajah
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Mark W Konijnenberg
- Department of Medical Imaging, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
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