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Signore A, Bentivoglio V, Varani M, Lauri C. Current Status of SPECT Radiopharmaceuticals for Specific Bacteria Imaging. Semin Nucl Med 2023; 53:142-151. [PMID: 36609002 DOI: 10.1053/j.semnuclmed.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Imaging infection still represents a challenge for researchers. Despite nuclear medicine (NM) offers valuable tools able to discriminate between infections and inflammation, there is an unmet clinical need to develop new strategies able to specifically target the causative pathogen, to select the best antimicrobial treatment for each patient and to accurately assess therapeutic efficacy. These aspects are commonly addressed by microbiology or histology but the diagnosis often relies on invasive procedures that are prone to contamination or sample bias and do not reflect the spatial heterogeneity of the infective process. Therefore, in the era of personalized medicine and treatment, a lot of efforts are in play to improve a personalized diagnosis. Molecular imaging is an ideal candidate for this purpose and, indeed, research is going fast to this direction aiming to find more selective and proper antimicrobial treatments and to overcome broad-spectrum antibiotic use, which still represents the major cause of bacterial drug-resistance. Several approaches for specifically image bacteria have been proposed and provided encouraging perspectives in preclinical studies. Nevertheless, the majority of these promising approaches are still confined in "bench stages" and crucial issues still need to be addressed before their translation in clinical practice. This review will focus on radiolabeled antibiotics for SPECT imaging of bacteria, their mechanisms of action, their potentiality and limitations for "bed-side" applications.
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Affiliation(s)
- Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Italy.
| | - Valeria Bentivoglio
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Italy
| | - Michela Varani
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Italy
| | - Chiara Lauri
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Italy
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Naqvi SAR. 99m Tc-labeled antibiotics for infection diagnosis: Mechanism, action, and progress. Chem Biol Drug Des 2021; 99:56-74. [PMID: 34265177 DOI: 10.1111/cbdd.13923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/08/2021] [Accepted: 06/06/2021] [Indexed: 01/01/2023]
Abstract
Discovery of penicillin marked a turning point in the history of infection therapy which also led to the emergence of bacterial resistance. It is now 100 years to fight with ever-muted variants of pathogens by developing more and more antibiotics. Since 1987 to todate, no successful class of antibiotic was introduced; this three decade period is known as "the discovery void" period. While, the clinically approved antibiotics are gradually dying in front of bacterial resistance due to which bacterial infections are appearing leading cause of death and disability. Nuclear medicine imaging technique is the strongest modality to diagnose and follow-up of deep-seated and complicated infections. However, the selection of radiolabeled antimicrobial agents plays critical role in gaining sensitivity and specificity of the imaging results. This review comprises of two main sections; first section explains antibiotic targets, and second section explains the imaging efficacy of 99m Tc-labeled antimicrobial agents against bacterial infection along with the emphasis on progress and update of 99m Tc-labeled antibiotics as infection imaging probes. The review, in conclusion, could be an acceleration for radiopharmaceutical chemists for designing and developing 99m Tc-labeled antimicrobial agents to improve infection imaging quality.
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Affiliation(s)
- Syed Ali Raza Naqvi
- Department of Chemistry, Government College University, Faisalabad, Pakistan
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Abstract
Infection is ubiquitous. However, its management is challenging for both the patients and the health-care providers. Scintigraphic imaging of infection dates back nearly half a century. The advances in our understanding of the pathophysiology of disease at cellular and molecular levels have paved the way to the development of a large number of radiopharmaceuticals for scintigraphic imaging of infection. These include radiolabeling of blood elements such as serum proteins, white blood cells (WBCs), and cytokines, to name a few. Infectious foci have also been imaged using a radiolabeled sugar molecule by taking advantage of increased metabolic activity in the infectious lesions. Literature over the years has well documented that none of the radiopharmaceuticals and associated procedures that facilitate imaging infection are flawless and acceptable without a compromise. As a result, only a few compounds such as 99mTc-hexamethylpropyleneamineoxime, 18F-FDG, the oldest but still considered as a gold standard 111In-oxine, and, yes, even 67Ga-citrate in some countries, have remained in routine clinical practice. Nonetheless, the interest of scientists and physicians to improve the approaches to imaging and to the management of infection is noteworthy. These approaches have paved the way for the development of numerous, innovative radiopharmaceuticals to label autologous WBCs ex vivo or even those that could be injected directly to image infection or inflammation without direct involvement of WBCs. In this review, we briefly describe these agents with their pros and cons and place them together for future reference.
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Affiliation(s)
- Ebru Salmanoglu
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107; Department of Nuclear Medicine, Kahramanmaras Sutcu Imam University Faculty of Medicine, Avsar Kampus, Kahramanmaras 46040, Turkey
| | - Sung Kim
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
| | - Mathew L Thakur
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107; Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107.
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Dutta J, Naicker T, Ebenhan T, Kruger HG, Arvidsson PI, Govender T. Synthetic approaches to radiochemical probes for imaging of bacterial infections. Eur J Med Chem 2017; 133:287-308. [DOI: 10.1016/j.ejmech.2017.03.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 02/08/2023]
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Auletta S, Galli F, Lauri C, Martinelli D, Santino I, Signore A. Imaging bacteria with radiolabelled quinolones, cephalosporins and siderophores for imaging infection: a systematic review. Clin Transl Imaging 2016; 4:229-252. [PMID: 27512687 PMCID: PMC4960278 DOI: 10.1007/s40336-016-0185-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 05/17/2016] [Indexed: 12/20/2022]
Abstract
Bacterial infections are still one of the main causes of patient morbidity and mortality worldwide. Nowadays, many imaging techniques, like computed tomography or magnetic resonance imaging, are used to identify inflammatory processes, but, although they recognize anatomical modifications, they cannot easily distinguish bacterial infective foci from non bacterial infections. In nuclear medicine, many efforts have been made to develop specific radiopharmaceuticals to discriminate infection from sterile inflammation. Several compounds (antimicrobial peptides, leukocytes, cytokines, antibiotics…) have been radiolabelled and tested in vitro and in vivo, but none proved to be highly specific for bacteria. Indeed factors, including the number and strain of bacteria, the infection site, and the host condition may affect the specificity of tested radiopharmaceuticals. Ciprofloxacin has been proposed and intensively studied because of its easy radiolabelling method, broad spectrum, and low cost, but at the same time it presents some problems such as low stability or the risk of antibiotic resistance. Therefore, in the present review studies with ciprofloxacin and other radiolabelled antibiotics as possible substitutes of ciprofloxacin are reported. Among them we can distinguish different classes, such as cephalosporins, fluoroquinolones, inhibitors of nucleic acid synthesis, inhibitors of bacterial cell wall synthesis and inhibitors of protein synthesis; then also others, like siderophores or maltodextrin-based probes, have been discussed as bacterial infection imaging agents. A systematic analysis was performed to report the main characteristics and differences of each antibiotic to provide an overview about the state of the art of imaging infection with radiolabelled antibiotics.
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Affiliation(s)
- S. Auletta
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - F. Galli
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - C. Lauri
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - D. Martinelli
- Microbiology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - I. Santino
- Microbiology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
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Bunschoten A, Welling MM, Termaat MF, Sathekge M, van Leeuwen FWB. Development and Prospects of Dedicated Tracers for the Molecular Imaging of Bacterial Infections. Bioconjug Chem 2013; 24:1971-89. [DOI: 10.1021/bc4003037] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- A. Bunschoten
- Department
of Radiology, Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands
| | - M. M. Welling
- Department
of Radiology, Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands
| | - M. F. Termaat
- Department
of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - M. Sathekge
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - F. W. B. van Leeuwen
- Department
of Radiology, Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands
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Chattopadhyay S, Ghosh M, Sett S, Das MK, Chandra S, De K, Mishra M, Sinha S, Ranjan Sarkar B, Ganguly S. Preparation and evaluation of 99mTc-cefuroxime, a potential infection specific imaging agent: A reliable thin layer chromatographic system to delineate impurities from the 99mTc-antibiotic. Appl Radiat Isot 2012; 70:2384-7. [DOI: 10.1016/j.apradiso.2012.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 05/16/2012] [Accepted: 06/07/2012] [Indexed: 12/01/2022]
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El-Azony KM, El-Mohty AA, Seddik U, Khater SI. Radioiodination and bioevaluation of nitrofurantoin for urinary tract imaging. J Labelled Comp Radiopharm 2012. [DOI: 10.1002/jlcr.2942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- K. M. El-Azony
- Radioactive Isotopes and Generators Department; Hot Labs. Centre; B.O. 13759; Cairo; Egypt
| | - A. A. El-Mohty
- Radioactive Isotopes and Generators Department; Hot Labs. Centre; B.O. 13759; Cairo; Egypt
| | - U. Seddik
- Cyclotron Project; Nuclear Research Centre; B.O. 13759; Cairo; Egypt
| | - S. I. Khater
- Cyclotron Project; Nuclear Research Centre; B.O. 13759; Cairo; Egypt
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Shah SQ, Khan MR. Radiosynthesis and biodistribution of the 99mTc-trovafloxacin complex as a potential methicillin resistant Staphylococcus aureus infection radiotracer. J Radioanal Nucl Chem 2011. [DOI: 10.1007/s10967-011-0991-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Shah SQ, Khan MR. Synthesis of 99mTcV ≡ N-Pazufloxacin dithiocarbamate complex and biological evaluation in Wister rats artificially infected with Escherichia coli. J Radioanal Nucl Chem 2011; 288:511-6. [DOI: 10.1007/s10967-010-0954-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shah SQ, Khan MR. Synthesis of techentium-99m labeled clinafloxacin (99mTc–CNN) complex and biological evaluation as a potential Staphylococcus aureus infection imaging agent. J Radioanal Nucl Chem 2011. [DOI: 10.1007/s10967-010-0937-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shah SQ, Khan MR. Radiosynthesis and biodistribution of 99mTc-tricarbonyl complex of temafloxacin dithiocarbamate: a potential Streptococci pneumoniae infection radiotracer. J Radioanal Nucl Chem 2011; 288:411-6. [DOI: 10.1007/s10967-010-0936-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shah SQ, Khan MR. 99mTc(CO)3-tosufloxacin dithiocarbamate complexation and radiobiological evaluation in male Wister rat model. J Radioanal Nucl Chem 2011; 288:485-90. [DOI: 10.1007/s10967-010-0943-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Shah SQ, Khan MR. Radiocharacterization of the 99mTc–rufloxacin complex and biological evaluation in Staphylococcus aureus infected rat model. J Radioanal Nucl Chem 2010. [DOI: 10.1007/s10967-010-0923-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Shah SQ, Khan MR. Synthesis of the 99mTc(CO)3–trovafloxacin dithiocarbamate complex and biological characterization in artificially methicillin-resistant Staphylococcus aureus infected rats model. J Radioanal Nucl Chem 2011; 288:297-302. [DOI: 10.1007/s10967-010-0914-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Shah SQ, Khan MR. Evaluation of 99mTcN–moxifloxacin dithiocarbamate, as a potential radiopharmaceutical for scintigraphic localization of infectious foci. J Radioanal Nucl Chem 2011; 288:357-62. [DOI: 10.1007/s10967-010-0918-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shah SQ, Khan MR. Radiolabeling of gemifloxacin with technetium-99m and biological evaluation in artificially Streptococcus pneumoniae infected rats. J Radioanal Nucl Chem 2010. [DOI: 10.1007/s10967-010-0916-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shah SQ, Khan MR. Radiocomplexation and biological characterization of the 99mTcN-trovafloxacin dithiocarbamate: a novel methicillin-resistant Staphylococcus aureus infection imaging agent. J Radioanal Nucl Chem 2010. [DOI: 10.1007/s10967-010-0903-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Shah SQ, Khan AU, Khan MR. Synthesis, biological evaluation and biodistribution of the 99mTc–Garenoxacin complex in artificially infected rats. J Radioanal Nucl Chem 2011; 288:207-13. [DOI: 10.1007/s10967-010-0896-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Shah SQ, Khan AU, Khan MR. Radiosynthesis and biodistribution of 99mTcN–Garenoxacin dithiocarbamate complex a potential infection imaging agent. J Radioanal Nucl Chem 2010. [DOI: 10.1007/s10967-010-0871-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Shah SQ, Khan AU, Khan MR. Radiosynthesis and biological evaluation of 99mTcN-sitafloxacin dithiocarbamate as a potential radiotracer for Staphylococcus aureus infection. J Radioanal Nucl Chem 2011; 287:827-32. [DOI: 10.1007/s10967-010-0833-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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