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Zhao Y, Culman J, Cascorbi I, Nithack N, Marx M, Zuhayra M, Lützen U. PSMA-617 inhibits proliferation and potentiates the 177Lu-PSMA-617-induced death of human prostate cancer cells. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:3315-3326. [PMID: 37284895 PMCID: PMC10567812 DOI: 10.1007/s00210-023-02539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/17/2023] [Indexed: 06/08/2023]
Abstract
The human prostate-specific membrane antigen (PSMA) is substantially up-regulated in metastatic prostate cancer (PCa) cells. PSMA can be targeted by 177Lu conjugated to PSMA-617, a high-affinity ligand for the PSMA. The binding of the radioligand, 177Lu-PSMA-617, results in its internalisation and delivery of β-radiation into the cancer cells. However, PSMA-617, a component of the final product in the synthesis of the radioligand, may also play a role in the pathophysiology of PCa cells. The present study aimed to clarify the effects of PSMA-617 (10, 50 and 100 nM) on the expression of PSMA in PSMA-positive LNCaP cells, their proliferation, 177Lu-PSMA-617-induced cell death by WST-1 and lactate dehydrogenase assays, immunohistochemistry, western blotting, immunofluorescence staining and uptake of 177Lu-PSMA-617. PSMA-617 at 100 nM concentration induced cell-growth arrest, down-regulated cyclin D1 and cyclin E1 (by 43 and 36%, respectively) and up-regulated the cyclin-dependent kinase inhibitor p21Waf1/Cip1 (by 48%). Immunofluorescence staining demonstrated reduced content of DNA, pointing to a lower rate of cell division. PSMA-617 (up to 100 nM) did not alter the uptake of 177Lu-PSMA-617 into the LNCaP cells. Interestingly, simultaneous treatment with 177Lu-PSMA-617 and PSMA-617 for 24 and 48 h substantially potentiated the cell-death promoting effects of the radioligand. In conclusion, the combination of impeding tumour cell proliferation by PSMA-617 and its potentiation of the radiation-induced cell death brought about by 177Lu-PSMA-617 in PCa cells may considerably improve the outcome of the radiation therapy with 177Lu-PSMA-617, especially in patients with decreased radiosensitivity of PCa cells to the radioligand.
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Affiliation(s)
- Yi Zhao
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - Juraj Culman
- Institute of Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ingolf Cascorbi
- Institute of Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Niklas Nithack
- Central Rhine Community Hospital-Clinic for Urology and Pediatric Urology, Koblenz, Germany
| | - Marlies Marx
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Maaz Zuhayra
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulf Lützen
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Zuhayra M, Lützen A, Ruiz MA. X-ray-determined structure of the technetium complex [Tc 2(μ-CO) 2(NC 5H 5) 2(CO) 6] revisited: [Tc 2(μ-OMe) 2(NC 5H 5) 2(CO) 6] as the correct formulation. Acta Crystallogr C Struct Chem 2023; 79:395-398. [PMID: 37725081 PMCID: PMC10551881 DOI: 10.1107/s2053229623007957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023] Open
Abstract
Some of us reported previously the structure of di-μ-carbonyl-bis[tricarbonyl(pyridine)technetium], [Tc2(μ-CO)2(C5H5N)2(CO)6], as the main product of the reaction of [Tc2(CO)10] with pyridine at room temperature, using the reagent itself as solvent [Zuhayra et al. (2008). Inorg. Chem. 47, 10177-10182]. On the basis of an X-ray analysis of the product, a molecular structure was proposed with two bridging carbonyls displaying very unusual geometrical features, not explained at the time. Subsequent chemical considerations, coupled with density functional theory (DFT) calculations, prompted us to revise the original structure determination. Using the original raw diffraction data, we have now performed new refinements to show that the previously proposed `bridging carbonyls' actually correspond to bridging methoxide groups, and that the crystals analyzed at the time therefore would correspond to the complex di-μ-methoxido-bis[tricarbonyl(pyridine)technetium], syn-[Tc2(μ-OMe)2(NC5H5)2(CO)6]. This methoxide-bridged complex likely was a minor side product formed along with the main product in the above reaction, perhaps due to the presence of trace amounts of methanol and air in the reaction mixture.
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Affiliation(s)
- Maaz Zuhayra
- Klinik für Nuklearmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 9, D-24105 Kiel, Germany
| | - Arne Lützen
- Kekulé-Institut für Organische Chemie and Biochemie, Universität Bonn, Gerhard-Domagk-Strasse 1, D-53121 Bonn, Germany
| | - Miguel A. Ruiz
- Departamento de Química Orgánica e Inorgánica/IUQOEM, Universidad de Oviedo, E-33071 Oviedo, Spain
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Assam I, Dierck SP, Zhao Y, Jüptner M, Siebert FA, Zuhayra M, Lützen U. Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy. J Appl Clin Med Phys 2023:e14077. [PMID: 37357570 PMCID: PMC10402664 DOI: 10.1002/acm2.14077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 05/23/2023] [Accepted: 06/07/2023] [Indexed: 06/27/2023] Open
Abstract
INTRODUCTION Performing lymphoscintigraphy in a separate room, frees up the conventional gamma camera, coupled with the desire to directly localize sentinel lymph nodes (SLN) in the operating theatre has led to the development of high-resolution semiconductor-detector based handheld gamma-cameras, CrystalCam. METHODS This work consists of phantom and clinical studies. For the first part, a Jaszczak phantom with hollow spheres of various volumes were filled with the 99m Tc and the camera's sensitivity was measured at various distances to assess the possibilities and limitations of the device. The clinical study evaluates the effectiveness of CrystalCam in localizing SLN in 40 consecutive malignant melanoma patients compared to both conventional planar lymphoscintigraphy and hybrid SPECT/CT. SLNs detected by planar lymphoscintigraphy were marked on the patients' skin using a UV-marker. CrystalCam images were acquired in another room by another examiner and the SLNs were marked with a felt pen. The detected nodes by both camera systems were evaluated using UV-lamp and normal light to visualize the UV- and felt pen marks respectively. The concordance rate of the SLNs and higher-echelon nodes localized by both planar scintigraphy and CrystalCam imaging with respect to the total SLNs and higher-echelon nodes detected by SPECT/CT imaging are compared and statistically analyzed. RESULTS The results of the phantom study show a good correlation between activity and count-rates for all distancesSPECT/CT, CrystalCamm, and planar lymphoscintigraphy detected 69, 58, and 61 SLNs respectively. The concordance rate of 95.65% by the CrystalCam and planar scintigraphy implies both cameras are statistically coequal in preoperative SLN detection of malignant melanoma. For the higher-echelon nodes, SPECT/CT, planar and CrystalCam imaging systems identified 82, 48, and 13 respectively; thus, CrystalCam was statistically inferior to planar imaging. CONCLUSION The handheld CrystalCam is a reliable instrument for localizing SLNs in surgical centers without an on-site nuclear medicine department.
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Affiliation(s)
- Isong Assam
- Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Offenburg, Germany
| | - Simon P Dierck
- UKSH, Campus Kiel, Clinic of Anesthesiology and Operative Medicine, Kiel, Germany
| | - Yi Zhao
- UKSH, Campus Kiel, Clinic of Nuclear Medicine, Molecular Imaging and Therapy, Kiel, Germany
| | - Michael Jüptner
- UKSH, Campus Kiel, Clinic of Nuclear Medicine, Molecular Imaging and Therapy, Kiel, Germany
| | | | - Maaz Zuhayra
- UKSH, Campus Kiel, Clinic of Nuclear Medicine, Molecular Imaging and Therapy, Kiel, Germany
| | - Ulf Lützen
- UKSH, Campus Kiel, Clinic of Nuclear Medicine, Molecular Imaging and Therapy, Kiel, Germany
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Anikeeva M, Sangal M, Speck O, Norquay G, Zuhayra M, Lützen U, Peters J, Jansen O, Hövener JB. Nichtinvasive funktionelle Lungenbildgebung mit hyperpolarisiertem Xenon. Z Pneumologie 2022. [PMCID: PMC9387426 DOI: 10.1007/s10405-022-00462-0] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hintergrund Die Magnetresonanztomographie (MRT) ist ein nichtinvasives Verfahren mit hervorragendem Weichteilkontrast. Aufgrund der geringen Protonendichte und vielen Luft-Gewebe-Übergängen ist die Anwendung in der Lunge jedoch eingeschränkt, so dass hier häufig röntgenbasierte Methoden eingesetzt werden (mit den bekannten Nachteilen ionisierender Strahlung). Fragestellung In dieser Übersichtsarbeit wird die Lungen-MRT mit hyperpolarisiertem Xenon-129 (Xe-MRT) dargestellt. Die Xe-MRT erlaubt einzigartige wertvolle Einblicke in die Mikrostruktur und Funktion der Lunge, einschließlich des Gasaustauschs mit roten Blutkörperchen – Parameter, die mit klinischen Standardmethoden nicht zugänglich sind. Material und Methoden Durch die magnetische Markierung, die Hyperpolarisierung, wird das Signal von Xenon-129 um bis zu 100.000-fach verstärkt. Hierbei werden die Elektronen von Rubidium mittels Laserlicht zunächst auf 100 % polarisiert und dann durch Stöße auf Xenon übertragen. Danach wird das hyperpolarisierte Gas in einem Beutel zum Patienten gebracht und eingeatmet, kurz bevor die MRT-Aufnahmen beginnen. Ergebnisse Durch spezielle Programmierungen (Sequenzen) in der MRT kann die Ventilation, Mikrostruktur oder der Gasaustausch der Lunge in 3‑D dargestellt werden. Dies ermöglicht z. B. die quantitative Darstellung von Belüftungsdefekten, der Größe der Alveolen, der Gasaufnahme im Gewebe und des Gastransfers ins Blut. Schlussfolgerung Die Xe-MRT liefert einzigartige Informationen über den Zustand der Lunge – nichtinvasiv, in vivo und in weniger als einer Minute.
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Affiliation(s)
- Mariia Anikeeva
- Sektion Biomedizinische Bildgebung, Molecular Imaging North Competence Center (MOIN CC), Klinik für Radiologie und Neuroradiologie, Universtätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Am Botanischen Garten 14, 24118 Kiel, Deutschland
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Maitreyi Sangal
- Abteilung Biomedizinische Magnetresonanz, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Oliver Speck
- Abteilung Biomedizinische Magnetresonanz, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Graham Norquay
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, Großbritannien
| | - Maaz Zuhayra
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Ulf Lützen
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Josh Peters
- Sektion Biomedizinische Bildgebung, Molecular Imaging North Competence Center (MOIN CC), Klinik für Radiologie und Neuroradiologie, Universtätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Am Botanischen Garten 14, 24118 Kiel, Deutschland
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Olav Jansen
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Jan-Bernd Hövener
- Sektion Biomedizinische Bildgebung, Molecular Imaging North Competence Center (MOIN CC), Klinik für Radiologie und Neuroradiologie, Universtätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Am Botanischen Garten 14, 24118 Kiel, Deutschland
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
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Alfteimi A, Lützen U, Helm A, Jüptner M, Marx M, Zhao Y, Zuhayra M. Automated synthesis of [ 68Ga]Ga-FAPI-46 without pre-purification of the generator eluate on three common synthesis modules and two generator types. EJNMMI Radiopharm Chem 2022; 7:20. [PMID: 35904684 PMCID: PMC9338183 DOI: 10.1186/s41181-022-00172-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background The recent development of quinoline-based radiotracers, which act as fibroblast activation protein inhibitors (FAPIs), has shown promising preclinical and clinical advantages. [68Ga]Ga-FAPI-46 is a new radiotracer for in vivo detection of the fibroblast activation protein by positron emission tomography (PET). Recently, the automated synthesis of [68Ga]Ga-FAPI-46 was reported based on pre-concentration and purification of the generator eluate by using a cation exchange-cartridge. Our aim was to simplify the synthesis and shorten the automated synthesis of [68Ga]Ga-FAPI-46 to make it accessible and thus even more attractive to a broader clinical and scientific community. Results We developed and evaluated the GMP compliant automatic synthesis of [68Ga]Ga-FAPI-46 using two different 68Ge/68Ga generators (an Eckert & Ziegler, GalliaPharm generator, 1.85 GBq/50 mCi and an iThemba generator, 1.85 GBq/50 mCi) Somerset West, South Africa) and three different commercial and customized systems: the EasyOne module from Trasis; the GaSy module from Synthra with a customized synthesis template and a customized single use cassette. Additionally, the automatic synthesis of [68Ga]Ga-FAPI-46 was established on a GallElut synthesis module from Scintomics with fixed tubing. Conclusions Independent of the synthesis modules or the generators employed we were able to complete the synthesis of [68Ga]Ga-FAPI-46 in 12 min including the process of purification and formulation. In all cases, the final products showed more than 99.5% chemical purity and the radiochemical yield reached around 92.5% (decay corrected). All quality control parameters (e.g. sterility, stability and radiochemical purity) were conform to the European Pharmacopoeia.
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Affiliation(s)
- Ammar Alfteimi
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Karl Lennert Cancer Center North, Feld-Str. 21 (Haus L), 24105, Kiel, Germany
| | - Ulf Lützen
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Karl Lennert Cancer Center North, Feld-Str. 21 (Haus L), 24105, Kiel, Germany
| | - Alexander Helm
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Karl Lennert Cancer Center North, Feld-Str. 21 (Haus L), 24105, Kiel, Germany
| | - Michael Jüptner
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Karl Lennert Cancer Center North, Feld-Str. 21 (Haus L), 24105, Kiel, Germany
| | - Marlies Marx
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Karl Lennert Cancer Center North, Feld-Str. 21 (Haus L), 24105, Kiel, Germany
| | - Yi Zhao
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Karl Lennert Cancer Center North, Feld-Str. 21 (Haus L), 24105, Kiel, Germany
| | - Maaz Zuhayra
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Karl Lennert Cancer Center North, Feld-Str. 21 (Haus L), 24105, Kiel, Germany.
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Wrenger R, Jüptner M, Marx M, Zhao Y, Zuhayra M, Caliebe A, Osmonov D, Lützen U. Pre- and intratherapeutic predictors of overall survival in patients with advanced metastasized castration-resistant prostate cancer receiving Lu-177-PSMA-617 radioligand therapy. BMC Urol 2022; 22:96. [PMID: 35788220 PMCID: PMC9254582 DOI: 10.1186/s12894-022-01050-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systemic Lutetium-177 prostate-specific membrane antigen-617 radioligand therapy (Lu-177-PSMA-617-RLT) is a novel treatment approach in patients suffering from metastasized castration-resistant prostate cancer. Nonetheless, a therapeutic response may fail to appear in a proportion of patients. This study aims to identify routinely obtainable pre- and intratherapeutic parameters to allow a prediction of overall survival in patients receiving Lu-177-PSMA-617 radioligand therapy. METHODS Between January 2015 and December 2020 52 patients treated with a total of 146 cycles Lu-177-PSMA-617-RLT were retrospectively analysed in a single-center trial. The median overall survival time (OS) was compared to pre-therapeutic serological parameters, the extend of metastatic spread and previously performed therapies using Kaplan-Meier estimators and multivariate Cox-regression. Bonferroni-Holm correction was performed on all statistical tests. RESULTS The median OS of all patients was 55.6 weeks. Multivariate Cox-regression revealed significant lower survival for decreased pretherapeutic hemoglobin levels (HR 0.698 per g/dl; 95%-CI 0.560-0.872; p = 0.001), increased lactate dehydrogenase (LDH) levels (HR 1.073 per 25 U/l; 95%-CI 1.024-1.125; p = 0.003) and the presence of hepatic metastasis (HR 6.981; 95%-CI 2.583-18.863; p < 0.001). Increased pretherapeutic c-reactive protein (CRP), alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) levels were also associated with a shorter survival. A prostate-specific antigen decline after one therapy cycle did not significantly correlate with an increased survival. No significant relations were observed between overall survival time and other serological parameters or previously performed therapies. CONCLUSION Pre-therapeutic hemoglobin and LDH levels, as well as the presence of hepatic metastasis are independent predictors of overall survival in patients receiving Lu-177-PSMA-617-RLT. CRP, ALP and GGT levels cloud be utilized as additional decision aids when a Lu-177-PSMA-617-RLT is intended. Trial Registration Not applicable (retrospective observational study).
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Affiliation(s)
- Robin Wrenger
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
| | - Michael Jüptner
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
| | - Marlies Marx
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
| | - Yi Zhao
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
| | - Maaz Zuhayra
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
| | - Amke Caliebe
- Institute of Medical Informatics and Statistics, Kiel University and University Hospital of Schleswig-Holstein (UKSH), Kiel, Germany
| | - Daniar Osmonov
- Department of Urology and Pediatric Urology, University Hospital of Schleswig-Holstein (UKSH), Kiel, Germany
| | - Ulf Lützen
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany.
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Anikeeva M, Sangal M, Speck O, Norquay G, Zuhayra M, Lützen U, Peters J, Jansen O, Hövener JB. Nichtinvasive funktionelle Lungenbildgebung mit hyperpolarisiertem Xenon. Radiologe 2022; 62:475-485. [PMID: 35403905 PMCID: PMC8996207 DOI: 10.1007/s00117-022-00993-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Mariia Anikeeva
- Sektion Biomedizinische Bildgebung, Molecular Imaging North Competence Center (MOIN CC), Klinik für Radiologie und Neuroradiologie, Universtätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Am Botanischen Garten 14, 24118, Kiel, Deutschland.
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland.
| | - Maitreyi Sangal
- Abteilung Biomedizinische Magnetresonanz, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Oliver Speck
- Abteilung Biomedizinische Magnetresonanz, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Graham Norquay
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, Großbritannien
| | - Maaz Zuhayra
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Ulf Lützen
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Josh Peters
- Sektion Biomedizinische Bildgebung, Molecular Imaging North Competence Center (MOIN CC), Klinik für Radiologie und Neuroradiologie, Universtätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Am Botanischen Garten 14, 24118, Kiel, Deutschland
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Olav Jansen
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland
| | - Jan-Bernd Hövener
- Sektion Biomedizinische Bildgebung, Molecular Imaging North Competence Center (MOIN CC), Klinik für Radiologie und Neuroradiologie, Universtätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Am Botanischen Garten 14, 24118, Kiel, Deutschland.
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland.
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Zuhayra M, Helm A, Ranjan J, Jüptner M, Zhao Y, Marx M, Assam I, Alfteimi A, Lützen U. A simple, reliable and accurate approach for assessing [ 131I]-capsule activity leading to significant reduction of radiation exposure of medical staff during radioiodine therapy. Phys Med 2022; 96:157-165. [PMID: 35306454 DOI: 10.1016/j.ejmp.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE According to German law, the [131I]-capsule activity has to be checked in the context of radioiodine therapy (RIT) immediately before application. The measurement leads to significant radiation exposure of the medical personnel, especially of their hands. We aimed to establish a method for estimating [131I]-capsule activity by measuring the dose rate (DR) at contact of the delivered lead closed container carrying the [131I]-capsules and to evaluate radiation exposure in comparison to conventional [131I]-capsule measurement using a dose calibrator. METHODS DR on the surface of the closed lead container was measured at two locations and correlated linearly with the [131I]-capsule activity measured in a dose calibrator to create calibrating curves. The hand and whole body (effective) doses were determined with official dose meters during validation of our method in clinical practice. RESULTS The determination coefficients (R2) of linear calibration curves were greater than 0.9974. The total relative uncertainty for estimating [131I]-capsule activity with our method was <±7.5% which is lower than the uncertainty of the nominal activity and quite close to the threshold limit for the maximum allowed uncertainty of ± 5% for measuring activity in radioactive drugs. The reduction of the hand dose caused by our method was 97% compared with the conventional measurements of the [131I]-capsules in a dose calibrator. CONCLUSION Measuring DR on the surface of the closed lead containers enables the [131I]-capsules activity to be estimated simply, reliably and with sufficient accuracy leading to significant reduction of the radiation exposure for the medical staff.
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Affiliation(s)
- Maaz Zuhayra
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Alexander Helm
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Joshua Ranjan
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Michael Jüptner
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Yi Zhao
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Marlies Marx
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Isong Assam
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Ammar Alfteimi
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Ulf Lützen
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
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Jüptner M, Marx M, Zuhayra M, Lützen U. Experimental 177Lu-PSMA-617 radioligand therapy in a patient with extended metastasized leiomyosarcoma. Nuklearmedizin 2019; 58:328-330. [PMID: 31140181 DOI: 10.1055/a-0914-2486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Systemic radionuclide therapy with 177Lu-PSMA-617 is a novel treatment option in patients with metastasized and castration-resistant prostate cancer 4. The molecular target of the 177Lu-PSMA-617 radioligand therapy is the prostate-specific membrane antigen (PSMA) highly expressed on prostate cancer cells. Beyond the enhanced accumulation of PSMA on prostate cancer cells, PSMA expression is also found on the molecular surface or in the tumor-associated neovasculature of various tumor tissues including sarcomas of the soft tissue 2. Thus, PSMA has theoretically been discussed as a possible future target for systemic radioligand therapy with 177Lu-PSMA-617 even in non-prostate malignancies 1.Here we report on a female patient with extended metastasized leiomyosarcoma experimentally treated with one application of 177Lu-PSMA-617 radioligand therapy.
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LÜtzen U, Zhao Y, Lucht K, Zuhayra M, Hedderich J, Cascorbi I, Culman J. Activation of the cell membrane angiotensin AT2 receptors in human leiomyosarcoma cells induces differentiation and apoptosis by a PPARγ - dependent mechanism. Neoplasma 2019; 64:395-405. [PMID: 28253719 DOI: 10.4149/neo_2017_310] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Angiotensin II (Ang II), the main effector peptide of the renin-angiotensin system (RAS), acting on AT1 and AT2 receptors participates in the regulation of proliferation, differentiation and apoptosis in tumour cells. The peroxisome-proliferator activated receptor γ (PPARγ) and its ligands exert anti-tumour effects in various human cancer cell lines. The present study investigates the effects initiated by AT1- and AT2 receptor stimulation in SK-UT-1 cells, a human leiomyosarcoma cell line, and clarifies the role of the PPARγ in the AT2 receptor-induced differentiation and apoptosis.Selective stimulation of AT1- and AT2 receptors was achieved by incubation of the cells with Ang II (10-6 M) in the presence of the selective AT2 receptor antagonist, PD 123177 (10-6 M) and the AT1 receptor antagonist, losartan (10-5 M), respectively, the selective PPARγ antagonist, GW 9662, was used at concentration 10-6 M. The expression of smooth muscle cell differentiation markers, SM22α and calponin, was analysed at RNA- and protein levels using RT PCR and Western blot, which was also used to quantify Bcl-2-, Bax- and cleaved caspase-3 proteins. The translocation of the AT2-receptor interacting protein 1 (ATIP1) to the nuclei was studied by Western blot and immunofluorescence staining. The mitochondrial status and the metabolic activity in response to AT1- and AT2 receptor activation were assessed by the quantification of 99mTc - sestamibi and 2´-deoxy-2´-[18F]fluoro-D-glucose uptake.AT1 receptor stimulation did not exert any profound effects in quiescent SK-UT-1 cells. The effects induced by Ang II acting on AT2 receptors were time-dependent. A short, 3 - 6 h lasting stimulation promotes differentiation, i.e increases in the mRNA- and protein levels of SM22α and calponin, whereas a sustained stimulation for 48 h activates the intrinsic apoptotic pathway, as evidenced by reduced cell numbers, down-regulation of the anti-apoptotic Bcl-2 protein and increased levels of the Bax protein and cleaved caspase-3. The effects were reversed by the PPARγ antagonist, GW 9662, clearly implying a PPARγ-dependent mechanism. Our results also demonstrate a co-localisation of the AT2-receptor interacting protein, ATIP1, and the PPARγ in nuclei of SK-UT-1 cells and an accumulation of ATIP1 in the nuclear fraction in response to AT2 receptor stimulation. The regulation of the differentiation and apoptosis via the AT2 receptor favours an important functional role of this receptor in quiescent, slow-cycling SK-UT-1 cells and provides the rationale for the use of AT1 receptor antagonists for the treatment of human leiomyosarcomas.
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11
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Zeissig S, Rosati E, Dowds CM, Aden K, Bethge J, Schulte B, Pan WH, Mishra N, Zuhayra M, Marx M, Paulsen M, Strigli A, Conrad C, Schuldt D, Sinha A, Ebsen H, Kornell SC, Nikolaus S, Arlt A, Kabelitz D, Ellrichmann M, Lützen U, Rosenstiel PC, Franke A, Schreiber S. Vedolizumab is associated with changes in innate rather than adaptive immunity in patients with inflammatory bowel disease. Gut 2019; 68:25-39. [PMID: 29730603 DOI: 10.1136/gutjnl-2018-316023] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 04/03/2018] [Accepted: 04/17/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Vedolizumab, a monoclonal antibody directed against the integrin heterodimer α4β7, is approved for the treatment of Crohn's disease and ulcerative colitis. The efficacy of vedolizumab has been suggested to result from inhibition of intestinal T cell trafficking although human data to support this conclusion are scarce. We therefore performed a comprehensive analysis of vedolizumab-induced alterations in mucosal and systemic immunity in patients with inflammatory bowel disease (IBD), using anti-inflammatory therapy with the TNFα antibody infliximab as control. DESIGN Immunophenotyping, immunohistochemistry, T cell receptor profiling and RNA sequencing were performed using blood and colonic biopsies from patients with IBD before and during treatment with vedolizumab (n=18) or, as control, the anti-TNFα antibody infliximab (n=20). Leucocyte trafficking in vivo was assessed using single photon emission computed tomography and endomicroscopy. RESULTS Vedolizumab was not associated with alterations in the abundance or phenotype of lamina propria T cells and did not affect the mucosal T cell repertoire or leucocyte trafficking in vivo. Surprisingly, however, α4β7 antibody treatment was associated with substantial effects on innate immunity including changes in macrophage populations and pronounced alterations in the expression of molecules involved in microbial sensing, chemoattraction and regulation of the innate effector response. These effects were specific to vedolizumab, not observed in response to the TNFα antibody infliximab, and associated with inhibition of intestinal inflammation. CONCLUSION Our findings suggest that modulation of innate immunity contributes to the therapeutic efficacy of vedolizumab in IBD. TRIAL REGISTRATION NUMBER NCT02694588.
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Affiliation(s)
- Sebastian Zeissig
- Department of Medicine I, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität (TU) Dresden, Dresden, Germany.,Center for Regenerative Therapies Dresden, Technische Universität (TU) Dresden, Dresden, Germany.,Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Elisa Rosati
- Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - C Marie Dowds
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany.,Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Konrad Aden
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany.,Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Johannes Bethge
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Berenice Schulte
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Wei Hung Pan
- Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Neha Mishra
- Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Maaz Zuhayra
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Marlies Marx
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Maren Paulsen
- Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Anne Strigli
- Department of Medicine I, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität (TU) Dresden, Dresden, Germany.,Center for Regenerative Therapies Dresden, Technische Universität (TU) Dresden, Dresden, Germany
| | - Claudio Conrad
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Dörthe Schuldt
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Anupam Sinha
- Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Henriette Ebsen
- Institute of Immunology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Sabin-Christin Kornell
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany.,Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Susanna Nikolaus
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Alexander Arlt
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Dieter Kabelitz
- Institute of Immunology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Mark Ellrichmann
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulf Lützen
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Philip C Rosenstiel
- Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Stefan Schreiber
- Department of Internal Medicine I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany.,Institute of Clinical Molecular Biology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
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12
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Jüptner M, Zuhayra M, Assam I, Lützen U. Successful handling of an accidental extravasation of 177Lu-PSMA-617 in the treatment of advanced prostate cancer. Nuklearmedizin 2018; 57:N10-N12. [DOI: 10.1055/s-0038-1641692] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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13
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Naumann CM, Colberg C, Jüptner M, Marx M, Zhao Y, Jiang P, Hamann MF, Jünemann KP, Zuhayra M, Lützen U. Evaluation of the diagnostic value of preoperative sentinel lymph node (SLN) imaging in penile carcinoma patients without palpable inguinal lymph nodes via single photon emission computed tomography/computed tomography (SPECT/CT) as compared to planar scintigraphy. Urol Oncol 2018; 36:92.e17-92.e24. [DOI: 10.1016/j.urolonc.2017.11.012] [Citation(s) in RCA: 7] [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: 08/10/2017] [Revised: 10/11/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022]
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14
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Schem C, Tower RJ, Kneissl P, Rambow AC, Campbell GM, Desel C, Damm T, Heilmann T, Fuchs S, Zuhayra M, Trauzold A, Glüer CC, Schott S, Tiwari S. Pharmacologically Inactive Bisphosphonates as an Alternative Strategy for Targeting Osteoclasts: In Vivo Assessment of 5-Fluorodeoxyuridine-Alendronate in a Preclinical Model of Breast Cancer Bone Metastases. J Bone Miner Res 2017; 32:536-548. [PMID: 27714838 DOI: 10.1002/jbmr.3012] [Citation(s) in RCA: 9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 09/23/2016] [Accepted: 10/02/2016] [Indexed: 12/17/2022]
Abstract
Bisphosphonates have effects that are antiresorptive, antitumor, and antiapoptotic to osteoblasts and osteocytes, but an effective means of eliciting these multiple activities in the treatment of bone metastases has not been identified. Antimetabolite-bisphosphonate conjugates have potential for improved performance as a class of bone-specific antineoplastic drugs. The primary objective of the study was to determine whether an antimetabolite-bisphosphonate conjugate will preserve bone formation concomitant with antiresorptive and antitumor activity. 5-FdU-ale, a highly stable conjugate between the antimetabolite 5-fluoro-2'-deoxyuridine and the bisphosphonate alendronate, was tested for its therapeutic efficacy in a mouse model of MDA-MB231 breast cancer bone metastases. In vitro testing revealed osteoclasts to be highly sensitive to 5-FdU-ale. In contrast, osteoblasts had significantly reduced sensitivity. Tumor cells were resistant in vitro but in vivo tumor burden was nevertheless significantly reduced compared with untreated mice. Sensitivity to 5-FdU-ale was not mediated through inhibition of farnesyl diphosphate synthase activity, but cell cycle arrest was observed. Although serum tartrate-resistant acid phosphatase (TRAP) levels were greatly reduced by both drugs, there was no significant decrease in the serum bone formation marker osteocalcin with 5-FdU-ale treatment. In contrast, there was more than a fivefold decrease in serum osteocalcin levels with alendronate treatment (p < 0.001). This finding is supported by time-lapse micro-computed tomography analyses, which revealed bone formation volume to be on average 1.6-fold higher with 5-FdU-ale treatment compared with alendronate (p < 0.001). We conclude that 5-FdU-ale, which is a poor prenylation inhibitor but maintains potent antiresorptive activity, does not reduce bone formation and has cytostatic antitumor efficacy. These results document that conjugation of an antimetabolite with bisphosphonates offers flexibility in creating potent bone-targeting drugs with cytostatic, bone protection properties that show limited nephrotoxicity. This unique class of drugs may offer distinct advantages in the setting of targeted adjuvant therapy and chemoprevention of bone diseases. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Christian Schem
- Department of Gynecology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Robert J Tower
- Section of Biomedical Imaging, Department of Radiology and Neuroradiology, MOIN CC, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Philipp Kneissl
- Department of Gynecology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Anna-Christina Rambow
- Department of Gynecology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Graeme M Campbell
- Section of Biomedical Imaging, Department of Radiology and Neuroradiology, MOIN CC, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.,Institute of Biomechanics, TUHH Hamburg University of Technology, Hamburg, Germany
| | - Christine Desel
- Section of Biomedical Imaging, Department of Radiology and Neuroradiology, MOIN CC, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Timo Damm
- Section of Biomedical Imaging, Department of Radiology and Neuroradiology, MOIN CC, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thorsten Heilmann
- Department of Gynecology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.,Division of Molecular Oncology, Institute for Experimental Cancer Research, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sabine Fuchs
- Department of Trauma Surgery, Section Experimental Trauma Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Maaz Zuhayra
- Department of Nuclear Medicine, Section Radiopharmaceutical Chemistry, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Anna Trauzold
- Division of Molecular Oncology, Institute for Experimental Cancer Research, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Claus C Glüer
- Section of Biomedical Imaging, Department of Radiology and Neuroradiology, MOIN CC, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sarah Schott
- Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Sanjay Tiwari
- Section of Biomedical Imaging, Department of Radiology and Neuroradiology, MOIN CC, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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15
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Lützen U, Naumann CM, Marx M, Zhao Y, Jüptner M, Baumann R, Papp L, Zsótér N, Aksenov A, Jünemann KP, Zuhayra M. A study on the value of computer-assisted assessment for SPECT/CT-scans in sentinel lymph node diagnostics of penile cancer as well as clinical reliability and morbidity of this procedure. Cancer Imaging 2016; 16:29. [PMID: 27604900 PMCID: PMC5015237 DOI: 10.1186/s40644-016-0087-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/21/2016] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Because of the increasing importance of computer-assisted post processing of image data in modern medical diagnostic we studied the value of an algorithm for assessment of single photon emission computed tomography/computed tomography (SPECT/CT)-data, which has been used for the first time for lymph node staging in penile cancer with non-palpable inguinal lymph nodes. In the guidelines of the relevant international expert societies, sentinel lymph node-biopsy (SLNB) is recommended as a diagnostic method of choice. The aim of this study is to evaluate the value of the afore-mentioned algorithm and in the clinical context the reliability and the associated morbidity of this procedure. METHODS Between 2008 and 2015, 25 patients with invasive penile cancer and inconspicuous inguinal lymph node status underwent SLNB after application of the radiotracer Tc-99m labelled nanocolloid. We recorded in a prospective approach the reliability and the complication rate of the procedure. In addition, we evaluated the results of an algorithm for SPECT/CT-data assessment of these patients. RESULTS SLNB was carried out in 44 groins of 25 patients. In three patients, inguinal lymph node metastases were detected via SLNB. In one patient, bilateral lymph node recurrence of the groins occurred after negative SLNB. There was a false-negative rate of 4 % in relation to the number of patients (1/25), resp. 4.5 % in relation to the number of groins (2/44). Morbidity was 4 % in relation to the number of patients (1/25), resp. 2.3 % in relation to the number of groins (1/44). The results of computer-assisted assessment of SPECT/CT data for sentinel lymph node (SLN)-diagnostics demonstrated high sensitivity of 88.8 % and specificity of 86.7 %. CONCLUSIONS SLNB is a very reliable method, associated with low morbidity. Computer-assisted assessment of SPECT/CT data of the SLN-diagnostics shows high sensitivity and specificity. While it cannot replace the assessment by medical experts, it can still provide substantial supplement and assistance.
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Affiliation(s)
- Ulf Lützen
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), 24105, Kiel, Germany.
| | - Carsten Maik Naumann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Marlies Marx
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), 24105, Kiel, Germany
| | - Yi Zhao
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), 24105, Kiel, Germany
| | - Michael Jüptner
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), 24105, Kiel, Germany
| | - René Baumann
- Department of Radiotherapy, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - László Papp
- Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Alexey Aksenov
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Klaus-Peter Jünemann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Maaz Zuhayra
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), 24105, Kiel, Germany
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16
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Lützen U, Zuhayra M, Marx M, Zhao Y, Colberg C, Knüpfer S, Baumann R, Kähler KC, Jünemann KP, Naumann CM. Value and efficiency of sentinel lymph node diagnostics in patients with penile carcinoma with palpable inguinal lymph nodes as a new multimodal, minimally invasive approach. Eur J Nucl Med Mol Imaging 2016; 43:2313-2323. [PMID: 27519598 DOI: 10.1007/s00259-016-3482-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 04/27/2016] [Accepted: 07/31/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE The international guidelines recommend sentinel lymph node biopsy (SLNB) for lymph node staging in penile cancer with non-palpable inguinal lymph nodes (LN) but it is not recommended with palpable inguinal LN. The aim of this study was to evaluate the reliability and morbidity of SLNB in combination with an ultrasound-guided resection of suspect inguinal LNs as a new multimodal, minimally invasive staging approach in these patients. METHODS We performed SLNB in 26 penile cancer patients with 42 palpable inguinal LNs. Prior to the combined staging procedures the patients underwent an ultrasound examination of the groins as well as planar lymphatic drainage scintigraphy and SPECT/CT scans. During the surgical procedure, the radioactive-labelled sentinel lymph nodes and, in addition, sonographically suspect LNs, were resected under ultrasound guidance. Follow-up screening was done by ultrasound examination of the groins according to the guidelines of the European Association of Urology. RESULTS Nineteen groins of 42 preoperatively palpable inguinal findings were histologically tumor-positive. SLNB alone showed lymphogenic metastases in 14 groins. Sonography revealed five further metastatic groins, which would not have been detected during SLNB due to a tumor-related blockage of lymphatic drainage or a so-called re-routing of the tracer. During follow-up, none of the 28 groins with tumor-negative LN status showed any LN recurrence in this combined investigation technique. The median follow-up period was 46 (24 to 92) months. Morbidity of this procedure was low at 4.76 % in relation to the number of groins resp. 7.69 % in relation to the number of patients. CONCLUSIONS The results show that this combined procedure is a reliable multimodal diagnostic approach for treatment of penile cancer patients with palpable inguinal LNs. It is associated with low morbidity rates. SLNB alone would lead to a significantly higher false-negative rate in these patients. The encouraging results of this work can extend the range of indications for nuclear medicine in the form of SLNB using radioactive tracers in this patient group.
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Affiliation(s)
- Ulf Lützen
- Department of Nuclear Medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), D-24105, Kiel, Germany.
| | - Maaz Zuhayra
- Department of Nuclear Medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), D-24105, Kiel, Germany
| | - Marlies Marx
- Department of Nuclear Medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), D-24105, Kiel, Germany
| | - Yi Zhao
- Department of Nuclear Medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), D-24105, Kiel, Germany
| | - Christian Colberg
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 18, D-24105, Kiel, Germany
| | - Stephanie Knüpfer
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 18, D-24105, Kiel, Germany
| | - René Baumann
- Department of Radio Oncology, University Hospital Schleswig Holstein, Campus Kiel, Feldstr. 21 (Haus 50), D-24105, Kiel, Germany
| | - Katharina Charlotte Kähler
- Department of Dermatology, Venerology and Allergology, University Hospital Schleswig Holstein, Campus Kiel, Schittenhelmstr. 7, D-24105, Kiel, Germany
| | - Klaus-Peter Jünemann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 18, D-24105, Kiel, Germany
| | - Carsten Maik Naumann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 18, D-24105, Kiel, Germany
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Lützen U, Naumann CM, Dischinger J, Marx M, Baumann R, Zhao Y, Jüptner M, Osmonov D, Bothe K, Jünemann KP, Zuhayra M. 10-Year experience regarding the reliability and morbidity of radio guided lymph node biopsy in penile cancer patients and the associated radiation exposure of medical staff in this procedure. BMC Urol 2016; 16:47. [PMID: 27485215 PMCID: PMC4969690 DOI: 10.1186/s12894-016-0166-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/22/2016] [Indexed: 11/20/2022] Open
Abstract
Background The guidelines of the European Association of Urologists (EAU), of the German Society of Nuclear Medicine (DGN), and the European Society for Medical Oncology (ESMO) recommend sentinel lymph node biopsy (SLNB) for lymph node staging in penile cancer with non-palpable inguinal lymph nodes as one diagnostic method. Despite this, the method is neither widely nor regularly applied in Germany – the same applies to many other countries, which may be due to insecurity in dealing with open radioactive tracers. This study aims to assess the reliability and morbidity of this method, as well as the associated radioactive burden for clinical staff. Methods Between 2006 and 2016, 34 patients with an invasive penile carcinoma and inconspicuous inguinal lymph node status underwent SLNB in 57 groins after application of a radiotracer (Tc-99 m nanocolloid). We collected the results prospectively. The reliability of the method was assessed by determining the false-negative rate. In addition, we evaluated complication rates and determined the radioactive burden for the clinical staff both pre- and intraoperatively. Results SLNB was performed in 34 patients with penile cancer with non-palpable inguinal lymph nodes in 57 groins. In two patients inguinal lymph node metastases were detected by means of SLNB. In one patient recurrent inguinal lymph node disease was found after negative SLNB in both groins. Thus, the false negative rate was 3.13 % per patient (1/32 patients) and 3.51 % per groin (2/57 groins). The morbidity rate was 2.94 % per patient (1/34 patients) and 1.75 % per groin (1/57 groins). Radiation exposure for the clinical staff during this procedure was low at a maximum of ca. four μSV per intervention. Conclusions SLNB is a reliable method with low morbidity that is associated with a low radiation burden for clinical staff. Due to the enhanced methodological and logistic demands, this intervention should be performed in specialized centres and in an interdisciplinary approach.
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Affiliation(s)
- Ulf Lützen
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany.
| | - Carsten Maik Naumann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Jens Dischinger
- Northern German Seminar for Radiation Protection gGmbH at the Christian-Albrechts-University Kiel, Kiel, Germany
| | - Marlies Marx
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - René Baumann
- Department of Radio Oncology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Yi Zhao
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Michael Jüptner
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Daniar Osmonov
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Katrin Bothe
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Klaus-Peter Jünemann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Maaz Zuhayra
- Department of Nuclear medicine, Molecular Imaging Diagnostics and Therapy, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
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Lützen U, Zhao Y, Marx M, Imme T, Assam I, Siebert FA, Culman J, Zuhayra M. Effective method of measuring the radioactivity of [ 131I]-capsule prior to radioiodine therapy with significant reduction of the radiation exposure to the medical staff. J Appl Clin Med Phys 2016; 17:59-72. [PMID: 27455475 PMCID: PMC5690049 DOI: 10.1120/jacmp.v17i4.5942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 02/21/2016] [Accepted: 02/16/2016] [Indexed: 11/23/2022] Open
Abstract
Radiation Protection in Radiology, Nuclear Medicine and Radio Oncology is of the utmost importance. Radioiodine therapy is a frequently used and effective method for the treatment of thyroid disease. Prior to each therapy the radioactivity of the [131I]-capsule must be determined to prevent misadministration. This leads to a significant radiation exposure to the staff. We describe an alternative method, allowing a considerable reduction of the radiation exposure. Two [131I]-capsules (A01 = 2818.5; A02 = 7355.0 MBq) were measured multiple times in their own delivery lead containers - that is to say, [131I]-capsules remain inside the containers during the measurements (shielded measurement) using a dose calibrator and a well-type and a thyroid uptake probe. The results of the shielded measurements were correlated linearly with the [131I]-capsules radioactivity to create calibration curves for the used devices. Additional radioactivity measurements of 50 [131I]-capsules of different radioactivities were done to validate the shielded measuring method. The personal skin dose rate (HP(0.07)) was determined using calibrated thermo luminescent dosimeters. The determination coefficients for the calibration curves were R2 > 0.9980 for all devices. The relative uncertainty of the shielded measurement was < 6.8%. At a distance of 10 cm from the unshielded capsule the HP(0.07) was 46.18 μSv/(GBq•s), and on the surface of the lead container containing the [131I]-capsule the HP(0.07) was 2.99 and 0.27 μSv/(GBq•s) for the two used container sizes. The calculated reduction of the effective dose by using the shielded measuring method was, depending on the used container size, 74.0% and 97.4%, compared to the measurement of the unshielded [131I]-capsule using a dose calibrator. The measured reduction of the effective radiation dose in the practice was 56.6% and 94.9 for size I and size II containers. The shielded [131I]-capsule measurement reduces the radiation exposure to the staff significantly and offers the same accuracy of the unshielded measurement in the same amount of time. In order to maintain the consistency of the measuring method, monthly tests have to be done by measuring a [131I]-capsule with known radioactivity.
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Affiliation(s)
- Ulf Lützen
- Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel.
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19
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Kaschwich M, Lützen U, Zhao Y, Tjiong A, Marx M, Haenisch S, Wiedow O, Preuss S, Culman J, Zuhayra M. Biodistribution and pharmacokinetics of the (99m)Tc labeled human elastase inhibitor, elafin, in rats. Drug Metab Pharmacokinet 2016; 31:146-55. [PMID: 26948953 DOI: 10.1016/j.dmpk.2016.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 08/24/2015] [Revised: 01/25/2016] [Accepted: 01/27/2016] [Indexed: 11/27/2022]
Abstract
Elafin is a potent reversible inhibitor of the pro-inflammatory proteases leukocyte elastase and protease 3. It is currently in clinical development for the use in postoperative inflammatory diseases. We investigated the pharmacokinetics of (99m)Tc-labeled elafin ((99m)Tc-Elafin) in blood and individual organs in rat after bolus intravenous injection using the single photon emission tomography (SPECT). (99m)Tc-Elafin predominantly accumulated in the kidney reaching a maximum of 8.5% ± 0.1% of the injected dose per gram (ID/g) at 5 min post injection (p.i) and decreased only slowly during 24 h. In contrast, the initially high radio activity recorded in the other organs rapidly decreased parallel to the radioactivity detected in blood. The blood kinetics fits to a two compartment kinetics model. The radio activity in the dissected kidney was 4.98 ± 1.24%ID/g 24 h p.i, while in other organs, including the brain, no accumulation of (99m)Tc-Elafin was detected. At this time point 30% of the detected radioactivity in the kidney was identified to be not metabolized (99m)Tc-Elafin. In conclusion, the blood and organ-specific kinetic data provide a basis for planning of adequate dosing regimens and the high accumulation of intact elafin in the kidney favors clinical developments targeting inflammatory kidney diseases, such as chronic allograft nephropathy after kidney transplantation.
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Affiliation(s)
- Mark Kaschwich
- Department of Cardiovascular Surgery, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Arnold-Heller-Strasse 3, D-24105 Kiel, Germany
| | - Ulf Lützen
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Karl Lennert Cancer Center North, Feldstrasse 21, D-24105, Germany
| | - Yi Zhao
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Karl Lennert Cancer Center North, Feldstrasse 21, D-24105, Germany
| | - Angelina Tjiong
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Karl Lennert Cancer Center North, Feldstrasse 21, D-24105, Germany
| | - Marlies Marx
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Karl Lennert Cancer Center North, Feldstrasse 21, D-24105, Germany
| | - Sierk Haenisch
- Institute of Experimental and Clinical Pharmacology, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Arnold-Heller-Strasse 3, D-24105 Kiel, Germany
| | - Oliver Wiedow
- Department of Dermatology, Venereology and Allergology, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Schittenhelmstrasse 7, D-24105 Kiel, Germany
| | - Stefanie Preuss
- Department of General Pediatrics, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Arnold-Heller-Strasse 9, D-24105 Kiel, Germany
| | - Juraj Culman
- Institute of Experimental and Clinical Pharmacology, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Arnold-Heller-Strasse 3, D-24105 Kiel, Germany
| | - Maaz Zuhayra
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital of Schleswig-Holstein (UK-SH), Campus Kiel, Karl Lennert Cancer Center North, Feldstrasse 21, D-24105, Germany.
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Zhao Y, Lucht K, Zuhayra M, Cascorbi I, Lützen U, Culman J. P0180 Effect of pioglitazone on proliferation and apoptosis in human uterine leiomyosarcoma cells. Eur J Cancer 2015. [DOI: 10.1016/j.ejca.2015.06.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Cohrs B, Zhao Y, Lützen U, Culman J, Clement B, Zuhayra M. In vivo SPECT imaging of [123I]-labeled pentamidine pro-drugs for the treatment of human African trypanosomiasis, pharmacokinetics, and bioavailability studies in rats. Int J Pharm 2014; 477:167-75. [DOI: 10.1016/j.ijpharm.2014.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 10/07/2014] [Accepted: 10/11/2014] [Indexed: 10/24/2022]
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Zuhayra M, Zhao Y, von Forstner C, Henze E, Gohlke P, Culman J, Lützen U. Activation of cerebral peroxisome proliferator-activated receptors γ (PPARγ) reduces neuronal damage in the substantia nigra after transient focal cerebral ischaemia in the rat. Neuropathol Appl Neurobiol 2012; 37:738-52. [PMID: 21366664 DOI: 10.1111/j.1365-2990.2011.01169.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM The function of brain (neuronal) peroxisome proliferator-activated receptor(s) γ (PPARγ) in the delayed degeneration and loss of neurones in the substantia nigra (SN) was studied in rats after transient occlusion of the middle cerebral artery (MCAO). METHODS The PPARγ agonist, pioglitazone, or vehicle was infused intracerebroventricularly over a 5-day period before, during and 5 days after MCAO (90 min). The neuronal degeneration in the SN pars reticularis (SNr) and pars compacta (SNc), the analysis of the number of tyrosine hydroxylase-immunoreactive (TH-IR) neurones and the expression of the PPARγ in these neurones were studied by immunohistochemistry and immunofluorescence staining. The effects of PPARγ activation on excitotoxic and oxidative neuronal damage induced by glutamate and 6-hydroxydopamine were investigated in primary cortical neurones expressing PPARγ. RESULTS Pioglitazone reduced the total and striatal infarct size, neuronal degeneration in both parts of the ipsilateral SN, the loss of TH-IR neurones in the SNc and increased the number of PPARγ-positive TH-IR neurones. Pioglitazone protected primary cortical neurones against oxidative and excitotoxic damage, prevented the loss of neurites and supported the formation of synaptic networks in neurones exposed to glutamate or 6-hydroxydopamine by a PPARγ-dependent mechanism. CONCLUSIONS Activation of cerebral PPARγ confers neuroprotection after ischaemic stroke by preventing both, neuronal damage within the peri-infarct zone and delayed degeneration of neurones and neuronal death in areas remote from the site of ischaemic injury. Pioglitazone and other PPARγ agonists may be useful therapeutic agents to prevent progression of brain damage after cerebral ischaemia.
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Affiliation(s)
- M Zuhayra
- Department of Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Hutchinson JA, Riquelme P, Sawitzki B, Tomiuk S, Miqueu P, Zuhayra M, Oberg HH, Pascher A, Lützen U, Janssen U, Broichhausen C, Renders L, Thaiss F, Scheuermann E, Henze E, Volk HD, Chatenoud L, Lechler RI, Wood KJ, Kabelitz D, Schlitt HJ, Geissler EK, Fändrich F. Cutting Edge: Immunological consequences and trafficking of human regulatory macrophages administered to renal transplant recipients. J Immunol 2011; 187:2072-8. [PMID: 21804023 DOI: 10.4049/jimmunol.1100762] [Citation(s) in RCA: 184] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Regulatory macrophages (M regs) were administered to two living-donor renal transplant recipients. Both patients were minimized to low-dose tacrolimus monotherapy within 24 wk of transplantation and subsequently maintained excellent graft function. After central venous administration, most M regs remained viable and were seen to traffic from the pulmonary vasculature via the blood to liver, spleen, and bone marrow. By 1 y posttransplantation, both patients displayed patterns of peripheral blood gene expression converging upon the IOT-RISET signature. Furthermore, both patients maintained levels of peripheral blood FOXP3 and TOAG-1 mRNA expression within the range consistent with nonrejection. It is concluded that M regs warrant further study as a potential immune-conditioning therapy for use in solid-organ transplantation. The results of this work are being used to inform the design of The ONE Study, a multinational clinical trial of immunomodulatory cell therapy in renal transplantation.
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Affiliation(s)
- James A Hutchinson
- Laboratory for Transplantation Research, Department of Surgery, University Hospital Regensburg, Regensburg 93053, Germany.
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Lützen U, Zsoter N, Egeler B, Garai I, Zuhayra M, Arslandemir C, Papp L. Vollautomatische Software zur Detektion von Wächterlymphknoten bei Brust- und Prostata-Karzinom-Patienten unter Anwendung von SPECT/CT-Daten. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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25
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von Forstner C, Zuhayra M, Ammerpohl O, Zhao Y, Tiwari S, Jansen O, Kalthoff H, Henze E, Egberts JH. Expression of L amino acid transport system 1 and analysis of iodine-123-methyltyrosine tumor uptake in a pancreatic xenotransplantation model using fused high-resolution-micro-SPECT-MRI. Hepatobiliary Pancreat Dis Int 2011; 10:30-7. [PMID: 21269932 DOI: 10.1016/s1499-3872(11)60004-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The specificity in discriminating pancreatitis is limited in the positron emission tomography (PET) using Fluorine-18-fluorodeoxyglucose. Furthermore, PET is not widely available compared to the single photon emission computed tomography (SPECT). Since amino acids play a minor role in metabolism of inflammatory cells, the potential of the SPECT tracer, 3-[123I]iodo-L-alpha-methyltyrosine (123I-IMT), for detecting pancreatic cancer was examined in xenotransplantation models of human pancreatic carcinoma in mice. METHODS 123I-IMT was injected to eight mice inoculated with subcutaneous or orthotopic pancreatic tumors. Fused high-resolution-micro-SPECT (Hi-SPECT) and magnetic resonance imaging were performed. The gene expression level of L amino acid transport-system 1 (LAT1) was analyzed and correlated with tumor uptake of 123I-IMT. RESULTS A high uptake of 123I-IMT was detected in all tumor-bearing mice. The median tumor-to-background ratio (T/B) was 12.1 (2.0-13.2) for orthotopic and 8.4 (1.8-11.1) for subcutaneous xenotransplantation, respectively. Accordingly, the LAT1 expression in transplanted Colo357 cells was increased compared to non-malignant controls. CONCLUSIONS Our mouse model could show a high 123I-IMT uptake in pancreatic cancer. Fused MRI scans facilitate precise evaluation of uptake in the specific regions of interest. Further studies are required to confirm these findings in tumors derived from other human pancreatic cancer cells. Since amino acids play a minor role in the metabolism of inflammatory cells, the potential for application of 123I-IMT to distinguish pancreatic tumor from inflammatory pancreatitis warrants further investigation.
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Affiliation(s)
- Corinna von Forstner
- Department of Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
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26
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Culman J, Das G, Ohlendorf C, Haass M, Maser-Gluth C, Zuhayra M, Zhao Y, Itoi K. Blockade of tachykinin NK1/NK2 receptors in the brain attenuates the activation of corticotrophin-releasing hormone neurones in the hypothalamic paraventricular nucleus and the sympathoadrenal and pituitary-adrenal responses to formalin-induced pain in the rat. J Neuroendocrinol 2010; 22:467-76. [PMID: 20210847 DOI: 10.1111/j.1365-2826.2010.01987.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Evidence from pharmacological studies has implicated substance P (SP), a natural ligand of tachykinin NK(1) receptors which can also interact with NK(2) receptors, in the generation of pressor and tachycardic responses to stress. Using selective blockade of brain NK(1) and NK(2) receptors, we tested in conscious rats the hypothesis that SP initiates, within the neuronal brain circuits, the sympathoadrenal, hypothalamic-pituitary-adrenal (HPA) and behavioural responses to noxious stimuli. Formalin injected s.c. through a chronically implanted catheter in the area of the lower leg was used as a pain stimulus. Rats were pretreated i.c.v. with vehicle or the selective, nonpeptide antagonists of tachykinin NK(1) and NK(2) receptors, RP 67580 and SR 48968, respectively. Ten minutes thereafter, formalin was injected s.c. and the cardiovascular responses were recorded, plasma concentrations of catecholamines, adrenocorticotrophic hormone (ACTH) and corticosterone were determined and the expression of the inducible transcription factor c-Fos in the paraventricular (PVN) and supraoptic nuclei was detected to identify neurones which were activated during pain stimulation. Blockade of NK(1) and NK(2) receptors attenuated the formalin-induced increases in mean arterial pressure and heart rate, adrenaline and ACTH concentrations in plasma, and completely abolished the pain-induced c-Fos expression in corticotrophin-releasing hormone neurones localised in the parvocellular division of the PVN. The results obtained provide pharmacological evidence that tachykinins, most probably SP, act as mediators within the neuronal circuits linked to the initiation and control of the cardiovascular, sympathoadrenal, HPA and behavioural responses to pain stimuli and provide an excitatory input to corticotrophin-releasing hormone neurones in the PVN to activate the HPA axis. Our data demonstrating the inhibition of the complex response pattern to noxious stimuli and stress are consistent with the proposed anxiolytic and antidepressant activity of NK(1) and NK(2) receptor antagonists.
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Affiliation(s)
- J Culman
- Institute of Experimental and Clinical Pharmacology, University Hospital of Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
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Papp L, Zsoter N, Szabo G, Bejan C, Szimjanovszki E, Zuhayra M. Parallel registration of multi-modal medical image triples having unknown inter-image geometry. Annu Int Conf IEEE Eng Med Biol Soc 2009; 2009:5825-8. [PMID: 19965252 DOI: 10.1109/iembs.2009.5335168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A method is proposed to register three multimodal medical data, where none of the images are superimposed. Contrary to previously presented solutions that perform more simultaneous registrations after one-by-one, present method registers all images in parallel. The method minimizes the registration error by seeking the optimum of a vector including rigid transformation parameters of both reslice images. To measure the similarity among all three images, a higher dimensional extended normalized mutual information have been adopted. Comparison with simultaneous methods have been performed on brain and femoral multi-modal image triples. Based on the comparative results, presented parallel method significantly outperforms the simultaneous methods in both translation and rotation registration error minimizations. On the contrary, the simultaneous methods need less computational time to converge.
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Affiliation(s)
- Laszlo Papp
- Nuclear Medicine Department, UK-SH Campus Kiel, Christian Albrechts University of Kiel, D 24105, Germany.
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28
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Zuhayra M, Alfteimi A, Forstner CV, Lützen U, Meller B, Henze E. New approach for the synthesis of [18F]fluoroethyltyrosine for cancer imaging: simple, fast, and high yielding automated synthesis. Bioorg Med Chem 2009; 17:7441-8. [PMID: 19804977 DOI: 10.1016/j.bmc.2009.09.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 09/07/2009] [Accepted: 09/17/2009] [Indexed: 11/15/2022]
Abstract
O-(2-[(18)F]fluoroethyl)-L-tyrosine ([(18)F]FET) is one of the first (18)F-labeled amino acids for imaging amino acid metabolism in tumors. This tracer overcomes the disadvantages of [(18)F]fluorodeoxyglucose, [(18)F]FDG, and [(11)C]methionine, [(11)C]MET. Nevertheless, the various synthetic methods providing (18)F[FET] exhibit a big disadvantage concerning the necessity of two purification steps during the synthesis including HPLC purification, which causes difficulties in the automation, moderate yields, and long synthesis times >60 min. A new approach for the synthesis of [(18)F]FET is developed starting from 2-bromoethyl triflate as precursor. After optimization of the synthesis parameters including the distillation step of [(18)F]-FCH(2)CH(2)Br combined with the final purification of [(18)F]FET using a simple solid phase extraction instead of an HPLC run the synthesis [(18)F]FET could be significantly simplified, shortened, and improved. The radiochemical yield (RCY) was about 45% (not decay corrected and calculated relative to [(18)F]F(-) activity that was delivered from the cyclotron). Synthesis time was only 35 min from the end of bombardment (EOB) and the radiochemical purity was >99% at the end of synthesis (EOS). Thus, this simplified synthesis for [(18)F]FET offers a very good option for routine clinical use.
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Affiliation(s)
- M Zuhayra
- Klinik für Nuklearmedizin, Universitätsklinikum Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany.
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Zuhayra M, Lützen U, Lützen A, Papp L, Henze E, Friedrichs G, Oberdorfer F. C-H bond activation of coordinated pyridine: ortho-pyridyl-ditechnetiumhydridocarbonyl metal cyclus. Crystal structure and dynamic behavior in solution. Inorg Chem 2008; 47:10177-82. [PMID: 18844344 DOI: 10.1021/ic8015063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The reaction of pyridine with ditechnetium decacarbonyl [Tc2(CO)10] (1) leads to a novel ortho-pyridyl-ditechnetium hydrido complex, [Tc2(mu-H)(mu-NC5H4)(NC5H5)2(CO)6] (2) and its precursor [Tc2(mu-CO)2(NC5H5)2(CO)6] (3). At ambient temperature 1 was found to react slowly with pyridine to afford the substitution product 3 after 120 h. However, heating the reaction mixture to reflux exclusively leads to the pyridine-ortho-metalated complex 2 in only 30 min. Similarly, complex 3 can be converted completely into 2 upon heating in pyridine for 30 min. Both compounds 2 and 3 were characterized by NMR spectroscopy and X-ray analysis. Both compounds 2 and 3 show a complex dynamic behavior in solution that was investigated by one-dimensional and two-dimensional NMR spectroscopy. Both compounds 2 and 3 show isomerization in solution according to the relative position of the non-bridging pyridine ligands. For 2 the existence of three isomers was shown at equilibrium conditions, 2a (56%) with trans-diaxial, 2b (38%) with cis-diaxial, and 2c (6%) with axial-equatorial arrangement of the non-bridging pyridines. For 3 an equilibrium was detected between two isomers, 3a (67%) with a cis-diaxial and 3b (33%) with a trans-diaxial arrangement of the pyridines.
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Affiliation(s)
- Maaz Zuhayra
- Klinik fur Nuklearmedizin, Universitatsklinikum Schleswig Holstein, Campus Kiel, Arnold-Heller-Strasse 9, D-24105 Kiel, Germany.
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Kampen WU, Giehrtmühlen M, Sommer P, Zuhayra M, Zavazava N, Hedderich J, Fändrich F. Nicht-invasive Diagnostik der akuten Abstoßung von Herztransplantaten mittels Tc-99m-markierter Oligonukleotidsonden gegen IL-2-mRNA im Rattenmodell. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2006-956191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zuhayra M, Kampen WU, Henze E, Soti Z, Zsolnai L, Huttner G, Oberdorfer F. A planar water tetramer with tetrahedrally coordinated water embedded in a hydrogen bonding network of [Tc4(CO)12-(mu3-OH)4.4H2O]. J Am Chem Soc 2006; 128:424-5. [PMID: 16402825 DOI: 10.1021/ja057142j] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A virtually planar water tetramer in which the water molecules are virtually tetrahedrally coordinated could be realized in the solid in a three-dimensional network of [Tc4(CO)12-(mu3-OH)4.4H2O]. The network could be produced by cocrystallization of the new cubane-like cluster [Tc(CO)3-(mu3-OH)]4 and water as a complementary component. The amphiphilic behavior of cluster and water results in a highly ordered three-dimensional network. The complementary components, the water tetramer and the cubic cluster, independently of one another form two interpenetrating tetragonal lattice networks held together exclusively by hydrogen bonds.
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Affiliation(s)
- Maaz Zuhayra
- Klinik für Nuklearmedizin U-K Schleswig Holstein, Campus Kiel, Germany.
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Brenner W, Aicher A, Eckey T, Massoudi S, Zuhayra M, Koehl U, Heeschen C, Kampen WU, Zeiher AM, Dimmeler S, Henze E. 111In-labeled CD34+ hematopoietic progenitor cells in a rat myocardial infarction model. J Nucl Med 2004; 45:512-8. [PMID: 15001696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
UNLABELLED Transplantation of progenitor cells (PCs) has been shown to improve neovascularization and left ventricular function after myocardial ischemia. The fate of transplanted PCs has been monitored by fluorescence labeling or by genetic modifications introducing reporter genes. However, these techniques are limited by the need to kill the experimental animal. The aim of this study was to radiolabel CD34(+) hematopoietic PCs (HPCs) with (111)In-oxine and to evaluate the feasibility of this in vivo method for monitoring myocardial homing of transplanted cells in a rat myocardial infarction model. METHODS Human HPCs were isolated from mobilized peripheral blood and labeled with (111)In-oxine. Labeled HPCs were injected into the cavity of the left ventricle in nude rats 24 h after induction of myocardial infarction (n = 4) or sham operation (n = 4). Scintigraphic images were acquired up to 96 h after HPC injection. After animals were killed, tissue samples of various organs were harvested to calculate tissue-specific activity and for immunostaining. RESULTS Labeling efficiency of HPCs was 32% +/- 11%. According to trypan-blue staining, viability of radiolabeled HPCs was impaired by 30% after 48 and 96 h in comparison with unlabeled cells, whereas proliferation and differentiation of HPCs was nullified after 7 d, as assessed by colony-forming assays. After injection of HPCs, the specific activity ratio of heart to peripheral muscle tissue increased from 1.10 +/- 0.32 in sham-operated rats to 2.47 +/- 0.92 (P = 0.020) in infarcted rats. However, the overall radioactivity detected in the heart was only about 1%. A transient high lung uptake of 17% +/- 6% was observed within the first hour after infusion of HPCs. At 24 h after injection, the initial lung activity had shifted toward liver, kidneys, and spleen, resulting in an increase of radioactivity in these organs from 37% +/- 6% to 57% +/- 5%. CONCLUSION Radiolabeling with (111)In-oxine is a feasible in vivo method for monitoring transplanted HPCs in a rat myocardial infarction model. The potential to detect differences in myocardial homing between infarcted and normal hearts suggests that this method may provide a noninvasive imaging approach for clinical trials using transplanted HPCs in patients. Our findings, however, also demonstrated a negative effect of (111)In-oxine on cellular function, which resulted in complete impairment of HPC proliferation and differentiation. For future trials in stem cell imaging with (111)In-oxine, therefore, it will be mandatory to carefully check for radiation-induced cell damage.
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Affiliation(s)
- Winfried Brenner
- Department of Nuclear Medicine, University Hospital Kiel, Kiel, Germany.
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Brenner W, Kampen WU, Brümmer C, Von Forstner C, Zuhayra M, Muhle C, Czech N, Henze E. Myeloprotective Effects of Different Amifostine Regimens in Rabbits Undergoing High-Dose Treatment with 186Rhenium-(tin)1,1- Hydroxyethylidene Diphosphonate (186Re-HEDP). Cancer Biother Radiopharm 2003; 18:887-93. [PMID: 14969601 DOI: 10.1089/108497803322702851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study is to investigate the myeloprotective effects of different amifostine regimens in rabbits undergoing high-dose treatment with 186Rhenium-(tin)1,1-hydroxyethylidene diphosphonate (186Re-HEDP) and to analyze the impact of amifostine on the bone uptake of the radiopharmaceutical. All animals were treated with 1000 MBq 186Re-HEDP. Group ReA received 500 mg amifostine prior to radionuclide therapy, group ReA3 received 3 x 200 mg amifostine 24 hours and 30 minutes prior to and 24 hours after radionuclide therapy. Group ReC served as control receiving no amifostine. Scintigrams were acquired to quantify the skeletal uptake of 186Re-HEDP, and platelet and leucocyte counts were measured. The mean decrease in platelets was 36% +/- 2%, 37% +/- 3%, and 61% +/- 5% for ReA, ReA3, and ReC, respectively. The decrease in ReC was significantly higher than in amifostine-treated animals with no difference between ReA and ReA3. For the leucocytes the mean decrease was 75% +/- 12%, 82% +/- 5%, and 73% +/- 4%, with no significant differences between the respective groups. Bone uptake of 186Re-HEDP was significantly reduced by 50% in ReA and ReA3 compared to ReC. Thus, the 3-day amifostine regimen had no advantage over the single dose regimen, with both regimens reducing bone uptake and yielding a platelet-protective but no leucoprotective effect.
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Affiliation(s)
- Winfried Brenner
- Division of Nuclear Medicine, University of Washington Medical Center, Seattle, WA, USA.
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Kampen WU, Czech N, Massoudi S, Zuhayra M, Brenner W, Henze E. [Radiosynovectomy. Nuclear medical treatment for inflammatory rheumatic joint diseases]. Med Monatsschr Pharm 2003; 26:303-8. [PMID: 14526614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- Willm Uwe Kampen
- Oberarzt, Klinik für Nuklearmedizin, Universitätklinikum Kiel, Arnold-Heller-Str. 9, 24105 Kiel.
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Aicher A, Brenner W, Zuhayra M, Badorff C, Massoudi S, Assmus B, Eckey T, Henze E, Zeiher AM, Dimmeler S. Assessment of the tissue distribution of transplanted human endothelial progenitor cells by radioactive labeling. Circulation 2003; 107:2134-9. [PMID: 12695305 DOI: 10.1161/01.cir.0000062649.63838.c9] [Citation(s) in RCA: 389] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Transplantation of endothelial progenitor cells (EPCs) improves vascularization and left ventricular function after experimental myocardial ischemia. However, tissue distribution of transplanted EPCs has not yet been monitored in living animals. Therefore, we tested whether radioactive labeling allows us to detect injected EPCs. METHODS AND RESULTS Human EPCs were isolated from peripheral blood, characterized by expression of endothelial marker proteins, and radioactively labeled with [111In]indium oxine. EPCs (106) were injected in athymic nude rats 24 hours after myocardial infarction (n=8) or sham operation (n=8). Scintigraphic images were acquired after 1, 24, 48, and 96 hours after EPC injection. Animals were then killed, and specific radioactivity was measured in different tissues. At 24 to 96 hours after intravenous injection of EPCs, approximately 70% of the radioactivity was localized in the spleen and liver, with only approximately 1% of the radioactivity identified in the heart of sham-operated animals. After myocardial infarction, the heart-to-muscle radioactivity ratio increased significantly, from 1.02+/-0.19 in sham-operated animals to 2.03+/-0.37 after intravenous administration of EPCs. Injection of EPCs into the left ventricular cavity increased this ratio profoundly, from 2.69+/-1.54 in sham-operated animals to 4.70+/-1.55 (P<0.05) in rats with myocardial infarction. Immunostaining of cryosections from infarcted hearts confirmed that EPCs homed predominantly to the infarct border zone. CONCLUSIONS Although only a small proportion of radiolabeled EPCs are detected in nonischemic myocardium, myocardial infarction increases homing of transplanted EPCs in vivo profoundly. Radiolabeling might eventually provide an useful tool for monitoring the fate of transplanted progenitor cells and for clinical cell therapy.
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Affiliation(s)
- Alexandra Aicher
- Department of Molecular Cardiology, University of Frankfurt, Frankfurt, Germany
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Brenner W, Kampen WU, Brümmer C, von Forstner C, Zuhayra M, Czech N, Muhle C, Henze E. Bone uptake studies in rabbits before and after high-dose treatment with 153Sm-EDTMP or 186Re-HEDP. J Nucl Med 2003; 44:247-51. [PMID: 12571217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
UNLABELLED The aim of this animal study was to measure the bone uptake of (99m)Tc-hydroxymethylene diphosphonate (HDP) before and after high-dose treatment with (153)Sm-ethylenediaminetetramethylenephosphonate (EDTMP) or (186)Re-(tin)1,1-hydroxyethylidene diphosphonate (HEDP) to prove or disprove post-therapeutic alterations of bone uptake of radiolabeled bisphosphonates. METHODS Quantitative bone scanning using 100 MBq (99m)Tc-HDP was performed on 12 rabbits before and 8 wk after radionuclide therapy with 1,000 MBq of either (153)Sm-EDTMP or (186)Re-HEDP. Whole-body images were acquired at 3 min, 3 h, and 24 h after injection, and the activities for the whole body, urinary bladder, and soft tissue were measured by region-of-interest technique. From these data, bone uptake was calculated as initial whole-body activity minus urinary excretion and remainder soft-tissue activity. RESULTS In animals treated with (153)Sm-EDTMP (n = 6), no differences could be proven for the bone uptake of (99m)Tc-HDP at 24 h after injection before and after therapy (51.1% +/- 5.5% vs. 48.0% +/- 6.1%, P > 0.05). There were also no significant differences for the remainder soft-tissue activities and the urinary excretion rates before and after therapy. Similar results were obtained in rabbits treated with (186)Re-HEDP: Bone uptake (44.8% +/- 6.7% vs. 40.4% +/- 4.9%, P > 0.05) and urinary excretion revealed no significant differences before and after treatment. CONCLUSION No significant impairment of bone uptake of (99m)Tc-HDP could be observed 8 wk after high-dose radionuclide bone therapy. Because both the biokinetic data obtained for (186)Re-HEDP and (153)Sm-EDTMP and the myelotoxic effects were quite similar in rabbits to those in patients, it seems justifiable to expect the same result (i.e., no significant alteration of bone uptake of radiolabeled bisphosphonates) in patients undergoing a second radionuclide therapy within 2-3 mo after standard treatment with (186)Re-HEDP or (153)Sm-EDTMP.
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Affiliation(s)
- Winfried Brenner
- Clinic of Nuclear Medicine, University Hospital Kiel, Kiel, Germany.
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Wagner S, Eritja R, Zuhayra M, Oberdorfer F, Mohammed A, Mier W, Haberkorn U, Eisenhut M. Synthesis and properties of radiolabeled CPTA-oligonucleotides. J Labelled Comp Radiopharm 2003. [DOI: 10.1002/jlcr.656] [Citation(s) in RCA: 5] [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: 11/10/2022]
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Brenner W, Kampen WU, von Forstner C, Brümmer C, Zuhayra M, Muhle C, Czech N, Henze E. High-dose treatment with (186)Re-HEDP or (153)Sm-EDTMP combined with amifostine in a rabbit model. J Nucl Med 2001; 42:1545-50. [PMID: 11585871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
UNLABELLED The aim of this experimental study was to investigate the myeloprotective potential of amifostine in rabbits receiving high-dose treatment with either (153)Sm-ethylenediaminetetramethylene phosphonate (EDTMP) or (186)Re-hydroxyethylidene diphosphonate (HEDP) and to check for drug interactions impairing the skeletal uptake of these radiopharmaceuticals by amifostine. METHODS To a total of 24 rabbits, we administered 1,000 MBq of either (153)Sm-EDTMP (n = 12) or (186)Re-HEDP (n = 12). Six animals of each group received 500 mg amifostine intravenously 10-15 min before injection of the radiopharmaceutical, whereas the other 6 animals served as controls. Up to 8 wk after treatment, blood samples were collected every 3-5 d to measure platelet and leukocyte counts. Furthermore, whole-body images were acquired at 3 min, 3 h, and 24 h after injection of the radiopharmaceutical to quantify the skeletal uptake. RESULTS For (186)Re-HEDP, the mean decrease in platelets was significantly less in the amifostine group (35.5% +/- 2.4%) than in the control group (61.3% +/- 5.4%, P < 0.001). Similar results were found for (153)Sm-EDTMP (36.5% +/- 8.3% vs. 52.3% +/- 14.0%, P < 0.05). No significant differences in leukocyte counts were found for (186)Re-HEDP (75.3% +/- 12.3% in the amifostine group and 72.5% +/- 4.1% in the control group, P > 0.05), whereas rabbits treated with (153)Sm-EDTMP plus amifostine showed a significantly greater decrease in leukocytes (69.2% +/- 10.8%) than did the control group (56.6% +/- 4.0%, P < 0.05). Bone uptake in percentage of initial total whole-body activity was significantly decreased in animals treated with amifostine compared with the control groups for both (186)Re-HEDP (15.8% +/- 3.1% vs. 30.9% +/- 1.9%, P < 0.001) and (153)Sm-EDTMP (31.7% +/- 8.9% vs. 44.0% +/- 6.5%, P < 0.05). CONCLUSION For amifostine, we found a highly significant cytoprotective effect on platelets but no leukoprotective effect. The latter probably relies on the intrinsic myelotoxicity of high-dose amifostine, which seemed to potentiate the leukodepression of the radiopharmaceuticals. The lower bone uptake in amifostine-treated animals may be caused by the chemical structure of amifostine, which is a potentially complex-forming compound that may be able to displace bisphosphonates from the rhenium- and samarium-bisphosphonate complexes, resulting in altered biodistribution patterns.
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Affiliation(s)
- W Brenner
- Clinic of Nuclear Medicine, Christian-Albrechts-Universität, Arnold-Heller-Strasse 9, D-24105 Kiel, Germany
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Brenner W, Sieweke N, Bohuslavizki KH, Kampen WU, Zuhayra M, Clausen M, Henze E. Age- and sex-related bone uptake of Tc-99m-HDP measured by whole-body bone scanning. Nuklearmedizin 2000; 39:127-32. [PMID: 10984888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
UNLABELLED AIM of this study was to validate a recently introduced new and easy-to-perform method for quantifying bone uptake of Tc-99m-labelled diphosphonate in a routine clinical setting and to establish a normal data base for bone uptake depending on age and gender. METHODS In 49 women (14-79 years) and 47 men (6-89 years) with normal bone scans as well as in 49 women (33-81 years) and 37 men (27-88 years) with metastatic bone disease whole-body bone scans were acquired at 3 min and 3-4 hours p.i. to calculate bone uptake after correction for both urinary excretion and soft tissue retention. RESULTS Bone uptake values of various age-related subgroups showed no significant differences between men and women (p > 0.05). Furthermore, no differences could be proven between age-matched subgroups of normals and patients with less than 10 metastatic bone lesions, while patients with wide-spread bone metastases revealed significantly increased uptake values. In both men and women highest bone uptake was obtained (p < 0.05) in subjects younger than 20 years with active epiphyseal growth plates. In men, bone uptake slowly decreased with age up to 60 years and then showed a tendency towards increasing uptake values. In women, the mean uptake reached a minimum in the decade 20-29 years and then slowly increased with a positive linear correlation of age and uptake in subjects older than 55 years (r = 0.57). CONCLUSION Since the results proposed in this study are in good agreement with data from literature, the new method used for quantification could be validated in a large number of patients. Furthermore, age- and sex-related normal bone uptake values of Tc-99m-HDP covering a wide range of age could be presented for this method as a basis for further studies on bone uptake.
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Affiliation(s)
- W Brenner
- Klinik für Nuklearmedizin, Christian-Albrechts-Universität zu Kiel.
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Sieweke N, Bohuslavizki KH, Kampen WU, Zuhayra M, Clausen M, Henze E, Brenner W. Age- and sex-related bone uptake of Tc-99m-HDP measured by whole-body bone scanning. Nuklearmedizin 2000. [DOI: 10.1055/s-0038-1632258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim of this study was to validate a recently introduced new and easy-to-perform method for quantifying bone uptake of Tc-99m-labelled diphosphonate in a routine clinical setting and to establish a normal data base for bone uptake depending on age and gender. Methods: In 49 women (14-79 years) and 47 men (6-89 years) with normal bone scans as well as in 49 women (33-81 years) and 37 men (27-88 years) with metastatic bone disease whole-body bone scans were acquired at 3 min and 3-4 hours p.i. to calculate bone uptake after correction for both urinary excretion and soft tissue retention. Results: Bone uptake values of various age-related subgroups showed no significant differences between men and women (p >0.05 ). Furthermore, no differences could be proven between age-matched subgroups of normals and patients with less than 10 metastatic bone lesions, while patients with wide-spread bone metastases revealed significantly increased uptake values. In both men and women highest bone uptake was obtained (p <0.05 ) in subjects younger than 20 years with active epiphyseal growth plates. In men, bone uptake slowly decreased with age up to 60 years and then showed a tendency towards increasing uptake values. In women, the mean uptake reached a minimun in the decade 20-29 years and then slowly increased with a positive linear correlation of age and uptake in subjects older than 55 years (r = 0.57). Conclusion: Since the results proposed in this study are in good agreement with data from literature, the new method used for quantification could be validated in a large number of patients. Furthermore, age- and sexrelated normal bone uptake values of Tc-99m-HDP covering a wide range of age could be presented for this method as a basis for further studies on bone uptake.
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