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In vivo evaluation of TNF-alpha in the lungs of patients affected by sarcoidosis.

Galli F, Lanzolla T, Pietrangeli V, Malviya G, Ricci A, Bruno P, Ragni P, Scopinaro F, Mariotta S, Signore A - Biomed Res Int (2015)

Bottom Line: SUV mean and SUV max were calculated over lungs for FDG.Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [(18)F]-FDG PET.In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative   (99m)Tc-infliximab scintigraphy.

View Article: PubMed Central - PubMed

Affiliation: Nuclear Medicine Unit, Department of Medical-Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Ospedale S. Andrea, "Sapienza" University of Rome, Via di Grottarossa 1035, 00189 Roma, Italy.

ABSTRACT

Introduction: Sarcoidosis is a multisystemic granulomatous disorder characterized by multiple noncaseating granulomas involving intrathoracic lymph nodes and lung parenchyma. Recently, the use of anti-tumor necrosis factor alpha (anti-TNFα) agents has been introduced for therapy of chronic and refractory sarcoidosis with controversial results. Infliximab (Remicade) is a chimeric monoclonal antibody (mAb) that recognizes and binds TNFα, neutralizing its biological effects. In the present study,   (99m)Tc labelled infliximab was used to study the expression of TNFα in sarcoid lesions and to evaluate its role as a predictive marker in response to therapy with Remicade.

Material and methods: A total of 10 patients with newly diagnosed sarcoidosis were enrolled together with 10 control patients affected by rheumatoid arthritis. All patients were studied by planar imaging of the chest with   (99m)Tc-infliximab at 6 h and 24 h and total body [(18)F]-FDG PET/CT. Regions of interest were drawn over the lungs and the right arm and target-to-background ratios were analysed for   (99m)Tc-infliximab. SUV mean and SUV max were calculated over lungs for FDG.

Results and discussion: Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [(18)F]-FDG PET.

Conclusion: In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative   (99m)Tc-infliximab scintigraphy.

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Related in: MedlinePlus

Correlation between lung uptake of 99mTc-infliximab at 6 h (T/B ratio) and CD4+/CD8+ ratio in lymphocytes from BAL. Correlation coefficient is r = 0.6487 and P = n.s.
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fig4: Correlation between lung uptake of 99mTc-infliximab at 6 h (T/B ratio) and CD4+/CD8+ ratio in lymphocytes from BAL. Correlation coefficient is r = 0.6487 and P = n.s.

Mentions: Comparing T/B ratios on 99mTc-infliximab scintigraphy at 6 h and 24 h, with SUVmax⁡ values of pulmonary uptake of FDG, no significant correlation was observed between these parameters. In only three patients a detectable diffuse bilateral lung uptake of anti-TNFα at 6 h and 24 h on scintigraphic images was present, which could indicate increased levels of TNFα in lung parenchyma of these patients. When we compared the mean values of lung uptake of labelled anti-TNFα mAb in sarcoidosis patients and control subjects, we found significant differences at 6 h (4.28 ± 0.57 versus 3.2 ± 0.74; patients versus controls; P = 0.002) but not at 24 h (3.15 ± 0.45 versus 2.7 ± 0.65; patients versus controls; P = 0.057). A moderate correlation was found between CD4+/CD8+ ratio peripheral blood lymphocytes and the value of T/B ratio at 6 h (Figure 3) but no correlation was found between average value of T/B ratio at 6 h or 24 h and, respectively, CD4+/CD8+ ratio and cellularity of BAL (Figure 4).


In vivo evaluation of TNF-alpha in the lungs of patients affected by sarcoidosis.

Galli F, Lanzolla T, Pietrangeli V, Malviya G, Ricci A, Bruno P, Ragni P, Scopinaro F, Mariotta S, Signore A - Biomed Res Int (2015)

Correlation between lung uptake of 99mTc-infliximab at 6 h (T/B ratio) and CD4+/CD8+ ratio in lymphocytes from BAL. Correlation coefficient is r = 0.6487 and P = n.s.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383433&req=5

fig4: Correlation between lung uptake of 99mTc-infliximab at 6 h (T/B ratio) and CD4+/CD8+ ratio in lymphocytes from BAL. Correlation coefficient is r = 0.6487 and P = n.s.
Mentions: Comparing T/B ratios on 99mTc-infliximab scintigraphy at 6 h and 24 h, with SUVmax⁡ values of pulmonary uptake of FDG, no significant correlation was observed between these parameters. In only three patients a detectable diffuse bilateral lung uptake of anti-TNFα at 6 h and 24 h on scintigraphic images was present, which could indicate increased levels of TNFα in lung parenchyma of these patients. When we compared the mean values of lung uptake of labelled anti-TNFα mAb in sarcoidosis patients and control subjects, we found significant differences at 6 h (4.28 ± 0.57 versus 3.2 ± 0.74; patients versus controls; P = 0.002) but not at 24 h (3.15 ± 0.45 versus 2.7 ± 0.65; patients versus controls; P = 0.057). A moderate correlation was found between CD4+/CD8+ ratio peripheral blood lymphocytes and the value of T/B ratio at 6 h (Figure 3) but no correlation was found between average value of T/B ratio at 6 h or 24 h and, respectively, CD4+/CD8+ ratio and cellularity of BAL (Figure 4).

Bottom Line: SUV mean and SUV max were calculated over lungs for FDG.Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [(18)F]-FDG PET.In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative   (99m)Tc-infliximab scintigraphy.

View Article: PubMed Central - PubMed

Affiliation: Nuclear Medicine Unit, Department of Medical-Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Ospedale S. Andrea, "Sapienza" University of Rome, Via di Grottarossa 1035, 00189 Roma, Italy.

ABSTRACT

Introduction: Sarcoidosis is a multisystemic granulomatous disorder characterized by multiple noncaseating granulomas involving intrathoracic lymph nodes and lung parenchyma. Recently, the use of anti-tumor necrosis factor alpha (anti-TNFα) agents has been introduced for therapy of chronic and refractory sarcoidosis with controversial results. Infliximab (Remicade) is a chimeric monoclonal antibody (mAb) that recognizes and binds TNFα, neutralizing its biological effects. In the present study,   (99m)Tc labelled infliximab was used to study the expression of TNFα in sarcoid lesions and to evaluate its role as a predictive marker in response to therapy with Remicade.

Material and methods: A total of 10 patients with newly diagnosed sarcoidosis were enrolled together with 10 control patients affected by rheumatoid arthritis. All patients were studied by planar imaging of the chest with   (99m)Tc-infliximab at 6 h and 24 h and total body [(18)F]-FDG PET/CT. Regions of interest were drawn over the lungs and the right arm and target-to-background ratios were analysed for   (99m)Tc-infliximab. SUV mean and SUV max were calculated over lungs for FDG.

Results and discussion: Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [(18)F]-FDG PET.

Conclusion: In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative   (99m)Tc-infliximab scintigraphy.

Show MeSH
Related in: MedlinePlus