Imaging infection/inflammations. Pathophysiologic basis and radiopharmaceuticals.
Imaging infection/inflammations. Pathophysiologic basis and radiopharmaceuticals.
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感染/炎症成像。
DOI：
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
M. Thakur
中科院分区：
文献类型：
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作者：
R. Weiner;M. Thakur
炎症是微循环中的局部反应，其特征在于流体和白细胞从血液转运到细胞外组织中。在放射性药物递送中，该部位处血流的增加和内皮完整性的丧失特别重要。微血管的这种改变可能是组织损伤的最早反应。在炎症开始的数小时内，该部位被大量的多形核白细胞（PMN）侵入。这些细胞被各种化学引诱剂引导到该部位，并能够集中在炎症附近的血管中。PMN和内皮细胞上的三个粘附分子家族，如整合素、免疫球蛋白超基因和选择素的上调是该过程的重要组成部分。虽然111 In和99 mTc标记的WBC在检测感染和炎症方面都取得了无可争议的成功，但存在明显的局限性。由于这些局限性，已经有许多尝试来开发主要针对PMN的新药剂。放射性试剂可以与存在于该部位的PMN结合，或者被携带到与PMN结合的部位。这些靶标可以是活化的PMN上的PMN相关抗原或受体。四种单克隆抗体CEA-47、BW 250/183、IMMU-NN 3和MCA-480已被广泛用于人类脓肿/感染检测。
Inflammation is a localized reaction in the microcirculation that is characterized by fluid and leukocyte transport from the blood into the extracellular tissues. The increase in blood flow and loss of endothelial integrity at the site are particularly important in radiopharmaceutical delivery. This alteration of the microvasculature is probably the earliest response to tissue injury. Within hours of inflammation initiation, the site is invaded with large numbers of polymorphonuclear leukocytes (PMN). These cells are led to the site by various chemo-attractants and are able to concentrate in the blood vessels near the inflammation. Upregulation of three families of adhesion molecules, such as the integrins, immunoglobulin supergene and selectins on both the PMN and endothelial cells is an essential component of this process. While both 111In and 99mTc labeled WBC have had undisputed success in detecting infections and inflammations but there are significant limitations. Because of these limitations there have been many attempts to develop new agents which have primarily targeted PMN. The radioactive agent can either bind to the PMN present at the site or be carried to the site bound to PMN. These targets can be PMN-associated antigens or receptors on an activated PMN. Four monoclonal antibodies, CEA-47, BW 250/183, IMMU-NN3 and MCA-480 have been examined extensively for abscess/infection detection in humans.