THE DEVELOPMENT OF RADIATION SYNOVECTOMY IN ARTHRITIS

关节炎放射滑膜切除术的进展

• 批准号: 3157405
• 负责人: CLEMENT B SLEDGE
• 金额: $ 27.91万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1984
• 资助国家: 美国
• 起止时间: 1984-12-01 至 1993-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3157405
• 关键词: allergic arthritis; articular cartilage; bioassay; disease /disorder model; histopathology; human subject; human therapy evaluation; laboratory rabbit; musculoskeletal disorder diagnosis; radiation therapy dosage; radiobiology; radiological health; radionuclide imaging /scanning; radionuclide therapy; radiopharmacology; rheumatoid arthritis; skeletal pharmacology; thermometry

Radiation synovectomy produces functional ablation of inflamed synovium following intra-articular administration of short-range, beta-emitting radioisotopes. The isotope is complexed to a particulate carrier in order to delay and decrease leakage rom the joint, thereby reducing the total body radiation exposure. We have developed a new agent for radiation synovectomy - dysprosium-165-ferric hydroxide macroaggregates (165Dy-FHMA) - and have been using it in clinical trials over the past six years. Ninety-five of 112 (85%) rheumatoid knees showed significant improvement one year after treatment. Leakage of radioactivity from the treated joint has been less than 1% of the injected dose. We propose to conduct a prospective trial of 165Dy-FHMA to confirm the efficacy indicated in our previous uncontrolled studies. Anticipating a favorable outcome from these studies, and recognizing the impractical half life of 165Dy, we propose to develop new agents that will be appropriate for use in areas not adjacent to a reactor, greatly extending the availability of this therapy. Other isotopes and carrier systems, in various combinations, will be investigated in the animal model of antigen-induced arthritis. Potential isotopes include rhenium 188 and yttrium-90; carriers include FHMA, sulfur colloids and lipophilic complexes. In addition to its usefulness in rheumatoid arthritis of the knee (and potentially other joints), our preliminary studies in hemophilic arthropathy of the knee and pigmented villonodular synovitis indicate a high degree of probability that radiation synovectomy will be useful in these disorders as well. Objective evaluation of the efficacy of treatment remains problematic; to address this problem, we propose to continue our investigation of indium-111 scanning as a clinically useful, objective and quantitative indicator of inflammation in the synovial tissues.

放射滑膜切除术可对炎性组织进行功能性消融