IMAGING OF PULMONARY-DISEASE IN SCLERODERMA WITH J001X SCINTIGRAPHY

Background - J001X is an acylated poly-galactoside isolated from the m embrane of Klebsiella and able to interact with macrophages, mainly in their activated state. The aim of the present study was to determine the ability of 99m-labelled technetium (Tc-99m)-J001X scintigraphy to image pulmonary disease, defined by high resolution computed tomograph ic scanning and pulmonary function tests, in patients suffering from s cleroderma. Methods - Patients were considered to have pulmonary disea se when they had at least two positive signs on high resolution comput ed tomography, or a decrease in lung volume and single breath carbon m onoxide transfer, or both, with no disease process other than sclerode rma in their medical history. Positive J001X scintigraphic imaging was defined by symmetrical bilateral pulmonary fixation three and five ho urs after inhalation of Tc-99m-J001X. J001X scintigraphic results were compared with disease activity as indicated by bronchoalveolar lavage (BAL) fluid lymphocytosis. Results - Seventeen patients were studied, in 12 of whom J001X scintigraphy was positive. There was no correlati on between BAL lymphocytosis and J001X scintigraphic findings, nor bet ween BAL and pulmonary scleroderma. This was not surprising because of the high specificity of macrophage targeting by J001X. Conclusions - Follow up of a larger population over a longer period is needed to est ablish whether there is a prognostic value for positive J001X scintigr aphic findings in scleroderma.