RADIOPHARMACEUTICALS FOR THE STUDY OF INFLAMMATORY PROCESSES - A REVIEW

Recent advances in our understanding of the pathophysiology of inflamm atory processes at the molecular level, combined with progress in radi opharmaceutical sciences, has boosted the development of nuclear medic ine techniques for the diagnosis of infection/inflammation. The use of radiolabelled white blood cells has been studied and evaluated in sev eral pathologies and is still the reference method. Several alternativ e approaches, however, have been developed that may, in the future, im prove the specificity and the ease of use of the technique. For the fi rst time, a radiopharmaceutical that may distinguish between sterile a nd septic inflammation, Tc-99(m)-Infecton, has been developed. Also, m onoclonal antibody fragments, cytokines and a variety of new synthetic peptides that bind specifically to granulocytes have been prepared. P articularly promising appears to be the detection of the expression of adhesion molecules by activated endothelium as a first-line technique for the detection of inflammatory foci. For the diagnosis of autoimmu nity and chronic inflammatory processes, important progress has also b een made. Autoimmunity can now be studied by in vivo detection of tiss ue-infiltrating activated lymphocytes by radiolabelled interleukin-2. A radiopharmaceutical for the diagnosis of monocyte infiltration, J001 X, is also available, and the commercially available Octreoscan(R) hol ds promise in autoimmune and chronic inflammatory diseases. The effort s of the scientific community have given us new perspectives in diagno stic nuclear medicine: easier techniques that promise better sensitivi ty and specificity are now also being tested for the study of new dise ase conditions. The results of the clinical trials now in progress wil l determine the future of this challenging and fascinating field and t he role of nuclear medicine in the management of patients with infecti on/inflammation.