Background Tumour necrosis factor α (TNFα) is a crucial proinflammatory cytokine present in inflamed joints of rheumatoid arthritis (RA) patients. Therapies using anti-TNFα monoclonal antibodies (MAb) have proven their efficacy in RA and other chronic inflammatory diseases. Such antibodies could also be used to detect inflammation.
Objectives To determine the potential of a 99Tc-labelled anti-TNFα MAb to image synovitis in patients with RA.
Methods Eight consenting patients with active RA, defined as a disease activity score (DAS) > 3.2 were enrolled in the study. No previous anti-TNFα therapy was allowed. NSAIDs and low-dose steroids were kept stable during the study. Patients received a single dose of 300 MBq 99Tc-labelled anti-TNFα MAb and whole body images and spot views were obtained with a double-headed gamma camera.
Results Prominent uptake of the radiolabeled anti-TNFα MAb was clearly visible in inflamed joints of all patients examined. The distribution of the label was compatible with binding to both soluble and membrane-bound TNFα. To elucidate the latter, displacement studies are now in process.
Conclusion Our results show that scintigraphic detection of inflammation with anti-TNFα MAb is feasible. The potential use of this technique to monitor disease activity and response to therapy deserves further investigation.
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