De Gersem R, Jamar F
Centre of Nuclear Medicine, Louvain Catholic University, Brussels, Belgium.
Q J Nucl Med Mol Imaging. 2010 Dec;54(6):617-28.
Radiolabeled human non specific immunoglobulin G (IgG or HIG) was proposed in the early nineties as a potential tracer for imaging infection and sterile inflammation. Formulations with ¹¹¹In and (99m)Tc as the label were developed and extensive preclinical work was undertaken to assess its potential as a diagnostic agent. ¹¹¹In-HIG was used in a number of clinical studies and proved efficient in detecting orthopedic infections, especially in patients with prostheses, fever of unknown origin, opportunistic infections in immunocompromised patients, including patients infected with the human immunodeficiency virus and neutropenic patients. In the latter patients, there was no need for blood manipulation to harvest white cells for leukocyte labeling which was a considerable advantage. (99m)Tc-HIG was also successfully used for imaging sterile arthritis, especially rheumatoid arthritis. Two decades later, radiolabeled HIG is almost completely abandoned as a general purpose tracer for imaging infection and inflammation and this article aims to find out why this has happened.
放射性标记的人非特异性免疫球蛋白G（IgG或HIG）在九十年代初被提出，作为一种用于感染和无菌性炎症成像的潜在示踪剂。开发了以¹¹¹In和（99m）Tc作为标记的制剂，并开展了广泛的临床前工作以评估其作为诊断剂的潜力。¹¹¹In-HIG被用于多项临床研究，并被证明在检测骨科感染方面有效，特别是在假体植入患者、不明原因发热患者、免疫功能低下患者（包括感染人类免疫缺陷病毒的患者和中性粒细胞减少患者）的机会性感染中。对于后一类患者，无需进行血液处理来采集白细胞进行白细胞标记，这是一个相当大的优势。（99m）Tc-HIG也成功用于无菌性关节炎成像，尤其是类风湿性关节炎。二十年后，放射性标记的HIG几乎完全被弃用，不再作为用于感染和炎症成像的通用示踪剂，本文旨在找出发生这种情况的原因。
