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[放射性标记单克隆抗体在诊断成像中的应用]

[Use of radiolabeled monoclonal antibodies for diagnostic imaging].

作者信息

Endo K

机构信息

Kyoto University Hospital.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1990 Aug 25;50(8):901-9.

PMID:2235337
Abstract

Monoclonal antibodies (MoAbs) are expected to carry radionuclides selectively to target tissues and to offer antigen-specific diagnosis. Indium (In)-111 has many favorable nuclear properties and is efficiently labeled with MoAbs using DTPA as a bifunctional chelating agent. In-111 labeled MoAbs are clinically employed for the diagnosis of malignant melanoma, colorectal cancer and acute myocardial infarction in Japan. Although non-specific deposit of In-111 was seen in liver and bone-marrow, scintigraphy using In-111 labeled MoAbs was encouraging, since it detected about 80% of tumors, tumors missed by conventional diagnostic methods such as CT, and tumors in patients with normal serum CEA values, and acute myocarditis as well as acute myocardial infarction was positive with In-11 labeled Fab fraction of anti-myosin Ab. Acute or subacute toxicity was not observed. Human anti-murine antibody (HAMA) was detected in 53 of 64 (82.8%) patients who were intravenously administered with 20 to 42 mg of anti-melanoma or anti-CEA MoAbs (whole IgG). In contrast, only 5 of 406 (1.2%) patients had detectable levels of HAMA in their serum after receiving 0.5 mg of Fab fraction of MoAb. Recently mouse-human chimeric Ab has been produced by recombinant DNA techniques, which localized well in xenografted tumors and seems to be promising for clinical use. Investigations are under way to increase the tumor to non-tumor ratio by modifying chelating agents for coupling MoAbs with radionuclides.

摘要

单克隆抗体(MoAbs)有望将放射性核素选择性地带到靶组织,从而实现抗原特异性诊断。铟(In)-111具有许多良好的核性质,并且使用二乙三胺五乙酸(DTPA)作为双功能螯合剂能够有效地将其标记到单克隆抗体上。在日本,铟-111标记的单克隆抗体被临床用于诊断恶性黑色素瘤、结直肠癌和急性心肌梗死。尽管在肝脏和骨髓中可见铟-111的非特异性沉积,但使用铟-111标记的单克隆抗体进行闪烁扫描是令人鼓舞的,因为它能检测出约80%的肿瘤、传统诊断方法(如CT)漏诊的肿瘤、血清癌胚抗原(CEA)值正常的患者体内的肿瘤,并且抗肌球蛋白抗体的铟-111标记的Fab片段对急性心肌炎以及急性心肌梗死呈阳性反应。未观察到急性或亚急性毒性。在静脉注射20至42毫克抗黑色素瘤或抗CEA单克隆抗体(全IgG)的64例患者中,有53例(82.8%)检测到了人抗鼠抗体(HAMA)。相比之下,在接受0.5毫克单克隆抗体Fab片段的406例患者中,只有5例(1.2%)血清中可检测到HAMA水平。最近,通过重组DNA技术生产出了鼠-人嵌合抗体,其在异种移植肿瘤中定位良好,似乎具有临床应用前景。目前正在进行研究,通过改进用于将单克隆抗体与放射性核素偶联的螯合剂来提高肿瘤与非肿瘤的比例。

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