Sheremeta M S, Trukhin A A, Yartsev V D, Yudakov D V, Korchagina M O, Gojaeva S A
Endocrinology Research Centre.
M.M. Krasnov Scientific Research Institute of Eye Diseases.
Probl Endokrinol (Mosk). 2024 Feb 27;70(1):13-17. doi: 10.14341/probl13163.
Within the framework of the article, the authors analyzed the available information about the damage to the lacrimal apparatus during radionuclide therapy. In focus of article lesions of the lacrimal production system, the main and accessory lacrimal glands, as well as lacrimal drainage are considered. It was found that damage to the lacrimal apparatus is characteristic of 131I therapy for thyroid cancer, as well as for radioligand therapy using anti-PSMA antibodies labeled with 177Lu and 225Ac. 177Lu-PSMA and 225Ac-PSMA may damage the lacrimal gland with the formation of a clinically pronounced "dry eye syndrome". The pathogenesis of such lesions is associated with the accumulation of a radioisotope in the tissues of the lacrimal apparatus, while during therapy with 131I, accumulation is realized due to the expression of the sodium-iodine symporter in the nasolacrimal duct, and during therapy with 177Lu-PSMA and 225Ac-PSMA, the radiobiological effect is realized in connection with the expression PSMA by lacrimal tissue. An analysis of the available sources showed that to date there are no results of systematic studies on the problem, there is a lack of knowledge regarding the individual risks of developing these complications, methods for their prevention that have proven effectiveness have not been developed, and the treatment methods used, having relatively low efficiency, are not specialized. The authors concluded that the strengthening of interdisciplinary interaction, as well as the organization verification methodology and correct studies, can contribute to solving problems related to the study of the complications under consideration.
在本文框架内，作者分析了放射性核素治疗期间泪器损伤的现有信息。本文重点关注泪液分泌系统、主泪腺和副泪腺以及泪液引流的病变。研究发现，泪器损伤是甲状腺癌131I治疗以及使用177Lu和225Ac标记的抗PSMA抗体进行放射性配体治疗的特征。177Lu-PSMA和225Ac-PSMA可能会损伤泪腺并形成临床上明显的“干眼综合征”。此类病变的发病机制与放射性同位素在泪器组织中的蓄积有关，在131I治疗期间，由于鼻泪管中钠碘同向转运体的表达而发生蓄积，而在177Lu-PSMA和225Ac-PSMA治疗期间，放射生物学效应是与泪腺组织中PSMA的表达相关而实现的。对现有资料的分析表明，迄今为止，尚无关于该问题的系统研究结果，缺乏关于发生这些并发症的个体风险的知识，尚未开发出已证实有效的预防方法，且所采用的治疗方法效率相对较低，缺乏针对性。作者得出结论，加强跨学科互动以及组织验证方法和正确的研究，有助于解决与所考虑并发症研究相关的问题。
