de Jong M, Rolleman E J, Bernard B F, Visser T J, Bakker W H, Breeman W A, Krenning E P
Department of Nuclear Medicine, Erasmus Medical University, Rotterdam, The Netherlands.
J Nucl Med. 1996 Aug;37(8):1388-92.
Indium-111-DTPA-octreotide has been successfully used for imaging of somatostatin receptor-positive lesions. However, significant renal uptake of 111In-DTPA-octreotide exists, reducing the scintigraphic sensitivity for detection of small tumors in the perirenal region and the possibilities for radiotherapy. The aim of the present study was to determine whether renal uptake of 111In-DTPA-octreotide could be reduced in vivo in rats.
Male Wistar rats (200-250 g) were placed in metabolic cages and injected with 111In-DTPA-octreotide (0.2 MBq and 0.5 microgram octreotide), in the presence or absence of re-uptake blockers. At time t = 20 hr after injection, rats were sacrificed and organs were isolated and counted for radioactivity.
Adding NH4Cl or NaHCO3 to the food, resulting in the production of more acid or alkaline urine respectively, resulted in less radioactivity in the kidneys 20 hr after injection compared to controls. Lysine in a single dose of 400 mg/kg resulted in an inhibition of kidney uptake of 40%. When lysine was injected 30 min before 111In-DTPA-octreotide, the inhibition was 25%. Arginine had less effect on tubular uptake of 111In-DTPA-octreotide than lysine (20% inhibition). Sodium maleate inhibited kidney uptake of 111In-DTPA-octreotide most successfully. Acetazolamide (100 mg/kg), succinylacetone (100 mg/kg), cystine dimethylester (340 mg/kg) and increase in urinary flow did not influence 111In-DTPA-octreotide retention in the kidneys.
It appeared possible to reduce re-uptake of 111In-DTPA-octreotide in the rat kidney in vivo. The most pronounced effects were seen after administration of sodium maleate or lysine but, because of the described toxic effects of maleate, we will study further only the effects of lysine in a clinical setting.
铟 - 111 - 二乙三胺五乙酸 - 奥曲肽已成功用于生长抑素受体阳性病变的成像。然而,铟 - 111 - 二乙三胺五乙酸 - 奥曲肽在肾脏有显著摄取,降低了肾周区域小肿瘤检测的闪烁显像敏感性以及放射治疗的可能性。本研究的目的是确定在大鼠体内能否降低铟 - 111 - 二乙三胺五乙酸 - 奥曲肽的肾脏摄取。
将雄性Wistar大鼠(200 - 250克)置于代谢笼中,在有或无再摄取阻滞剂的情况下注射铟 - 111 - 二乙三胺五乙酸 - 奥曲肽(0.2兆贝可及0.5微克奥曲肽)。注射后20小时,处死大鼠,分离器官并计数放射性。
在食物中添加氯化铵或碳酸氢钠,分别导致产生更多酸性或碱性尿液,与对照组相比,注射后20小时肾脏中的放射性减少。单次剂量400毫克/千克的赖氨酸可使肾脏摄取抑制40%。当在注射铟 - 111 - 二乙三胺五乙酸 - 奥曲肽前30分钟注射赖氨酸时,抑制率为25%。精氨酸对铟 - 111 - 二乙三胺五乙酸 - 奥曲肽肾小管摄取的影响小于赖氨酸(抑制率20%)。马来酸钠最成功地抑制了铟 - 111 - 二乙三胺五乙酸 - 奥曲肽的肾脏摄取。乙酰唑胺(100毫克/千克)、琥珀酰丙酮(100毫克/千克)、胱氨酸二甲酯(340毫克/千克)以及尿流量增加均未影响铟 - 111 - 二乙三胺五乙酸 - 奥曲肽在肾脏中的潴留。
在大鼠体内似乎有可能降低铟 - 111 - 二乙三胺五乙酸 - 奥曲肽在肾脏的再摄取。给予马来酸钠或赖氨酸后观察到最明显的效果,但由于马来酸钠所述的毒性作用,我们将仅在临床环境中进一步研究赖氨酸的作用。