Clinical evaluation of antimicrobial peptide [99mTc/Tricine/HYNIC0]ubiquicidin 29–41 as a human-specific infection imaging agent

Gandomkar, Mostafa; Najafi, Reza; Shafiei, Mohammad; Mazidi, Mohammad; Goudarzi, Mostafa; Mirfallah, Seyed Hassan; Ebrahimi, Farhad; Heydarpor, Hamid Reza; Abdie, Noroz

doi:10.1016/j.nucmedbio.2008.11.003

« Previous Next »Nuclear Medicine and Biology
Volume 36, Issue 2 , Pages 199-205, February 2009

Clinical evaluation of antimicrobial peptide [^99mTc/Tricine/HYNIC⁰]ubiquicidin 29–41 as a human-specific infection imaging agent

Mostafa Gandomkar
- Nuclear Science Research School, Nuclear Science and Technology Research Institute, Atomic Energy Organization of Iran, Tehran, 11365-3486, Iran
- Corresponding author. Tel.: + 98 21 88221097; fax: +98 21 88021412.
Reza Najafi
- Nuclear Science Research School, Nuclear Science and Technology Research Institute, Atomic Energy Organization of Iran, Tehran, 11365-3486, Iran
Mohammad Shafiei
- Nuclear Science Research School, Nuclear Science and Technology Research Institute, Atomic Energy Organization of Iran, Tehran, 11365-3486, Iran
Mohammad Mazidi
- Nuclear Science Research School, Nuclear Science and Technology Research Institute, Atomic Energy Organization of Iran, Tehran, 11365-3486, Iran
Mostafa Goudarzi
- Nuclear Science Research School, Nuclear Science and Technology Research Institute, Atomic Energy Organization of Iran, Tehran, 11365-3486, Iran
Seyed Hassan Mirfallah
- Nuclear Science Research School, Nuclear Science and Technology Research Institute, Atomic Energy Organization of Iran, Tehran, 11365-3486, Iran
Farhad Ebrahimi
- Noor Institute of Nuclear Medicine, Tehran, Iran
Hamid Reza Heydarpor
- Noor Institute of Nuclear Medicine, Tehran, Iran
Noroz Abdie
- Noor Institute of Nuclear Medicine, Tehran, Iran

Received 26 August 2008; received in revised form 27 October 2008; accepted 11 November 2008.

Abstract

Introduction

Ubiquicidin (UBI) 29–41 is a cationic synthetic antimicrobial peptide fragment that binds preferentially with the anionic microbial cell membrane at the site of infection. This study was conducted to evaluate the potentiality of [^99mTc/Tricine/HYNIC⁰]UBI 29–41 prepared from lyophilized kits as an infection imaging agent in humans.

Methods

Seven patients (5 males and 2 females; mean age=55 years; age range=35–75 years) with suspected bone or soft-tissue infections participated in this study. [^99mTc/Tricine/HYNIC]UBI 29–41, corresponding to activity in the range 555–740 MBq added to 40 μg of peptide obtained from instant freeze-dried kit formulations with radiochemical purities >95%, was injected intravenously. A 45-min dynamic study was followed by spot views of the suspected region of infection (target) and a corresponding normal area (nontarget). Whole-body anterior and posterior images were also acquired at 30, 60 and 120 min after injection. True- or false-positive or true- or false-negative images were interpreted upon bacterial culture, radiography, clinical tests and bone scanning.

Results

The biodistribution of [^99mTc/Tricine/HYNIC]UBI 29–41 in patients showed rapid accumulation of activity in the kidneys in the first 30 min after injection that gradually declined and accumulated in the urinary bladder. There were positive findings in five studies and negative findings in two. Findings were subsequently confirmed to be true positive or negative. Images showed minimal accumulation in nontarget tissues, with an average target/nontarget ratio of 2.10±0.33 in positive lesions at 30 min.

Conclusion

Given its favorable clinical characteristics, [^99mTc/Tricine/HYNIC]UBI 29–41 shows promise as a tracer for infection imaging that allows early diagnosis (30 min) of infection.

Keywords: Ubiquicidin, Antimicrobial peptide, HYNIC, Infection imaging, ^99mTc