Formulation of freeze-dried radiopharmaceutical immunoglobulin G – kit for infection and inflammation imaging

Marie, Alemu (2019) Formulation of freeze-dried radiopharmaceutical immunoglobulin G – kit for infection and inflammation imaging. Masters thesis, Goce Delcev University Stip.

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Infection and inflammation still remain the major cause of mortality and morbidity in most developing countries despite advances in treatment and diagnosis [1] Appropriate diagnosis of infection and inflammation at an early stage is crucial to the improvement of the efficiency of treatment and prognosis. Different diagnosis modalities such as ultrasound, computed tomography (CT), magnetic resonance (MRI), etc. have been used, which only gives anatomical sites of infection and inflammation foci. Nuclear medicine procedure using radiopharmaceuticals is invaluable in providing both anatomical and functional imaging of infection and inflammation information [2, 3].
Several radiopharmaceuticals have been developed, evaluated and clinically used to identify the site of infection and inflammation in a specific situation. These include 99mTcmethylene diphosphonate (MDP), 67Ga citrate, radiolabeled leukocytes, FDG positron emission tomography, radiolabeled antimicrobial, radiolabeled antibacterial peptides, radiolabeled monoclonal and polyclonal human immunoglobulin G (antibodies). However, none of them is an ideal radiopharmaceutical for the detection of infection and inflammation [4].
Currently 99mTc labeled leukocyte radiopharmaceutical is accepted as a gold standard method for the detection of acute infection and inflammation foci. Unfortunately, the method has several disadvantages limiting its application. It requires a complex blood handling procedure that is a risk for contamination of a patient or personnel, additional facility, equipment, as well as trained experts. Furthermore, the accumulation of radioactivity in non-target organs; 99mTc-HMPAO in bowel, and 99mTc nano-colloid in RES organs gives false positive results. It is contraindicated in patients with neutropenia and infants, as it requires a large volume of blood for the procedure. Another limitation with this method is the condition that affects leukocyte harvesting and function resulting in poor image quality for instance, patient receiving chemotherapy and other immune modulating agent like glucocorticoids [5, 6].
Furthermore, a Radiopharmacy unit in developing African countries is classified under 2a international atomic energy agency Radiopharmacy classification, which restricts to handle white blood cell labeling.
Therefore, there is need for a new agent at least as good as radiolabeled leukocyte, but easier to prepare, and without its inherent risks. Since there is a commercially introduced injectable form of human immunoglobulin (IgG) suitable for intravenous administration for the treatment of immunodeficiency syndrome, it is good to reconsider radiolabeling of IgG for immunodetection of infection and inflammation foci in the situation where the facility, equipment and personnel are not adequate and radiolabeled leukocyte is contraindicated. Radiolabeled IgG was previously used for the detection of infection and inflammation foci, although it is less specific, radiolabeled IgG offers a simple and practical approach for early detection of acute focal infection. In addition, different authors used various techniques for labeling antibodies and obtained promising results.
The present study shows the approach how to formulate a radiopharmaceutical kit for the detection of infection and inflammation foci using human immunoglobulin G polyclonal antibody. The kit labeled with 99mTc by direct and indirect methods.

Item Type: Thesis (Masters)
Subjects: Medical and Health Sciences > Other medical sciences
Divisions: Faculty of Medical Science
Depositing User: Katerina Hadzi-Vasileva
Date Deposited: 21 Feb 2019 11:23
Last Modified: 28 Mar 2019 10:39

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