A type of computed tomography (CT) imaging known as SPECT (Single Photon Emission Computed Tomography) in combination with a new imaging agent could allow clinicians and researchers to visualize inflammation in the lungs to better target treatment to patients.
Interstitial lung disease includes over 200 conditions that scar and inflame the lungs. Researchers estimate around 650,000 people in the U.S. have this kind of lung disease and 50,000 new patients are diagnosed in the U.S. each year with interstitial pulmonary fibrosis (IPF) alone. The main problem with interstitial lung disease is that doctors currently cannot reliably tell inflammation from scarring without invasive diagnostic procedures.
In this Phase II study, presented at the Society of Nuclear Medicine and Molecular Imaging Annual Meeting in Los Angeles, Druin Burch, consultant physician at John Radcliffe Hospital in Oxford, U.K., and colleagues tested whether a radioactive imaging agent, 99mTc-maraciclatide, injected into patients imaged with SPECT-CT could detect inflammation in the lungs.
“The molecular imaging agent 99mTc-maraciclatide binds to αvβ3 integrin, which is upregulated in vascular endothelial cells during angiogenesis, a cardinal feature of inflammation,” explain Burch and colleagues. “The agent has demonstrated diagnostic promise in other inflammatory conditions such as endometriosis.”
Overall, 15 people were scanned as part of the study: five healthy controls, five with IPF, and five with fibrotic hypersensitivity pneumonitis, which involves more active inflammation. The researchers found that those with fibrotic hypersensitivity pneumonitis had nearly double the inflammatory signal on imaging of healthy controls. Patients with IPF were somewhere between these two groups, which might be expected as IPF is known to be more fibrotic than inflammatory.
“While current imaging techniques can provide a structural view of fibrosis in the lungs, there is no reliable, non-invasive way to identify inflammation,” commented Burch in a press statement. “A tool that could detect inflammation in interstitial lung disease patients could help pinpoint those most likely to respond to anti-inflammatory therapy.”
To reach a wider group of patients a Phase III study is required to test the imaging agent in more people. 99mTc-maraciclatide has FDA Fast Track status for use in patients with interstitial lung disease, so if a larger study is successful it could be available to patients in less than five years.
“Being able to differentiate the fibrotic and inflammation stages of interstitial lung disease is not just beneficial to inform treatment decisions, but also for the development new therapies,” said Burch. “This approach has the potential to unlock a wide range of anti-inflammatory drugs.”
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