Abstract
Objectives: To validate 99mTc-labeled arginylglycylaspartic acid (99mTc-3PRGD2) scintigraphy as a means to image synovial neoangiogenesis in joints afflicted by rheumatoid arthritis and to investigate its potential in the early detection and management of rheumatoid arthritis.Methods: Rheumatoid arthritis and osteoarthritis were generated in Sprague Dawley rats by type II collagen immunization and papain injection, respectively. Rats were imaged with 99mTc-3PRGD2 and 99mTc- methyl diphosphonate (99mTc MDP). X-ray images were also obtained and assessed by a radiologist. Immunohistochemistry of αvβ3 and CD31confirmed the onset of synovial neoangiogenesis. The effect of bevacizumab on rheumatoid arthritis was followed with 99mTc-3PRGD2 scintigraphy. A patient with rheumatoid arthritis and a healthy volunteer were scanned with 99mTc-3PRGD2.Results: Two weeks after immunization, a significant increase in 99mTc-3PRGD2 was observed in the joints of the rheumatoid arthritis model though uptake in osteoarthritis model and untreated controls was low. 99mTc-MDP whole body scans failed to distinguish early rheumatoid arthritis joints from healthy controls. The expression of αvβ3 and CD31was significantly higher in the joints of rheumatoid arthritis rats compared to normal controls. In serial 99mTc-3PRGD2 scintigraphy studies, 99mTc-3PRGD2 uptake increased in parallel with disease progression. Bevacizumab anti-angiogenetic therapy both improved the symptoms of the rheumatoid arthritis rats and significantly decreased 99mTc-3PRGD2 uptake. Significantly higher 99mTc-3PRGD2 accumulation was also observed in rheumatoid arthritis joints in the patient.Conclusions: Our findings indicate that 99mTc-3PRGD2 scintigraphy could detect early rheumatoid arthritis by imaging the associated synovial neoangiogenesis, and may be useful in disease management.
Highlights
Rheumatoid arthritis is a systemic autoimmune disease of unknown etiology which is characterized by chronic, symmetrical and erosive joint destruction.Patients with rheumatoid arthritis can develop serious joint deformities and loss of function resulting in serious disability and mortality [1]
Imaging techniques that would allow the early detection of rheumatoid arthritis are not yet well established
We explored 99mTc-3PRGD2 imaging in patients with rheumatoid arthritis
Summary
Rheumatoid arthritis is a systemic autoimmune disease of unknown etiology which is characterized by chronic, symmetrical and erosive joint destruction. Patients with rheumatoid arthritis can develop serious joint deformities and loss of function resulting in serious disability and mortality [1]. Rheumatoid arthritis affects the patients’ quality of life, it imposes a heavy financial burden on society. There are www.impactjournals.com/oncotarget few effective therapies that can fully reverse the existing joint damage. Joint destruction can occur from 4 months to 1 year after the onset of disease, making early diagnosis and treatment vital [2]. Imaging techniques that would allow the early detection of rheumatoid arthritis are not yet well established
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