Technetium-99m (99mTc) radiopharmaceuticals are widely used for diagnostic imaging of heart, kidney, and liver disease, and cancer. Evolution from perfusion type tracers to targeted agents however has proven difficult. 99mTc labeled antibodies for imaging specific disease biomarkers would be of great interest, however the disparity between the isotopes half-life (6 hours) and the long circulation time of most antibodies (multiple days) has been a significant barrier. Furthermore, the conjugation of bifunctional 99mTc-chelate complexes to small molecules often has a detrimental impact on targeting. The use of bioorthogonal chemistry derived from tetrazines and trans-cyclooctene derivatives, along with pretargeting has the potential to overcome these issues and create a new generation of targeted 99mTc radiopharmaceuticals. Initially, the synthesis of three generations of imidazole based tridentate chelates linked to a tetrazine was completed. These new ligands were labeled with 99mTc under mild conditions (60 °C, 20 min, pH 3.5) with modest to good radiochemical yields ranging from 31 to 83%. Biodistribution studies revealed that compound 14, which contains a polyethylene glycol 5 (PEG5) linker had the best clearance from non-target tissues. Compound 14 was also used successfully in a pretargeting strategy along with a transcyclooctene (TCO) derivative of the bone targeting bisphosphonate, alendronate (ALN). One hour following the administration of TCO-ALN to BALB/c mice, compound 14 was injected intravenously where uptake at sites of high calcium turn over (i.e. the joints) was observed. At 6 hours post injection, for example, uptake reached as high as 20.1 ± 4.91 and 16.1 ± 4.84 %ID/g in the knee and shoulder, respectively. Pretargeted imaging studies were performed subsequently with a TCO-functionalized huA33 antibody in mice bearing SW122 xenografts. The TCO-huA33 antibody was injected 24 hours before the administration of two radiolabeled tetrazines at high and low specific activities. At 6 hours post injection tumour uptake was minimal, with tumour: blood ratios <1 in all cases. Blood clearance studies determined that the tetrazines were being cleared rapidly, with a blood residence half-life of 1.3-2.1 minutes. The hypothesis is that the low concentration of the antibody (owing to its high molecular weight), combined with the rapid clearance of the tetrazine and significant off-target uptake resulted in unfavorable kinetics and low tumor binding. Studies of the clearance pathway of 14 were investigated with clinically approved hepatobiliary transport inhibitors to help understand the mechanism of clearance, which could in turn be used to optimize the pharmacokinetics of the tetrazine ligands. A range of different inhibitors of key clearance pathways were evaluated with limited success. However, co-administration of 14 with ALN resulted in a 75% decrease in gall bladder uptake of 14 (216 ± 75.9 to 33.6 ± 3.93 %ID/g). Pretargeting studies of 14 with TCO-ALN in the presence of excess ALN revealed that ALN did not hinder the uptake of TCO-ALN in the bone, with all organs and tissues having the same uptake with TCO-ALN or TCO-ALN + ALN (knee: 20.1 ± 4.91 and 14.9 ± 2.43 %ID/g, respectively). There was also a concomitant decrease in gall bladder uptake (91.5 ± 17.1 to 28.8 ± 2.63 %ID/g). Further work on improving the distribution of the tetrazine ligands involved investigating the effect of the chelate. The core chelate found in 14 without the tetrazine moiety (compound 11a) was labeled with 99mTc to produce 11b in a 31% radiochemical yield. Biodistribution studies of 11b and 14 at 6 hours post injection demonstrated that the imidazole-based 99mTc-chelate was a major factor in the rapid and significant uptake and retention in the liver and gallbladder. A new triazole based chelate with optimal clearance from Kluba and coworkers was synthesized in 45% yield and successfully labeled with 99mTc (compound 23a). Biodistribution studies were performed where at 6 hours post injection, 23a had five times lower uptake in all non-target organs compared to 11b. The synthesis of a tetrazine derivative of 23a (compound 32) unfortunately demonstrated high hepatobiliary uptake compared to the original triazole chelate (gall bladder: 228 ± 251 and 8.77 ± 0.73 %ID/g, large intestine: 85.5 ± 83.5 and 6.88 ± 0.30 %ID/g, respectively). This particular derivative had a lipophilic linker as a result of the synthetic challenges faced during the preparation of a more hydrophilic triazole-tetrazine derivative. In addition to pretargeting applications, the 99mTc-tetrazine was used as a reagent to create multimodal imaging agents. Nanoscale gas vesicle (GV) ultrasound contrast agents were functionalized with TCO via an amide coupling to lysine residues. TCO-GVs were then radiolabeled by adding compound 6 where the desired product, a new multimodal probe, was obtained in 59% radiochemical yield. SPECT imaging and biodistribution studies in mice were completed where the labeled GV’s showed uptake in the gall bladder (120 ± 29.1 %ID/g), liver (16.8 ± 7.50 %ID/g), lungs (3.26 ± 1.53 %ID/g), small intestines (14.5 ± 5.30 %ID/g), and spleen (5.47 ± 2.71 %ID/g) at 120 min post injection. In addition to radiolabelling, the TCO-GVs were also functionalized with a near IR-tetrazine dye to produce a multimodal ultrasound/photoacoustic (US/PA) imaging agent in a 68% yield. / Thesis / Doctor of Philosophy (PhD)

Hintergrund: Ein sehr häufig in der nuklearmedizinischen Diagnostik genutztes Radionuklid ist 99mTc. Es emittiert Gammastrahlung mit einer relativ niedrigen Energie (140 keV) und hat eine kurze Halbwertszeit von 6 h. Zusätzlich zur Gammastrahlung entstehen bei jedem Zerfall von 99mTc Auger-Elektronen. Diese niederenergetischen Elektronen, sehr kurzer Reichweite verfügen über einen hohen LET und erzeugen somit eine ausreichende Energiedeposition, um direkte DSB zu erzeugen. Bei Untersuchungen zu Chemotoxizität und Radiotoxizität mit Zellexperimenten gilt es eine Vielzahl an verschiedenen Schutzmechanismen, Reparaturmechanismen und Signalkaskaden in Zellen zu beachten, welche häufig noch nicht vollständig erforscht sind. Um das schädigende Potential von unterschiedlichen Substanzen und Strahlenqualitäten auf die DNA zu untersuchen, wurde ein zellfreies System gewählt. Ziel dieser Arbeit war es, neben den Strahlenqualitäten der Alpha-, Beta, Gamma- und Röntgenstrahlung die Auger-Elektronen des 99mTc auf ihr Potential zur Induktion von DNA-Strangbrüchen zu untersuchen. Hierfür stand die Substanz 99mTc-HYNIC-DAPI zur Verfügung, welche 99mTc an das Plasmid binden und somit in direkte DNA-Nähe bringen kann. Material und Methode: Alle Versuche wurden mit dem Plasmid pUC 19, einem künstlich hergestellten, bakteriellen Plasmid mit 2686 Basenpaaren, welches als nackte DNA ohne Proteine vorliegt, durchgeführt. Der Vergleich zwischen bestrahltem Plasmid in Ab- und Anwesenheit des Radikalfängers DMSO gibt Hinweise darauf, ob Strangbrüche direkt induziert oder nach Radikalbildung indirekt erzeugt werden. Bei radikalvermittelter Wirkung verhindert DMSO DNA-Strangbrüche und die ungeschädigte Supercoiled-Plasmid-Konformation bleibt erhalten. Nach Bestrahlung des Plasmids erfolgte der Nachweis von Strangbrüchen mittels Agarose-Gelelektrophorese. Bekommt ein Plasmid Einzel- oder Doppelstrangbrüche, so verändert sich seine Konformation zu einem ringförmigen/open circle (ESB) oder einem linearen Plasmid (DSB). Durch veränderte Laufeigenschaften im Agarosegel sind die verschiedenen Konformationen voneinander trennbar. Nach Anfärben der DNA mit dem Fluoreszenzfarbstoff Ethidiumbromid konnte das fluoreszierende Plasmid fotografiert und die Intensität der Konformationsbanden quantifiziert werden. Ergebnisse: Zuerst wurde die Reproduzierbarkeit der Methodik überprüft und festgestellt, dass eine Korrelation zwischen Plasmidmasse und Fluoreszenzintensität besteht. Anschließend wurde in Vorversuchen gezeigt, dass die Inkubationstemperaturen, pH-Werte und der Radikalfänger DMSO keinen Einfluss auf die Plasmidintegrität haben. Bei Bestrahlung mit Röntgenstrahlung, dem Beta-Strahler 188Re und dem nicht DNA-gebundenen Gamma-Strahler und Auger-Emitter 99mTc konnte mit steigender Dosis eine Zunahme an ESB festgestellt werden. Vergleichsproben mit DMSO zeigten keinen Anstieg von ESB, was auf eine radikalvermittelte 67 DNA-Schädigung mittels Reaktiver Sauerstoffspezies (ROS) hinweist. Ab einer Energiedosis von ca. 80 Gy konnten nach Bestrahlung mit 188Re und 99mTc zusätzlich zu den ESB auch DSB nachgewiesen werden. DMSO konnte in den Vergleichsproben sowohl die ESB als auch die DSB erfolgreich verhindern. Bei einer sehr hohen Dosis ≥ 600 Gy zeigte DMSO Kapazitätsgrenzen und es konnten nicht mehr alle Strangbrüche verhindert werden. Die Bestrahlung mit dem Alpha-Strahler (hoher LET) 223Ra fügte, im Vergleich zu Strahlung mit niedrigem LET, dem Plasmid überproportional viele DSB zu. Einige dieser DSB konnten nicht durch DMSO verhindert werden, was auf einen direkten DNA-Schaden bzw. eine zu hohe Radikaldichte hinweist. Ein noch stärkerer direkter Effekt konnte beobachtet werden, wenn 99mTc über die Substanz 99mTc-HYNIC-DAPI an DNA gebunden wurde. Dabei konnten schon ab einer Energiedosis von 4 Gy DSB erzeugt werden, welche trotz Radikalfänger nicht verhindert werden konnten. Schlussfolgerung: Dieser bei 99mTc-HYNIC-DAPI beobachtete Effekt wird den Auger-Elektronen zugeschrieben. Aufgrund ihrer kurzen Reichweite und ihres hohen LET sind sie in der Lage direkte DSB zu erzeugen, wenn sie DNA-gebunden sind oder sich in geringem Abstand zur DNA befinden. Die Ergebnisse der Experimente weisen auf ein therapeutisches Potential von 99mTc hin. Weitere Untersuchungen müssen zeigen, ob eine Adressierung von 99mTc an die DNA im Zellkern einer intakten Zelle zu verwirklichen ist und ob DNA-gebundenes 99mTc durch die Energie der Auger-Elektronen den Zelltod herbeiführen kann. Im nächsten Schritt sollte die Erforschung von Trägersubstanzen erfolgen, welche es ermöglichen Auger-Emitter spezifisch an die DNA von Tumorzellen zu koppeln. / Introduction and aim of the study: A radionuclide commonly used in diagnostic nuclear medicine is 99mTc. It emits gamma rays with a relatively low energy (140 keV) and has a short half-time (6h). In addition to gamma rays, 99mTc radiates so called Auger-electrons with low energy, low range and high linear energy transfer. Due to the high-LET Auger-electrons have a sufficient energy deposition to induce direct double-strand breaks to the DNA. In these experiments we used plasmid DNA to evaluate damage induced to biological systems by different chemotoxical substances and radionuclides as well as external radiation. By using plasmids instead of cell cultures we avoid lots of unexplored signal pathways in cells and it is possible to quantify chemotoxical and radiation damage to the DNA. Materials and methods: The double-stranded plasmid pUC 19 with 2686 bp is used in all experiments. It is a synthetically produced bacterial plasmid without any proteins. To distinguish between directly and indirectly (radical induced) induced damage we used the radical scavenger DMSO. Indirectly induced damage via reactive oxygen species (ROS) can be prevented by DMSO. The quantification of supercoiled forms, single strand breaks (SSB) and double strand breaks (DSB) was measured by the method of agarose gel electrophoresis. After the electrophoresis, agarose gels are dyed in ethidium bromide and imaged with a ccd-camera using ultraviolet transillumination. The bands of the different plasmid forms were quantified through the FIJI computer program. Results: First of all a correlation between plasmid mass and fluorescence intensity was shown. In a pretrial no damaging effect to the plasmid from incubation temperature, pH-value and radical scavenger DMSO appeared. Afterwards we examined chemotoxical SnCl2, external x-rays, the alpha emitter 223Ra, the beta emitter 188Re, gamma- and Auger-emitter 99mTc and the DNA-bound 99mTc-HYNIC-DAPI. The radical scavenger DMSO was used to differentiate between indirect (radical induced) and direct DNA-damage. All different radiation qualities showed an increasing DNA-damage with increasing energy dose. For the low-LET radiation qualities like chemotoxical SnCl2, external x-rays, the beta emitter 188Re and not DNA-bound 99mTc, DMSO showed the quality to prevent the damage. After the deposition of an energy dose ≥ 600 Gy DMSO showed a limitation in his scavenger capacity. During radiation with high-LET beams like 223Ra or DNA-bound 99mTc-HYNIC-DAPI DMSO showed less or nearly no ability to prevent DNA-damage. A 4 Gy dose of 99mTc-HYNIC-DAPI was able to induce DSB into the plasmid. These DSB could not be prevented by DMSO. The lower ESB:DSB ratio for high-LET beams also displays that direct damage is more likely to create DSB than indirect damage. Conclusion: In conclusion we can say that DNA-bound 99mTc-HYNIC-DAPI was most appropriate to induce DSB via a direct effect. It was impossible to prevent this damage due to adding the 69 radical scavenger DMSO. We attribute this to low range, low-LET Auger-electrons and suppose that it may be possible to use DNA-bound 99mTc for therapeutic purpose. Further research has to show if 99mTc can be targeted to the DNA of intact cells and if suitable tracers can be found to safely target and kill tumor cells.

Thesis (MScMed)--Stellenbosch University, 2004. / Copy not signed by author. / ENGLISH ABSTRACT: This study involved 33 patients, 19 men and 14 women. The age range was wide (20-90 years) and median age was 57 years. These patients had a single pulmonary nodule (SPN) defined radiologically as a well defined, round or oval intrapulmonary lung lesion not associated with atelectasis or adenopathy on chest radiography or computed tomography. Patients were investigated with Tc-99m MIBI and TI-201 (25 patients) and with Tc-99m MIBI alone (8 patients). Single photon emission computed tomography images were reconstructed using both iterative reconstruction (Ordered Subsets - Expectation Maximisation: aSEM) and filtered backprojection (FBP), on the Hermes system. Transverse, coronal and sagittal slices were displayed on the screen using a grey scale. The aSEM and FBP images for each study were co-registered semi-automatically using the multimodality programme on the Hermes. The best slice for the lesion was chosen according to the best view used to locate the SPN on chest radiograph. Regions of interest (Ral) were drawn manually outside the outer margin of the detected lesion, first on the aSEM image. This was automatically mirrored on the co-registered FBP image. For most patients, the background was automatically mirrored horizontally on the contralateral side, again, first on the OSEM then automatically on the FBP image. Automatic vertical mirroring or manual horizontal mirroring was used when background was found to be in a visually 'hot' area like the heart or vertebrae. The average counts and standard deviation of the Ral and background were generated automatically. Semi-quantitative image analysis was done by calculating the signal-to-noise ratio (SNR) and tumour-to-background (TIB) ratio using the following formulae: SNR = Mean counts ROI(lesion) - Mean counts background Standard deviation background TIB rati.o = -M---e-a-n-'--c-o--u-n-'t-s- ROI(lesion) Mean counts background Detection was found to be the same for the two reconstruction algorithms, that is, every lesion detected by using OSEM could also be detected by using FBP. However lesion detection did differ between Tl-201 and Tc-99m-MIBI. Sensitivity and specificity were calculated for different thresholds of SNR and TIB ratios. Receiver operating characteristics (ROC) curves were drawn to represent the different sensitivities and specificities at each threshold. Tuberculosis (TB) was not included in this analysis as uptake of Tl-20l was found to be significantly high and comparable to that of malignant nodules. However the effect of OSEM and FBP on the 'positive' TB nodules was assessed separately. By calculating the area under the ROC curves, TI-201 using OSEM was shown to be more accurate at differentiating malignant nodules from benign ones than FBP. Although this difference was not statistically significant (p=0.1 0), there was a clear tendency. The two reconstruction algorithms were found to be almost equally accurate, when using Tc-99m-MIBI, the difference between them being considerably insignificant. In conclusion, it was shown that there is a tendency that OSEM outperforms FBP for studies using Tl-201 but not for Tc-99m-MIBI. / AFRIKAANSE OPSOMMING: Hierdie studie sluit 33 pasiënte in, 19 mans en 14 vroue. Die ouderdomme wissel tussen 20 en 90 jaar met 'n gemiddelde ouderdom van 57 jaar. Elkeen van die pasiënte het 'n enkel longnodule (SPN) op borskas X-straal en/of rekenaar tomografie getoon, wat radiologies gedefinieer word as 'n goed omskrewe, ronde of ovaal intrapulmonale longletsel wat nie met atelektase of adenopatie geassosieer is nie. Pasiënte is met Tc-99m MIDI en TI-201 (25 pasiënte) of slegs met Tc-99m MIBI (8 pasiënte) ondersoek. Enkelfoton emissie rekenaar tomografiese (EFERT) beelde is met beide iteratiewe rekonstruksie (Ordered Subsets - Expectation Maximisation: OSEM) en gefilterde terugprojeksie (FBP) met die Hermes sisteem gerekonstrueer. Transvers, koronale en sagittale snitte is in grysskaal op die sisteem vertoon. Die OSEM en FBP beelde vir elke studie is semi-outomaties gekoregistreer met behulp van die multimodaliteitsprogram op die Hermes. Die optimale snit vir elke letsel is gekies volgens die beste aansig op die borskas X-straalom die SPN te lokaliseer. Gebiede van belang (ROl) is met die hand buite-om die buitenste rand van die letsel getrek op die OSEM beeld en daarna outomaties in die ooreenstemmende area op die gekoregistreerde FPB beeld geplaas. Vir die meeste pasiënte is die agtergrond outomaties as horisontale spieëlbeeld op die kontralaterale kant geplaas, eers op die OSEM en dan outomaties op die FBP beeld. 'n Outomatiese vertikale spieëlbeeld of manuele horisontale verskuiwing van die agtergrondsarea is gedoen indien die agtergrond oorvleuel het met 'n 'warm' area soos die hart of werwels. Die gemiddelde tellings en standaardafwyking van die ROl en agtergrond is outomaties gegenereer. Semi-kwantitatiewe beeldanalise is gedoen deur berekening van die sein-tot-agtergrond verhouding (signal-to-noise ratio - SNR) en tumor-tot-agtergrond (TIB) verhouding met behulp van die volgende formules: SNR = gemiddelde tellings ROI(letsel) - gemiddelde tellings agtergrond Standaard afwyking van agtergrond TIB rati.o = -g=em--id-d-e-l-d-e--te=ll-in-g-s__R:_O-I(-le-t-s'e-l) gemiddelde tellings agtergrond Opsporing is soortgelyk bevind vir die twee rekonstruksie algoritmes, dit wil sê elke letselopgespoor met behulp van OSEM kon ook met FBP opgespoor word. Letselwaameming het egter verskil tussen TI-201 en Tc-99m-MIBI. Sensitiwiteit en spesifisiteit is vir verskillende drempels van SNR en TIB verhoudings bereken. 'Receiver operating characteristics' (ROC) kurwes is getrek om die verskillende sensitiwiteite en spesifisiteite by elke drempel te verteenwoordig. Tuberkulose (TB) is nie in hierdie analise ingesluit nie aangesien opname van Tl-201 beduidend hoog en vergelykbaar met die van maligne nodules was. Die effek van OSEM en FBP op die 'positiewe' TB nodules is egter apart beoordeel. Deur berekening van die area onder die ROC kurwes, is getoon dat OSEM van Tl-201 tomografiese data meer akkuraat as FBP was om maligne van benigne nodules te onderskei. Alhoewel hierdie verskil nie statisties betekenisvol was nie (p=0.10), is daar wel 'n duidelike neiging gevind. Die twee rekonstruksie algoritmes was byna ewe akkuraat wanneer Tc-99m-MIBI gebruik is, met duidelik geen betekenisvolle verskil tussen die algoritmes nie. Gevo lgtrekking In hierdie studie is dit getoon dat daar 'n neiging is dat OSEM beter vaar as FBP vir studies met tallium-201 maar nie vir Tc-99m-MIBI nie.

A imagem molecular oferece a perspectiva de detectar doenças bem antes de os sintomas surgirem. A vasculatura tumoral é vital no crescimento do tumor e na disseminação de metástases, sendo assim alguns radiofármacos são dirigidos para a angiogênese. O glioma, tumor cerebral de baixa incidência porém alta mortalidade, requer um diagnóstico precoce para favorecimento da abordagem terapêutica. O objetivo desse estudo foi o desenvolvimento de novo radiofármaco para diagnóstico por imagem de glioma, baseado em peptídeos angiogênicos (GX1 e GX1-RGD) marcados com o radioisótopo tecnécio-99m. O desempenho dos conjugados peptídicos mostraram-se bastante parecidos em diversas avaliações. Eles foram radiomarcados com alta pureza radioquímica (>96%) e estáveis em soro até pelo menos 4h. Ambos são hidrofílicos e com baixa ligação às proteínas plasmáticas. A biodistribuição em animais sadios demonstrou alta excreção renal e depuração sanguínea rápida para ambos os radiotraçadores. Nos estudos in vitro, o 99mTc-HYNIC-PEG4-c(GX1) apresentou picos de ligação aos 60 min e o 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) aos 120 min, nas células endoteliais HUVEC, usadas como controle, e nas células tumorais das linhagens U87MG e T98G. A captação tumoral nos animais foi mais acentuada para células U87MG, especialmente para o 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) (2,87 ± 0,53% DI/g) aos 60 min p.i., com boa visualização em imagens adquiridas por gama-câmara e micro-SPECT/CT. Estudos realizados com os peptídeos conjugados à nanopartículas magnéticas para visualização em ressonância magnética também demonstraram especificidade dos produtos em tecidos tumorais. O desempenho do 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) foi superior que o do traçador GX1, quanto à captação no glioma humano, podendo ser considerado como um promissor radiofármaco para diagnóstico de gliomas. / Molecular imaging offers the prospect of detecting diseases well before the symptoms appear. The tumor vasculature is vital in the tumor growth and dissemination of metastasis, thus some radiopharmaceuticals are directed to angiogenesis. The glioma, a brain tumor of low incidence but high mortality, requires an early diagnosis for favoring therapeutic approaches. The aim of this study was the development of a new radiopharmaceutical for imaging diagnosis of glioma, based in angiogenic peptides (GX1 and RGD-GX1) radiolabeled with technetium-99m radioisotope. The peptidic conjugates showed very similar performance in several evaluation. They were radiolabeled with high radiochemical purity (>96%) and are stable in the blood serum at least for four hours. Both are hydrofilic and had minimal binding to plasma protein. The biodistribution in healthy mice at many times, showed high renal excretion and fast blood clearance for both radiotracers. At in vitro studies, the 99mTc-HYNIC-PEG4-c(GX1) exhibit binding peaks at 60 min and the 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) at 120 min, at HUVEC endotelial cells, used as control, and at tumor cell lines U87MG and T98G. The animal tumor uptake was more pronounced for U87MG cells, specially for 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) (2.87 ± 0.53% DI/g) at 60 min p.i., with good visualization in images acquired with gama-camara and micro-SPECT/CT. Studies performed with peptides conjugate to magnetonanoparticles for MRI visualization also demonstred the peptides specificity in tumor tissue.The 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) performance was superior to the GX1 tracer, regarding the glioma uptake, and may be consider as a promisser radiopharmaceutical for glioma diagnosis.

L’imagerie moléculaire est aujourd’hui un outil non-invasif essentiel pour le diagnostic de nombreuses pathologies. Les traceurs technétiés sont actuellement les plus répandus car le 99mTc est facilement disponible, abordable et présente des caractéristiques idéales pour l’imagerie. Néanmoins, le développement de traceurs efficaces nécessite un long et coûteux processus d’optimisation souvent empirique. Dans ce contexte, nous avons entrepris le développement d’une plateforme technétiée conçue pour présenter au sein de sa structure de nombreux sites potentiels de fonctionnalisation et compatible avec une approche combinatoire.Dans un premier temps, un ensemble de 12 ligands N3X (X = N, O, S) a été préparé. Chacun d’entre eux présente dans sa structure un motif triazole introduit par chimie-click et intervenant dans la complexation du métal par un de ses atomes d’azote. Nous avons ensuite évalué l’aptitude de ces ligands à chélater le cœur oxotechnétium dans des conditions douces (5 min, température ambiante) compatible avec une utilisation en milieu hospitalier. Le complexe TriaS-99mTc a été formé quantitativement et sa stabilité en plasma murin a été étudiée. Il s’est révélé stable à plus de 90% dans le plasma murin après 6h d’incubation. L’étude in vivo de ce complexe a par la suite révélé une élimination efficace du milieu circulant par la voie urinaire avec une dégradation minoritaire.A titre d’illustration, nous avons ensuite engagé la structure TriaS dans deux approches distinctes pour le développement de traceurs de la néoangiogenèse tumorale en ciblant l’intégrine αvβ3. D’une part, dans le cadre d’une approche intégrée, plusieurs complexes fonctionnalisés, mimes de RGD, ont été obtenus. Dans chaque cas, l’adjonction de groupements fonctionnels n’a pas affecté l’efficacité de la chélation. En outre la stabilité en plasma est maintenue à un niveau très correct. D’autre part, nous avons développé une approche bifonctionnelle dans laquelle le motif c(RGDfK) joue le rôle de molécule ciblante. Dans ce cas, un motif variable (ici un PEG) peut être introduit par chimie combinatoire pour moduler la solubilité, la biodistribution, et l’excrétion des traceurs. / Molecular imaging is an essential non-invasive tool usable for diagnosis and characterisation of many diseases. Technetium-based tracers are the most popular ones due to disponibility, cost and radiochemical properties of 99mTc. Nevertheless, effective tracers development requires a long, expensive, and mainly empirical optimisation process. This context prompted us tu carry on the development of a new technetium structure which exhibits lots of potential functionalisation spots compatible with a combinatorial approach. We synthesised 12 N3X (X = N, O, S) different ligands. Each of them includes a triazole moiety, (formed via a click-chemistry reaction), which is involved in the metal complexation that implies one of its nitrogen atoms. Then we evaluated their ability to readily form oxotechnetium complexes in conditions that are compatible with medical use in hospital. One complex was formed in quantitative yields and its stability in mice plasma was investigated. A complex called TriaS-99mTc, stable to more than 90% after 6h incubation, was selected. In vivo study of TriaS-99mTc revealed an efficient blood clearance via the urinary excretion pathway with very low degradation. As an application, we used this structure for the development of tracers that target integrin αvβ3, a known biomarker of tumor neoangiogenesis. First, we synthesised functionnalised TriaS-based integrated complexes. Fonctionnal modification of TriaS by addition of side chains and substituents did not affect its ability to chelate oxotechnetium quantitatively. In addition, its stability in mice plasma was satisfactory. We also developped a bifonctionnal approach using c(RGDfK) peptide as the targeting biomolecule. In this way, a variable moiety (herein a PEG moiety) can be inserted in the structure through click-chemistry in order to modulate tracers solubility, biodistribution and excretion.

Com o objetivo de se avaliar a importância do \"clearance\" do dietilenotriamino-pentacetato marcado com Tecnécio 99m (DTPA-Tecnécio-99m) em portadores de pneumopatia por amiodarona foram estudados 40 indivíduos, em quatro grupos. Grupo I: 10 voluntários normais, assintomáticos e não fumantes (8 homens e 2 mulheres), com média de idade de 56,80 anos. Grupo II: 10 voluntários normais, assintomáticos e fumantes (6 homens e 4 mulheres ), com média de idade de 27,50 anos. Grupo III: 10 pacientes não fumantes ( 4 homens e 5 mulheres ), com média de idade de 52,90 anos. Todos faziam uso crônico de amiodarona por via oral. Grupo IV: 10 pacientes portadores de pneumopatia por amiodarona, quatro ex-fumantes, dois fumantes e quatro não fumantes ( 8 homens e 2 mulheres) com média de idade de 52,90 anos. Todos faziam uso de amiodarona por via oral e nenhum fumou nas 4 semanas que precederam o estudo. Após espirometria que constou do registro da curva volume-tempo, todos inalaram 4 ml de solução salina contendo 740 MBq de DTPA Tecnécio-99m, durante cinco minutos. Através de uma c~mara de cintilação computadorizada foram obtidas imagens pulmonares, definindo-se 9 áreas de interesse. Para cada região escolhida foi determinada uma curva de \"clearance\" extraindo-se o valor de meia-vida biológica em minu- tos ( T 1/2 ) e a taxa percentual de \" clearance\" alvéolo capilar do radioaerossol por minuto (K%/min). Observamos que, das variáveis espirométricas consideradas, a capacidade vital forçada (CVF) e o volume expiratório forçado no 1 segundo (VEF1) mostraram diferenças significantes entre os grupos I e IV. A contagem total de radioatividade de ambos os pulmões não mostrou relação com a CVF e o VEF1. O \" clearance \" pulmonar do DTPA Tecnécio-99m foi maior nos grupos 11 e IV, porém não permitindo sua diferenciação. Estes resultados permitem concluir: Os pacientes portadores de pneumonite por amiodaro- na apresentam\" clearance \" alvéolo-capilar de DTPA Tecnécio-99m significativamente maior que os indivíduos do grupo de normais não fumantes. Este fato também se verificou em relação aos pacientes em uso crônico de amiodarona mas sem evidências de pneumopatia. Não é possível diferenciar os fumantes dos portadores de pneumonite por amiodarona através da análise da integridade da barreira alvéolo-epitelial com DTPA Tecnécio-99m. Comparativamente, o estudo da integridade alvéolo-epitelial pelo \"clearance\" pulmonar de DTPA Tecnécio-99m é mais sensível que a espirometria na avaliação da pneumonite por amiodarona, permitindo diferenciar estes pacientes dos que fazem uso crônico da droga / In order to evaluate the role of the clearance of 99m Technetium chelated to diethylenetriamine-penta-acetate ( 99mTc-DTPA) in amiodarone induced pulmonary disease, 40 individuaIs were studied in four groups. Group I: 10 normal non smoking volunteers (8 men and 2 women ), whose mean age was 56.80 years. Group lI: 10 normal smoking volunteers ( 6 men and 4 women ), aging 27.50 years in average. Group III: 10 non smoking patients ( 4 men and women ), aging 52.90 years in average, who were chronically taking oral amiodarone. Group IV: 10 patients with amiodarone induced pul- monary disease (8 men and 2 women), four non-smokers, two smokers and four previous smokers. Their mean age was 62.90 years. AIl of them were taking oral amiodarone and none has smoked in the 4 weeks previous to the study. After spirometry, where a volume-time curve was registered, alI individuaIs inhaled 740 MBq of 99mTc-DTPA diluted in 4 ml of saline, for five minutes. Pulmonary images were obtained in a computadorized scintillation camera and 9 regions of interest were selected. A clearance curve of each region was determined, from which the effective half-life in minutes (T 1/2 ) and the alveolar-capilar clearance rate per minute ( k%/min ) of the radiolabeled aerosol were mea- sured. The spirometric analys disclosed a statistically lower value of the forced vital capacity ( FVC ) and forced expiratory volume in the first second ( FEV1 ) in the patients of group IV when compared to group I. The total radioactivity count for both lungs were not influenced by FVC and FEV1. The 99mTc-DTPA clearance rate was higher in groups 11 and IV, but these two groups could not be statistically differentiated. Based on these results it 1s concluded: patients with amiodarone induced pulmonary pneumonitis have higher clearance rates of 99m Tc-DTPA than normal non smoking controls and than patients taking amiodarone but with no lung toxicity. It is not possible to separate patients with amiodarone induced disease from normal smokers by determining 99m Tc-DTPA clearance rates. The determination of the alveolar-epithelial barrier integrity by 99m Tc-DTPA clearance rate is a more sensitive test than spirometry in the evaluation of amiodarone induced pneumonitis making it possible to differentiate these patients from those who take the drug and have no lung toxicity

Com o objetivo de se avaliar a importância do \"clearance\" do dietilenotriamino-pentacetato marcado com Tecnécio 99m (DTPA-Tecnécio-99m) em portadores de pneumopatia por amiodarona foram estudados 40 indivíduos, em quatro grupos. Grupo I: 10 voluntários normais, assintomáticos e não fumantes (8 homens e 2 mulheres), com média de idade de 56,80 anos. Grupo II: 10 voluntários normais, assintomáticos e fumantes (6 homens e 4 mulheres ), com média de idade de 27,50 anos. Grupo III: 10 pacientes não fumantes ( 4 homens e 5 mulheres ), com média de idade de 52,90 anos. Todos faziam uso crônico de amiodarona por via oral. Grupo IV: 10 pacientes portadores de pneumopatia por amiodarona, quatro ex-fumantes, dois fumantes e quatro não fumantes ( 8 homens e 2 mulheres) com média de idade de 52,90 anos. Todos faziam uso de amiodarona por via oral e nenhum fumou nas 4 semanas que precederam o estudo. Após espirometria que constou do registro da curva volume-tempo, todos inalaram 4 ml de solução salina contendo 740 MBq de DTPA Tecnécio-99m, durante cinco minutos. Através de uma c~mara de cintilação computadorizada foram obtidas imagens pulmonares, definindo-se 9 áreas de interesse. Para cada região escolhida foi determinada uma curva de \"clearance\" extraindo-se o valor de meia-vida biológica em minu- tos ( T 1/2 ) e a taxa percentual de \" clearance\" alvéolo capilar do radioaerossol por minuto (K%/min). Observamos que, das variáveis espirométricas consideradas, a capacidade vital forçada (CVF) e o volume expiratório forçado no 1 segundo (VEF1) mostraram diferenças significantes entre os grupos I e IV. A contagem total de radioatividade de ambos os pulmões não mostrou relação com a CVF e o VEF1. O \" clearance \" pulmonar do DTPA Tecnécio-99m foi maior nos grupos 11 e IV, porém não permitindo sua diferenciação. Estes resultados permitem concluir: Os pacientes portadores de pneumonite por amiodaro- na apresentam\" clearance \" alvéolo-capilar de DTPA Tecnécio-99m significativamente maior que os indivíduos do grupo de normais não fumantes. Este fato também se verificou em relação aos pacientes em uso crônico de amiodarona mas sem evidências de pneumopatia. Não é possível diferenciar os fumantes dos portadores de pneumonite por amiodarona através da análise da integridade da barreira alvéolo-epitelial com DTPA Tecnécio-99m. Comparativamente, o estudo da integridade alvéolo-epitelial pelo \"clearance\" pulmonar de DTPA Tecnécio-99m é mais sensível que a espirometria na avaliação da pneumonite por amiodarona, permitindo diferenciar estes pacientes dos que fazem uso crônico da droga / In order to evaluate the role of the clearance of 99m Technetium chelated to diethylenetriamine-penta-acetate ( 99mTc-DTPA) in amiodarone induced pulmonary disease, 40 individuaIs were studied in four groups. Group I: 10 normal non smoking volunteers (8 men and 2 women ), whose mean age was 56.80 years. Group lI: 10 normal smoking volunteers ( 6 men and 4 women ), aging 27.50 years in average. Group III: 10 non smoking patients ( 4 men and women ), aging 52.90 years in average, who were chronically taking oral amiodarone. Group IV: 10 patients with amiodarone induced pul- monary disease (8 men and 2 women), four non-smokers, two smokers and four previous smokers. Their mean age was 62.90 years. AIl of them were taking oral amiodarone and none has smoked in the 4 weeks previous to the study. After spirometry, where a volume-time curve was registered, alI individuaIs inhaled 740 MBq of 99mTc-DTPA diluted in 4 ml of saline, for five minutes. Pulmonary images were obtained in a computadorized scintillation camera and 9 regions of interest were selected. A clearance curve of each region was determined, from which the effective half-life in minutes (T 1/2 ) and the alveolar-capilar clearance rate per minute ( k%/min ) of the radiolabeled aerosol were mea- sured. The spirometric analys disclosed a statistically lower value of the forced vital capacity ( FVC ) and forced expiratory volume in the first second ( FEV1 ) in the patients of group IV when compared to group I. The total radioactivity count for both lungs were not influenced by FVC and FEV1. The 99mTc-DTPA clearance rate was higher in groups 11 and IV, but these two groups could not be statistically differentiated. Based on these results it 1s concluded: patients with amiodarone induced pulmonary pneumonitis have higher clearance rates of 99m Tc-DTPA than normal non smoking controls and than patients taking amiodarone but with no lung toxicity. It is not possible to separate patients with amiodarone induced disease from normal smokers by determining 99m Tc-DTPA clearance rates. The determination of the alveolar-epithelial barrier integrity by 99m Tc-DTPA clearance rate is a more sensitive test than spirometry in the evaluation of amiodarone induced pneumonitis making it possible to differentiate these patients from those who take the drug and have no lung toxicity

A imagem molecular oferece a perspectiva de detectar doenças bem antes de os sintomas surgirem. A vasculatura tumoral é vital no crescimento do tumor e na disseminação de metástases, sendo assim alguns radiofármacos são dirigidos para a angiogênese. O glioma, tumor cerebral de baixa incidência porém alta mortalidade, requer um diagnóstico precoce para favorecimento da abordagem terapêutica. O objetivo desse estudo foi o desenvolvimento de novo radiofármaco para diagnóstico por imagem de glioma, baseado em peptídeos angiogênicos (GX1 e GX1-RGD) marcados com o radioisótopo tecnécio-99m. O desempenho dos conjugados peptídicos mostraram-se bastante parecidos em diversas avaliações. Eles foram radiomarcados com alta pureza radioquímica (>96%) e estáveis em soro até pelo menos 4h. Ambos são hidrofílicos e com baixa ligação às proteínas plasmáticas. A biodistribuição em animais sadios demonstrou alta excreção renal e depuração sanguínea rápida para ambos os radiotraçadores. Nos estudos in vitro, o 99mTc-HYNIC-PEG4-c(GX1) apresentou picos de ligação aos 60 min e o 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) aos 120 min, nas células endoteliais HUVEC, usadas como controle, e nas células tumorais das linhagens U87MG e T98G. A captação tumoral nos animais foi mais acentuada para células U87MG, especialmente para o 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) (2,87 ± 0,53% DI/g) aos 60 min p.i., com boa visualização em imagens adquiridas por gama-câmara e micro-SPECT/CT. Estudos realizados com os peptídeos conjugados à nanopartículas magnéticas para visualização em ressonância magnética também demonstraram especificidade dos produtos em tecidos tumorais. O desempenho do 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) foi superior que o do traçador GX1, quanto à captação no glioma humano, podendo ser considerado como um promissor radiofármaco para diagnóstico de gliomas. / Molecular imaging offers the prospect of detecting diseases well before the symptoms appear. The tumor vasculature is vital in the tumor growth and dissemination of metastasis, thus some radiopharmaceuticals are directed to angiogenesis. The glioma, a brain tumor of low incidence but high mortality, requires an early diagnosis for favoring therapeutic approaches. The aim of this study was the development of a new radiopharmaceutical for imaging diagnosis of glioma, based in angiogenic peptides (GX1 and RGD-GX1) radiolabeled with technetium-99m radioisotope. The peptidic conjugates showed very similar performance in several evaluation. They were radiolabeled with high radiochemical purity (>96%) and are stable in the blood serum at least for four hours. Both are hydrofilic and had minimal binding to plasma protein. The biodistribution in healthy mice at many times, showed high renal excretion and fast blood clearance for both radiotracers. At in vitro studies, the 99mTc-HYNIC-PEG4-c(GX1) exhibit binding peaks at 60 min and the 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) at 120 min, at HUVEC endotelial cells, used as control, and at tumor cell lines U87MG and T98G. The animal tumor uptake was more pronounced for U87MG cells, specially for 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) (2.87 ± 0.53% DI/g) at 60 min p.i., with good visualization in images acquired with gama-camara and micro-SPECT/CT. Studies performed with peptides conjugate to magnetonanoparticles for MRI visualization also demonstred the peptides specificity in tumor tissue.The 99mTc-HYNIC-E-[c(RGDfk)-c(GX1)]) performance was superior to the GX1 tracer, regarding the glioma uptake, and may be consider as a promisser radiopharmaceutical for glioma diagnosis.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 6 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2006. / Härtill 5 uppsatser.