(131)I-mIBG therapy produces symptomatic and hormonal improvement and moderate tumour regression/stabilization in patients with metastatic neuroendocrine tumours with minimal adverse effects. It may be a valuable alternative or additional therapeutic option to the currently available conventional treatment modalities.

A comparison has been made of [(123)I]meta-iodobenzylguanidine ([(123)I]MIBG) and [(111)In]pentetreotide scintigraphy in 54 patients with a variety of neuroendocrine tumors of whom 46 patients had metastatic disease. [(111)In]Pentetreotide scintigraphy was more sensitive in detecting metastatic lesions, as demonstrated on computed tomography and/or magnetic resonance scanning, than [(123)I]MIBG: 67% vs. 50% for carcinoid tumors (n = 24), 91% vs. 9% for pancreatic islet cell tumors (n = 12), 100% vs. 60% for medullary thyroid carcinomas (n = 5), and 75% vs. 100% for pheochromocytomas/paragangliomas (n = 4). In only 2 patients were lesions seen with [(123)I]MIBG scanning that were not apparent with [(111)In]pentetreotide. With the exception of pancreatic islet cell tumors, both radionuclides exhibited a similar sensitivity in detecting hepatic metastases, whereas in three patients the two radionuclides exerted a complementary role as different deposits exhibited uptake to only 1 or the other radionuclide. Hepatic metastases were the most important clinical predictor of a positive scan for both radionuclides. Neither elevated 5-hydroxyindoleacetic acid levels nor any other hormonal marker was predictive of a positive scan. In 8 patients with clinical and/or hormonal evidence of a neuroendocrine tumor but negative conventional radiology, [(111)In]pentetreotide scintigraphy was more sensitive than [(123)I]MIBG (37.5% vs. 12.5%) in detecting lesions. In conclusion, scintigraphy with [(111)In]pentetreotide detects more metastatic lesions than [(123)I]MIBG in patients with carcinoid and pancreatic islet cell tumors and medullary thyroid carcinomas; [(123)I]MIBG scintigraphy may be more sensitive for sympathoadrenomedullary tumors. The radionuclides may exert a complementary role in the detection and treatment of neuroendocrine tumors in occasional patients, as areas of different pattern of uptake were identified within the same patient. These data have implications not only for staging such tumors, but also for identifying patients who might benefit from treatment using either [(131)I]MIBG or radioactive somatostatin analogs.

The mononuclear phagocyte system plays a central role in mediating host responses in inflammation (1). Glucocorticoids have anti-inflammatory actions that may be of considerable importance in the therapeutic effects of these agents in chronic inflammation; it is possible that some of these effects are mediated through direct hormonal action on macrophages. Although the site of action of the glucocorticoids on macrophages has not been established, it has been shown that in many other glucocorticoid target systems the effects of glucocorticoids are mediated by specific macromolecular binding proteins, referred to as receptors (2-4).In this study we have established that monocytes and macrophages contain saturable glucocorticoid-binding proteins, with specificity of binding for cortisol, corticosterone, and related synthetic steroids such as dexamethasone, and that they have dissociation constants for binding within physiological ranges. Materials and MethodsCell Culture. Mouse peritoneal macrophages were harvested from female Swiss Webster mice ~CD-1 and CF-1; Charles River Breeding Laboratories, Inc., Wilmington, Mass.) weighing 20-25 g, as described previously (5, 6). Resident macrophages were obtained from unstimulated animals, and elicited macrophages were obtained from mice injected 4 days before with 1.0 ml of Brewer thioglycollate medium ~5, 6). Cells were plated at 0.5-1 × 10 ' cells/well in 2-cm-'-diameter muhiwell plates I Microbiological Associates, Walkersville, Md.) in Dulbecco~s modified Eagle's medium high glucose formulation IDME~' supplemented with 10~ heat-inactivated fetal calf serum (FCS)IGrand Island Biological Co., Grand Island, N. Y.I. 1-24 h before binding experiments, cells were placed in serum-free DME supplemented with 0.2~ lactalbumin hydrolysate DME-LH~.Rabbit alveolar macrophages were obtained by lung lavage

No abstract

No abstract