Chromosome Damage in Patients Who Have Had Intra-Articular Injections of Radioactive Gold

Stevenson, A. C.; Bedford, Jean; Hill, AlanG.S.; Hill, H F

doi:10.1016/s0140-6736(71)91500-5

Cited by 27 publications

(9 citation statements)

References 5 publications

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“…Attempts to destroy proliferative synovium with chemical compounds have been too destructive of other normal articular tissues to merit clinical use ( 1 4 ) . Radiation synovectomies have had limited success (5)(6)(7)(8)(9)(10). In this study we investigate the feasibility of using photodynamic therapy to destroy diseased synovium in an effort to develop a less invasive and less morbid synovectomy technique.…”

Section: Introductionmentioning

confidence: 99%

Photodynamic Synovectomy Using Benzoporphyrin Derivative in an Antigen‐induced Arthritis Model for Rheumatoid Arthritis

Trauner

Gandour‐Edwards

Bamberg

et al. 1998

Photochem & Photobiology

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Experimental photodynamic therapy (PDT) has recently been adapted for the treatment of inflammatory and rheumatoid arthritis. The biodistribution of benzoporphyrin derivative monoacid ring A (BPD-MA) and the effect of percutaneous light activation via intra-articular bare cleaved optical fibers was investigated using a rabbit-antigen-induced arthritis model. Qualitative evaluation of intra-articular photosensitizer clearance was performed with laser-induced fluorescence from 0 to 6 h following intravenous injection. The compound was rapidly taken up within the joint and then cleared steadily over the 6 h interval. Biodistribution was determined by fluorescence microscopy and spectrofluoroscopic extraction techniques 3 h following intravenous injection of 2 mg/kg BPD-MA. The biodistribution study demonstrated elevated levels of BPD-MA in synovium (0.35 microgram/g) and muscle (0.35 microgram/g). Fluorescence microscopy demonstrated presence of the compound within pathologic synovium but absence of the photosensitizer within meniscus, ligament, bone and articular cartilage. Tissue effects were evaluated histologically at 2 and 4 weeks posttreatment. BPD-MA-mediated PDT caused synovial necrosis in the region of light activation in 50% of treatment knees at 2 weeks and 43% at 4 weeks. No damage to nonpathologic tissues was observed. These studies indicate that selective destruction of synovium can be achieved by the light-activated photosensitizing agent BPD-MA without damage to articular cartilage or periarticular soft tissues. PDT needs to be further evaluated to optimize treatment parameters to provide for a new minimally invasive synovectomy technique.

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Section: Introductionmentioning

confidence: 99%

Photodynamic Synovectomy Using Benzoporphyrin Derivative in an Antigen‐induced Arthritis Model for Rheumatoid Arthritis

Trauner

Gandour‐Edwards

Bamberg

et al. 1998

Photochem & Photobiology

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“…In 1971, Stevenson et al . [9] described chromosome abnormalities in circulating lymphocytes after injection of radioactive gold for rheumatoid arthritis due to escape of radioactivity to the lymphatic system and the draining lymph nodes. Their report was followed by several publications [9–13] confirming their results and also discussing cytogenetic differences between 198 Au, 90 Y, Rhenium‐186 and other isotopes used in radioactive joint treatment.…”

Section: Discussionmentioning

confidence: 99%

Synoviorthesis with radioactive gold in haemophilia

Petersson

2001

Haemophilia

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“…An abbreviated account of the formation of these aberrations has also been given in a previous communication (Stevenson, Bedford, Hill, and Hill, 1971b).…”

Section: Served Chromosome Damage Occurred Invivomentioning

confidence: 98%

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confidence: 99%

Cytogenetic and scanning study of patients receiving intra-articular injections of gold-198 and yttrium-90.

Stevenson¹,

Bedford²,

Dolphin³

et al. 1973

Annals of the Rheumatic Diseases

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An account of the chromosome damage found in the lymphocytes of thirteen patients who had received injections of gold-198 into knee joints was reported in a preliminary communication (Stevenson, Bedford, Hill, and Hill, 1971a). There were great differences in the amount of damage which followed injections of the same amount of activity in these patients. However, the mean level of damage appeared too high to be explained by the assumption either that it occurred as a result of irradiation of lymphocytes in the injected joint, or that the radionuclide was distributed throughout the whole body, for the average radiation dose to the body would only be about 0 5 rad from the gamma radiation per mCi of gold-198. It was suggested that the high level of chromosome damage in lymphocytes relative to the amount of activity injected was most probably due to the movement of gold from the knee along the lymphatics to the inguinal lymph nodes, where enormous numbers of lymphocytes in transit through the nodes would come within the range of the beta emission of the radionuclide.Many patients have been treated with benefit by gold-198 or yttrium-90 intra-articular injections (Ansell, Crook, Mallard, and Bywaters, 1963;Delbarre, Cayla, Menkes, Roucayrol, Ingrand, and Aignan, 1969; Bridgnan, Bruckner, and Bleehen, 1971), and it seemed important to try to assess more accurately the amount of chromosome damage in lymphocytes in order to attempt to elucidate the prognostic significance, if any, to patients from these procedures. For this reason, and because there is very little available information on the cytogenetic effects of parenterally-administered radioactive isotopes in man, it was decided to investigate further cases.Including those reported in the preliminary paper, 48 patients who have had gold-198 injections, and 22 who have had yttrium-90 injections have now been investigated. None of these patients received any external radiotherapy. As the appendices show, blood samples from some patients were not taken until several months or years after the injections. Some were taken both before and at intervals after treatment, and some patients were scanned after injection in order to determine the distribution of the isotopes.The colloidal gold-198 (half life 65 hrs) and yttrium-90 (half life 64 hrs) were obtained from the Radiochemical Centre, Amersham, catalogue numbers GCS1P and YAS3P respectively.The gold preparation is a colloidal suspension of metallic gold stabilized with gelatin and with particle sizes of up to 20 pm. Most of the activity is in the 10-13 pm particles. The yttrium preparation is ionic yttrium bound to a colloidal ion exchange resin with a particle size range from 20 to 50 pum.

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Chromosome Damage in Patients Who Have Had Intra-Articular Injections of Radioactive Gold

Cited by 27 publications

References 5 publications

Photodynamic Synovectomy Using Benzoporphyrin Derivative in an Antigen‐induced Arthritis Model for Rheumatoid Arthritis

Photodynamic Synovectomy Using Benzoporphyrin Derivative in an Antigen‐induced Arthritis Model for Rheumatoid Arthritis

Synoviorthesis with radioactive gold in haemophilia

Cytogenetic and scanning study of patients receiving intra-articular injections of gold-198 and yttrium-90.

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