Potential use of iodine-123 metaiodobenzylguanidine radioaerosol as a marker of pulmonary neuroadrenergic function

Giordano, Alessandro; Calcagni, Maria Lucia; Rossi, Brunella; Fuso, Leonello; Accardo, Daniela; Valente, Salvatore; Pistelli, Riccardo; Franceschini, R; Troncone, L

doi:10.1007/bf01728309

Cited by 15 publications

(10 citation statements)

References 19 publications

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“…Damaged AECs cannot efficiently extract circulating 123 I-MIBG (9,12,13,28). The previous animal model studies of pulmonary vascular damage showed a linear relationship between the degree of reduced 123 I-MIBG uptake and loss of the pulmonary vascular bed (17,23). Poor delivery of 123 I-MIBG due to decreased perfusion also may reduce 123 I-MIBG uptake, as 123 I-MIBG defects were persistently seen at the lung lobes with perfusion defects in our patients.…”

Section: Rgbmentioning

confidence: 93%

“…Although extracellular 123 I-MIBG increases because of decreased extraction of circulating 123 I-MIBG to damaged AECs and sympathetic neurons, decreased perfusion disrupts back-diffusion of this component to systemic circulation (15,17,21). Lack of integrity or dysfunction of AECs in PE patients also decreases the 123 I-MIBG washout rate, as various other lung disorders with injury of AECs persistently show a decreased 123 I-MIBG washout rate (16,18,(20)(21)(22)(23)34).…”

Section: Rgbmentioning

confidence: 99%

“…123 I-metaiodobenzylguanidine ( 123 I-MIBG) shares the same uptake as norepinephrine in AECs (12)(13)(14)(15). 123 I-MIBG scintigraphic studies have been used to detect and assess the functional injury or integrity of AECs in various lung diseases, including PE (16)(17)(18)(19)(20)(21)(22)(23). SPECT provides better assessment of lung 123 I-MIBG uptake than planar scanning and allows cross-sectional comparisons with lung morphologic CT scans and perfusion SPECT scans.…”

mentioning

confidence: 99%

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Impaired Lung ¹²³I-MIBG Uptake on SPECT in Pulmonary Emphysema

Suga¹,

Okada

Kunihiro

et al. 2011

J Nucl Med

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The aim of this study was to evaluate impaired lung uptake of 123 I-metaiodobenzylguanidine ( 123 I-MIBG) on SPECT, compared with perfusion SPECT and morphologic CT, in patients with pulmonary emphysema (PE). Methods: 123 I-MIBG SPECT was performed at 15 min and 4 h after intravenous injection of 123 I-MIBG in 36 PE patients with a history of smoking and variable-extent low-attenuation areas on CT, indicative of emphysematous changes, and in 16 controls with no history of smoking and no noticeable low-attenuation areas. The distribution of 123 I-MIBG was compared with that of low-attenuation areas on CT and perfusion on SPECT at the base of the 180 lung lobes of the PE patients. Total-lung 123 I-MIBG kinetics were calculated, including early and delayed lung-to-mediastinum uptake ratios and washout rate. Results: The controls showed a fairly uniform lung 123 I-MIBG distribution nearly consistent with perfusion. PE patients had heterogeneous 123 I-MIBG defects showing frequent discordance with low-attenuation areas or perfusion distribution; 123 I-MIBG defects were more extensive than low-attenuation areas in 76 lobes (42.2%) of 31 patients (86%) and more extensive than perfusion defects in 44 lobes (24.4%) of 22 patients (61%). 123 I-MIBG defects were seen regardless of the absence of noticeable low-attenuation areas and perfusion defects in 19 lobes (10.5%) of 16 patients (44%). All total-lung 123 I-MIBG kinetic parameters in PE patients were significantly lower than the control values (P , 0.0001), with significant correlation with alveolar-arterial oxygen tension gradient but without correlation with the extent of perfusion defects or low-attenuation areas. Conclusion: 123 I-MIBG SPECT allows evaluation of lung pathophysiology in PE independently of perfusion SPECT or morphologic CT, and impairment of lung 123 I-MIBG uptake may be more extensive than perfusion or morphologic abnormalities in PE.

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Section: Rgbmentioning

confidence: 93%

Section: Rgbmentioning

confidence: 99%

mentioning

confidence: 99%

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Impaired Lung ¹²³I-MIBG Uptake on SPECT in Pulmonary Emphysema

Suga¹,

Okada

Kunihiro

et al. 2011

J Nucl Med

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“…Noradrenergic dysfunction in bronchial innervation has been demonstrated in a group of patients with type 1 diabetes who underwent lung ventilation scintigraphy with 123-Imetaiodobenzylguanidine (MIBG) [40]. The radiotracer was taken up in the lung by the same mechanism that controls the uptake of norepinephrine and selectively binds bronchial neuroadrenergic receptors [78]. Diabetic patients with autonomic neuropathy showed an increased lung uptake of 123-MIBG and a decreased rate of its clearance [40].…”

Section: Bronchomotor Tone and Control Of Ventilationmentioning

confidence: 99%

The Diabetic Lung - A New Target Organ?

Pitocco

Fuso²,

Conte³

et al. 2012

Rev Diabet Stud

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142

112

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■ AbstractSeveral abnormalities of the respiratory function have been reported in patients with type 1 and type 2 diabetes. These abnormalities concern lung volume, pulmonary diffusing capacity, control of ventilation, bronchomotor tone, and neuroadrenergic bronchial innervation. Many hypotheses have emerged, and characteristic histological changes have been described in the "diabetic lung", which could explain this abnormal respiratory function. Given the specific abnormalities in diabetic patients, the lung could thus be considered as a target organ in diabetes. Although the practical implications of these functional changes are mild, the presence of an associated acute or chronic pulmonary and/or cardiac disease could determine severe respiratory derangements in diabetic patients. Another clinical consequence of the pulmonary involvement in diabetes is the accelerated decline in respiratory function. The rate of decline in respiratory function in diabetics has been found to be two-to-three times faster than in normal non-smoking subjects, as reported in longitudinal studies. This finding, together with the presence of anatomical and biological changes similar to those described in the aging lung, indicates that the "diabetic lung" could even be considered a model of accelerated aging. This review describes and analyses the current insight into the relationship of diabetes and lung disease, and suggests intensifying research into the lung as a possible target organ in diabetes.

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“…By sharing several pathways with noradrenaline in the adrenergic nerve terminal and being non-metabolized, MIBG qualifies as a reliable marker of neuroadrenergic activity [19]. The scintigraphy was performed as previously reported [9].…”

Section: Neuroadrenergic Bronchial Innervationmentioning

confidence: 99%