Schmidkonz C, Rauber S, Atzinger A, Götz TI, Soare A, Cordes M, Prante O, Ritt P, Bäuerle T, Köhner M, Haberkorn U, Kuwert T, Schett G, Ramming A (2021)
Publication Type: Journal article
Publication year: 2021
Publisher: SPRINGER
City/Town: NEW YORK
Pages Range: S125-S126
Conference Proceedings Title: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
Ziel/Aim To date, there is no valuable tool to assess fibrotic disease activity in humans in vivo in a non-invasive way. This study aims to uncouple inflammatory from fibrotic disease activity in fibroinflammatory diseases such as IgG4-related disease.
Methodik/Methods In this cross-sectional clinical study, 27 patients with inflammatory, fibrotic and overlapping manifestations of IgG4-related disease underwent positron emission tomography (PET) scanning with tracers specific for fibroblast activation protein (FAP; 68Ga-FAP inhibitor (FAPI)-04), 18F-fluorodeoxyglucose (FDG), magnetic resonance imaging (MRI) and histopathological assessment. In a longitudinal approach, 18F-FDG and 68Ga-FAPI-04 PET/CT data were evaluated before and after immunosuppressive treatment and correlated to clinical and MRI data.
Ergebnisse/Results Using combination of 68Ga-FAPI-04 and 18F-FDG-PET, we demonstrate that non-invasive functional tracking of IgG4-related disease evolution from inflammatory towards a fibrotic outcome becomes feasible. 18F-FDG-PET positive lesions showed dense lymphoplasmacytic infiltration of IgG4 + cells in histology, while 68Ga-FAPI-04 PET positive lesions showed abundant activated fibroblasts expressing FAP according to results from RNA-sequencing of activated fibroblasts. The responsiveness of fibrotic lesions to anti-inflammatory treatment was far less pronounced than that of inflammatory lesions.
Schlussfolgerungen/Conclusions FAP-specific PET/CT permits the discrimination between inflammatory and fibrotic activity in IgG4-related disease. This finding may profoundly change the management of certain forms of immune-mediated disease, such as IgG4-related disease, as subtypes dominated by fibrosis may require different approaches to control disease progression, for example, specific antifibrotic agents rather than broad spectrum anti-inflammatory treatments such as glucocorticoids.
APA:
Schmidkonz, C., Rauber, S., Atzinger, A., Götz, T.I., Soare, A., Cordes, M.,... Ramming, A. (2021). Disentangling inflammatory from fibrotic disease activity by fibroblast activation protein imaging. European Journal of Nuclear Medicine and Molecular Imaging, S125-S126. https://doi.org/10.1055/s-0041-1726701
MLA:
Schmidkonz, Christian, et al. "Disentangling inflammatory from fibrotic disease activity by fibroblast activation protein imaging." European Journal of Nuclear Medicine and Molecular Imaging (2021): S125-S126.
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