title: Clinical evaluation of antimicrobial peptide [(99m)Tc/Tricine/HYNIC(0)]ubiquicidin 29-41 as a human-specific infection imaging agent.
abstract: BACKGROUND
  Ubiquicidin (UBI) 29-41 is a cationic synthetic antimicrobial peptide fragment that binds preferentially with the anionic microbial cell membrane at the site of infection. This study was conducted to evaluate the potentiality of [(99m)Tc/Tricine/HYNIC(0)]UBI 29-41 prepared from lyophilized kits as an infection imaging agent in humans.
  
  
  METHODS
  Seven patients (5 males and 2 females; mean age=55 years; age range=35-75 years) with suspected bone or soft-tissue infections participated in this study. [(99m)Tc/Tricine/HYNIC]UBI 29-41, corresponding to activity in the range 555-740 MBq added to 40 mug of peptide obtained from instant freeze-dried kit formulations with radiochemical purities >95%, was injected intravenously. A 45-min dynamic study was followed by spot views of the suspected region of infection (target) and a corresponding normal area (nontarget). Whole-body anterior and posterior images were also acquired at 30, 60 and 120 min after injection. True- or false-positive or true- or false-negative images were interpreted upon bacterial culture, radiography, clinical tests and bone scanning.
  
  
  RESULTS
  The biodistribution of [(99m)Tc/Tricine/HYNIC]UBI 29-41 in patients showed rapid accumulation of activity in the kidneys in the first 30 min after injection that gradually declined and accumulated in the urinary bladder. There were positive findings in five studies and negative findings in two. Findings were subsequently confirmed to be true positive or negative. Images showed minimal accumulation in nontarget tissues, with an average target/nontarget ratio of 2.10+/-0.33 in positive lesions at 30 min.
  
  
  CONCLUSIONS
  Given its favorable clinical characteristics, [(99m)Tc/Tricine/HYNIC]UBI 29-41 shows promise as a tracer for infection imaging that allows early diagnosis (30 min) of infection.
authors.affiliation: Nuclear Science Research School, Nuclear Science and Technology Research Institute, Atomic Energy Organization of Iran, Tehran, 11365-3486, Iran. mgandomkar@aeoi.org.ir
authors.forename: Mostafa
authors.initials: M
authors.lastname: Gandomkar
authors.forename: Reza
authors.initials: R
authors.lastname: Najafi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shafiei
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mazidi
authors.forename: Mostafa
authors.initials: M
authors.lastname: Goudarzi
authors.forename: Seyed Hassan
authors.initials: SH
authors.lastname: Mirfallah
authors.forename: Farhad
authors.initials: F
authors.lastname: Ebrahimi
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Heydarpor
authors.forename: Noroz
authors.initials: N
authors.lastname: Abdie
mesh_terms: D000328:Adult; D000368:Aged; D023181:Antimicrobial Cationic Peptides; D001424:Bacterial Infections / Q000000981:diagnostic imaging*; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives; D006801:Humans; D006834:Hydrazines; D008297:Male; D008875:Middle Aged; D009539:Nicotinic Acids; D015609:Organotechnetium Compounds; D010446:Peptide Fragments; D011786:Quality Control; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D018461:Soft Tissue Infections / Q000000981:diagnostic imaging*; D014018:Tissue Distribution
chemical_list: C120392:6-hydrazinopyridine-3-carboxylic acid; D023181:Antimicrobial Cationic Peptides; D006834:Hydrazines; D009539:Nicotinic Acids; D015609:Organotechnetium Compounds; D010446:Peptide Fragments; D019275:Radiopharmaceuticals; C485080:technetium 99m ubiquicidin(29-41); D005998:Glycine; C100184:tricine