title: Imaging of inflamed carotid artery atherosclerotic plaques with the use of 99mTc-HYNIC-IL-2 scintigraphy in end-stage renal disease patients.
abstract: OBJECTIVE
  Identification of vulnerable plaques remains crucial for better cardiovascular risk assessment. At least 20% of inflammatory cells within unstable (vulnerable) plaques comprise T lymphocytes, which contain receptors for interleukin-2 (IL-2); those receptors can be identified by scintigraphy with radiolabelled IL-2.The aim of this study was to identify the "inflamed" (vulnerable) plaques by scintigraphy using IL-2 labelled with (99m)Tc in the selected, high cardiovascular risk group of end-stage renal disease (ESRD) patients.
  
  
  METHODS
  A total of 28 patients (18 men, 10 women, aged 55.2 ± 9.6 years, 17 on peritoneal dialysis, 11 on haemodialysis) underwent common carotid artery (CCA) scintigraphy with the use of (99m)Tc-hydrazinonicotinamide (HYNIC)-IL-2. In all cases, ultrasound examination of the CCA was performed and levels of selected proinflammatory factors, atherogenic markers and calcium-phosphate balance parameters were measured. Finally, the target to non-target (T/nT) ratio of IL-2 uptake in atherosclerotic plaques with intima-media thickness (IMT), classic cardiovascular risk factors and concentrations of the measured factors were compared.
  
  
  RESULTS
  Increased (99m)Tc-HYNIC-IL-2 uptake in atherosclerotic plaques in 38/41 (91%) cases was detected. The median T/nT ratio of focal (99m)Tc-HYNIC-IL-2 uptake in atherosclerotic plaques was 2.35 (range 1.23-3.63). The mean IMT value on the side of plaques assessed by scintigraphy was 0.79 ± 0.18 mm (median 0.8, range 0.5-1.275). Correlations between T/nT ratio and homocysteine (R = 0.22, p = 0.037), apolipoprotein B (apoB) (R = 0.31, p = 0.008), apoB to apoA-I ratio (R = 0.29, p = 0.012) and triglyceride concentration (R = 0.26, p = 0.021) were detected. A lower T/nT ratio in patients with better parameters of nutritional status (haemoglobin, albumin, adiponectin) in comparison with patients with worse nutritional parameters (3.20 ± 0.5 vs 2.16 ± 0.68, p = 0.025) was revealed as well as a difference between values of T/nT ratio in groups of patients with values of apoB, soluble CD40 ligand and asymmetric dimethylarginine above and below median (3.18 ± 0.52 vs 2.16 ± 0.68, p = 0.031). No statistically significant association was found between T/nT ratio and mean value of either IMT or classic cardiovascular risk factors.
  
  
  CONCLUSIONS
  Scintigraphy with the use of (99m)Tc-HYNIC-IL-2 can be a tool for inflamed atherosclerotic (vulnerable) plaque visualization within CCA in ESRD patients. Quantitative results of carotid artery scintigraphy with (99m)Tc-HYNIC-IL-2 correlate with serum concentration of selected cardiovascular risk markers.
authors.affiliation: Department of Endocrinology, Jagiellonian University Medical School, Cracow, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Opalinska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stompor
authors.forename: Dorota
authors.initials: D
authors.lastname: Pach
authors.forename: Renata
authors.initials: R
authors.lastname: Mikolajczak
authors.forename: Danuta
authors.initials: D
authors.lastname: Fedak
authors.forename: Marcin
authors.initials: M
authors.lastname: Krzanowski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rakowski
authors.forename: Anna
authors.initials: A
authors.lastname: Sowa-Staszczak
authors.forename: Boguslaw
authors.initials: B
authors.lastname: Glowa
authors.forename: Piotr
authors.initials: P
authors.lastname: Garnuszek
authors.forename: Michał
authors.initials: M
authors.lastname: Maurin
authors.forename: Urszula
authors.initials: U
authors.lastname: Karczmarczyk
authors.forename: Władysław
authors.initials: W
authors.lastname: Sulowicz
authors.forename: Alicja
authors.initials: A
authors.lastname: Hubalewska-Dydejczyk
mesh_terms: D001692:Biological Transport; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging; D018664:Interleukin-12 / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000378:metabolism; D058226:Plaque, Atherosclerotic / Q000150:complications* / Q000000981:diagnostic imaging* / Q000378:metabolism; D011877:Radionuclide Imaging; D012306:Risk
chemical_list: C513398:99mTc-HYNIC-interleukin-12; D006454:Hemoglobins; D015609:Organotechnetium Compounds; D018664:Interleukin-12