Disentangling inflammatory from fibrotic disease activity by fibroblast activation protein imaging
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
Journal
Publisher: SPRINGER
City/Town: NEW YORK
Pages Range: S125-S126
Conference Proceedings Title: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
Abstract
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.
Authors with CRIS profile
Christian Schmidkonz
Medizinische Fakultät
Simon Rauber
Department of Medicine 3 – Rheumatology and Immunology
Armin Atzinger
Department of Nuclear Medicine
Michael Cordes
Medizinische Fakultät
Olaf Prante
Professur für Molekulare Bildgebung und Radiochemie
Philipp Ritt
Department of Nuclear Medicine
Tobias Bäuerle
Professur für Multimodale Bildgebung in der präklinischen Forschung
Torsten Kuwert
Lehrstuhl für Klinische Nuklearmedizin
Georg Schett
Lehrstuhl für Innere Medizin III
Andreas Ramming
Medizinische Fakultät
Involved external institutions
Germany (DE)How to cite
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://dx.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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