Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2015, Article ID 401341, 7 pages
http://dx.doi.org/10.1155/2015/401341
Research Article

In Vivo Evaluation of TNF-Alpha in the Lungs of Patients Affected by Sarcoidosis

1Nuclear Medicine Unit, Department of Medical-Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Ospedale S. Andrea, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Roma, Italy
2Pneumology Unit, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Ospedale S. Andrea, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Roma, Italy

Received 7 June 2014; Revised 9 August 2014; Accepted 11 August 2014

Academic Editor: Andor Glaudemans

Copyright © 2015 Filippo Galli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Sarcoidosis is a multisystemic granulomatous disorder characterized by multiple noncaseating granulomas involving intrathoracic lymph nodes and lung parenchyma. Recently, the use of anti-tumor necrosis factor alpha (anti-TNFα) agents has been introduced for therapy of chronic and refractory sarcoidosis with controversial results. Infliximab (Remicade) is a chimeric monoclonal antibody (mAb) that recognizes and binds TNFα, neutralizing its biological effects. In the present study, labelled infliximab was used to study the expression of TNFα in sarcoid lesions and to evaluate its role as a predictive marker in response to therapy with Remicade. Material and Methods. A total of 10 patients with newly diagnosed sarcoidosis were enrolled together with 10 control patients affected by rheumatoid arthritis. All patients were studied by planar imaging of the chest with -infliximab at 6 h and 24 h and total body [18F]-FDG PET/CT. Regions of interest were drawn over the lungs and the right arm and target-to-background ratios were analysed for -infliximab. SUVmean and SUVmax were calculated over lungs for FDG. Results and Discussion. Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [18F]-FDG PET. Conclusion. In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative -infliximab scintigraphy.