Intraarticular Application of Unsealed Beta-Emitting Radionuclides in the Treatment Course of Inflammatory Joint Diseases

ISSN: 1875-614X (Online)
ISSN: 1871-5230 (Print)


Volume 15, 3 Issues, 2016


Download PDF Flyer




Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry

Formerly: Current Medicinal Chemistry - Anti-Inflammatory and Anti-Allergy Agents

This journal supports open access

Aims & ScopeAbstracted/Indexed in


Submit Abstracts Online Submit Manuscripts Online

Editor-in-Chief:
Claudiu T. Supuran
Neurofarba Department
University of Florence
Florence
Italy


View Full Editorial Board

Subscribe Purchase Articles Order Reprints


Intraarticular Application of Unsealed Beta-Emitting Radionuclides in the Treatment Course of Inflammatory Joint Diseases



Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry, 1(1): 77-87.

Author(s): W. U. Kampen, W. Brenner, N. Czech and E Henze.

Affiliation: Clinic of Nuclear Medicine, Christian-Albrechts-University Kiel Germany

Abstract

Intraarticular injection of β-emitting radionuclides, called radiation synovectomy or radiosynoviorthesis, is an effective treatment in patients suffering from inflammatory-rheumatoid and degenerative joint diseases. Since the first description of intraarticular radionuclide therapy in 1952, several gamma- and beta-emitting radionuclides have been used in both experimental and clinical studies. Today, mainly three substances are in clinical use, each of them for special joints regarding to their biophysical characteristics: Yttrium-90 for knee joints, Rhenium-186 for mid-sized joints like shoulder, wrist or ankle joints and Erbium-169 for small joints of fingers and toes. Except for Rhenium, which consists of an additional gamma-radiation, all nuclides are pure beta-emitter with a tissue penetration depth of a few mm to avoid radiation damage to other diarthrodial tissues. Indication for radiosynoviorthesis is based on both clinical symptoms and on acute synovitis, proven in a pretherapeutic three-phase bone scan. Following intraarticular injection, the radionuclides are taken up by the synovial lining cells. A colloidal preparation with a mean particle size between 100nm and 2μm favors cellular uptake and minimizes extraarticular leakage by lymphatic or venous drainage. The local high energy irradiation results in sclerosis and fibrosis of the inflamed synovial membrane, achieving significant reduction of pain and joint effusion in appr. 70% of the patients. Present-day studies and future developments do focus in part on radiochemical aspects like new radionuclides with promising biophysical characteristics to optimize therapeutic effects with minimizing radation burden. Clinically oriented studies search for combined therapeutic approaches, e.g. the benefit of endoscopic synovectomy prior to radiosynoviorthesis.

Keywords:

inflammatory joint diseases, radiation synovectomy, radiosynoviorthesis, inflammatory-rheumatiod, degenerative joint diseases.



Download Free Order Reprints Order Eprints Rights and Permissions




Article Details

Volume: 1
Issue Number: 1
First Page: 77
Last Page: 87
Page Count: 11
DOI: 10.2174/1568014024606502
Advertisement

Related Journals




Webmaster Contact: urooj@benthamscience.org Copyright © 2016 Bentham Science