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¹²³I-Interleukin-2 Scintigraphy for In Vivo Assessment of Intestinal Mononuclear Cell Infiltration in Crohn's Disease

Department of Clinical Sciences, University "La Sapienza", Rome
Institute of Anatomic Pathology, Department of Biopathology and Imaging Diagnostic, University "Tor Vergata", Rome, Italy

Correspondence: For correspondence or reprints contact: Alberto Signore, MD, Nu.M.E.D. Group, Dipartimento Scienze Cliniche, Policlinico Umberto I, 00161 Roma, Italy.

ABSTRACT

Activated mononuclear cells expressing interteukin-2 (IL2) receptors (IL2-Rs) heavily infiltrate the Crohn's disease (CD) gut wall. A new technique for the in vivo detection of tissue infiltrating IL2-R positive (IL2R+ve) cells was developed based on ¹²³I-IL2 scintigraphy. The aim of this study was to investigate whether ¹²³I-IL2 accumulates in the CD gut wall in different phases of the disease and to evaluate the specificity of ¹²³I-IL2 binding to activated IL2R+ve cells infiltrating the gut wall. Methods: Fifteen patients with ileal CD (10 active and 5 inactive) and 10 healthy volunteers were studied by ¹²³I-IL2 scintigraphy. Six patients with active CD were studied before and after 12 wk of steroid treatment. After scintigraphy, patients were followed up for 29–54 mo. Ex vivo autoradiography was performed to determine specificity of ¹²⁵I-IL2 binding to IL2R+ve cells. For bowel scintigraphy, ¹²³I-IL2 (75 MBq) was injected intravenously and camera images were acquired after 1 h. Bowel radioactivity was quantified in 64 regions of interest (ROIs). Results: Autoradiography showed specific binding of ¹²⁵I-IL2 to IL2R+ve mononuclear cells infiltrating the CD gut wall. Intestinal ¹²³I-IL2 uptake assessed by the number of positive ROIs was higher in patients with active or inactive CD than in healthy volunteers (P < 0.0001 and P = 0.03, respectively) and positively correlated with the CD activity index (P = 0.01). ¹²³I-IL2 intestinal uptake significantly decreased in patients with CD in steroid-induced remission (P = 0.03). A significant correlation was observed between the number of positive ROIs and time to disease relapse. Conclusion: ¹²³I-IL2 accumulates in the diseased CD gut wall by specific binding to IL2R+ve cells, infiltrating the involved tissues. ¹²³I-IL2 scintigraphy may be an objective tool for the in vivo assessment of intestinal activated mononuclear cell infiltration.

Key Words: Crohn's disease • mucosal lymphocytes • interleukin-2 • scintigraphy

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