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Imaging of Human Infection with ¹³¹I-Labeled Recombinant Human Interleukin-8

Nuclear Medicine Service, Department of Veterans Affairs Health System, Ann Arbor; and Division of Nuclear Medicine, Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan

The chemotactic cytokine interleukin-8 (IL-8) plays an important role in attraction and activation of polymorphonuclear leukocytes in infection and inflammation. A pilot study was conducted to determine if radiolabeled IL-8 would depict infection in humans. Methods: Human recombinant IL-8 (rhIL-8) labeled with ¹³¹I (specific activity, 0.4–0.7 MBq [11–18 µCi] ¹³¹I/µg IL-8) was injected intravenously into 8 diabetic patients with active foot infections and evidence of osteomyelitis, 2 patients with successfully treated osteomyelitis, and 1 patient with cellulitis of the thumb. Results: Focal accumulation of ¹³¹I-rhIL-8 was seen in 8 of 8 patients with active foot infection and diffuse uptake was seen in the thumb of the 1 patient with cellulitis. In the 2 patients with successfully treated bone infection, multiphase ^99mTc-hydroxyethylene diphosphonate bone scans were negative early, but late-phase (>3 h) uptake depicted degenerative lesions that did not image with ¹³¹I-rhIL-8. Conclusion: ¹³¹I-rhIL-8 accumulates rapidly within infected foci in osteomyelitis and cellulitis but not in successfully treated infections or degenerative joint disease.

Key Words: infection • osteomyelitis • cytokine • interleukin-8 • radioiodine

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