Can Nuclear Imaging of Activated Macrophages with Folic Acid-Based Radiotracers Serve as a Prognostic Means to Identify COVID-19 Patients at Risk?


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Date

2020-09

Publication Type

Journal Article

ETH Bibliography

yes

Citations

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Data

Abstract

Herein, we discuss the potential role of folic acid-based radiopharmaceuticals for macrophage imaging to support clinical decision-making in patients with COVID-19. Activated macrophages play an important role during coronavirus infections. Exuberant host responses, i.e., a cytokine storm with increase of macrophage-related cytokines, such as TNFα, IL-1β, and IL-6 can lead to life-threatening complications, such as acute respiratory distress syndrome (ARDS), which develops in approximately 20% of the patients. Diverse immune modulating therapies are currently being tested in clinical trials. In a preclinical proof-of-concept study in experimental interstitial lung disease, we showed the potential of 18F-AzaFol, an 18F-labeled folic acid-based radiotracer, as a specific novel imaging tool for the visualization and monitoring of macrophage-driven lung diseases. 18F-AzaFol binds to the folate receptor-beta (FRβ) that is expressed on activated macrophages involved in inflammatory conditions. In a recent multicenter cancer trial, 18F-AzaFol was successfully and safely applied (NCT03242993). It is supposed that the visualization of activated macrophage-related disease processes by folate radiotracer-based nuclear imaging can support clinical decision-making by identifying COVID-19 patients at risk of a severe disease progression with a potentially lethal outcome.

Publication status

published

Editor

Book title

Volume

13 (9)

Pages / Article No.

238

Publisher

MDPI

Event

Edition / version

Methods

Software

Geographic location

Date collected

Date created

Subject

COVID-19; imaging biomarker; macrophages; folate receptor-beta (FRβ); Positron emission tomography (PET); inflammation; folate-based 18F-PET tracer

Organisational unit

03688 - Schibli, Roger / Schibli, Roger check_circle

Notes

Funding

154490 - Novel Imaging and Therapeutic Tools in Systemic Sclerosis (SNF)
156803 - Development of New Folate-Based RadioImaging Agents and RadioTherapeutics (SNF)

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