Imaging of pulmonary disease in scleroderma with JO0iX scintigraphy

Abstract

Background - JOOIX is an acylated polygalactoside isolated from the membrane of Klebsiella and able to interact with macrophages, mainly in their activated state. The aim of the present study was to determine the ability of 99m-labelled technetium (99mTc)-JOOlX scintigraphy to image pulmonary disease, defined by high resolution computed tomographic scanning and pulmonary function tests, in patients suffering from scleroderma. Methods - Patients were considered to have pulmonary disease when they had at least two positive signs on high resolution computed tomography, or a decrease in lung volume and single breath carbon monoxide transfer, or both, with no disease process other than scleroderma in their medical history. Positive JOO1X scintigraphic imaging was defined by symmetrical bilateral pulmonary fixation three and five hours after inhalation of 99mTc-JOO1X. JOOlX scintigraphic results were compared with disease activity as indicated by bronchoalveolar lavage (BAL) fluid lymphocytosis. Results - Seventeen patients were studied, in 12 ofwhomJOO1X scintigraphy was positive. There was no correlation between BAL lymphocytosis and JOO1X scintigraphic findings, nor between BAL and pulmonary scleroderma. This was not surprising because of the high specificity of macrophage targeting by JOO1X. Conclusions - Follow up of a larger population over a longer period is needed to establish whether there is a prognostic value for positive JOOlX scintigraphic findings in scleroderma.