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 18 F-AzaFol, an 18 F-labeled folic acid-based radiotracer, as a specific novel imaging tool for the visualization and monitoring of macrophage-driven lung diseases. 18 F-AzaFol binds to the folate receptor-beta (FRβ) that is expressed on activated macrophages involved in inflammatory conditions. In a recent multicenter cancer trial, 18 F-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.
【저자키워드】 COVID-19, Inflammation, macrophages, positron emission tomography (PET), imaging biomarker, folate receptor-beta (FRβ), folate-based 18F-PET tracer, 【초록키워드】 Macrophage, ARDS, Cytokine storm, therapy, Cytokines, Trial, IL-6, Cancer, clinical trials, risk, Interstitial lung disease, outcome, immune, Coronavirus infections, Lung diseases, complications, multicenter, disease, patients, acute respiratory distress, IL-1β, COVID-19 patient, host responses, Support, syndrome, life-threatening, TNFα, inflammatory conditions, nuclear, severe disease progression, bind, tested, develop, involved, applied, activated, expressed, activated macrophage, Exuberant, modulating, patients with COVID-19, 【제목키워드】 imaging, radiotracer, Can,