Determination of dissolution profiles for several commercially available therapeutic [131I]sodium iodide capsules

The dissolution profiles for [¹³¹I]sodium iodide therapeutic capsules from three commerical vendors were studied. The ¹³¹I release rate in water was rapid for the capsules with 100% release attained within 35 min. There was no significant difference in dissolution profiles for the capsules from the three vendors.     

Influence of initial large dose on subsequent uptake of therapeutic radioiodine in thyroid cancer patients

Fifty-two patients with differentiated thyroid cancer, following thyroidectomy were studied by administering a quantity of up to 5 mCi of [¹³¹I]sodium iodide. In most of these patients, radioiodine uptake values obtained with the subsequent therapeutic dose were markedly lower than those observed with the initial doses. This observation was verified in seven of the patients with differentiated thyroid cancer, by measuring the radioiodine uptake with a second dose of 4.5 mCi of [¹³¹I]sodium iodide. Calculations showed that the major etiology was probably therapeutic irradiation of the thyroid by the first dose.     

Intrathyroidal iodine metabolism in the rat. The influence of diet and the administration of thyroid-stimulating hormone

1. Ratios of mono[¹³¹I]iodotyrosine and di[¹³¹I]iodotyrosine (R values) and the incorporation of ¹³¹I into iodothyronines have been estimated in rat thyroid glands from 30min. to 38hr. after the administration of [¹³¹I]iodide. 2. In rats receiving a powdered low-iodine diet the R values were close to unity and did not change with time after the administration of [¹³¹I]iodide. In rats receiving a commercial pellet diet the R values fell from a mean of 0·8 at 30min. after [¹³¹I]iodide administration to 0·49 at 38hr. 3. Administration of 0·5–2·0i.u. of thyroid-stimulating hormone before giving the injection of [¹³¹I]iodide caused a small diminution in the R value when the time between injecting [¹³¹I]iodide and killing the animal was 16hr. or more. 4. Iodothyronines represented a greater percentage of the total thyroid-gland radioactivity in the iodine-deficient animals than in animals fed on the pellet diet. Thyroid-stimulating hormone had little effect, if any, on the iodothyronine contents.     

A Case of Esophageal Stricture After Iodine 131 Ablation

ObjectiveTo report the first case of esophageal stricture as a complication of radioiodine (¹³¹I) ablation therapy.MethodsWe review the medical and surgical history of this patient and discuss various potential causes of the esophageal stricture.ResultsA 79-year-old woman presented with increasing dysphagia and weight loss of about 4.5 kg after recent ¹³¹I therapy for thyroid cancer remnant ablation. Her pertinent history included gastroesophageal reflux disease, an anterior midcervical esophageal web, and a distal esophageal stricture. She also had a history of radiation therapy to her chest for breast cancer about 28 years previously. On the day of ¹³¹I therapy, the 5.5-GBq ¹³¹I capsule lodged accidentally in her midcervical area for approximately 2.5 hours. The resulting radiation dose to the proximal esophagus was estimated to be 7.86 Gy from gamma radiation and possibly as high as several thousand grays from beta radiation. During this time, the esophagus had possible direct exposure to the sodium phosphate dibasic that was used as filler in the sodium iodide capsule. Because of the worsening dysphagia, an esophagogastroduodenoscopy was performed 4 weeks after the ¹³¹I therapy, which showed a new proximal esophageal stricture.ConclusionWe believe that the additional localized radiation and sodium phosphate exposure from the lodging of the ¹³¹I capsule may have contributed to the development of a proximal esophageal stricture. To our knowledge, such an occurrence has not previously been described in the medical literature. For prevention of such an occurrence, we recommend a careful swallowing evaluation of patients with any history of esophageal radiation exposure, dysphagia, or esophageal strictures before administration of ¹³¹I in capsule form. Alternative methods of ¹³¹I delivery, if available, should be considered. (Endocr Pract. 2012;18: e61-e64)     

Thyroid Scanning with 131Cs

Scanning of the thyroid gland after the administration of radioactive caesium (¹³¹Cs) was performed in 45 patients; in 38 of these it had been shown that a thyroid nodule failed to accumulate sodium per-technetate (^99mTc) or sodum iodide (¹³¹I). ¹³¹Cs was concentrated in the nodule to a greater degree than in the paranodular thyroid tissue in seven patients, in five of whom thyroid carcinoma was subsequently identified. In five patients ¹³¹Cs accumulated in both the nodule and paranodular tissue, while in the other 26 no ¹³¹Cs uptake occurred in the nodule. In only one of the latter group was the thyroid lesion malignant. Caesium scanning seems to offer a useful supplementary procedure in the investigation of thyroid nodules.     

Determination of iodide amounts in urine and water by isotope dilution analysis

Urinary iodide and iodine in drinking water were determined in 318 healthy children aged 0 to 18 yr living in Izmir and environmental rural and urban areas in the western part of Turkey. The method is based on substochiometric isotope dilution analysis. Iodide was precipitated by substoichiometric amounts of AgNO₃. Iodide-131 was used as a tracer. Electrophoresis was performed to separate Ag¹³¹I from excess¹³¹I-. The Ag¹³¹I zone was cut off the electrophoresis paper and counted with a Nal(Tl) scintillation counter. Count rates were plotted versus added KI concentrations. The unknown iodide amount was found by using these linear plots. Iodide concentration ranges were within 1.8 –100.45 Μg/L in the analyzed drinking water samples. The mean value was 44.14 ±17.33 Μg/L and the median was 58.08 Μg/L. Urinary iodide concentration ranges were 0.22 –142.22 Μg/L. The median of the distribution was 37.71 Μg/L and the mean was 40.30 ±24.05 Μg/L. The results show that the examined area suffers moderate iodine deficiency.     

Evidence for a secretion of thyroxine by isolated hog thyroid cells

Isolated thyroid cells prepared from hog thyroid glands by tryptic dispersion were incubated with ¹³¹I⁻ for 1–6 h. Free [¹³¹I]thyroxine was identified in the incubation medium by three chromatographic methods. Neither [¹³¹I]iodotyurosines nor [¹³¹I]triiodothyronine were detected. The [¹³¹I]thyroxine released in the medium by 100 μl of cells (packed cell volume) after a 6-h incubation period amounted to 1.16% (S.E. = ± 0.39) of the total radioactivity. The medium [¹³¹I]thyroxine represented 15–25% of the total [¹³¹I]thyroxine synthesized during the 6 h of incubation. Thyrotropin, 1–60 munits/ml, increased the medium [¹³¹I]thyroxine content 2–4 fold. Dibutyryl cyclic AMP mimicked the effect of thyrotropin. The amount of medium [¹³¹I]thyroxine was strictly related to the amount of incubated cells but was independent of the volume of the incubation medium. When prelabeled cells were incubated in the presence of methimazole the increase in medium [¹³¹I]thyroxine was quantitatively related to a decrease in the intracellular [¹³¹I]thyroxine. Addition of dinitrotyrosine, an inhibitor of the deiodinase activity, induced the release of iodotyrosines in the incubation medium. That the incubation supernatant of isolated thyroid cells did contain free thyroxine but no iodotyrosines suggests that the normal mechanisms of proteolysis of thyroglobulin and deiodination of iodotyrosines inside the cells are preserved. From these data, it was concluded that the thyroxine release by isolated cells represents a real secretion.     

Nuclear factor-kappa B inhibition can enhance apoptosis of differentiated thyroid cancer cells induced by 131I

Objective

To evaluate changes of nuclear factor-kappa B (NF-κB) during radioiodine 131 (¹³¹I) therapy and whether NF-κB inhibition could enhance ¹³¹I-induced apoptosis in differentiated thyroid cancer (DTC) cells in a synergistic manner.

Methods

Three human DTC cell lines were used. NF-κB inhibition was achieved by using a NF-κB inhibitor (Bay 11-7082) or by p65 siRNA transfection. Methyl-thiazolyl-tetrazolium assay was performed for cell viability assessment. DNA-binding assay, luciferase reporter assay, and Western blot were adopted to determine function and expression changes of NF-κB. Then NF-κB regulated anti-apoptotic factors XIAP, cIAP1, and Bcl-xL were measured. Apoptosis was analyzed by Western blot for caspase 3 and PARP, and by flow cytometry as well. An iodide uptake assay was performed to determine whether NF-κB inhibition could influence radioactive iodide uptake.

Results

The methyl-thiazolyl-tetrazolium assay showed significant decrease of viable cells by combination therapy than by mono-therapies. The DNA-binding assay and luciferase reporter assay showed enhanced NF-κB function and reporter gene activities due to ¹³¹I, yet significant suppression was achieved by NF-κB inhibition. Western blot proved ¹³¹I could increase nuclear NF-κB concentration, while NF-κB inhibition reduced NF-κB concentration. Western blot also demonstrated significant up-regulation of XIAP, cIAP1, and Bcl-xL after ¹³¹I therapy. And inhibition of NF-κB could significantly down-regulate these factors. Finally, synergism induced by combined therapy was displayed by significant enhancements of cleaved caspase 3 and PARP from Western blot, and of Annexin V positively staining from flow cytometry. The iodine uptake assay did not show significant changes when NF-κB was inhibited.

Conclusion

We demonstrated that ¹³¹I could induce NF-κB activation, which would attenuate ¹³¹I efficacy in DTC cells. NF-κB inhibition by Bay 11-7082 or by p65 siRNA transfection was effective in suppressing NF-κB regulated anti-apoptotic changes and in combined regimen apoptosis was achieved synergistically.     

A study of some factors that influence the iodination of ox insulin

1. The influence of carrier iodide, iodine monochloride and pH on the labelling of ox insulin with ¹³¹I by the iodine monochloride method have been studied. 2. The quantitative effect of the iodide in the radioactive iodine preparation was that predicted from a calculation of its specific activity. No other interfering factors were detected in the [¹³¹I]iodide solutions used. 3. Increasing the molar ratio of iodine monochloride to insulin resulted in an increase followed progressively by a decrease in the proportion of ¹³¹I bound, while the total iodine bound increased to an amount characteristic of pH and thereafter remained constant. 4. The influence of pH on the iodination of insulin with iodine monochloride was complex and the pH curve showed two maxima, at pH2·8 and 6·4. At pH2·8 it was not possible to exceed 8 atoms of iodine bound per molecule by increasing the molar ratio of iodine monochloride. Similarly, at pH6·4 the substitution value of 11·5 atoms of iodine per molecule could not be exceeded. 5. Iodinated insulins containing an average of 1·96, 2·74, 6·0 and 7·0 atoms of iodine per molecule fully retained the ability to bind guinea-pig anti-(ox insulin) serum, and the ability to compete with unlabelled insulin for antibody sites only became significantly changed in the most highly substituted preparations and in the presence of large concentrations of unlabelled insulin. 6. The method for the iodination of insulin with 98% incorporation of ¹³¹I by using chloramine-t is described. 7. ¹³¹I-iodinated insulin prepared with graded quantities of chloramine-t in excess of that required for efficient labelling was less efficiently bound by guinea-pig anti-(ox insulin) serum than insulin labelled by the iodine monochloride method.     

The preparation and immunological properties of I-labelled adrenocorticotrophin

1. A procedure is described for preparing ¹³¹I-labelled adrenocorticotrophin suitable for use in radioimmunoassay. 2. Adsorption of labelled and unlabelled adrenocorticotrophin at low concentrations occurs to various surfaces despite the presence of diluent protein. Adsorption and desorption errors are minimized by low pH and by the use of polystyrene vials. 3. Preparations with low initial damage are obtained if the radioiodination is performed rapidly and the separation of ¹³¹I-labelled adrenocorticotrophin from unchanged [¹³¹I]iodide is carried out on cellulose columns by using dilute acid. 4. The immunological activity of ¹³¹I-labelled α^1–24-adrenocorticotrophin, but not of ¹³¹I-labelled porcine adrenocorticotrophin, decreases with increasing specific radioactivity. The involvement of tyrosine residues in the immunological specificity of the α^1–24-adrenocorticotrophin only is suggested to explain this finding.     

A radiotracer method to study efflux transport of iodide liberated from thyroid hormones via deiodination metabolism in the brain

AimsThyroid hormones (TH) play an important role in the development and functional maintenance of the central nervous system. The purpose of this study was to develop a radiotracer method for studying the in vivo efflux transport of iodide liberated by the TH metabolism in the brain. The rationale of our method is as follows: a radioiodinated compound can enter the brain and rapidly release iodide in situ; the iodide efflux rate can be estimated from the clearance of brain radioactivity after disappearance of the iodinated compound.Main methods6-[¹²⁵I]Iodo-9-pentylpurine ([¹²⁵I]9Pe6IP) was designed to enter the brain and release ¹²⁵I^? by the reaction with glutathione and synthesized from the corresponding bromo derivative in a Br/¹²⁵I exchange reaction. The brain kinetics of radioactivity and radioactive metabolites were investigated after intravenous injection of [¹²⁵I]9Pe6IP into mice. The iodide efflux rate was estimated in mice pretreated with perchlorate, an inhibitor of iodide transport from the brain.Key findingsHigh brain uptake (5.3% injected dose/g) was observed at 1 min, and almost complete conversion of [¹²⁵I]9Pe6IP to ¹²⁵I^? occurred 10 min after injection. The ¹²⁵I^? uptake from the blood was negligible. ¹²⁵I^? was eliminated from the brain along a single-exponential curve with a half-life of 6.0 min. Furthermore, dose-dependent inhibition of ¹²⁵I^? efflux was observed in mice pretreated with perchlorate.SignificanceWe conclude that 9Pe6IP labeled with ¹²⁴I (positron emitter) or ¹²³I (single-photon emitter) may be useful for studying the in vivo efflux transport of iodide in the brain using nuclear medicine imaging devices.     

Metabolism of 131I in relation to strobilation of Aurelia aurita L. (Scyphozoa)

The ¹³¹I isotope of iodine has been used to follow the uptake and metabolism of iodine during the process of strobilation in pre-conditioned polyps of Aurelia aurita L. Strobilating polyps accumulated free iodide from the media against a concentration gradient, the segmented portion of the polyps accumulating about three times as much as the basal portion. Almost all of the accumulated iodide appeared in the soluble portion of an acid-ethanol extract of polyp tissue as inorganic iodide. The time course of accumulation of iodine was not affected by previous exposure to either higher temperature or iodide. Inorganic iodide rather than organically bound iodine is thought to be the effective factor in the initiation of strobilation.     

Effect of methyl thiouracil on radioiodine thyroidal retention in rats

Summary Some goitrogens like methyl thiouracil (MTU) because of their thynamide grouping act as antithyroid drugs inhibiting the organification of iodide, but do not alter the iodide transport. Their administration to an intact animal, therefore, might alter the thyroidal iodine kinetics. Here an attempt has been made to study the effect of MTU on thyroidal iodine kinetics in rats as well as to find out whether any difference in kinetics could be detected between different radioiodines, viz.,¹³¹I,¹²⁵I, and¹²³I. Cumulated thyroidal activity which is a time integral of the activity has been taken as the parameter to represent the sum effect of thyroidal iodine kinetics over a specific time period of interest.From the in vivo thyroidal activity measurements, carried out over extended periods of time, the cumulated activity was calculated for both MTU treated and normal rats that received¹³¹I,¹²⁵I, or¹²³I at different times before the MTU start. Within a day of the start of the MTU there is a rapid loss of thyroidal iodine. The severity of the loss depended upon the time that elapsed between the start of the MTU schedule and the particular radioiodine administered. The absence of isotopic effect on the uptake as well as on the rate of uptake for the three different radioiodine isotopes studied has been brought out.Alexander von Humboldt Fellow, on leave from Institute of Nuclear Medicine and Allied Sciences, Delhi -7, India     

Experimental Study of Nasopharyngeal Carcinoma Radionuclide Imaging and Therapy Using Transferred Human Sodium/Iodide Symporter Gene

Purpose

The aim of this study was to design a method of radionuclide for imaging and therapy of nasopharyngeal carcinoma (NPC) using the transferred human sodium/iodide symporter (hNIS) gene.

Methods

A stable NPC cell line expressing hNIS was established (CNE-2-hNIS). After ¹³¹I treatment, we detected proliferation and apoptosis of NPC cells, both in vitro and vivo. In vivo, the radioactivity of different organs of nude mice was counted and ^99mTc imaging using SPECT was performed. The apparent diffusion coefficient (ADC) value changes of tumor xenografts were observed by diffusion-weighted magnetic resonance imaging (DW-MRI) within 6–24 days of ¹³¹I treatment. The correlation of ADC changes with apoptosis and proliferation was investigated. Post-treatment expression levels of P53, Bax, Bcl-2, Caspase-3, and Survivin proteins were detected by western blotting.

Results

¹³¹I uptake was higher in CNE-2-hNIS than in CNE-2 cells. The proliferation and apoptosis rate decreased and increased respectively both in vitro and vivo in the experimental group after ¹³¹I treatment. The experimental group tumors accumulated ^99mTc in vivo, leading to a good visualization by SPECT. DW-MRI showed that ADC values increased in the experimental group 6 days after treatment, while ADC values were positively and negatively correlated with the apoptotic and Ki-67 proliferation indices, respectively. After treatment, CNE-2-hNIS cells up-regulated the expression of P53 and Survivin proteins and activated Caspase-3, and down-regulated the expression of Bcl-2 proteins.

Conclusions

The radionuclide imaging and therapy technique for NPC hNIS-transfected cell lines can provide a new therapy strategy for monitoring and treatment of NPC.     

Hipertiroidismo y captaciones de yodo bajas en una paciente con enfermedad de Graves

Thyrotoxicosis factitia is defined as thyrotoxicosis resulting from exogenous ingestion of thyroid hormone, usually in patients with a psychiatric disorder. Diagnosis can be difficult and this entity should be suspected in patients with high free tiroxine (T4) concentrations, low or suppressed thyroglobulin concentrations, normal urinary iodide excretion and low or suppressed ¹³¹I uptake. To establish the differential diagnosis, thyrotoxicosis factitia must be distinguished from several diseases with low ¹³¹I uptake, such as Graves’ disease, subacute thyroiditis, hyperthyroidism due to excessive iodine intake, struma ovarii and metastasis from thyroid cancer. Treatment is based on b-blockers to reduce symptoms and avoid iatrogeny. We present a case of thyrotoxicosis factitia treated in our outpatient clinic.     

Synthesis and bioevaluation of radioiodinated nitroimidazole hypoxia imaging agents by one-pot click reaction

Eight radioiodinated 2-nitroimidazole derivatives for use as hypoxia imaging agents were synthesized by one-pot click reaction using four azides, two alkynes, and [¹³¹I]iodide ions and evaluated by hypoxic cellular uptake and biodistribution experiments. The results suggested that radiotracers with suitable partition coefficients (log P: −0.2–1.2) were more likely to have higher hypoxic cellular uptake. Among these eight molecules, [¹³¹I]15 ([¹³¹I]-(5-iodo-1-(2-(2-(2-nitro-1H-imidazol-1-yl)ethoxy)ethyl)-4-((2-nitro-1H-imidazol-1-yl)methyl)-1H-1,2,3-triazole)) had a suitable log P (0.05 ± 0.03) and contained two 2-nitroimidazole groups. The hypoxic/aerobic cellular uptake ratio of [¹³¹I]15 was 4.4 ± 0.5, and the tumor/blood (T/B) and tumor/muscle (T/M) ratios were 2.03 ± 0.45 and 6.82 ± 1.70, respectively. These results suggested that [¹³¹I]15 was a potential hypoxia imaging agent.     

Failure of Cytochalasin or Colchicine to inhibit Secretion of Immunoglobulins

SECRETIONS are often packaged in granules which are held within the cells of origin until some specific stimulus brings about release by exocytosis. Granules containing catecholamines are liberated from adrenal medullary cells by acetylcholine; granules containing insulin are released from pancreatic β-cells by high concentrations of glucose; and granules containing histamine, serotonin and slow-reacting substance are discharged from mast cells in the presence of cell-bound antibody and antigen. The release of secretory granules requires calcium ions in the extracellular medium¹ and may follow the entry into the cytoplasm of calcium ions which trigger contraction of an actomyosin-like microfilament system². This interpretation is supported by our recent observation² that induced release from mast cells of granules containing mediators of acute hypersensitivity is strongly inhibited by cytochalasins, a group of fungal products that selectively block the activity of microfilament-related contractile systems in many cells^3,4. Stimulated release of ¹³¹I from previously labelled mouse thyroids and endocytosis of colloid, are also inhibited by cytochalasin⁵. Cytochalasin inhibits cell movement, movement of ruffled membranes, pinocytosis and phagocytosis in macrophages and polymorphonuclear leucocytes^4,6. Release of ¹³¹ I from previously ¹³¹I-labelled mouse thyroid⁷ is also inhibited by colchicine and other agents that disperse labile cytoplasmic microtubules. Thus it seems that a contractile microfilament-related system, acting together with microtubules, brings about the controlled release, when required, of certain secretions.     

Chemical modification of ribonucleosides with N-acetyl-3,5-di[125I]iodotyrosyl hydrazide

Several 3,5-diiodotryrosyl derivatives have been synthesized by both sodium iodideiodine and the sodium iodide-iodic acid methods. Conditions optimizing yield and purity of the product have been established for the latter reaction. Under those conditions, treatment of N-acetyl-tyrosyl ethyl ester with sodium [¹²⁵I]iodide and iodic acid gave N-acetyl-3,5-di[¹²⁵I]iodotyrosyl ethyl ester (ADITEE) with high specific activity. Hydrazination of [¹²⁵I]ADITEE produces N-acetyl-3,5-di[¹²⁵I]iodotyrosyl hydrazide. This hydrazide has been successfully used to modify four different ribonucleoside dialdehydes.     

The Purity of Radioiodide-I131 Assessed by in Vivo and in Vitro Methods

Between 41 and 94% of the radioactivity of 24 preparations of I¹³¹ supplied without cysteine preservative was non-iodide on chromatographic analysis. Extraneous radio-activity was essentially absent from I¹³¹ supplied with cysteine. It was converted to iodide-I¹³¹ by 10^-3 M cysteine or iodide but not by incubation at pH 2. The average thyroid uptake of I¹³¹ containing extraneous radioactivity was significantly lower than the uptake of I¹³¹ free from non-iodide impurity in 16 human subjects measured under controlled conditions and in a random group of 669 patients. Incubation of samples of I¹³¹ containing non-iodide radioactivity with tyrosine and cupric chloride resulted in the non-enzymatic formation of monoiodotyrosine-I¹³¹ either in the presence or absence of thyroid homogenate. Enzymatic formation of monoiodotyrosine-I¹³¹ by thyroid homogenates could be demonstrated only when I¹³¹ free from extraneous activity was used.     

Mutagenicity of diagnostic and therapeutical doses of radiopharmaceutical iodine-131 in Wistar rats

Iodine-131 (¹³¹I) is a radioisotope used for the diagnosis and treatment of thyroidal disorders such as hyperthyroidism and cancer. During its decay, ¹³¹I emits beta particles and gamma rays; its physical half-life is 8 days, and it is accumulated preferentially in the thyroid tissue. This study aimed to evaluate the cytotoxicity and mutagenicity of diagnostic and therapeutic doses of ¹³¹I using bone marrow cells of rats treated in vivo in a test system with a single dose by gavage. Concentrations of 5, 25, 50 and 250 μCi in 1 ml of water were used, and after 24 h, the animals were killed. Also, a concentration of 25 μCi/ml of water was used, and the animals were killed after 5 days. The results showed that no concentration of ¹³¹I was cytotoxic and that all concentrations were mutagenic. As a result, there was no statistically significant difference detected by the χ² test in the induction of chromosomal aberrations between the different doses. Thus, the present study demonstrated a significant increase in chromosomal aberration in bone marrow cells exposed to ¹³¹I regardless of the dose or the treatment time.