Possible accumulation of critical metals in plants that hyperaccumulate their chemical analogues?

Lithium (Li), gallium (Ga) and indium (In) are industry-critical metals, with no known plant species that (hyper)accumulate these metals to any substantial degree. We hypothesised that sodium (Na) hyperaccumulators (i.e., halophytes) may accumulate Li, whilst aluminium (Al) hyperaccumulators may accumulate Ga and In, based on the chemical similarities of these elements. Experiments were conducted in hydroponics at various molar ratios for six weeks to determine accumulation in roots and shoots of the target elements. For the Li experiment, the halophytes Atriplex amnicola, Salsola australis and Tecticornia pergranulata were subjected to Na and Li treatments, whilst for the Ga and In experiment, Camellia sinensis was exposed to Al, Ga, and In. The halophytes were able to accumulate high shoot Li and Na concentrations reaching up to ~10 g Li kg-1 and 80 g Na kg-1, respectively. The translocation factors for Li were higher than for Na (about two-fold) in A. amnicola and S. australis. The results from the Ga and In experiment show that C. sinensis is capable of accumulating high concentrations of Ga (mean 150 mg Ga kg-1), comparable with Al (mean 300 mg Al kg-1), but virtually no In (<20 mg In kg-1) in its leaves. Competition between Al and Ga suggests that Ga might be taken up via Al pathways in C. sinensis. The findings suggest that there are opportunities to explore Li and Ga phytomining on respective Li- and Ga-enriched mine water/soil/mine waste materials using halophytes and Al hyperaccumulators to complement the global supply of these critical metals.

Activating Silent Synapses in Sulfurized Indium Selenide for Neuromorphic Computing.

The transformation from silent to functional synapses is accompanied by the evolutionary process of human brain development and is essential to hardware implementation of the evolutionary artificial neural network but remains a challenge for mimicking silent to functional synapse activation. Here, we developed a simple approach to successfully realize activation of silent to functional synapses by controlled sulfurization of chemical vapor deposition-grown indium selenide crystals. The underlying mechanism is attributed to the migration of sulfur anions introduced by sulfurization. One of our most important findings is that the functional synaptic behaviors can be modulated by the degree of sulfurization and temperature. In addition, the essential synaptic behaviors including potentiation/depression, paired-pulse facilitation, and spike-rate-dependent plasticity are successfully implemented in the partially sulfurized functional synaptic device. The developed simple approach of introducing sulfur anions in layered selenide opens an effective new avenue to realize activation of silent synapses for application in evolutionary artificial neural networks.

Superior antibacterial activity of gallium based liquid metals due to Ga3+ induced intracellular ROS generation.

Gallium-based liquid metals have increasing applications in a wide variety of emerging areas and they are involved more in frontier studies, the energy industry and additive manufacturing production, and even in daily life. When exposed to open air, large amounts of microorganisms may interact with liquid metals. However, the research of the relationship between pure gallium-based liquid metals and bacterial cells is still limited. In this study, the antibacterial properties of eutectic gallium-indium (EGaIn) alloys were tested against the typical Gram-negative bacteria-Escherichia coli and the Gram-positive bacteria-Staphylococcus aureus and the experimental results displayed that the antibacterial rates reached 100%. We also explored the mechanism of the anti-bacterial properties of EGaIn alloys by measuring the surface composition of the EGaIn film and the concentration of dissolved metal ions. The morphology of the bacterial cells showed that the cell growth and division were influenced by exposure to EGaIn. We also found that the synergistic antibacterial effect came along with the production of reactive oxygen species (ROS). Moreover, the EGaIn film showed enhanced antibacterial activity compared to gallium nitrate at the same initial ion concentration in the solution. This study shows the enormous potential of the anti-bacterial effect of liquid metals.

Exploiting the biological response of two Serratia fonticola strains to the critical metals, gallium and indium.

The use of microorganisms that allows the recovery of critical high-tech elements such as gallium (Ga) and indium (In) has been considered an excellent eco-strategy. In this perspective, it is relevant to understand the strategies of Ga and In resistant strains to cope with these critical metals. This study aimed to explore the effect of these metals on two Ga/In resistant strains and to scrutinize the biological processes behind the oxidative stress in response to exposure to these critical metals. Two strains of Serratia fonticola, A3242 and B2A1Ga1, with high resistance to Ga and In, were submitted to metal stress and their protein profiles showed an overexpressed Superoxide Dismutase (SOD) in presence of In. Results of inhibitor-protein native gel incubations identified the overexpressed enzyme as a Fe-SOD. Both strains exhibited a huge increase of oxidative stress when exposed to indium, visible by an extreme high amount of reactive oxygen species (ROS) production. The toxicity induced by indium triggered biological mechanisms of stress control namely, the decrease in reduced glutathione/total glutathione levels and an increase in the SOD activity. The effect of gallium in cells was not so boisterous, visible only by the decrease of reduced glutathione levels. Analysis of the cellular metabolic viability revealed that each strain was affected differently by the critical metals, which could be related to the distinct metal uptakes. Strain A3242 accumulated more Ga and In in comparison to strain B2A1Ga1, and showed lower metabolic activity. Understanding the biological response of the two metal resistant strains of S. fonticola to stress induced by Ga and In will tackle the current gap of information related with bacteria-critical metals interactions.

Synthesis of In37P20(O2CR)51 Clusters and Their Conversion to InP Quantum Dots.

This text presents a method for the synthesis of In37P20(O2C14H27)51 clusters and their conversion to indium phosphide quantum dots. The In37P20(O2CR)51 clusters have been observed as intermediates in the synthesis of InP quantum dots from molecular precursors (In(O2CR)3, HO2CR, and P(SiMe3)3) and may be isolated as a pure reagent for subsequent study and use as a single-source precursor. These clusters readily convert to crystalline and relatively monodisperse samples of quasi-spherical InP quantum dots when subjected to thermolysis conditions in the absence of additional precursors above 200 °C. The optical properties, morphology, and structure of both the clusters and quantum dots are confirmed using UV-Vis spectroscopy, photoluminescence spectroscopy, transmission electron microscopy, and powder X-ray diffraction. The molecular symmetry of the clusters is additionally confirmed by solution-phase 31P NMR spectroscopy. This protocol demonstrates the preparation and isolation of atomically-precise InP clusters, and their reliable and scalable conversion to InP QDs.

Role of pH on indium bioaccumulation by Chlamydomonas reinhardtii.

For divalent metals, the Biotic Ligand Model (BLM) has been proven to be an effective tool to predict biological effects by taking into account speciation calculations and competitive interactions. Nonetheless, the BLM has only rarely been validated for trivalent metals (e.g. rare earth elements), and the potential competitive effects of protons has been understudied. In this paper, the short-term biouptake of indium (In), a trivalent metal that is a byproduct of zinc extraction and used in numerous applications including the semiconductor industry, was evaluated under controlled conditions. Short-term (i.e. 60 min) indium biouptake by Chlamydomonas reinhardtii was measured as a function of pH in order to verify the validity of the BLM. At a given pH, In biouptake could be well described by the Michaelis-Menten equation with conditional stability constants of KIn,pH=4.0 = 106.7 M-1, KIn,pH=5.0 = 108.6 M-1, KIn,pH=6.0 = 109.3 M-1 and maximum internalization fluxes of Jmax, pH=4.0 = 0.74 × 10-14 mol cm-2 s-1, Jmax, pH=5.0 = 1.60 × 10-14 mol cm-2 s-1, Jmax, pH=6.0 = 2.22 × 10-14 mol cm-2 s-1. Although several potential mechanisms for the role of pH were examined, the results were best explained by a competitive interaction of H+ with the In uptake sites using overall stability constants of logKIn = 9.76 M-1 and logKH = 15.66 M-1. Based on these results, pH will play a critical role in bioavailability measurements of the trivalent cations in natural waters.

Leaching of indium from end-of-life LCD panels via catalysis by synergistic microbial communities.

Currently, a large amount of discarded liquid crystal displays (LCDs) are being produced, and the improper treatment of discarded LCDs causes serious environmental pollution problems. Indium is the most valuable metal in LCDs and is present in such devices at a concentration of over 0.025%. In this study, the bioleaching of indium from end-of-life LCD panels was comprehensively investigated through three methods: S-mediated pathway, Fe-mediated pathway and Mixed pathway of S- and Fe-mediated, which yielded maximum bioleaching efficiencies of approximately 100%, 0% and 78%, respectively. Microbial community analysis showed that the dominant functional bacteria under the S-mediated pathway were Acidithiobacillus. The Acidithiobacillus genus catalysed the leaching of indium, which was mainly achieved by indirect bioleaching. In addition, the microorganisms can secrete enzymes and extracellular polymeric substances, which also contributed to the leaching of indium. Therefore, this work provides an economical and efficient biological method for future research and practical applications in indium recovery from solid waste.

Synthesis and photoelectrocatalytic activity of In2O3 hollow microspheres via a bio-template route using yeast templates.

Indium oxide (In2O3) hollow microspheres were prepared using yeast as a bio-template with the aid of a precipitation method. The yeast provided a solid frame for the deposition of In(OH)3 to form the precursor. The resulting In2O3 hollow microspheres were obtained by calcining the precursor at 650 °C. The samples were characterized by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), N2 adsorption-desorption isotherms and UV-Vis diffuse reflectance spectroscopy. The results showed that the diameter of the In2O3 hollow microspheres was about 2.0-3.0 µm and the spherical shells were composed of In2O3 nanoparticles with a size of ∼20 nm. The BET specific surface area of the sample was 19.23 m2 g-1. The photoelectrocatalytic test results showed that the photoelectrocatalytic degradation efficiency of methylene blue (MB) using In2O3 hollow microspheres as catalysts under visible light irradiation and a certain voltage could reach above 95% after 4 hours, much higher than that of only photodegradation. The enhanced photoelectrocatalytic activity could be attributed to the hydroxyl radicals HO˙ produced by the light irradiation reaction process which could oxidize the electron donors and were beneficial to reducing the recombination of electrons and holes.

The role of lysosomes in the phenomenon of concentration of aluminum and indium in the female reproductive system. An ultrastructural study.

The female reproductive system is one of the most complex systems in the body taking into account the hormonal fluctuations associated with ovarian and uterine menstrual cycles. The purpose of this work was to study the impact of aluminum nitrate and indium sulfate on the uterus and the ovary of a pregnant rat. The experiment was performed on adult female rats of Wistar strain weighing approximately 250g. The Transmission Electron Microscopy (TEM) showed the presence of electron-dense material in lysosomes of both uterine cells (myometrium and endometrium cells) and in the cells of the ovary (internal theca and granulosa cells). In addition to the presence of aluminum and indium deposits in the uterine and ovarian tissue, impaired endoplasmic reticulum, mitochondria and vacuolation were also identified. We concluded that lysosomes of uterus and ovary cells had the function to extract aluminum and indium introduced into the body in a soluble form. Then, the two elements were sequestrated within these organelles in an insoluble form most probably as phosphate salts such as reported for other kind of cells; kidney, liver, bone morrow Berry, 1996 [1]. This mechanism seems to be a defense one in which the lysosome would play a central role. Our results concerning the impact of the aluminum or indium presence in the lysosome of female reproductive system will be further used in order to assess their effects on the fertility and viability of oocytes in the pregnant treated rats.

Indium (III) induces isolated mitochondrial permeability transition by inhibiting proton influx and triggering oxidative stress.

While Indium's toxicity to organs is realized, its effects on mitochondria are still under investigation. Mitochondrial permeability transition (MPT) is widely accepted in mitochondrial dysfunction approaches and its importance in metal-induced mitochondrial degradation has been proposed. Since mitochondria are respiratory organelles, their interaction with free In3+ is analyzed to access structural and functional changes. Spectral methods and multimode plate reader was used to detect mitochondrial swelling, membrane potential, membrane fluidity, and inner membrane permeability. Flow cytometry was employed to detect mitochondrial reactive oxygen species (ROS) generation and transmission electron microscopy to image mitochondria. And oxygen electrode was used to measure respiratory rate, microcalorimetry to monitor long-term real-time mitochondrial metabolism. In3+ at a concentration up to 1mM induces mitochondrial swelling, membrane depolarization and inhibits the protons transportation. In3+-induced mitochondrial swelling and membrane depolarization is protected by MPT inhibitors and -SH protectors, but the influence on protons transportation is not protected. In addition, In3+ is able to accelerate the ROS production and inhibit the electron transition and respiratory chain while it stimulates long-term metabolism. Our findings show that In3+ induces MPT by inhibiting the proton channels located in the inner mitochondrial membrane and by stimulating mitochondrial oxidative stress.

Complexes of gastrin with In3+, Ru3+ or Ga3+ ions are not recognised by the cholecystokinin 2 receptor.

The peptide hormone gastrin (Gamide) binds trivalent metal ions, including indium (In), ruthenium (Ru) and gallium (Ga), with high affinity. Complexes of gastrin with chelated isotopes of In and Ga have previously been used for the location of tumours expressing the cholecystokinin 2 receptor (CCK2R). The aim of the present study was to purify the complexes of Gamide with radioactive isotopes of In, Ru or Ga and to investigate their ability to bind to the CCK2R. The radioactive Gamide complexes were purified on Sep-Pak C18 cartridges or by anion exchange HPLC. Binding to the CCK2R was assessed with a stably transfected clone of the gastric carcinoma cell line AGS. The 106Ru-Gamide complex could be eluted from the C18 cartridge; the 111In-Gamide and 68Ga-Gamide complexes bound irreversibly. All three complexes were successfully purified by anion exchange HPLC. The failure to detect binding of the 111In-Gamide, 106Ru-Gamide and 68Ga-Gamide complexes to the CCK2R suggests that formation of these complexes will not be useful for the detection of tumours expressing this receptor, but may instead provide alternative ways to block the actions of Gamide as a growth factor or a stimulant of gastric acid secretion. The complexes between the hormone gastrin and radioactive 111In, 106Ru or 68Ga ions were purified by anion exchange HPLC using a NaCl gradient. The failure to detect binding of the complexes to the cholecystokinin 2 receptor suggests that metal ion treatment may provide novel approaches to block the biological actions of gastrin.

Facile Synthesis of Cadmium-Free Zn-In-S:Ag/ZnS Nanocrystals for Bio-Imaging.

High quality cadmium-free Zn-In-S:Ag doped-nanocrystals (d-NCs) were synthesized via a simple one-step noninjection route using silver nitrate, indium acetate, zinc acetate, oleylamine, S powder and 1-dodecanethiol as starting materials in an organic phase. The size and optical properties can be effectively tailored by controlling the reaction time, reaction temperature, Ag(+) dopant concentration, and the molar ratio of In to Zn. The photoluminescence wavelength of as-prepared Zn-In-S:Ag NCs covered a broad visible range from 458 nm to 603 nm. After being passivated by protective ZnS shell, the photoluminescence quantum yield (PLQY) of Zn-In-S:Ag(+) /ZnS was greatly improved to 43.5%. More importantly, the initial high PLQY of the obtained core/shell d-NCs in organic media can be preserved when being transferred into the aqueous media via ligand exchange. Finally, high quality Zn-In-S:Ag(+) /ZnS d-NCs in aqueous phase were applied as bio-imaging agents for identifying living KB cells.

Evaluation of Nonferrous Metals as Potential In Vivo Tracers of Transferrin-Based Therapeutics.

Transferrin (Tf) is a promising candidate for targeted drug delivery. While development of such products is impossible without the ability to monitor biodistribution of Tf-drug conjugates in tissues and reliable measurements of their levels in blood and other biological fluids, the presence of very abundant endogenous Tf presents a significant impediment to such efforts. Several noncognate metals have been evaluated in this work as possible tracers of exogenous transferrin in complex biological matrices using inductively coupled plasma mass spectrometry (ICP MS) as a detection tool. Placing Ni(II) on a His-tag of recombinant Tf resulted in formation of a marginally stable protein-metal complex, which readily transfers the metal to ubiquitous physiological scavengers, such as serum albumin. An alternative strategy targeted iron-binding pockets of Tf, where cognate Fe(III) was replaced by metal ions known to bind this protein. Both Ga(III) and In(III) were evaluated, with the latter being vastly superior as a tracer (stronger binding to Tf unaffected by the presence of metal scavengers and the retained ability to associate with Tf receptor). Spiking serum with indium-loaded Tf followed by ICP MS detection demonstrated that protein quantities as low as 0.04 nM can be readily detected in animal blood. Combining laser ablation with ICP MS detection allows distribution of exogenous Tf to be mapped within animal tissue cross-sections with spatial resolution exceeding 100 µm. The method can be readily extended to a range of other therapeutics where metalloproteins are used as either carriers or payloads. Graphical Abstract ᅟ.

Intracellular accumulation of indium ions released from nanoparticles induces oxidative stress, proinflammatory response and DNA damage.

Due to the widespread use of indium tin oxide (ITO), it is important to investigate its effect on human health. In this study, we evaluated the cellular effects of ITO nanoparticles (NPs), indium chloride (InCl3) and tin chloride (SnCl3) using human lung epithelial A549 cells. Transmission electron microscopy and inductively coupled plasma mass spectrometry were employed to study cellular ITO NP uptake. Interestingly, greater uptake of ITO NPs was observed, as compared with soluble salts. ITO NP species released could be divided into two types: 'indium release ITO' or 'tin release ITO'. We incubated A549 cells with indium release ITO, tin release ITO, InCl3 or SnCl2 and investigated oxidative stress, proinflammatory response, cytotoxicity and DNA damage. We found that intracellular reactive oxygen species were increased in cells incubated with indium release ITO, but not tin release ITO, InCl3 or SnCl2. Messenger RNA and protein levels of the inflammatory marker, interleukin-8, also increased following exposure to indium release ITO. Furthermore, the alkaline comet assay revealed that intracellular accumulation of indium ions induced DNA damage. Our results demonstrate that the accumulation of ionic indium, but not ionic tin, from ITO NPs in the intracellular matrix has extensive cellular effects.

High Affinity Binding of Indium and Ruthenium Ions by Gastrins.

The peptide hormone gastrin binds two ferric ions with high affinity, and iron binding is essential for the biological activity of non-amidated forms of the hormone. Since gastrins act as growth factors in gastrointestinal cancers, and as peptides labelled with Ga and In isotopes are increasingly used for cancer diagnosis, the ability of gastrins to bind other metal ions was investigated systematically by absorption spectroscopy. The coordination structures of the complexes were characterized by extended X-ray absorption fine structure (EXAFS) spectroscopy. Changes in the absorption of gastrin in the presence of increasing concentrations of Ga3+ were fitted by a 2 site model with dissociation constants (Kd) of 3.3 x 10-7 and 1.1 x 10-6 M. Although the absorption of gastrin did not change upon the addition of In3+ ions, the changes in absorbance on Fe3+ ion binding in the presence of indium ions were fitted by a 2 site model with Kd values for In3+ of 6.5 x 10-15 and 1.7 x 10-7 M. Similar results were obtained with Ru3+ ions, although the Kd values for Ru3+ of 2.6 x 10-13 and 1.2 x 10-5 M were slightly larger than observed for In3+. The structures determined by EXAFS all had metal:gastrin stoichiometries of 2:1 but, while the metal ions in the Fe, Ga and In complexes were bridged by a carboxylate and an oxygen with a metal-metal separation of 3.0-3.3 Å, the Ru complex clearly demonstrated a short range Ru-Ru separation, which was significantly shorter, at 2.4 Å, indicative of a metal-metal bond. We conclude that gastrin selectively binds two In3+ or Ru3+ ions, and that the affinity of the first site for In3+ or Ru3+ ions is higher than for ferric ions. Some of the metal ion-gastrin complexes may be useful for cancer diagnosis and therapy.

Advancing novel molecular imaging agents from preclinical studies to first-in-humans phase I clinical trials in academia--a roadmap for overcoming perceived barriers.

There is a critical need to advance promising novel molecular imaging (MI) agents for cancer from preclinical studies to first-in-humans Phase I clinical trials in order to realize their full potential for cancer detection and for predicting or monitoring response to targeted ("personalized") cancer therapies. Steps to clinical translation include radiopharmaceutical formulation, preclinical pharmacology and toxicology studies, clinical trial design and human ethics approval, and regulatory agency submission. In this Topical Review, we provide a "roadmap" to advancing one class of novel MI agents to Phase I trials in academia and illustrate the processes that we have successfully applied for (111)In-labeled pertuzumab, a MI probe for monitoring response of HER2-positive breast cancer to treatment with trastuzumab (Herceptin). We hope that our experience will encourage other academic radiopharmaceutical scientists to embrace this challenge.

Cytotoxicity of cadmium-free quantum dots and their use in cell bioimaging.

The use of quantum dots (QDots) as bright and photostable probes for long-term fluorescence imaging is gaining more interest. Thus far, (pre)clinical use of QDots remains limited, which is primarily caused by the potential toxicity of QDots. Most QDots consist of Cd2+ ions, which are known to cause high levels of toxicity. In order to overcome this problem, several strategies have been tested, such as the generation of cadmium-free QDots. In the present study, two types of cadmium-free QDots, composed of ZnSe/ZnS (QDotZnSe) and InP/ZnS (QDotInP), were studied with respect to their cytotoxicity and cellular uptake in a variety of cell types. A multiparametric cytotoxicity approach is used, where the QDots are studied with respect to cell viability, oxidative stress, cell morphology, stem cell differentiation, and neurite outgrowth. The data reveal slight differences in uptake levels for both types of QDots (maximal for QDotZnSe), but clear differences in cytotoxicity and cell functionality effects exist, with highest toxicity for QDotZnSe. Differences between cell types and between both types of QDots can be explained by the intrinsic sensitivity of certain cell types and chemical composition of the QDots. At concentrations at which no toxic effects can be observed, the functionality of the QDots for fluorescence cell visualization is evaluated, revealing that the higher brightness of QDotZnSe overcomes most of the toxicity issues compared to that of QDotInP. Comparing the results obtained with common Cd2+-containing QDots tested under identical conditions, the importance of particle functionality is demonstrated, revealing that cadmium-free QDots tested in this study are not significantly better than Cd2+-containing QDots for long-term cell imaging and that more work needs to be performed in optimizing the brightness and surface chemistry of cadmium-free QDots for them to replace currently used Cd2+-containing QDots.

Comparison of the intracellular behavior of gold (Au) and indium (In) in testicle after their parenteral administration.

The subcellular behavior of several mineral elements was studied using modern techniques of observation like transmission electron microscopy and analysis like electron probe microanalysis and secondary ion mass spectrometry. In the present ultrastructural and analytical investigations, we undertake to compare the intracellular behavior of a heavy metal, gold, and a III-A group element, indium, on rat testicular tissues after their parenteral administrations. Our ultrastructural results showed that while gold was found only in the lysosomes of Leydig cells under electron dense needles, indium was observed as electron-dense deposits in the lysosomes of both Leydig and Sertoli cells. No ultrastructural modifications were observed in the testicular tissues of the control rats. The microanalytical study showed that gold was concentrated in lysosomes with sulfur as a sulfate crystalline structure whereas indium was concentrated in the same organelle as insoluble phosphate salt. These results demonstrated that testicular Leydig and Sertoli cells have the ability to selectively concentrate indium but gold was concentrated only in the first kind of cells. The mechanism implicated in this concentration phenomenon is a biochemical one involving intralysosomal hydrolytic enzymes, the acid phosphatase and the arylsulfatase. This mechanism occurs in order to protect the organism and to avoid the presence of toxic metals under soluble and free form.

Reduction of renal uptake of 111In-DOTA-labeled and A700-labeled RAFT-RGD during integrin αvß3 targeting using single photon emission computed tomography and optical imaging.

Integrin α(v)ß(3) expression is upregulated during tumor growth and invasion in newly formed endothelial cells in tumor neovasculature and in some tumor cells. A tetrameric RGD-based peptide, regioselectively addressable functionalized template-(cyclo-[RGDfK])4 (RAFT-RGD), specifically targets integrin α(v)ß(3) in vitro and in vivo. When labeled with indium-111, the RAFT-RGD is partially reabsorbed and trapped in the kidneys, limiting its use for further internal targeted radiotherapy and imaging investigations. We studied the effect of Gelofusine on RAFT-RGD renal retention in tumor-bearing mice. Mice were imaged using single photon emission computed tomography and optical imaging 1 and 24 h following tracer injection. Distribution of RAFT-RGD was further investigated by tissue removal and direct counting of the tracer. Kidney sections were analyzed by confocal microscopy. Gelofusine significantly induced a >50% reduction of the renal reabsorption of (111)In-DOTA-RAFT-RGD and A700-RAFT-RGD, without affecting tumor uptake. Injection of Gelofusine significantly reduced the renal retention of labeled RAFT-RGD, while increasing the tumor over healthy tissue ratio. These results will lead to the development of future therapeutic approaches.

High prevalence of upper urinary tract involvement detected by 111indium-oxine leukocyte scintigraphy in patients with candiduria.

The purpose of this investigation was to assess the prevalence of upper urinary tract involvement in patients with candiduria by means of (111)indium-oxine-labeled leukocyte scintigraphy. An observational cohort study of patients with confirmed candiduria was conducted in an acute-care teaching hospital in Spain from March 2006 through February 2009. An (111)In-labeled leukocyte scan was performed in order to assess the upper urinary tract involvement. A series of non-matched patients without candiduria nor bacteriuria undergoing scintigraphy to exclude infections in other sites than the urinary tract was also studied. Demographics, baseline illness, and clinical data were recorded. Candiduria was detected in 428 patients, and scintigraphy was performed in 35 of these patients. Twenty-nine patients without candiduria nor bacteriuria were also studied. Positive renal scintigraphy was documented in 24 (68%) patients with confirmed candiduria and in 3 (10%) patients without candiduria (p < 0.005). Renal uptake was not associated with a higher mortality nor with re-admissions. Subclinical pyelonephritis could be more frequent in patients with candiduria than it has been previously considered.