A versatile bifunctional chelate for radiolabeling humanized anti-CEA antibody with In-111 and Cu-64 at either thiol or amino groups: PET imaging of CEA-positive tumors with whole antibodies.

Radiolabeled anti-carcinoembryonic antigen (CEA) antibodies have the potential to give excellent images of a wide variety of human tumors, including tumors of the colon, breast, lung, and medullar thyroid. In order to realize the goals of routine and repetitive clinical imaging with anti-CEA antibodies, it is necessary that the antibodies have a high affinity for CEA, low cross reactivity and uptake in normal tissues, and low immunogenicity. The humanized anti-CEA antibody hT84.66-M5A (M5A) fulfills these criteria with an affinity constant of >10 (10) M (-1), no reactivity with CEA cross-reacting antigens found in normal tissues, and >90% human protein sequence. A further requirement for routine clinical use of radiolabeled antibodies is a versatile method of radiolabeling that allows the use of multiple radionuclides that differ in their radioemissions and half-lives. We describe a versatile bifunctional chelator, DO3A-VS (1,4,7-tris(carboxymethyl)-10-(vinylsulfone)-1,4,7,10-tetraazacyclododecane) that binds a range of radiometals including 111 In for gamma-ray imaging and 64Cu for positron emission tomography (PET), and which can be conjugated with negligible loss of immunoreactivity either to sulfhydryls (SH) in the hinge region of lightly reduced immunoglobulins or surface lysines (NH) of immunoglobulins. Based on our correlative studies comparing the kinetics of radiolabeled anti-CEA antibodies in murine models with those in man, we predict that 64Cu-labeled intact, humanized antibodies can be used to image CEA positive tumors in the clinic.

Influence of impactor operating flow rate on particle size distribution of four jet nebulizers.

When a nebulizer is evaluated by the Andersen Cascade Impactor (ACI), the flow rate is generally maintained at 28.3 L/min, as recommended by the manufacturer. However, the nebulizer flow rate that a patient inhales is only around 18 L/min. Because the drive flow of a nebulizer is approximately 6-8 L/min, the nebulized drug is mixed with outside air when delivered. Evaluating impactor performance at the 28.3 L/min flow rate is less than ideal because an additional 10 L/min of outside air is mixed with the drug, thereby affecting the drug size distribution and dose before inhalation and deposition in the human lung. In this study we operated the ACI at an 18.0 L/min flow rate to test whether the effect of the changing ambient humidity was being exaggerated by the 28.3 L/min flow rate. The study was carried out at three different relative humidity levels and two different impactor flow rates with four commercially available nebulizers. The mass median aerodynamic diameter (MMAD) and the geometric standard deviation (GSD) of the droplets were found to increase when the impactor was operated at a flow rate of 18 L/min compared to that of 28.3 L/min. The higher MMAD and GSD could cause the patient to inhale less of the drug than expected if the nebulizer was evaluated by the ACI at the operating flow rate of 28.3 L/min.

Medical nebulizer performance: effects of cascade impactor temperature.

BACKGROUND: During operation of a jet nebulizer, the temperature of the nebulizer outlet could decrease by more than 10 degrees C, depending on the nebulizer type and operating conditions, such as driving flow rate and fill volume. The droplet size distribution generated from the nebulizer can be measured by a cascade impactor. However, when the cascade impactor is operated at ambient room temperature, the droplets could evaporate because of the temperature difference between the nebulizer outlet and the body of the impactor. METHODS: An 8-stage cascade impactor was used to measure the particle size distribution from 4 different types of jet nebulizer (LC Plus, Side-Stream, VixOne, and Micromist) in 2 temperature conditions: ambient (22 degrees C) and low (10 degrees C). Two different formulations, albuterol (aqueous solution) and budesonide (suspension), were used. RESULTS: There was a significantly larger (p < 0.05) mass median aerodynamic diameter and smaller respirable fraction for each nebulizer with the impactor at low temperature than with the impactor at ambient temperature. The mass median aerodynamic diameter of the nebulizers with the impactor operating at low temperature appeared 15-130% larger than with the impactor operating at ambient temperature, for both formulations. The respirable fraction also changed from 10% when the impactor was operated at low temperature to 65% when the impactor was operated at ambient temperature. CONCLUSION: The results provide important information for the use of a cascade impactor to measure the particle-size distribution of nebulizer aerosols.