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Opinion

Can Nuclear Imaging of Activated Macrophages with Folic Acid-Based Radiotracers Serve as a Prognostic Means to Identify COVID-19 Patients at Risk?

1
Center for Radiopharmaceutical Sciences, Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
2
Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
3
Center for Experimental Rheumatology, Department of Rheumatology, University Hospital Zurich, 8091 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
Pharmaceuticals 2020, 13(9), 238; https://0-doi-org.brum.beds.ac.uk/10.3390/ph13090238
Received: 17 August 2020 / Revised: 2 September 2020 / Accepted: 4 September 2020 / Published: 9 September 2020
(This article belongs to the Special Issue COVID-19 in Pharmaceuticals)
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 18F-AzaFol, an 18F-labeled folic acid-based radiotracer, as a specific novel imaging tool for the visualization and monitoring of macrophage-driven lung diseases. 18F-AzaFol binds to the folate receptor-beta (FRβ) that is expressed on activated macrophages involved in inflammatory conditions. In a recent multicenter cancer trial, 18F-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. View Full-Text
Keywords: COVID-19; imaging biomarker; macrophages; folate receptor-beta (FRβ); positron emission tomography (PET); inflammation; folate-based 18F-PET tracer COVID-19; imaging biomarker; macrophages; folate receptor-beta (FRβ); positron emission tomography (PET); inflammation; folate-based 18F-PET tracer
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MDPI and ACS Style

Müller, C.; Schibli, R.; Maurer, B. Can Nuclear Imaging of Activated Macrophages with Folic Acid-Based Radiotracers Serve as a Prognostic Means to Identify COVID-19 Patients at Risk? Pharmaceuticals 2020, 13, 238. https://0-doi-org.brum.beds.ac.uk/10.3390/ph13090238

AMA Style

Müller C, Schibli R, Maurer B. Can Nuclear Imaging of Activated Macrophages with Folic Acid-Based Radiotracers Serve as a Prognostic Means to Identify COVID-19 Patients at Risk? Pharmaceuticals. 2020; 13(9):238. https://0-doi-org.brum.beds.ac.uk/10.3390/ph13090238

Chicago/Turabian Style

Müller, Cristina, Roger Schibli, and Britta Maurer. 2020. "Can Nuclear Imaging of Activated Macrophages with Folic Acid-Based Radiotracers Serve as a Prognostic Means to Identify COVID-19 Patients at Risk?" Pharmaceuticals 13, no. 9: 238. https://0-doi-org.brum.beds.ac.uk/10.3390/ph13090238

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