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Rheumatology (Oxford). 2018 Apr 1;57(4):737-747. doi: 10.1093/rheumatology/kex456.

Imaging fibroblast activation protein to monitor therapeutic effects of neutralizing interleukin-22 in collagen-induced arthritis.

Author information

Department of Radiology and Nuclear Medicine, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
Department of Experimental Rheumatology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
Roche Pharmaceutical Research & Early Development, Innovation Center Basel, Basel, Switzerland.
Roche Pharmaceutical Research & Early Development, Innovation Center Zurich, Schlieren, Switzerland.
Inflammation & Immunology Research Unit, Pfizer Worldwide Research and Development, Cambridge, MA, USA.
Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht.
Department of Targeted Therapeutics, MIRA Institute, University of Twente, Enschede, The Netherlands.
Department of Experimental Molecular Imaging, University Clinic & Helmholtz Institute for Biomedical Engineering, RWTH-Aachen University, Aachen, Germany.



RA is a chronic autoimmune disease leading to progressive destruction of cartilage and bone. RA patients show elevated IL-22 levels and the amount of IL-22-producing Th cells positively correlates with the extent of erosive disease, suggesting a role for this cytokine in RA pathogenesis. The purpose of this study was to determine the feasibility of SPECT/CT imaging with 111In-labelled anti-fibroblast activation protein antibody (28H1) to monitor the therapeutic effect of neutralizing IL-22 in experimental arthritis.


Mice (six mice/group) with CIA received anti-IL-22 or isotype control antibodies. To monitor therapeutic effects after treatment, SPECT/CT images were acquired 24 h after injection of 111In-28H1. Imaging results were compared with macroscopic, histologic and radiographic arthritis scores.


Neutralizing IL-22 before CIA onset effectively prevented arthritis development, reaching a disease incidence of only 50%, vs 100% in the control group. SPECT imaging showed significantly lower joint tracer uptake in mice treated early with anti-IL-22 antibodies compared with the control-treated group. Reduction of disease activity in those mice was confirmed by macroscopic, histological and radiographic pathology scores. However, when treatment was initiated in a later phase of CIA, progression of joint pathology could not be prevented.


These findings suggest that IL-22 plays an important role in CIA development, and neutralizing this cytokine seems an attractive new strategy in RA treatment. Most importantly, SPECT/CT imaging with 111In-28H1 can be used to specifically monitor therapy responses, and is potentially more sensitive in disease monitoring than the gold standard method of macroscopic arthritis scoring.

[Indexed for MEDLINE]

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