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Novas abordagens de diagnóstico na doença de Alzheimer e de outras patologias neurodegenerativas
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As técnicas de imagiologia cerebral têm vindo a evoluir ao longo dos últimos anos, dando informações muito relevantes sobre o processo degenerativo das doenças neurodegenerativas, como a doença de Alzheimer, doença de Parkinson e outras demências.
Em Medicina Nuclear podem considerar-se duas técnicas de imagiologia a de SPECT que tem por base a deteção de radiação γ de radionuclídeos e a de PET que tem por base a deteção de radionuclídeos emissores de positrões (β+).
Com esta revisão bibliográfica pretende-se abordar diversos radiofármacos empregues no diagnóstico cerebral para várias patologias, realçando a importância da função dos neurotransmissores no cérebro, a identificação de proteínas características de patologias específicas, a importância do estudo do metabolismo da glucose no cérebro e do fluxo sanguíneo, não só para o diagnóstico como igualmente para o acompanhamento da evolução da doença e da resposta à terapêutica.
Os radiofármacos como qualquer medicamento para uso humano têm de ser seguros, sendo por esta razão realizados testes de controlos de qualidade.
Para a determinação do fluxo sanguíneo cerebral são utilizados os radiofármacos HMPAO-99mTc, o ECD-99mTc e para estudo de consumo de glucose no cérebro é utilizado o FDG-18F. Radiofármacos como FP-CIT-123I e TRODAT-1-99mTc, atuam como marcadores dos transportadores de dopamina dos neurónios dopaminérgicos. Na diferenciação entre a doença de Parkinson e o tremor essencial o radiofármaco FDOPA-18F teve um papel fundamental. Nos estudos de densidade das placas β-amiloides no cérebro são utilizados os radiofármacos Florbetapir-18F, Flutemetamol-18F e Florbetaben-18F.
Brain imaging techniques have evolved over the past few years, giving very relevant information about the degenerative process of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, and other dementias. In Nuclear Medicine, two imaging techniques can be considered, SPECT which is based on the detection of radionuclides γ and PET, which is based on the detection of radionuclides positron emitters (β+). This bibliographic review aims to address several radiopharmaceuticals used in brain pathologies diagnosis, highlighting the importance of neurotransmitters in the brain, the identification of proteins characteristic of specific pathologies, the importance of studying glucose metabolism in brain and blood flow, not only for diagnosis but also for monitoring the evolution of the disease, response to therapy. Radiopharmaceuticals, like any medicines for human use, must be safe, and for this reason quality control test must be carried out. For the determination of cerebral blood flow radiopharmaceuticals such as HMPAO-99mTc, ECD-99mTc are used and the FDG-18F is used to study glucose consumption in the brain. Radiopharmaceuticals such as FP-CIT-123I and TRODAT-1-99mTc, markers of dopamine transporters from dopaminergic neurons. In the differentiation between Parkinson's disease and essential tremor, the radiopharmaceutical FDOPA-18F played a key role. In studies of density β-amyloid plaques in the brain, the radiopharmaceuticals, such as Florbetapir-18F, Flutemetamol-18F and Florbetaben-18F are used.
Brain imaging techniques have evolved over the past few years, giving very relevant information about the degenerative process of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, and other dementias. In Nuclear Medicine, two imaging techniques can be considered, SPECT which is based on the detection of radionuclides γ and PET, which is based on the detection of radionuclides positron emitters (β+). This bibliographic review aims to address several radiopharmaceuticals used in brain pathologies diagnosis, highlighting the importance of neurotransmitters in the brain, the identification of proteins characteristic of specific pathologies, the importance of studying glucose metabolism in brain and blood flow, not only for diagnosis but also for monitoring the evolution of the disease, response to therapy. Radiopharmaceuticals, like any medicines for human use, must be safe, and for this reason quality control test must be carried out. For the determination of cerebral blood flow radiopharmaceuticals such as HMPAO-99mTc, ECD-99mTc are used and the FDG-18F is used to study glucose consumption in the brain. Radiopharmaceuticals such as FP-CIT-123I and TRODAT-1-99mTc, markers of dopamine transporters from dopaminergic neurons. In the differentiation between Parkinson's disease and essential tremor, the radiopharmaceutical FDOPA-18F played a key role. In studies of density β-amyloid plaques in the brain, the radiopharmaceuticals, such as Florbetapir-18F, Flutemetamol-18F and Florbetaben-18F are used.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2020, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Radiofármaco Diagnóstico Doenças neurodegenerativas SPECT PET Mestrado integrado - 2020