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Compostos iodados utilizados em imagiologia no diagnóstico, na terapêutica ou como agentes de contraste
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Esta monografia consiste numa revisão bibliográfica das aplicações de variados compostos iodados no diagnóstico e na terapêutica de diferentes patologias.
O iodo é um elemento químico indispensável à vida, sendo essencial na produção de hormonas e da regulação da função da glândula tiroide. Como não é sintetizado pelo organismo, necessita de ser obtido a partir da alimentação. Por vezes, podem ocorrer desequilíbrios da sua concentração, o que desencadeia o desenvolvimento de diversas patologias.
Desde a sua descoberta, no ano de 1811, que o iodo e os seus isótopos começaram a ser utilizados numa ampla variedade de aplicações com elevados benefícios, nomeadamente em Medicina Nuclear, tanto a nível de diagnóstico, assim como de terapêutico.
Os isótopos radioativos com maior utilidade nesta área são o 123I, 124I, 125I e o 131I, por apresentarem propriedades distintas, tais como tempo de semi-vida, modo de decaimento, e radiação emitida. As suas características possibilitam o desenvolvimento de diferentes radiofármacos, que permitem a obtenção de imagens de processos biológicos e fisiopatológicos, ou direcionar doses terapêuticas de radioatividade no tratamento de determinadas doenças. Para além do âmbito da Medicina Nuclear, os compostos iodados podem ser utilizados como agentes geradores de contraste artificial, o que permite a sua utilização em radiologia, com obtenção de imagens de elevada qualidade.
Os radiofármacos de iodo mais utilizados incluem o N-isopropil-p-iodoanfetamina-123I (IMP-123I), no diagnóstico da Doença de Alzheimer, o Ioflupano-123I, no diagnóstico e diferenciação de causas de parkinsonismo, o BMIPP-123I e a m-iodobenzilguanidina-123I (m-IBG-123I), no diagnóstico de doenças cardiovasculares. O iodeto de sódio, marcado radioativamente com o 123I ou 131I, pode ser utilizado tanto no diagnóstico, como na terapêutica de patologias da glândula tiroide, nomeadamente em carcinomas e no hipertiroidismo.
A radioimunoterapia permitiu o desenvolvimento de novas abordagens terapêuticas de doenças oncológicas, destacando-se o anticorpo monoclonal radiomarcado Tositumomab-131I, no tratamento do Linfoma não-Hodgkin.
This literature review consists of a bibliographic research of the applications of various iodinated compounds in the diagnosis and treatment of different pathologies. Iodine is an important chemical element for life, being essential in the production of hormones and in the regulation of the thyroid gland function. As it is not synthesized by the body, it needs to be obtained from food. Sometimes, concentration imbalances can occur, which triggers the development of several pathologies. Since its discovery in 1811, iodine and its isotopes began to be used in a wide variety of applications with high benefits, namely in Nuclear Medicine, both in terms of diagnosis, as well as therapy. The most useful radioactive isotopes in this field are 123I, 124I, 125I and 131I. Due to their distinct properties, such as half-life, decay mode, and emitted radiation, it is possible to develop different radiopharmaceuticals, which allow the acquisition of images of biological and physiopathological processes, or direct therapeutic dosages of radioactivity for treatment of certain diseases. In addition to the scope of Nuclear Medicine, iodized compounds can be used as agents that generate artificial contrast, which allows their use in radiology, with production of high quality images. The most widely used iodine radiopharmaceuticals include 123I-N-isopropyl-p-iodoamphetamine (123I-IMP), in the diagnosis of Alzheimer's Disease, 123I-Ioflupane, in the diagnosis and differentiation of causes of parkinsonism, 123I-BMIPP and 123I-m-iodobenzylguanidine (123I-mIBG), in the diagnosis of cardiovascular diseases. Sodium iodide, radiolabeled with 123I or 131I, can be used both in the diagnosis and treatment of pathologies of the thyroid gland, namely cancer and hyperthyroidism. Radioimmunotherapy has allowed the development of new therapeutic approaches for oncological diseases, especially the radiolabeled monoclonal antibody 131I-Tositumomab, in the treatment of non-Hodgkin's lymphoma.
This literature review consists of a bibliographic research of the applications of various iodinated compounds in the diagnosis and treatment of different pathologies. Iodine is an important chemical element for life, being essential in the production of hormones and in the regulation of the thyroid gland function. As it is not synthesized by the body, it needs to be obtained from food. Sometimes, concentration imbalances can occur, which triggers the development of several pathologies. Since its discovery in 1811, iodine and its isotopes began to be used in a wide variety of applications with high benefits, namely in Nuclear Medicine, both in terms of diagnosis, as well as therapy. The most useful radioactive isotopes in this field are 123I, 124I, 125I and 131I. Due to their distinct properties, such as half-life, decay mode, and emitted radiation, it is possible to develop different radiopharmaceuticals, which allow the acquisition of images of biological and physiopathological processes, or direct therapeutic dosages of radioactivity for treatment of certain diseases. In addition to the scope of Nuclear Medicine, iodized compounds can be used as agents that generate artificial contrast, which allows their use in radiology, with production of high quality images. The most widely used iodine radiopharmaceuticals include 123I-N-isopropyl-p-iodoamphetamine (123I-IMP), in the diagnosis of Alzheimer's Disease, 123I-Ioflupane, in the diagnosis and differentiation of causes of parkinsonism, 123I-BMIPP and 123I-m-iodobenzylguanidine (123I-mIBG), in the diagnosis of cardiovascular diseases. Sodium iodide, radiolabeled with 123I or 131I, can be used both in the diagnosis and treatment of pathologies of the thyroid gland, namely cancer and hyperthyroidism. Radioimmunotherapy has allowed the development of new therapeutic approaches for oncological diseases, especially the radiolabeled monoclonal antibody 131I-Tositumomab, in the treatment of non-Hodgkin's lymphoma.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2020, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Iodo Radioisótopos Imagiologia m-IBG-123I NaI-131I Mestrado integrado - 2020