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[A dynamic observation on the fate of samarium in mouse liver].

It is generally considered that the rare earth compounds are plasma membrane-impermeable, thus affecting the cells only on their surface. Recently, we found that after repeated injections to mice of large dose of samarium trichloride, a soluble compound of rare earth, samarium aggregates appeared in Kupffer cells and hepatocytes of liver. In this study, we aimed at observing the route by which samarium enters the liver cells and the process of the formation of samarium aggregates. Samarium trichloride was given to Swiss mice at one dose of 70 mg/kg intravenously. Thereafter, at different intervals from 15 min to 48 h after the injection, the samarium in liver was traced dynamically by electron microscopy and X ray microanalysis. From 15 min to 2 h both Kupffer cells and hepatocytes endocytosed samarium-containing particles and formed phagosomes, in which the ingested particles were progressively concentrated. Besides, the small phagosomes fused with each other. Phagocytosis was especially active in Kupffer cells. During the 4 h to 24 h many Kupffer cells were degenerated and broken. In hepatocytes the phagosomes gathered mostly around the bile canaliculi. Groups of highly electron-dense particles were found in the lumen of bile canaliculi, implying the excretion of samarium by bile. At the 48 h, the samarium-containing phagosomies were found still in both kinds of cells in the liver.

Animals

The standardization of samarium-153.

Samarium-153 has been standardized by 4 pi beta liquid-scintillation counting, with an uncertainty of 0.4%. The probability per decay for the 103.2-keV gamma ray was measured, using two germanium detectors, to be 0.298 +/- 0.004. The half life, based on liquid-scintillation measurements over 6.4 half lives and pressurized-ionization-chamber measurements over four half lives, was found to be 46.27 +/- 0.02 h. The uncertainties given are one estimated standard deviation (of the mean when applicable) for random and non-random components.

Gamma Rays

Samarium-153-labelled EDTMP for bone metastases from cancer of the prostate.

A Phase I dose-escalation trial of a bone seeking phosphonate labelled with Samarium-153 was conducted on heavily pretreated patients with widespread bony metastases from cancer of the prostate. The bone marrow dose was calculated initially on a 4:1 uptake of cortical to cancellous bone, but subsequent information suggested the distribution was approximately equal so that the marrow received about three times the dose that has been prescribed. As a result, what were at first thought to be doses of 0.5 Gy, 1.0 Gy and 1.5 Gy were probably 1.5 Gy, 3.0 Gy and 4.5 Gy respectively. Three patients were treated at each dose level. The dose was repeated in the first three. Pain relief was delayed for 2 weeks, and was maximal by 4 weeks. All but one patient gained some benefit but this was transitory, lasting only 4-6 weeks in most. A recalculated dose of 3 Gy proved the most effective. The major toxicity was to platelets. Thrombocytopenia was fatal in four cases (two with repeat doses). All patients died but three survived more than 6 months with the help of third line hormonal measures and local radiotherapy to maintain comfort. A second group of five patients, not previously irradiated, were given 153Sm-EDTMP to a marrow dose of 3 Gy and all have survived for more than 4 months and achieved minimal to excellent relief of pain. The technique is recommended as initial therapy in unirradiated patients with good bone marrow function and with significant pain above and below the diaphragm, making half-body irradiation less likely to be a useful palliative procedure.

Aged

An improved method for labeling monoclonal antibodies with samarium-153: use of the bifunctional chelate 2-(p-isothiocyanatobenzyl)-6- methyldiethylenetriaminepentaacetic acid.

Samarium-153 (153Sm) radioimmunoconjugates of the monoclonal antibody K-1-21 were produced using the bifunctional chelate 2-(p-isothiocyanatobenzyl)-6- methyldiethylenetriaminepentaacetic acid (Mx-DTPA). The specific activity (up to 150 MBq mg-1) and percent retained immunoreactivity (greater than 75%) were similar to that of 153Sm-K-1-21 conjugates formed with cyclic DTPA anhydride (cDTPAa). In vivo biodistribution studies showed specific localization of 153Sm-Mx-DTPA-K-1-21 to target antigen implants and higher blood pool and lower uptake in liver, spleen, kidney, and bone when compared to 153Sm-cDTPAa-K-1-21. The improved in vivo distribution of 153Sm-Mx-DTPA-K-1-21 should result in lower radiotoxicity to nontarget tissues when used for radioimmunotherapy purposes.

Animals

Dual-isotope imaging of neutron-activated erbium-171 and samarium-153 and the in vivo evaluation of a dual-labeled bilayer tablet by gamma scintigraphy.

The feasibility of dual-label scintigraphic studies which use the neutron-activated isotopes erbium-171 and samarium-153 is described. Experimental details are provided to correct and minimize the compton scatter contribution of 171Er into the lower-energy 153Sm window. The results from this study demonstrate that this dual-label procedure is sensitive enough to monitor simultaneously the behavior of two discrete regions of the same unit dose in the gastrointestinal tract of man.

Digestive System

Force generation by orthodontic samarium-cobalt magnets.

The use of samarium-cobalt (Sm-Co) magnets for light force application is a relatively new concept in orthodontic tooth movement. This study reports on the forces generated by these magnets. Magnets were attached to aluminum rods mounted in a universal testing machine. The magnets were initially separated by 10 mm were moved toward each other at 2.5mm/min in repulsion or attraction, depending upon the magnetic pole orientation. The magnets were also positioned initially in contact and then moved apart at a rate of 2.5mm/min, again producing repulsion or attraction, depending upon the pole orientation. The Sm-Co magnets exhibit very large forces when in close approximation but forces decrease markedly at separations greater than 2mm. The force, P, generated between magnets is determined by their separation, d, and follows the relationship P = dn. At magnet separations of 0 to 2mm, the exponent n is equal to -0.4; at separations of 2mm to 7mm, exponent n equals -2.1 for both attraction and repulsion. Thus the classic Coulomb law of magnetic force was followed only at magnet separations of greater than 2mm. Force-separation behavior and the high cost of these magnets may not justify their routine clinical use.

Cobalt

Samarium as a tool in studies on the responsiveness of the isolated guinea pig ventral taenia coli to barium.

The responsiveness of isolated guinea pig ventral taenia coli to barium in polarized (Ringer-Tris medium) and depolarized (Ringer-KCl medium) preparations was assayed in the presence of samarium (Sm3+, 6 or 8 X 10(5) M). No difference in EC50 or maximal response was observed between polarized and depolarized preparations (p greater than 0.05). The lower Sm3+ concentration increased Ba2+ EC50 in both experimental conditions (p less than 0.05) although no alteration was observed as to the maximal response (p greater than 0.05). On the other hand, maximal tension was strongly reduced by the higher Sm3+ concentration in polarized preparations (p less than 0.01) while a potentiation of the maximum response was observed on the depolarized tissues (p less than 0.05). A possible role for calcium ions in the mediation of the effects is suggested.

Animals

A phase I study of samarium-153 ethylenediaminetetramethylene phosphonate therapy for disseminated skeletal metastases.

Thirty-five patients with disseminated skeletal metastases from a variety of tumor types underwent clinical trial of samarium-153 ethylenediaminetetramethylene phosphonate (153Sm-EDTMP) on a day-patient basis. Individual beta radiation dosimetry was based on pharmacokinetic studies of a 20 mCi tracer dose of 153Sm-EDTMP. The retained skeletal activity varied unpredictably from 40% to 95% of the administered dose, but in all patients greater than 98% of the nonosseous activity was cleared in the urine within 6 hours. Prospective calculation of radiation dosimetry in each patient permitted an accurate dosage schedule based upon total red marrow exposure, starting at 100 cGy and escalating to 280 cGy to define the dose-limiting myelotoxicity. Pain was relieved in 22 of 34 evaluable patients (65%) for periods ranging from 4 to 35 weeks, following a single administration of 153Sm-EDTMP. Recurrence of pain responded to retreatment with 153Sm-EDTMP in five of nine patients. The dose-limiting toxicity was myelosuppression manifested particularly by delayed thrombocytopenia. Platelet counts less than 100 x 10(9)/L occurred in 42% of courses when bone marrow radiation absorbed dose exceeded 200 cGy. Myelosuppression was transient and platelet counts had recovered to pretreatment levels within 10 weeks of treatment. 153Sm-EDTMP is effective for the amelioration of pain due to disseminated skeletal metastases particularly with carcinoma of breast or prostate where 83% of patients experienced pain relief. In 15 of the 34 evaluable patients there was evidence of stabilization or regression of skeletal metastases on radiographs and follow-up technetium-99m methylene diphosphonate (99mTc-MDP) bone scans.

Bone Neoplasms

Radiation absorbed dose calculations for samarium-153-EDTMP localized in bone.

Calculations have been undertaken to estimate the likely radiation dose received by patients undergoing treatment with samarium-153-EDTMP. Previously known bone structure parameters have been employed to partition correctly the energy absorbed in the bone matrix between red bone marrow, yellow marrow, and various types of mineral bone. Both uniform surface and volume distribution of the radioactivity are considered. The key findings of the calculations can be stated in terms of the MIRD "S-factors" for red bone marrow and the endosteal layer of cells on bone surfaces. In particular, the S-factor for red bone marrow is either 0.0276 mGy/MBq.h or 0.0077 mGy/MBq.h for surface and volume distributed radioactivity, respectively. For the endosteal layer of thickness (10 microns) on bone surfaces, the corresponding values are 0.0723 mGy/MBq.h and 0.0213 mGy/MBq.h, respectively.

Beta Particles

Human pharmacokinetics of samarium-153 EDTMP in metastatic cancer.

Samarium-153 ethylenediaminetetramethylene phosphonic acid ([153Sm]EDTMP) has been proposed to palliate pain resulting from osteoblastic metastatic bone cancer. Encouraging results in dogs with primary malignant bone cancer provided the catalysis for human biodistribution studies in five patients with metastatic skeletal carcinoma. The objective was to assess the preferential localization of [153Sm]EDTMP in bony lesions and compare it to the 99mTc-labeled phosphonates. Blood clearance of [153Sm]EDTMP was rapid with minimal accumulation in nonosseous tissues. Both radiopharmaceuticals showed identical lesion uptake in 23 paired lesions (p greater than 0.05). This indicates that the two radiopharmaceuticals concentrate in metastatic skeletal lesions by the same mechanism and since [153Sm]EDTMP emits beta radiation it may be therapeutically useful in ameliorating metastatic bony cancer pain.

Aged

High specific activity [samarium-153] EDTA for imaging of experimental tumor models.

Enriched samarium oxide (98.2% 152Sm2O3) was irradiated in low neutron flux and high neutron flux reactors to produce 153Sm with specific activities of 14.3 GBq and 22.1 TBq mmol-1 Sm, respectively, at the time of use. Formulation of 153Sm as [153Sm]EDTA, with a 1:10 molar ratio of SM:EDTA, provided a stable radiotracer in vitro and in vivo. High specific activity [153Sm]EDTA showed superior uptake in cell culture (20.8 +/- 0.9% vs. 5.5 +/- 0.1% for 6 and 600 pmol Sm per 10(6) cells, respectively) and better tumor index values (51 vs. 37 at 10.9 nmol and 1.09 mumol Sm kg-1, respectively) in the BDF1 mouse/Lewis lung tumor model. High specific activity [153Sm]EDTA scintigrams of Copenhagen x Fisher rats bearing transplanted Dunning R3327 tumors clearly delineated the tumors within 6 hr, with moderate liver and bone uptake and low soft-tissue background. The injected radiotracer underwent rapid central compartment clearance and whole-body elimination. The absence of observed adverse histopathological toxicity combines with high image quality within 6 hr, to support the clinical tumor-imaging potential of this agent. Comparative studies with [67Ga]citrate at molar-equivalent doses indicated that high specific activity [153Sm]EDTA was a superior radiotracer in these in vitro and in vivo models.

Animals

Europium and samarium as labels in time-resolved immunofluorometric assay of follitropin.

This time-resolved immunofluorometric assay for human follitropin involves use of europium- or samarium-labeled monoclonal antibodies, with an average incorporation ratio of 3 mol of Eu3+ or Sm3+ per mole of antibody. These lanthanide ions are bound to the antibody molecules by means of the anhydride of diethylenetriaminepentaacetic acid. The solid-phase antibody is immobilized inside polystyrene tubes in which plasma samples were assayed in a one-step procedure. After incubation, the fluorescence intensity of Eu3+ or Sm3+ label is measured by time-resolved fluorometry, with a nitrogen laser as the pulsed excitation source. The sensitivity of the assay is largely better with Eu3+ than with Sm3+ because of the difference in their intrinsic luminescence properties. Results obtained with the proposed methods correlated well with those by an immunoradiometric method.

Adolescent

Radiation dose calculations in persons receiving injection of samarium-153 EDTMP.

Samarium-153 EDTMP has been proposed as a radionuclide therapeutic agent to treat malignant bone tissue disorders. Data obtained from laboratory rats has been used to calculate the radiation dose for humans following the administration of [153Sm]EDTMP. The data reveals that the highest doses are present in the skeleton and the urinary bladder wall (bladder dose varies with frequency of voiding). Skeletal activity was used to estimate the bone marrow dose from the [153Sm]EDTMP beta radiation. Although this estimate indicates high marrow irradiation it is only an approximation since the beta radiation from inhomogeneously deposited bone activity surrounding the marrow produces variable radiation dose distributions.

Animals

The effects of samarium on the contractile responses of the guinea-pig taenia coli to acetylcholine, potassium, histamine and barium.

The role of calcium in supporting the phasic contractions of the isolated guinea-pig taenia coli induced by acetylcholine, potassium, histamine or barium has been studied using the lanthanid samarium (Sm3+). A carefully selected concentration of Sm3+ (6 X 10(-5)M) depressed to a same extent the phasic responses of the tissue to submaximal concentrations of the agonists used whilst maximum responses to histamine and barium were unaffected. Calcium and barium-induced responses of the depolarized taenia coli were not inhibited by 6 X 10(-5)M Sm3+. The rate of loss of responsiveness of the depolarized tissue to acetylcholine was increased, that to histamine was not altered while that to barium was decreased by 6 X 10(-5)M Sm3+. These findings support the concept that phasic responses of the guinea-pig taenia coli to submaximal concentrations of the agonists used are dependent on a Sm3+-sensitive calcium store(s) probably located at the cell membrane. However, maximum responses to histamine and barium seem to be supported, at least partially, by a Sm3+-insensitive depot(s) probably located at cytoplasmic compartments.

Acetylcholine

Samarium-153-EDTMP: pharmacokinetic, toxicity and pain response using an escalating dose schedule in treatment of metastatic bone cancer.

Samarium-153 emits medium-energy beta particles and an imageable gamma photon with a physical half-life of 46.3 hr. When chelated to ethylenediaminetetramethylenephosphonic acid (EDTMP), it is remarkably stable in vitro and in vivo. In this study, we administered escalating amounts of 153Sm-EDTMP, from 0.1 to 1.0 mCi/kg (3.7-37 MBq/kg), to 22 patients with painful metastatic bone cancer. A complete concordance was found when the scintigrams of 153Sm-EDTMP were compared qualitatively to 99mTc-HDP bone images. Moreover, the skeletal uptake of the 153Sm-EDTMP related to the number of metastatic sites (r = 0.65; p = 0.001) showed an inverse proportion to the plasma radioactivity at 30 min following injection (r = -0.79; p = 0.0001) and was unaffected by the administered (mCi/kg), (r = 0.33; p = 0.13). Myelotoxicity was observed in 10 of the 29 treatment courses and leukopenia occurred in two. Thrombocytopenia occurred in patients who had low pretreatment platelet counts, albeit within the normal range (p = 0.001), most suffered from prostate cancer (p = 0.007) and retained a higher percentage of the 153Sm-EDTMP in their skeleton (p = 0.057). In four patients an exacerbation of the pre-existing pain ("flare reaction") was recorded. Pain palliation occurred in 65% of the treated patients (mean: 3.8 mo, range: 1-11 mo). Retreatment in first time responder patients was quite effective. Our preliminary results indicate that 153Sm-EDTMP is a promising radiotherapeutic agent for palliative treatment of metastatic bone cancer pain, and further study is necessary to ascertain its optimal dose, efficacy and toxicity.

Adult

Samarium-153 EDTMP therapy of disseminated skeletal metastasis.

153Sm-EDTMP (ethylenediaminetetramethylene phosphonate), prepared from a kit, was administered to 28 patients in a clinical trial of therapy for painful skeletal metastases unresponsive to all conventional treatment. The 103 keV gamma emission of 153Sm was utilized for prospective individual estimation of beta radiation absorbed dose to red marrow to minimize myelotoxicity and provide optimum internal radiotherapy to skeletal metastases in each patient. Pain relief occurred within 14 days of administration of 153Sm-EDTMP in 15 of 19 patients (79%) who could be evaluated at 6 weeks, when clinical response was maximal. Duration of response ranged from 4 to 35 weeks. Recurrence of pain responded to retreatment with 153Sm-EDTMP in five of eight cases. No dose-response relationship was apparent for pain relief but reversible myelotoxicity was frequently observed at radiation absorbed doses to bone marrow greater than or equal to 270 cGy. Dosimetry calculation was based on pharmacokinetic studies of a tracer administration of 153Sm-EDTMP in each patient. Assumptions inherent in this prospective method of predicting dose to bone marrow were validated experimentally. Biodistribution studies in rats demonstrated rapid skeletal uptake and long term retention of 153Sm-EDTMP in bone over 5 days. Urinary clearance accounted for 40% of injected dose, and less than 1.0% of administered activity was retained in non osseous tissue. Microdensitometry of autoradiographs of sheep vertebra and femur confirmed surface uptake of 153Sm-EDTMP in cortical bone and demonstrated relatively high trabecular bone activity which is the major component of radiation absorbed dose to bone marrow. Haematological studies in rabbits showed 153Sm-EDTMP-induced myelotoxicity to be transient and no histopathological abnormalities were demonstrable with doses ten times greater than those administered to patients.

Animals

Samarium-153 chelate localization in malignant melanoma.

153Sm, a radiolanthanide of half life 46.27 h, has a gamma emission of 0.103 MeV which is well suited to imaging, it is also a moderate energy beta emitter and tumour localization of various 153Sm chelates was evaluated in B16 murine melanoma to assess their endoradiotherapeutic potential. 153Sm was prepared from enriched 152Sm in the Australian Nuclear Science and Technology Organization reactor. 153Sm chelates were prepared from 153Sm-chloride and their chromatographic behaviour characterized. Tumour and organ uptake of 153Sm-chloride, 153Sm-citrate and the 153Sm chelates, DTPA, HEDTA, HIDA, BZ, PBH, PIH and NTA were measured at 1, 6, 24 and 48 h after intravenous administration to C57 black mice bearing either melanotic or amelanotic B16 melanoma of mean size 0.75 cm3. Histopathological examination of the tumours at each passaging assured comparability of the degree of melanogenesis and the absence of necrosis. 153Sm-chloride was immobile on chromatography and the rapid hepatic accumulation of both 153Sm-chloride and 153Sm-citrate was attributed to in vivo formation of a colloid. In contrast, 153Sm-DTPA, moving at the solvent front on chromatography, showed no reticuloendothelial accumulation in vivo and was rapidly excreted by the kidneys without tumour uptake. The other 153Sm chelates were of intermediate stability and all localized in both melanotic and amelanotic tumours, although to a significantly lesser degree than 67Ga-citrate. The relatively high 153Sm-HIDA activity in liver and 153Sm-NTA activity in bone impaired tumour definition, but on imaging of all the 153Sm chelates only 153Sm-DTPA failed to demonstrate the B16 melanoma and the best tumour delineation was obtained using 153Sm-HEDTA.

Animals