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      Preclinical Evaluation of Radiation-Induced Toxicity in Targeted Alpha Therapy Using [ 211At] NaAt in Mice: A Revisit

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          Abstract

          We recently reported the dose-dependent therapeutic effect of 211At-NaAt in differentiated thyroid cancer xenograft models. In the present study, we evaluated the radiation-induced toxicity of 211At-NaAt using detailed hematological, biochemical, and histological analyses. Biodistribution of 211At-NaAt was measured in normal ICR mice (n = 12), absorbed doses in the major organs were calculated. Groups of ICR mice (n = 60) were injected with 0.1 MBq or 1 MBq of 211At-NaAt, using saline as the control group (n = 30). Body weight and food intake were followed up for 60 days. Blood cell counts and serum level of biochemical parameters were measured 3, 7, 15, 29, 60 days after injection. Histological analyses of the major organs with hematoxylin and eosin staining were performed. Biodistribution study revealed a high-absorbed dose in the thyroid gland, stomach, bladder, heart, lungs, spleen, kidneys, and testis. The 0.1 MBq group showed no abnormalities. The 1 MBq group showed decreased body weight and food intake. Histological analysis showed atrophy and fibrosis in the thyroid gland, a transient hypospermatogenesis in the testis on day 29 was found in one mouse. Hematological toxicity was mild and transient. The total cholesterol, albumin, and total protein increased with no signs of recovery, which was considered to be caused by hypothyroidism. High-dose administration of 211At-NaAt showed transient toxicity in the white blood cells and testis without severe hematological or renal toxicity, suggesting its tolerable safety as targeted alpha-therapy for differentiated thyroid cancer in the 1 MBq group.

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          German Multicenter Study Investigating 177Lu-PSMA-617 Radioligand Therapy in Advanced Prostate Cancer Patients.

          (177)Lu-labeled PSMA-617 is a promising new therapeutic agent for radioligand therapy (RLT) of patients with metastatic castration-resistant prostate cancer (mCRPC). Initiated by the German Society of Nuclear Medicine, a retrospective multicenter data analysis was started in 2015 to evaluate efficacy and safety of (177)Lu-PSMA-617 in a large cohort of patients.
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            Definition and management of radioactive iodine-refractory differentiated thyroid cancer.

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              Update in lipid alterations in subclinical hypothyroidism.

              Thyroid hormone has multiple effects on the regulation of lipid synthesis, absorption, and metabolism. Studies consistently demonstrate elevated levels of serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B, lipoprotein(a), and possibly triglycerides in individuals with overt hypothyroidism, all of which are reversible with levothyroxine therapy. Although it is estimated that 1 to 11% of all patients with dyslipidemia have subclinical hypothyroidism, the effects of subclinical hypothyroidism on serum lipid values are less clear. Apolipoprotein B levels may be increased in patients with subclinical hypothyroidism. Although some studies have demonstrated that total cholesterol and LDL-C levels are elevated in patients with subclinical hypothyroidism, others have not shown any effect of subclinical hypothyroidism on these lipid measurements. Serum triglycerides, lipid subparticle size, and LDL-C oxidizability may be altered in subclinical hypothyroidism, but these studies have also been inconsistent. The preponderance of evidence suggests that HDL-C and lipoprotein(a) levels are not altered in subclinically hypothyroid patients. Smoking and insulin resistance may modify the effects of subclinical hypothyroidism on serum lipid values. Clinical trials to date have not consistently shown a beneficial effect of levothyroxine treatment on serum lipid levels in subclinically hypothyroid patients.
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                Author and article information

                Contributors
                Journal
                Transl Oncol
                Transl Oncol
                Translational Oncology
                Neoplasia Press
                1936-5233
                25 March 2020
                April 2020
                25 March 2020
                : 13
                : 4
                : 100757
                Affiliations
                [a ]Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
                [b ]Institute for Radiation Sciences, Osaka University, Toyonaka, Osaka, Japan
                [c ]Core for Medicine and Science Collaborative Research and Education, Project Research Center for Fundamental Sciences, Osaka University Graduate School of Science, Toyonaka, Osaka, Japan
                [d ]Department of Molecular Imaging in Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
                [e ]Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka, Japan
                [f ]Department of Chemistry, Graduate School of Science, Osaka University, Toyonaka, Osaka, Japan
                Author notes
                [* ]Address all correspondence to: Tadashi Watabe, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. watabe@ 123456tracer.med.osaka-u.ac.jp
                [1]

                2–2 Yamadaoka, Suita, Osaka 565–0871, JAPAN.

                Article
                S1936-5233(20)30026-7 100757
                10.1016/j.tranon.2020.100757
                7109464
                32220762
                6f3ebecb-0219-473f-84b8-525196a85710
                © 2020 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 9 January 2020
                : 6 March 2020
                : 8 March 2020
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