成纤维细胞激活蛋白抑制剂-正电子发射计算机断层显像在间质性肺疾病诊疗中的研究进展

Research Progress on Fibroblast Activation Protein Inhibitor-Positron Emission Tomography in the Diagnosis and Treatment of Interstitial Lung Disease

  • 摘要: 胸部影像学检查在间质性肺疾病(interstitial lung disease, ILD)的诊断、病情评估和预后判断中有着不可替代的重要作用。然而,目前广泛应用的胸部高分辨CT仅能提示肺内病变的范围及形态学特征,却不能反映肺内病变的病理生理过程(炎症或纤维化)。近期研究发现,成纤维细胞激活蛋白(fibroblast activation protein, FAP)可相对特异表达于纤维化区域活化的成纤维细胞中,FAP抑制剂正电子发射计算机断层显像(FAP-inhibitor-positron emission tomography, FAPI-PET)或许能较好地反映肺纤维化的程度及成纤维化细胞的活性,已被用于多种ILD纤维化程度的评价。本文综述了FAP在ILD的肺纤维化和炎症组织中的作用和表达,总结了近期FAPI-PET在多种ILD中的应用情况,为ILD诊断、病情程度和预后判断的新型影像学方法开发提供了新的思路。

     

    Abstract: Chest imaging examination plays an important role in the diagnosis, evaluation and prognosis of interstitial lung disease (ILD). However, the widely used chest high-resolution computed tomography (CT) can only reveal the extent and morphological characteristics of pulmonary lesions, but it can not reflect the pathophysiological process (inflammation or fibrosis) of pulmonary lesions. Recent studies showed that fibroblast activation protein (FAP) can be relatively specifically expressed in fibroblasts activated in fibrotic areas, and FAP inhibitor positron emission tomography (FAPI-PET) may reflect the degree of pulmonary fibrosis and the activity of fibroblasts, which has been used to evaluate the degree of fibrosis in various ILD. In this paper, the role and expression of FAP in pulmonary fibrosis and inflammatory tissue of ILD are reviewed, and the recent application of FAPI-PET in various ILD is summarized, which provides insight for the development of new imaging methods for the diagnosis and assessment of ILD.

     

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