Characterization of iodinated adrenomedullin derivatives suitable for lung nuclear medicine

We have recently demonstrated the effectiveness of 99m-technetium adrenomedullin (AM) as a new molecular lung imaging agent that could provide significant advantages for the diagnosis and follow-up of disorders affecting the pulmonary circulation such as pulmonary embolism and pulmonary hypertension. Having the possibility to conjugate the targeting molecule with different radionuclides would offer more flexibility and potential advantages depending on clinical situations. Since various iodine isotopes are currently used in nuclear medicine and in pharmacological studies, we have evaluated which iodination method should be privileged in order to produce a good iodinated AM-derived nuclear medicine agent.

Synthetic AM was labeled with iodine through chemical and lactoperoxidase oxidation methods. Position of the iodine atom on the peptide was determined by MALDI-TOF mass spectrometry analysis following cyanogen bromide cleavage and carboxypeptidase Y digestion. Binding affinity of iodinated AM analogues was evaluated by competition and saturation binding experiments on dog lung preparations.

In this study, we demonstrated that, upon lactoperoxidase oxidation, iodination occurred at Tyr(1) and that this radioligand retained higher binding affinity and specificity over preparations obtained through chemical oxidation.

These results emphasize the fact that even a small chemical modification, i.e. iodination, might deeply modify the pharmacological profile of a compound and support observations that the C-terminal tail of human AM plays an important role in the AM receptor binding process. Consequently, incorporation of a radionuclide to produce an AM-based nuclear medicine agent should privilege the N-terminus of the molecule.