Improving societal health remains a primary objective globally, especially in the fight against non-communicable diseases such as cancer, which is a leading cause of mortality in developing countries. Therefore, early detection is crucial for effective cancer treatment and management. PET and SPECT are molecular imaging methods that utilize tracers composed of a detector and a radioisotope component.
Nanobodies are particularly effective as detectors due to their high tissue penetration, rapid renal clearance, small size, and brief half-life, avoiding some of the challenges associated with full antibodies. Technetium-99m stands out as an optimal radioisotope for labeling because of its suitable half-life and robust signaling capabilities.
Currently, some nanobodies are undergoing clinical trials for cancer imaging, and others have received FDA approval. The sdAb 2Rs15d, targeting HER2, has shown promising results in clinical settings. A study by Keyaerts et al. (
15) using
68Ga-NOTA-2Rs15d reported favorable biodistribution and swift bloodstream clearance. Ongoing phase II clinical trials (NCT03331601 and NCT03924466) are investigating its efficacy in detecting brain metastases and correlating image-based HER2 quantification with uptake in local or distant metastases in breast cancer patients, respectively (
16).
Additionally, two other single-domain antibodies, MM-302 and NM-02, have advanced to phase I clinical studies.
64Cu-MM-302 is being tested for its effectiveness against advanced HER2+ cancers with brain metastases (NCT02735798) (
17), while
99mTc-labeled NM-02 is under investigation for breast cancer (NCT04040686) (
16).
In research by Altunay et al., a specific antibody labeled with
99mTc exhibited extensive distribution throughout the body and significant accumulation at active HER2-positive tumor sites. RAD201 SPECT/CT imaging for a single patient proved safe, with no serious or visible adverse reactions related to tracer administration. The biodistribution data indicated substantial tracer uptake in the kidneys, liver, thyroid, and spleen, with minimal background levels in other organs (
18).
Qin et al. demonstrated that [
18F]AlF-RESCA-MIRC213, a labeled nanobody developed for diagnosing HER2-positive cancers, exhibited high stability both in vitro and in vivo. Notably, there was no significant bone radioactivity in tumor-bearing animals or breast cancer patients, and no adverse reactions were reported during the study. Clinical transformation studies revealed that [
18F]AlF-RESCA-MIRC213 PET/CT offered favorable pharmacokinetic and dosimetry profiles, making it a promising candidate for noninvasive diagnosis of HER2-positive cancers (
19).
Moreover, Liu et al. investigated an anti-EpCAM nanobody for its ability to target EpCAM receptor expression, labeling it with
99mTc. [
99mTc]Tc-NB4 demonstrated high specificity for EpCAM both in vitro and in vivo. SPECT/CT imaging showed rapid clearance of [
99mTc]Tc-NB4 from the blood and normal organs, except the kidneys. HT-29 tumors were distinctly visualized, contrasting with HL-60 tumors, with the uptake value of [
99mTc]Tc-NB4 in HT-29 tumors increasing steadily from 3.77 ± 0.39% ID/g at 0.5 h to 5.53 ± 0.82% ID/g at 12 h post-injection. Additionally, [
99mTc]Tc-NB4 SPECT/CT effectively imaged tumor-draining lymph nodes (
20).
Furthermore, Joukar et al. (
1) optimized the radiolabeling of scFv with
99mTc-tricarbonyl. Their research indicated that the labeled scFv maintained stable binding with
99mTc-tricarbonyl using in-house produced boranocarbonates. Optimal radiolabeling conditions included a scFv concentration > 2 mg/mL, PBS (
21), 2 h incubation at 50°C, pH 8 - 9, and a high activity concentration of tricarbonyl. The radiochemical purity of scFv was 70% before purification (
1).
Arezumand et al. identified a high-quality nanobody against PlGF from an immune library via phage-display (
22). After enhancing the affinity of this nanobody through in silico experiments, two engineered nanobodies (Mut2:S31D and Mut4:R45E) were developed, showing promise based on bioinformatic parameters and molecular dynamics (MD) simulation (
23,
24). These mutant nanobodies were then tested for their effectiveness in inhibiting angiogenesis by measuring human umbilical vein endothelial cell proliferation and 3D capillary tube formation (
9).
In this study, in response to the need for more efficient methods for cancer diagnosis and treatment, the anti-PlGF nanobody was expressed in E. coli TG1. Following periplasmic extraction, the protein was purified using a Ni-NTA affinity chromatography column and confirmed by SDS-PAGE and Western blotting. After removing imidazole via dialysis and concentrating the solution using a freeze dryer, the protein was prepared in PBS buffer.
To minimize impact on the biological activity of the nanobody, the radiolabel was attached to its His-tag tail. 99mTc-tricarbonyl was prepared as a radiolabel, and its RCP was determined by TLC and radio-HPLC methods, showing 99% and 98% respectively. The nanobody was labeled under various conditions with 99mTc-tricarbonyl, and its RCP was measured by the TLC method, achieving 100% purity post-purification. The stability of the purified labeled nanobody was assessed in incubation with histidine and in PBS buffer; after 4 hours, RCP was approximately 95%. Further studies are needed to fully understand how this labeling method affects the physiological performance of the nanobody.
5.1. Conclusions
Nanobodies with a His-tag exhibit superior pharmacokinetic properties compared to whole antibodies, making them promising candidates for targeted imaging. 99mTc-tricarbonyl provides a rapid and straightforward method for radiolabeling nanobodies without compromising their biological activity. In this study, His-tagged mutant anti-PlGF Nb was radiolabeled with 99mTc-tricarbonyl using boranocarbonate, demonstrating stable binding between the nanobody and 99mTc. Thin-layer chromatography showed that the radiochemical purity percentage reached 70% after two hours and remained stable throughout the purification process, with the highest amount of labeled nanobodies recovered in the second fraction of the PD-10 column. The radiochemical purity of fractions one and two was 100%, and the labeled nanobody maintained over 95% purity after 4 hours in PBS and histidine solution, indicating stability. These findings are promising and may facilitate future in vitro and in vivo studies in cellular and animal models.