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Background  Designed ankyrin repeat proteins (DARPins) are small engineered scaffold proteins (14–18 kDa) that demonstrated promising tumor-targeting properties in preclinical studies. However, high renal accumulation of activity for DARPins labeled with residualizing labels is a limitation for targeted radionuclide therapy. A better understanding of the mechanisms behind the kidney uptake of DARPins could aid the development of strategies to reduce it. In this study, we have investigated whether the renal uptake of [ 99m Tc]Tc(CO) 3 -G3 DARPin could be reduced by administration of compounds that act on various parts of the reabsorption system in the kidney.    Results  Co-injection of lysine or Gelofusine was not effective for the reduction of kidney uptake of [ 99m Tc]Tc(CO) 3 -G3. Administration of sodium maleate before the injection of [ 99m Tc]Tc(CO) 3 -G3 reduced the kidney-associated activity by 60.4 ± 10.3%, while administration of fructose reduced it by 46.9 ± 7.6% compared with the control. The decrease in the kidney uptake provided by sodium maleate was also observed for [ 99m Tc]Tc(CO) 3 -9_29 DARPin. Preinjection of colchicine, probenecid, mannitol, or furosemide had no effect on the kidney uptake of [ 99m Tc]Tc(CO) 3 -G3. Kidney autoradiography showed mainly cortical accumulation of activity for all studied groups.    Conclusion  Common clinical strategies were not effective for the reduction of kidney uptake of [ 99m Tc]Tc(CO) 3 -G3. Both fructose and maleate lower the cellular ATP level in the proximal tubule cells and their reduction of the kidney reuptake indicates the involvement of an ATP-driven uptake mechanism. The decrease provided by maleate for both G3 and 9_29 DARPins indicates that their uptake proceeds through a mechanism independent of DARPin structure and binding site composition.

On the prevention of kidney uptake of radiolabeled DARPins