The safety of magnetic resonance imaging contrast agents
Gadolinium-based contrast agents are increasingly used in clinical practice. While these pharmaceuticals are verified causal agents in nephrogenic systemic fibrosis, there is a growing body of literature supporting their role as causal agents in symptoms associated with gadolinium exposure after intravenous use and encephalopathy following intrathecal administration. Gadolinium-based contrast agents are multidentate organic ligands that strongly bind the metal ion to reduce the toxicity of the metal. The notion that cationic gadolinium dissociates from these chelates and causes the disease is prevalent among patients and providers. We hypothesize that non-ligand-bound (soluble) gadolinium will be exceedingly low in patients. Soluble, ionic gadolinium is not likely to be the initial step in mediating any disease. The Kidney Institute of New Mexico was the first to identify gadolinium-rich nanoparticles in skin and kidney tissues from magnetic resonance imaging contrast agents in rodents. In 2023, they found similar nanoparticles in the kidney cells of humans with normal renal function, likely from contrast agents. We suspect these nanoparticles are the mediators of chronic toxicity from magnetic resonance imaging contrast agents. This article explores associations between gadolinium contrast and adverse health outcomes supported by clinical reports and rodent models.
Authors
- Joshua DeAguero (ORCID: https://orcid.org/0000-0001-6821-2067)
- Martin L. Kirk (ORCID: https://orcid.org/0000-0002-1479-3318)
- Tamara Howard (ORCID: https://orcid.org/0009-0000-2138-016X)
- Karol Dokładny (ORCID: https://orcid.org/0000-0003-4912-9051)
- Emily Hong (ORCID: https://orcid.org/0000-0003-3785-351X)
- Jacob A. Krawchuck (ORCID: https://orcid.org/0009-0006-8347-0383)
- Ian Henderson
- G. Patricia Escobar (ORCID: https://orcid.org/0000-0002-4505-5297)
- A. J. Brearley (ORCID: https://orcid.org/0000-0002-7364-8815)
- John Watt (ORCID: https://orcid.org/0000-0002-8012-9837)
- Brent Wagner (ORCID: https://orcid.org/0000-0002-7063-0142)
- Jing Yang (ORCID: https://orcid.org/0000-0001-8241-9160)
- Angelica Sáenz-Trevizo
- Amy Cunningham
Institutions
- Los Alamos National Laboratory (US)
- University of New Mexico (US)
- Center for Integrated Nanotechnologies (US)
- New Mexico Heart Institute (US)
- New Mexico VA Health Care System (US)
Publication Details
- Journal
- Frontiers in Toxicology
- Published
- 2024-08-12
- DOI
- https://doi.org/10.3389/ftox.2024.1376587
- Citations
- 10
- Primary Topic
- Lanthanide and Transition Metal Complexes
- Type
- article
- Field-Weighted Citation Impact
- 1.17
Funders
- National Science Foundation
- U.S. Department of Energy
- National Aeronautics and Space Administration
- U.S. Department of Veterans Affairs
- Center for Integrated Nanotechnologies
- Dialysis Clinics
- National Institutes of Health
- Office of Science
- National Nuclear Security Administration
- School of Medicine, University of New Mexico
- Clinical and Translational Science Center, University of New Mexico
- National Cancer Institute
- Division of Materials Research
- National Center for Research Resources
- National Center for Advancing Translational Sciences
- Los Alamos National Laboratory