Guerbet, Research & Innovation Division , Aulnay-sous-Bois , France.
Crit Rev Toxicol. 2014 Nov;44(10):895-913. doi: 10.3109/10408444.2014.955568. Epub 2014 Sep 26.
Nephrogenic systemic fibrosis (NSF) is an iatrogenic scleroderma-like fibrosing systemic disorder occurring in patients with severe or end-stage renal disease. It was established as a new clinical entity in the year 2000. A causal role for gadolinium chelates (GC), widely used as contrast agents for magnetic resonance imaging, was suggested six years later. It rapidly appeared that the occurrence of NSF was associated with prior administration of GCs with lower thermodynamic stability, leading to warnings being published by health authorities and learned societies worldwide. Although a role for the chelated form of the less stable GCs has been proposed, the most commonly accepted hypothesis involves the gradual release of dissociated gadolinium in the body, leading to systemic fibrosis. However, the entire chain of events is still not fully understood in a causal way and many uncertainties remain.
肾源性系统性纤维化（NSF）是一种医源性硬皮病样纤维性系统性疾病，发生于严重或终末期肾病患者。该疾病于 2000 年被确认为一种新的临床实体。六年后，人们提出钆螯合物（GC）在体内逐渐释放游离的钆，导致全身性纤维化，从而确立了其在发病中的因果作用。GC 被广泛用作磁共振成像的造影剂，先前的研究表明，GC 的热力学稳定性越低，发生 NSF 的风险越高。尽管有人提出了螯合形式的不稳定 GC 发挥了作用，但最常被接受的假设涉及游离钆在体内的逐渐释放，导致系统性纤维化。然而，目前仍不完全清楚这一因果关系的全部过程，许多不确定性仍然存在。
