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Intravenous Calcium-/Zinc-Diethylene Triamine Penta-Acetic Acid in Patients With Presumed Gadolinium Deposition Disease: A Preliminary Report on 25 Patients.静脉注射钙/锌-二乙烯三胺五乙酸在疑似钆沉积病患者中的应用:25 例初步报告。
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3
Gadolinium Retention and Deposition Revisited: How the Chemical Properties of Gadolinium-based Contrast Agents and the Use of Animal Models Inform Us about the Behavior of These Agents in the Human Brain.再探钆的潴留与沉积:基于钆的造影剂的化学性质及动物模型的应用如何让我们了解这些造影剂在人脑中的行为。
Radiology. 2017 Dec;285(3):721-724. doi: 10.1148/radiol.2017172138.
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Gadolinium Retention in the Rat Brain: Assessment of the Amounts of Insoluble Gadolinium-containing Species and Intact Gadolinium Complexes after Repeated Administration of Gadolinium-based Contrast Agents.钆在大鼠脑内的蓄积:重复给予基于钆的造影剂后,不溶性含钆物质和完整的钆配合物的量的评估。
Radiology. 2017 Dec;285(3):839-849. doi: 10.1148/radiol.2017162857. Epub 2017 Sep 4.
5
Comparison of Gadolinium Concentrations within Multiple Rat Organs after Intravenous Administration of Linear versus Macrocyclic Gadolinium Chelates.静脉注射线性对比剂与大环对比剂后大鼠多个器官内钆浓度的比较。
Radiology. 2017 Nov;285(2):536-545. doi: 10.1148/radiol.2017161594. Epub 2017 Jun 19.
6
The Impact of Excess Ligand on the Retention of Nonionic, Linear Gadolinium-Based Contrast Agents in Patients With Various Levels of Renal Dysfunction: A Review and Simulation Analysis.过量配体对不同程度肾功能不全患者中非离子线性钆基造影剂潴留的影响:综述与模拟分析
Adv Chronic Kidney Dis. 2017 May;24(3):176-182. doi: 10.1053/j.ackd.2017.03.002.
7
Gadolinium Retention and Toxicity-An Update.钆的潴留与毒性——最新进展
Adv Chronic Kidney Dis. 2017 May;24(3):138-146. doi: 10.1053/j.ackd.2017.03.004.
8
Gadolinium retention in the body: what we know and what we can do.体内钆的蓄积:我们已知的和我们能做的。
Radiol Med. 2017 Aug;122(8):589-600. doi: 10.1007/s11547-017-0757-3. Epub 2017 Mar 30.
9
Quantification and Assessment of the Chemical Form of Residual Gadolinium in the Brain After Repeated Administration of Gadolinium-Based Contrast Agents: Comparative Study in Rats.多次给予钆基造影剂后大鼠脑内残留钆化学形态的定量与评估:比较研究
Invest Radiol. 2017 Jul;52(7):396-404. doi: 10.1097/RLI.0000000000000352.
10
Penetration and distribution of gadolinium-based contrast agents into the cerebrospinal fluid in healthy rats: a potential pathway of entry into the brain tissue.钆基造影剂在健康大鼠脑脊液中的渗透与分布:进入脑组织的潜在途径。
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螯合时机对大鼠注射造影剂后钆沉积的影响。

Impact of chelation timing on gadolinium deposition in rats after contrast administration.

作者信息

Prybylski John P, Coste Sanchez Carla, Jay Michael

机构信息

Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States of America.

Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States of America.

出版信息

Magn Reson Imaging. 2019 Jan;55:140-144. doi: 10.1016/j.mri.2018.10.006. Epub 2018 Oct 12.

DOI:10.1016/j.mri.2018.10.006
PMID:30321663
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6263939/
Abstract

OBJECTIVE

To determine if gadolinium (Gd) can be rechelated once released from Gd-based contrast agents (GBCAs) and deposited in vivo. Despite extensive research comparing GBCAs and GBCA formulations as well as the ongoing debate about their risks of deposition and the role of Gd release, it remains unknown if retained Gd can be eliminated by administering chelating agents.

MATERIALS AND METHODS

Rats were injected intravenously with 10 doses of 1 mmol/kg gadodiamide and treated with intravenous Zn-DTPA (30 μmol/kg) concomitantly or 1, 4 or 8 h after GBCA administration (N = 3 rats per group). After euthanization, tissues were harvested three days after the last dose of gadodiamide and tissue Gd concentrations were assessed by ICP-MS. Additionally, a simulation of a single 0.1 mmol/kg gadopentetate dose with 30 μmol/kg DTPA given either concomitantly or within the first 24 h after GBCA was run; simulated tissue Gd concentrations were compared with those observed in rats to determine if simulated trends were accurate.

RESULTS

Concomitant DTPA did not produce a significant reduction in Gd concentration in any organ for rats. There was a time-dependent trend in liver Gd reduction. The 1 h timepoint was associated with a non-significant increase in kidney, brain and femur Gd relative to untreated controls. There were no significant deviations from the model-predicted Gd changes.

DISCUSSION

Both the simulation and rat study did not identify major benefits for chelation at the doses given, despite the simulation assuming all Gd deposited in tissues is unchelated. The potential redistribution in the rat study provide a compelling result that may impact the clinical relevance of further work investigating rechelation of Gd. Future work should further describe the three-dimensional dose-time-response relationship for preventing Gd deposition, and how that relates to long-term Gd toxicities.

摘要

目的

确定钆(Gd)从基于钆的造影剂(GBCAs)中释放并沉积于体内后是否能够再次螯合。尽管已对GBCAs及其制剂进行了广泛研究,且关于其沉积风险和钆释放作用的争论仍在持续,但尚不清楚给予螯合剂是否能够消除潴留的钆。

材料与方法

给大鼠静脉注射10剂1 mmol/kg的钆双胺,并同时或在给予GBCA后1、4或8小时静脉注射Zn-DTPA(30 μmol/kg)(每组3只大鼠)。安乐死后,在最后一剂钆双胺给药三天后采集组织,并用电感耦合等离子体质谱法评估组织中的钆浓度。此外,进行了单次给予0.1 mmol/kg钆喷酸葡胺并同时或在给予GBCA后的头24小时内给予30 μmol/kg DTPA的模拟实验;将模拟的组织钆浓度与在大鼠中观察到的浓度进行比较,以确定模拟趋势是否准确。

结果

对于大鼠,同时给予DTPA并未使任何器官中的钆浓度显著降低。肝脏中钆的减少存在时间依赖性趋势。相对于未治疗的对照组,1小时时间点时肾脏、大脑和股骨中的钆有非显著增加。与模型预测的钆变化无显著偏差。

讨论

尽管模拟实验假设所有沉积在组织中的钆均未螯合,但模拟实验和大鼠研究均未发现所给剂量的螯合有重大益处。大鼠研究中的潜在再分布提供了一个引人注目的结果,可能会影响进一步研究钆再螯合的临床相关性。未来的工作应进一步描述预防钆沉积的三维剂量-时间-反应关系,以及这与长期钆毒性的关系。