Prybylski John P, Coste Sanchez Carla, Jay Michael
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.
Magn Reson Imaging. 2019 Jan;55:140-144. doi: 10.1016/j.mri.2018.10.006. Epub 2018 Oct 12.
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.
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.
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.
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.
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。
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。
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。
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。