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年龄是否会影响钆毒性和在脑及骨骼组织中的存在:对比研究在幼年和成年大鼠中使用钆特酸葡胺和钆喷酸葡胺。

Does Age Interfere With Gadolinium Toxicity and Presence in Brain and Bone Tissues?: A Comparative Gadoterate Versus Gadodiamide Study in Juvenile and Adult Rats.

机构信息

Institut Curie INSERM, U1196 CNRS, UMR 9187 F-91405, Orsay.

Université Paris Sud, Université Paris-Saclay PSL Research University, Paris.

出版信息

Invest Radiol. 2019 Feb;54(2):61-71. doi: 10.1097/RLI.0000000000000517.


DOI:10.1097/RLI.0000000000000517
PMID:30394964
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6310471/
Abstract

OBJECTIVES: The main objective of the study was to assess the effect of age on target tissue total gadolinium (Gd) retention after repeated administration of gadodiamide (linear) or gadoterate (macrocyclic) Gd-based contrast agent (GBCA) in rats. The secondary objective was to assess the potential developmental and long-term consequences of GBCA administration during neonatal and juvenile periods. MATERIALS AND METHODS: A total of 20 equivalent human clinical doses (cumulated dose, 12 mmol Gd/kg) of either gadoterate or gadodiamide were administered concurrently by the intravenous route to healthy adult and juvenile rats. Saline was administered to juvenile rats forming the control group. In juvenile rats, the doses were administered from postnatal day 12, that is, once the blood-brain barrier is functional as in humans after birth. The tests were conducted on 5 juvenile rats per sex and per group and on 3 adult animals per sex and per group. T1-weighted magnetic resonance imaging of the cerebellum was performed at 4.7 T during both the treatment and treatment-free periods. Behavioral tests were performed in juvenile rats. Rats were euthanatized at 11 to 12 weeks (ie, approximately 3 months) after the last administration. Total Gd concentrations were measured in plasma, skin, bone, and brain by inductively coupled plasma mass spectrometry. Cerebellum samples from the juvenile rats were characterized by histopathological examination (including immunohistochemistry for glial fibrillary acidic protein or GFAP, and CD68). Lipofuscin pigments were also studied by fluorescence microscopy. All tests were performed blindly on randomized animals. RESULTS: Transient skin lesions were observed in juvenile rats (5/5 females and 2/4 males) and not in adult rats having received gadodiamide. Persisting (up to completion of the study) T1 hyperintensity in the deep cerebellar nuclei (DCNs) was observed only in gadodiamide-treated rats. Quantitatively, a slightly higher progressive increase in the DCN/brain stem ratio was observed in adult rats compared with juvenile rats, whereas no difference was noted visually. In all tissues, total Gd concentrations were higher (10- to 30-fold higher) in the gadodiamide-treated groups than in the gadoterate groups. No age-related differences were observed except in bone marrow where total Gd concentrations in gadodiamide-treated juvenile rats were higher than those measured in adults and similar to those measured in cortical bone tissue. No significant treatment-related effects were observed in histopathological findings or in development, behavior, and biochemistry parameters. However, in the elevated plus maze test, a trend toward an anxiogenic effect was observed in the gadodiamide group compared with other groups (nonsignificant). Moreover, in the balance beam test, a high number of trials were excluded in the gadodiamide group because rats (mainly males) did not completely cross the beam, which may also reflect an anxiogenic effect. CONCLUSIONS: No T1 hyperintensity was observed in the DCN after administration of the macrocyclic GBCA gadoterate regardless of age as opposed to administration of the linear GBCA gadodiamide. Repeated administration of gadodiamide in neonatal and juvenile rats resulted in similar total Gd retention in the skin, brain, and bone to that in adult rats with sex having no effect, whereas Gd distribution in bone marrow was influenced by age. Further studies are required to assess the form of the retained Gd and to investigate the potential risks associated with Gd retention in bone marrow in juvenile animals treated with gadodiamide. Regardless of age, total Gd concentration in the brain and bone was 10- to 30-fold higher after administration of gadodiamide compared with gadoterate.

摘要

目的:本研究的主要目的是评估在大鼠中重复给予线性钆喷酸葡胺(gadodiamide)或大环类对比剂(gadoterate)后,年龄对靶组织总钆(Gd)蓄积的影响。次要目的是评估在新生儿和青少年期给予 GBCA 可能产生的发育和长期后果。

材料和方法:共给予 20 等效人体临床剂量(累积剂量 12mmol Gd/kg)的gadoterate 或 gadodiamide 经静脉途径同时给予健康成年和幼年大鼠。幼年大鼠给予生理盐水作为对照组。在幼年大鼠中,从出生后第 12 天开始(即出生后与人类一样血脑屏障功能正常时)给予单次剂量。每组 5 只雄性和 5 只雌性幼鼠和 3 只雄性和 3 只雌性成年大鼠进行测试。在 4.7T 磁共振成像仪上进行小脑 T1 加权成像,在治疗和治疗期进行检测。在幼年大鼠中进行行为测试。最后一次给药后 11 至 12 周(即约 3 个月)处死大鼠。采用电感耦合等离子体质谱法测定血浆、皮肤、骨和脑的总 Gd 浓度。对幼年大鼠的小脑样本进行组织病理学检查(包括胶质纤维酸性蛋白或 GFAP 和 CD68 的免疫组化)。用荧光显微镜研究脂褐素色素。所有测试均在随机分组的动物上进行盲法检测。

结果:幼年大鼠(5/5 只雌性和 2/4 只雄性)在接受 gadodiamide 后出现短暂性皮肤损伤,而成年大鼠则没有。仅在 gadodiamide 治疗的大鼠中观察到深部小脑核(DCN)的 T1 高信号持续存在(直至研究结束)。定量分析显示,与幼年大鼠相比,成年大鼠的 DCN/脑干比值呈轻微但逐渐增加,而肉眼观察未见差异。在所有组织中,gadodiamide 治疗组的总 Gd 浓度均高于 gadoterate 组(高 10-30 倍)。除骨髓外,各组之间未见年龄相关差异,而骨髓中的总 Gd 浓度在幼年 gadodiamide 治疗大鼠中高于成年大鼠,与皮质骨组织中的测量值相似。组织病理学发现、发育、行为和生化参数均无明显的治疗相关性影响。然而,在高架十字迷宫测试中,与其他组相比,gadodiamide 组表现出焦虑样效应的趋势(无统计学意义)。此外,在平衡木测试中,由于大鼠(主要是雄性)未能完全穿过横梁,gadodiamide 组中有大量试验被排除,这也可能反映出焦虑样效应。

结论:与线性 GBCA gadodiamide 不同,给予大环类 GBCA gadoterate 后,DCN 中未观察到 T1 高信号,无论年龄如何。在新生和幼年期重复给予 gadodiamide 后,皮肤、脑和骨中的总 Gd 蓄积与成年大鼠相似,性别无影响,而骨髓中的 Gd 分布受年龄影响。需要进一步研究来评估保留的 Gd 的形态,并研究幼年动物接受 gadodiamide 治疗后骨髓中 Gd 蓄积相关的潜在风险。与 gadoterate 相比,无论年龄如何,给予 gadodiamide 后,脑和骨中的总 Gd 浓度高 10-30 倍。

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本文引用的文献

[1]
Multimodal Imaging Study of Gadolinium Presence in Rat Cerebellum: Differences Between Gd Chelates, Presence in the Virchow-Robin Space, Association With Lipofuscin, and Hypotheses About Distribution Pathway.

Invest Radiol. 2018-9

[2]
One-year Retention of Gadolinium in the Brain: Comparison of Gadodiamide and Gadoterate Meglumine in a Rodent Model.

Radiology. 2018-5-22

[3]
Gd accumulation in tissues of healthy mice upon repeated administrations of Gadodiamide and Gadoteridol.

J Trace Elem Med Biol. 2018-4-21

[4]
Gadolinium deposition within the paediatric brain: no increased intrinsic T1-weighted signal intensity within the dentate nucleus following the administration of a minimum of four doses of the macrocyclic agent gadobutrol.

Eur Radiol. 2018-5-9

[5]
Methodological Aspects for Preclinical Evaluation of Gadolinium Presence in Brain Tissue: Critical Appraisal and Suggestions for Harmonization-A Joint Initiative.

Invest Radiol. 2018-9

[6]
Impact of the Glymphatic System on the Kinetic and Distribution of Gadodiamide in the Rat Brain: Observations by Dynamic MRI and Effect of Circadian Rhythm on Tissue Gadolinium Concentrations.

Invest Radiol. 2018-9

[7]
Do we need gadolinium-based contrast medium for brain magnetic resonance imaging in children?

Pediatr Radiol. 2018-6

[8]
Changes in signal intensity in the dentate nucleus at unenhanced T1-weighted magnetic resonance imaging depending on class of previously used gadolinium-based contrast agent.

Pediatr Radiol. 2018-5

[9]
Gadolinium-based Contrast Media, Cerebrospinal Fluid and the Glymphatic System: Possible Mechanisms for the Deposition of Gadolinium in the Brain.

Magn Reson Med Sci. 2018-1-25

[10]
Gadolinium Retention, Brain T1 Hyperintensity, and Endogenous Metals: A Comparative Study of Macrocyclic Versus Linear Gadolinium Chelates in Renally Sensitized Rats.

Invest Radiol. 2018-6

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