The retention of gadolinium in the human body following the use of gadolinium-based MRI contrast agents: a call to action for analytical chemists
Gd-based contrast agends partly remain in the body of patients for quite some time. The information from speciation analysis is needed in order to answer why.
Gd-based MRI contrast agents are considered essential for modern medical diagnostic imaging leading to about 25 Mio applications per year. While most of the administered Gd (5-10 millimoles) is rapidly excreted via urine during the first few days following application, a small part is retained in different organs including liver, kidney, brain and bones for much longer time. While prolonged residence time was first observed for patients with reduced kidney function, it is meanwhile established that such retention also occurs in patients with normal kidney function. While retention of Gd in patients with advanced kidney disease can be related to nephrogenic systemic fibrosis (NSF), up to now retention in patients with normal kidney function could not be related to such pathology. Anyhow, regulatory agiencies have restricted the use of specific GBCA and have called manufactureres and researchers to present data on the biological effects of such retention.
The new publication:
Researchers from the Massachusetts General Hospital and Harvard Medical School have now compiled all the obervations regarding the Gd retention. From these obervations it is clear that not all of the injected dose of GBCA is eliminated.
However many questions remain:
What part of the injected dose remains in the body after a week, month or year ?
In what tissue does the Gd retain ?
In what form is the Gd retained ?
What is the reason for retention ?
Is the retention being different for the different types of GBCA?
What are the long-term effects?
The authors conclude that specialized expertise that exists in the bioinorganic and bioanalytical chemistry communities is needed to answer these questions and they express their hope that their review will stimulate this community to tackle these problems.
They also list the different techniques that could help to answer the open questions. These are the well known techniques within the tool-box for speciation analysis.
The cited study:
Mariane Le Fur, Peter Caravan, The biological fate of gadolinium-based MRIcontrast agents: a call to action forbioinorganic chemists, Metallomics, 11(2 (2019) 240-254. DOI: 10.1039/c8mt00302e
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