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Coimbra S, Rocha S, Sousa NR, Catarino C, Belo L, Bronze-da-Rocha E, Valente MJ, Santos-Silva A. Toxicity Mechanisms of Gadolinium and Gadolinium-Based Contrast Agents-A Review. Int J Mol Sci 2024; 25:4071. [PMID: 38612881 PMCID: PMC11012457 DOI: 10.3390/ijms25074071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Gadolinium-based contrast agents (GBCAs) have been used for more than 30 years to improve magnetic resonance imaging, a crucial tool for medical diagnosis and treatment monitoring across multiple clinical settings. Studies have shown that exposure to GBCAs is associated with gadolinium release and tissue deposition that may cause short- and long-term toxicity in several organs, including the kidney, the main excretion organ of most GBCAs. Considering the increasing prevalence of chronic kidney disease worldwide and that most of the complications following GBCA exposure are associated with renal dysfunction, the mechanisms underlying GBCA toxicity, especially renal toxicity, are particularly important. A better understanding of the gadolinium mechanisms of toxicity may contribute to clarify the safety and/or potential risks associated with the use of GBCAs. In this work, a review of the recent literature concerning gadolinium and GBCA mechanisms of toxicity was performed.
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Affiliation(s)
- Susana Coimbra
- 1H-TOXRUN—1H-Toxicology Research Unit, University Institute of Health Sciences, Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Advanced Polytechnic and University Cooperative, CRL, 4585-116 Gandra, Portugal
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Susana Rocha
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Nícia Reis Sousa
- Departamento de Ciências e Tecnologia da Saúde, Instituto Superior Politécnico de Benguela, Benguela, Angola
| | - Cristina Catarino
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Luís Belo
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Elsa Bronze-da-Rocha
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Maria João Valente
- National Food Institute, Technical University of Denmark, Kongens Lyngby, 2800 Copenhagen, Denmark
| | - Alice Santos-Silva
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
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Azzawri AA, Yildirim IH, Yegin Z, Dusak A. Expression of GRP78 and its copartners in HEK293 and pancreatic cancer cell lines (BxPC-3/PANC-1) exposed to MRI and CT contrast agents. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2023; 43:391-416. [PMID: 37787049 DOI: 10.1080/15257770.2023.2263496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
Endoplasmic reticulum (ER) stress-associated chaperones trigger a defense mechanism called as unfolded protein response (UPR) which can manage apoptosis and be determinative in cell fate. Both anticancer drug effects and potential toxicity effects of magnetic resonance imaging (MRI) and computed tomography (CT) contrast agents were aimed to be evaluated. For this purpose, we investigated expression profiles of endoplasmic reticulum stress-associated chaperone molecules in human pancreatic tumor lines BxPC-3 and PANC-1 and control human embryonic kidney cells 293 (HEK293) induced with a variety of gadolinium and iohexol contrast agents. Protein expression levels of ER stress-associated chaperones (master regulator: GRP78/Bip and its copartners: Calnexin, Ero1, PDI, CHOP, IRE1α and PERK) were evaluated with Western blotting. Expression levels at mRNA level were also assessed for GRP78/Bip and CHOP with real-time PCR. Induction of cells was carried out with four different Gd-based contrast agents (GBCAs): (Dotarem, Optimark, Primovist and Gadovist) and two different iohexol agents (Omnipol, Omnipaque). CT contrast agents tested in the study did not result in significant ER stress in HEK293 cells. However, they do not seem to have theranostic potential in pancreas cancer through ER pathway. The potential efficiency of macrocyclic MRI contrast agents to provoke apoptosis via ER stress-associated chaperones in BxPC-3 cells lends credibility for their future theranostic use in pancreas cancer as long as undesired toxicity effects were carefully considered. ER stress markers and/or contrast agents seem to have promising potential to be translated into the clinical practice to manage pancreas cancer progression.
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Affiliation(s)
| | | | - Zeynep Yegin
- Medical Laboratory Techniques Program, Vocational School of Health Services, Sinop University, Sinop, Turkey
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Takanezawa Y, Nakamura R, Ohshiro Y, Uraguchi S, Kiyono M. Gadolinium-based contrast agents suppress adipocyte differentiation in 3T3-L1 cells. Toxicol Lett 2023; 383:S0378-4274(23)00218-7. [PMID: 37437671 DOI: 10.1016/j.toxlet.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/28/2023] [Accepted: 07/09/2023] [Indexed: 07/14/2023]
Abstract
Gadolinium-based contrast agents (GBCAs) are widely used in magnetic resonance imaging (MRI) to improve the sensitivity and enhance diagnostic performance. GBCAs are mostly eliminated from the body through the kidney after administration; however small amounts of gadolinium are retained in the brain and other tissues. Although there is increasing concern about the adverse health effects of gadolinium, the cellular effects of GBCAs remains poorly understood. Here, we elucidated the potential cytotoxicity of the GBCAs Omniscan and Gadovist in 12 different cell lines, especially 3T3-L1 adipocyte cell line. Omniscan and Gadovist treatments significantly increased intracellular gadolinium levels in 3T3-L1 cells in a time- and dose-dependent manner. Additionally, Omniscan and Gadovist treatments downregulated the expression of adipocyte differentiation markers, including peroxisome proliferator-activated receptor γ (PPARG), adiponectin (ADIPOQ), and fatty acid-binding protein (FABP4), in 3T3-L1 cells, especially during early differentiation (day 0-2). Moreover, histological analysis using Oil red O staining showed that gadolinium chloride (GdCl3) treatment suppressed lipid droplet accumulation and the expression of adipocyte differentiation markers. Overall, the results showed that Omniscan and Gadovist treatment suppressed adipocyte differentiation in 3T3-L1 cells, contributing to the understanding of the potential toxic effects of GBCA exposure.
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Affiliation(s)
- Yasukazu Takanezawa
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| | - Ryosuke Nakamura
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| | - Yuka Ohshiro
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| | - Shimpei Uraguchi
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| | - Masako Kiyono
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan.
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Nakamura R, Takanezawa Y, Ohshiro Y, Uraguchi S, Kiyono M. Effects of chemical forms of gadolinium on the spleen in mice after single intravenous administration. Biochem Biophys Rep 2022; 29:101217. [PMID: 35128083 PMCID: PMC8808065 DOI: 10.1016/j.bbrep.2022.101217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 12/03/2022] Open
Abstract
Gadolinium-based contrast agents (GBCAs) are widely used to improve tissue contrast during magnetic resonance imaging. Exposure to GBCAs can result in gadolinium deposition within human tissues and has become a clinical concern because of the potential toxic effects of free gadolinium (Gd3+). Here, we report the impact of a single administration of GBCAs (Omniscan and Gadovist), and Gd3+ on mouse tissues. Five-week-old male BALB/c mice were injected intravenously with GBCAs or Gd3+. Seven days after injection, relatively high levels of gadolinium were detected in the spleen (118.87 nmol/g tissue), liver (83.00 nmol/g tissue), skin (48.56 nmol/g tissue), and kidneys (25.59 nmol/g tissue) of the Gd(NO3)3 (high dose: 0.165 mmol/kg) group; in the bones (11.12 nmol/g tissue), kidneys (7.49 nmol/g tissue), teeth (teeth: 6.18 nmol/g tissue), and skin (2.43 nmol/g tissue) of the Omniscan (high dose: 1.654 mmol/kg) group and in the kidneys (16.36 nmol/g tissue) and skin (4.88 nmol/g tissue) of the Gadovist (high dose: 3.308 mmol/kg) group. Enlargement of the spleen was observed in the Gd3+ group (p < 0.05), but not in the Omniscan or Gadovist groups. Gd3+ caused iron accumulation around the white pulp of the spleen, suggesting that enlargement of the spleen is, at least in part, associated with Gd3+ and/or iron accumulation. Our results may help elucidate the relative risks of different types of gadolinium agents, the mechanisms involved, and even recognition of potential toxic effects of GBCAs. The tissue deposition of gadolinium influenced by the chemical forms of gadolinium. Gd3+ causes enlargement and iron deposition in the spleen of mice. The spleen is a potential target for the release of Gd3+ from GBCAs.
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Sousa NR, Rocha S, Santos-Silva A, Coimbra S, Valente MJ. Cellular and molecular pathways underlying the nephrotoxicity of gadolinium. Toxicol Sci 2021; 186:134-148. [PMID: 34878122 DOI: 10.1093/toxsci/kfab148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Mounting evidence on the short- and long-term adverse effects associated with gadolinium [Gd (III)]-based contrast agents used in magnetic resonance imaging have emerged in the past three decades. Safety issues arise from the release of Gd (III) from chelates and its deposition in tissues, which is exacerbated in patients with renal disease, since the kidney is the major excretion organ of most of these agents. This study aimed at unveiling the cellular and molecular mechanisms of nephrotoxicity of Gd (III), using an in vitro model of human proximal tubular cells (HK-2 cell line). Cell viability declined in a concentration- and time-dependent manner after exposure to GdCl3·6H2O. The estimated inhibitory concentrations (ICs) eliciting 1 to 50% of cell death, after 24 h of exposure, ranged from 3.4 to 340.5 µM. At toxic concentrations, exposure to Gd (III) led to disruption of the oxidative status, mitochondrial dysfunction, cell death by apoptosis, switching to necrosis at higher levels, and autophagic activation. Disturbance of the lipid metabolism was already observed at low-toxicity ICs, with accumulation of lipid droplets, and upregulation of genes related to both lipogenesis and lipolysis. Gd (III)-exposure, even at the subtoxic IC01, increased the expression of modulators of various signaling pathways involved in the development and progression of renal disease, including inflammation, hypoxia and fibrosis. Our results give new insights into the mechanisms underlying the nephrotoxic potential of Gd (III) and highlight the need to further clarify the risks versus benefits of the Gd (III)-based contrast agents currently in use.
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Affiliation(s)
- Nícia Reis Sousa
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra, Portugal.,Departamento de Ciências e Tecnologia da Saúde, Instituto Superior Politécnico de Benguela, Benguela, Angola
| | - Susana Rocha
- LAQV, REQUIMTE, Laboratório de Química Aplicada, Departamento de Ciências Químicas, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Alice Santos-Silva
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculdade de Farmácia da, Universidade do Porto, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Susana Coimbra
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra, Portugal.,Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculdade de Farmácia da, Universidade do Porto, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Maria João Valente
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculdade de Farmácia da, Universidade do Porto, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
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Korolenko TA, Johnston TP, Vetvicka V. Lysosomotropic Features and Autophagy Modulators among Medical Drugs: Evaluation of Their Role in Pathologies. Molecules 2020; 25:molecules25215052. [PMID: 33143272 PMCID: PMC7662698 DOI: 10.3390/molecules25215052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 12/25/2022] Open
Abstract
The concept of lysosomotropic agents significantly changed numerous aspects of cellular biochemistry, biochemical pharmacology, and clinical medicine. In the present review, we focused on numerous low-molecular and high-molecular lipophilic basic compounds and on the role of lipophagy and autophagy in experimental and clinical medicine. Attention was primarily focused on the most promising agents acting as autophagy inducers, which offer a new window for treatment and/or prophylaxis of various diseases, including type 2 diabetes mellitus, Parkinson's disease, and atherosclerosis. The present review summarizes current knowledge on the lysosomotropic features of medical drugs, as well as autophagy inducers, and their role in pathological processes.
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Affiliation(s)
- Tatiana A. Korolenko
- Federal State Budgetary Scientific Institution Scientific Research Institute of Physiology and Basic Medicine, Timakova Str. 4, 630117 Novosibirsk, Russia;
| | - Thomas P. Johnston
- Division of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA;
| | - Vaclav Vetvicka
- Department of Pathology, University of Louisville, Louisville, KY 40292, USA
- Correspondence:
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