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HYPOTHESIS AND THEORY article

Front. Toxicol.
Sec. Clinical Toxicology
Volume 6 - 2024 | doi: 10.3389/ftox.2024.1376587
This article is part of the Research Topic Magnetic Resonance Imaging Contrast Agents: The Safety of Gadolinium View all articles

The Safety of Magnetic Resonance Imaging Contrast Agents

Provisionally accepted
Amy Cunningham Amy Cunningham 1Martin Kirk Martin Kirk 2Emily Hong Emily Hong 1Jing Yang Jing Yang 2Tamara Howard Tamara Howard 1Adrian Brearley Adrian Brearley 2Angelica Sáenz-Trevizo Angelica Sáenz-Trevizo 2Jacob Krawchuck Jacob Krawchuck 3John Watt John Watt 3Ian Henderson Ian Henderson 4Karol Dokladny Karol Dokladny 1,5Joshua DeAguero Joshua DeAguero 1,5G P. Escobar G P. Escobar 1,5Brent Wagner Brent Wagner 1,5,6*
  • 1 University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
  • 2 University of New Mexico, Albuquerque, New Mexico, United States
  • 3 Center for Integrated Nanotechnologies (DOE), Albuquerque, New Mexico, United States
  • 4 Omphalos Bioscience, Albuquerque, United States
  • 5 Kidney Institute of New Mexico, Albuquerque, New Mexico, United States
  • 6 New Mexico VA Health Care System, Veterans Health Administration, United States Department of Veterans Affairs, Albuquerque, United States

The final, formatted version of the article will be published soon.

    Gadolinium-based contrast agents are increasingly used in clinical practice. While these pharmaceuticals are verified causal agents in nephrogenic systemic fibrosis, there is a growing body of literature supporting their role as causal agents in symptoms associated with gadolinium exposure after intravenous use and encephalopathy following intrathecal administration. Gadolinium-based contrast agents are multidentate organic ligands that strongly bind the metal ion to reduce the toxicity of the metal. The notion that cationic gadolinium dissociates from these chelates and causes the disease is prevalent among patients and providers. We hypothesize that non-ligand-bound (soluble) gadolinium will be exceedingly low in patients. Soluble, ionic gadolinium is not likely to be the initial step in mediating any disease. The Kidney Institute of New Mexico was the first to identify gadolinium-rich nanoparticles in skin and kidney tissues from magnetic resonance imaging contrast agents in rodents. In 2023, they found similar nanoparticles in the kidney cells of humans with normal renal function, likely from contrast agents. We suspect these nanoparticles are the mediators of chronic toxicity from magnetic resonance imaging contrast agents. This article explores associations between gadolinium contrast and adverse health outcomes supported by clinical reports and rodent models.

    Keywords: Gadolinium, Metals, Gadodiamide, Magnetic resonance imaging contrast, renal tubular epithelium, mitochondriopathy, Electron microscopy, X-ray spectra

    Received: 25 Jan 2024; Accepted: 01 Jul 2024.

    Copyright: © 2024 Cunningham, Kirk, Hong, Yang, Howard, Brearley, Sáenz-Trevizo, Krawchuck, Watt, Henderson, Dokladny, DeAguero, Escobar and Wagner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Brent Wagner, New Mexico VA Health Care System, Veterans Health Administration, United States Department of Veterans Affairs, Albuquerque, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.