Used as a nuclear MRI contrast agent (usually in its chelated form). Also used in magnets, compact discs, superconductors, magnets, and fluorescent materials.Can also be found in ground and drinking water.
Gdions in chelates can be exchanged with cations like zinc, copper, calcium, or iron. Zinc is a major contributor, therefore adequatezinc levels improve Gd excretion.
Gdcan accumulatein tissue, bone, and brain. Usually removed via kidney. Chelated Gd can dissociate under certain metabolic conditions and inhibit intracellular calcium signalingand disrupt the action of thyroid hormone. Gd targets iron recycling macrophages, induces cellular iron import/export, and labile iron release, which participates in systemic fibrosis.
Rogowska J, Olkowska E, Ratajczyk W, Wolska L. Gadolinium as a new emerging contaminant of aquatic environments. Environ Toxicol Chem. 2018;37(6):1523-1534.
Cacheris WP, Quay SC, Rocklage SM. The relationship between thermodynamics and the toxicity of gadolinium complexes. Magn Res Imaging. 1990;8(4):467-481.
Ariyani W, Khairinisa MA, Perrotta G, Manto M, Koibuchi N. The Effects of Gadolinium-Based Contrast Agents on the Cerebellum: from Basic Research to Neurological Practice and from Pregnancy to Adulthood. Cerebellum. 2018;17(3):247-251.
Swaminathan S. Gadolinium toxicity: iron and ferroportin as central targets. Mag Res Imaging. 2016;34(10):1373-1376.
Malayeri AA, Brooks KM, Bryant LH, et al. National Institutes of Health Perspective on Reports of Gadolinium Deposition in the Brain. J Am Coll Radiol. 2016;13(3):237-241.
Runge VM. Critical Questions Regarding Gadolinium Deposition in the Brain and Body After Injections of the Gadolinium-Based Contrast Agents, Safety, and Clinical Recommendations in Consideration of the EMA’s Pharmacovigilance and Risk Assessment Committee Recommendation for Suspension of the Marketing Authorizations for 4 Linear Agents. Invest Radiol. 2017;52(6):317-323.
Gulani V, Calamante F, Shellock FG, Kanal E, Reeder SB. Gadolinium deposition in the brain: summary of evidence and recommendations. Lancet Neurol. 2017;16(7):564-570.
Leyba K, Wagner B. Gadolinium-based contrast agents: why nephrologists need to be concerned. Curr Opin Nephrol Hypertens. 2019;28(2):154-162.
In spite of past research, recent studies reveal brain deposition of Gd post MRI can occur, but information on adverse health effects in humans is lacking. In chronic kidney disease however, there is risk of nephrogenic systemic fibrosis (cutaneous and visceral fibrosis with renal failure).
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