Involvement of Gadolinium Chelates in the Mechanism of Nephrogenic Systemic Fibrosis: An Update
Involvement of Gadolinium Chelates in the Mechanism of Nephrogenic Systemic Fibrosis: An Update
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DOI：
10.1016/j.rcl.2009.06.006
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发表时间：
2009-09-01
影响因子：
1.9
通讯作者：
Corot, Claire
中科院分区：
文献类型：
--
作者：
Idee, Jean-Marc;Port, Marc;Corot, Claire
肾源性系统性纤维化（NSF）是一种高度衰弱的硬皮病样疾病，仅发生在严重或终末期肾衰竭患者中。自2006年两个独立的欧洲团队认识到钆螯合物（GC）用作MR成像造影剂与NSF之间的联系以来，许多研究描述了临床问题并调查了这种疾病的机制。到目前为止，最常报道的假设是基于GC的体内脱螯合。本文介绍了气相色谱的物理化学性质，特别是其热力学和动力学稳定性。由大环结构提供的高动力学稳定性与高热力学稳定性相结合，最大限度地减少了体内释放的游离钆的量。目前的假设有关的病理生理机制进行了批判性的讨论。
Nephrogenic systemic fibrosis (NSF) is a highly debilitating scleroderma-like disease occurring exclusively in patients with severe or end-stage renal failure. Since the recognition of a link between gadolinium chelates (GCs) used as contrast agents for MR imaging and NSF by two independent European teams in 2006, numerous studies have described the clinical issues and investigated the mechanism of this disease. So far the most commonly reported hypothesis is based on the in vivo dechelation of GCs. The physicochemical properties of GCs, especially their thermodynamic and kinetic stabilities, are described in the present article. High kinetic stability provided by the macrocyclic structure, combined with high thermodynamic stability, minimizes the amount of free gadolinium released in the body. The current hypotheses regarding the pathophysiologic mechanism are critically discussed.