The regulation of fibrosis and calcification by gadolinium

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Nephrogenic systemic fibrosis (NSF) is characterized by systemic fibrosis and abnormal calcification in patients with severe renal dysfunction. It is considered that gadolinium (Gd)-containing contrast agents used for magnetic resonance imaging trigger the development of NSF. However, the causative role of Gd and the mechanism of Gd-induced fibrosis and calcification in NSF are unknown. ET-1/ET receptor expression and phosphorylation of PDGF receptor, ERK and Aktin human mesenchymal stem cells (MSC) treated with Gd were elevated, suggeting that Gd induces proliferation and calcification of hMSC via enhancement of ETR signaling and/or PDGFR signaling and ERK and Akt pathway.