Results of a study to determine whether individuals with proposed gadolinium deposition disease (GDD) have elevated serum levels of pro-inflammatory and pro-fibrotic cytokines were recently published. GDD has been reported in patients with normal renal function after MRIs with a gadolinium-based contrast agent (GBCA). The study by Maecker et al., “An initial investigation of serum cytokine levels in patients with gadolinium retention”, also sought to determine whether specific cytokines are correlated with certain symptoms considered to be characteristic of GDD. The study involved 24 participants who were recruited between May 2016 and June 2017 and met the proposed GDD diagnostic criteria. Some of the participants were recruited from our MRI-Gadolinium-Toxicity support group. A control group of 64 subjects provided serum samples before their flu vaccination. Serum cytokine levels were obtained with Luminex serum cytokine assay using eBiosciences/Affymetrix human 62-plex kits.
In patients who had retained gadolinium, serum levels of 14 cytokines, including 9 pro-inflammatory cytokines, were “statistically significantly elevated” compared to controls (p ≤ 0.05). The authors’ hypothesis regarding pro-fibrotic cytokines and cytokine links to specific symptoms’ intensity were not confirmed. The authors concluded that GDD appears to be associated with elevations of cytokines that are pro-inflammatory or involved in inflammation. They noted that some of these cytokines can also enhance pain sensation, which is a common symptom of GDD. The findings suggest that individuals with normal renal function who complain of symptoms characteristic of GDD after contrast-enhanced MRI should be tested to determine whether their symptoms may be associated with gadolinium retention.
According to the authors, whether and how the symptoms of GDD are related to cytokine changes and the other biological effects of gadolinium observed in vitro and in animal studies deserve further investigation.
My thoughts –
I agree with the authors that further investigation is warranted. I believe this initial investigation of serum cytokine levels in patients who have retained gadolinium is an important piece of the puzzle that will help establish the link between GBCA administration, gadolinium retention, and the wide range of symptoms of gadolinium toxicity that have been reported by patients after their contrast-enhanced MRIs.
The paper is available to the public online.
Maecker, H. T., Wang, W., Rosenberg-Hasson, Y., Semelka, R. C., Hickey, J., & Koran, L. M. (2020). An initial investigation of serum cytokine levels in patients with gadolinium retention. Radiologia Brasileira. scielo. Retrieved from https://www.scielo.br/scielo.php?pid=S0100-39842020005005203&script=sci_arttext