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Influence of radiographic contrast media on granulocyte enzymes and complement during uncomplicated urographies
J Georgsen1, F Rasmussen, S Antonsen
1Regional Centre for Blood Transfusion and Clinical Immunology, Aalborg Hospital, Denmark.
Insights
This study found that while radiographic contrast media (RCM) did not activate complement, non-ionic RCM like iopamidol and iohexol decreased CH50 levels. Neutrophil increases were noted with ioxaglate, iohexol, and diatrizoate.
Area of Science:
- Immunology
- Radiology
- Pharmacology
Background:
- Radiographic contrast media (RCM) are essential for intravenous urography.
- Understanding RCM's interaction with the immune system is crucial for patient safety.
- Previous studies have suggested potential adverse effects of RCM on complement and neutrophil activity.
Purpose of the Study:
- To investigate the effects of four different RCM on complement activation and neutrophil response during intravenous urography.
- To compare the immunological impact of ionic and non-ionic RCM.
- To identify potential mechanisms behind observed changes in complement and neutrophil markers.
Main Methods:
- Forty patients undergoing intravenous urography were administered one of four RCM.
- Blood samples were analyzed for complement components (C3d, CH50) and neutrophil markers (neutrophils, elastase, lactoferrin).
- Statistical analysis was performed to compare pre- and post-administration values and between different RCM groups.
Main Results:
- No significant increase in C3d was observed for any RCM, indicating no complement activation.
- Significantly decreased CH50 values were detected with non-ionic RCM (iopamidol, iohexol), suggesting RCM-complement molecule interaction.
- Increased neutrophil counts were observed with ioxaglate, iohexol, and diatrizoate, potentially due to inhibited granulocyte adherence. Diatrizoate also showed decreased elastase, possibly inhibiting degranulation.
Conclusions:
- Non-ionic RCM may interact with complement components, leading to decreased CH50 levels.
- Certain RCM, including ionic and non-ionic types, can influence neutrophil behavior.
- Further research is needed to fully elucidate the immunological consequences of RCM administration.
Abstract:
Four different radiographic contrast media (RCM) were used for i.v. urography in 40 patients, none of whom had complications. No rise in C3d was observed for any of the RCM, indicating that complement was not activated. However, significantly decreased values for CH50 were detected when the non-ionic RCM iopamidol and iohexol were used, and this may be due to interaction between the RCM and the complement molecules. Significantly increased numbers of neutrophils were observed in patients receiving ioxaglate, iohexol and diatrizoate, which may be due to inhibition of granulocyte adherence. No rise in the concentration of elastase and lactoferrin was observed. On the other hand, significantly decreased values of elastase were seen after injection of diatrizoate, which may be due to inhibition of the degranulation process by this media.