[Changes in the kallikrein-kinin and complement system in angiography using non-ionic contrast media]

Area of Science:

• Biochemistry
• Immunology
• Radiology

Background:

• Contrast agents are essential in angiography.
• Non-ionic contrast agents are preferred due to lower adverse reactions.
• Potential effects on the kallikrein-kinin and complement systems are not fully understood.

Purpose of the Study:

• To investigate the impact of non-ionic contrast agents on the kallikrein-kinin system.
• To assess the effect on the complement system following contrast agent administration.
• To determine if these systems are activated despite the absence of clinical adverse reactions.

Main Methods:

• Venous blood samples were collected before and 3 minutes after contrast agent injection during angiography.
• Measurements included prekallikrein, kallikrein inhibition, beta-factor XIIa inhibition, C1-esterase inhibitor, C1q, C3, ATIII, HMW-kininogen, fibrinogen, and factor XII.
• Clinical observation for adverse reactions was conducted.

Main Results:

• Bolus injection of contrast medium led to significant activation of the kallikrein-kinin system (p < 0.05).
• Key indicators such as prekallikrein, kallikrein inhibition, beta-factor XIIa inhibition, and C1-esterase inhibitor levels decreased.
• Complement system activation was indicated by decreased levels of C1q and C3 (p < 0.05).

Conclusions:

• Angiography using newer non-ionic contrast agents significantly activates both the kallikrein-kinin and complement systems.
• These systemic activations occur even when no overt adverse clinical reactions are observed.
• Further research may be needed to understand the long-term implications of this activation.