title: In vitro and in vivo studies of radiographic contrast media-induced histamine release in pigs.
abstract: Routine clinical use of radiographic contrast media (RCM) causes adverse reactions in some patients. To elucidate the mechanisms of these reactions both in vitro and in vivo studies are necessary. In this study, RCM-induced histamine release from isolated mast cells was compared with the in vivo release of histamine and cardiovascular symptoms using a porcine model. The 2 non-ionic preparations examined (Solutrast and Ultravist) released little or no histamine from the 4 cell types tested (porcine pulmonary, cardiac, hepatic, and renal mast cells). The 4 ionic preparations (Angiographin, Hexabrix Rayvist, and Telebrix) caused histamine release from most of the cell suspensions. In almost all cases, the cardiac mast cells were the most sensitive followed by the hepatic mast cells. All 4 RCM tested in vivo produced elevated plasma histamine levels in some animals. The highest incidence was observed using the ionic, high osmolal Rayvist (6 of 12 animals), followed by the non-ionic RCM with the lowest osmolality Ultravist (4 of 12 animals). In vivo, mechanisms in addition to direct histamine release may also be involved in RCM-induced adverse reactions, since low osmolal, non-ionic RCM can cause elevated plasma histamine levels without in vitro release. The susceptibility of cardiac mast cells to RCM-induced histamine release suggests that patients undergoing e.g. coronary angiography may be especially at risk for an adverse reaction.
authors.affiliation: Institute for Theoretical Surgery, Clinic of the Philipps University, Marburg.
authors.forename: M
authors.initials: M
authors.lastname: Ennis
authors.forename: W
authors.initials: W
authors.lastname: Lorenz
authors.forename: E
authors.initials: E
authors.lastname: Nehring
authors.forename: C
authors.initials: C
authors.lastname: Schneider
mesh_terms: D000818:Animals; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D006632:Histamine / Q000097:blood; D006636:Histamine Release / Q000187:drug effects*; D007472:Iohexol / Q000031:analogs & derivatives / Q000494:pharmacology; D007479:Iopamidol / Q000494:pharmacology; D007483:Iothalamic Acid / Q000494:pharmacology / Q000031:analogs & derivatives; D007668:Kidney / Q000166:cytology; D008099:Liver / Q000166:cytology; D008168:Lung / Q000166:cytology; D008297:Male; D008407:Mast Cells / Q000187:drug effects / Q000502:physiology; D009206:Myocardium / Q000166:cytology; D013552:Swine
chemical_list: D003287:Contrast Media; D007483:Iothalamic Acid; D007472:Iohexol; C038192:iopromide; D006632:Histamine; C002587:ioxitalamic acid; C019462:meglumine ioglicinate; D007479:Iopamidol