A possible role for cysteinyl-leukotrienes in non-ionic contrast media induced adverse reactions.
OBJECTIVE
To test whether mono- or dimeric X-ray contrast media (CM) may induce the de novo production of cysteinyl-leukotriens (cys-LT), that could contribute to allergic/allergy-like side effects.


METHODS
Leukocytes from 39 patients receiving iopromide or iotrolan for routine CT-examination were analyzed for the production of cys-LT. Histamine levels were analyzed in plasma specimens. One patient with a positive history of a previous CM-reaction did not receive CM-injection.


RESULTS
Three patients of the iopromide and five of the iotrolan group showed adverse reactions. Reactors had increased cys-LT values in samples obtained before CM-injection induced by the positive control (anti-FcepsilonRI antibodies) (6763.7 pg/ml+/-1367.3 versus 2299.8 pg/ml+/-399.2; p<0.007). Patients with versus without CM-reaction did not differ significantly with respect to their histamine values before CM-administration. In vitro iopromide (p<0.0002) and iotrolan (p<0.0008) induced significant cys-LT production as compared to IL-3 stimulation. In vivo both CM induced a significant increase 6h after CM administration (p<0.05).


CONCLUSIONS
Our findings suggest that both CM seem to induce cys-LT production. As to whether the observed increased values in pre-dose samples of patients with as compared to those without reactions could contribute to identify high risk patients should be investigated in larger patient groups in future.
Böhm
Ingrid
I
Department of Radiology, University of Bonn, Sigmund Freud Strasse 25, 53105 Bonn, Germany. i.boehm@uni-bonn.de
Speck
Ulrich
U
Schild
Hans
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D003545:Cysteine / Q000097:blood*; D004342:Drug Hypersensitivity / Q000097:blood; D005260:Female; D006801:Humans; D007472:Iohexol / Q000009:adverse effects / Q000031:analogs & derivatives; D015289:Leukotrienes / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids / Q000009:adverse effects
D003287:Contrast Media; D015289:Leukotrienes; D014283:Triiodobenzoic Acids; C112381:cysteinyl-leukotriene; C033300:iotrolan; D007472:Iohexol; C038192:iopromide; D003545:Cysteine