title: Effects of gadolinium-based magnetic resonance imaging contrast agents on human skin in organ culture and human skin fibroblasts.
abstract: OBJECTIVE
  Nephrogenic systemic fibrosis (NSF) is a clinical syndrome linked with exposure in renal failure patients to gadolinium-based magnetic resonance imaging contrast agents (GBCAs). The pathogenesis of the disease is largely unknown. The present study addresses potential pathophysiological mechanisms.
  
  
  METHODS
  Here, we have examined human skin in organ culture and human dermal fibroblasts in monolayer culture for responses to GBCA stimulation.
  
  
  RESULTS
  Treatment of normal human skin in organ culture with Omniscan had no significant effect on type I procollagen but increased both matrix metalloproteinase-1 and tissue inhibitor of metalloproteinases-1. At the histologic level, many interstitial cells demonstrated cytologic features characteristic of activation (ie, light staining, oblong, plump nuclei). Omniscan, as well as 3 other magnetic resonance imaging contrast agents (Magnevist, Multihance, and Prohance), increased proliferation of human dermal fibroblasts in monolayer culture. Increased proliferation was accompanied by an increase in production of both matrix metalloproteinase-1 and tissue inhibitor of metalloproteinases-1 but no increase in type I procollagen. Concentrations required for effects differed among the 4 agents (Omniscan < Magnevist and Multihance < Prohance). In contrast to its effects on fibroblast function, Omniscan did not stimulate human epidermal keratinocyte proliferation when examined over a wide range of concentrations.
  
  
  CONCLUSIONS
  These data provide evidence that GBCA exposure in ex vivo skin from healthy individuals increases fibroblast proliferation and has effects on the enzyme/inhibitor system that regulates collagen turnover in the skin.
authors.affiliation: Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA. varani@umich.edu
authors.forename: James
authors.initials: J
authors.lastname: Varani
authors.forename: Marissa
authors.initials: M
authors.lastname: DaSilva
authors.forename: Roscoe L
authors.initials: RL
authors.lastname: Warner
authors.forename: Monica O'Brien
authors.initials: MO
authors.lastname: Deming
authors.forename: Adam G
authors.initials: AG
authors.lastname: Barron
authors.forename: Kent J
authors.initials: KJ
authors.lastname: Johnson
authors.forename: Richard D
authors.initials: RD
authors.lastname: Swartz
mesh_terms: D000293:Adolescent; D000368:Aged; D049109:Cell Proliferation / Q000187:drug effects; D002478:Cells, Cultured; D003287:Contrast Media / Q000008:administration & dosage; D016326:Extracellular Matrix Proteins / Q000378:metabolism*; D005347:Fibroblasts / Q000166:cytology / Q000187:drug effects / Q000378:metabolism*; D005682:Gadolinium / Q000008:administration & dosage*; D006801:Humans; D015603:Keratinocytes / Q000166:cytology / Q000187:drug effects / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D009924:Organ Culture Techniques; D012867:Skin / Q000166:cytology / Q000187:drug effects / Q000378:metabolism*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D016326:Extracellular Matrix Proteins; D005682:Gadolinium