title: Impact of short-duration administration of N-acetylcysteine, probucol and ascorbic acid on contrast-induced cytotoxicity.
abstract: BACKGROUND
  The best pharmaceutical prevention of contrast-medium-induced nephropathy for emergency procedures remains unknown. The aim of this study was to examine the impact of short-duration antioxidant pretreatment on contrast-medium-induced cytotoxicity.
  
  
  METHODS
  Human embryonic kidney cells were treated with three different contrast media: ionic ioxitalamate, non-ionic low-osmolar iopromide, and iso-osmolar iodixanol. The doses and durations of pretreatment with antioxidants were 2 mM/L N-acetylcysteine for 15 minutes, 40 µM/L probucol for 30 minutes, and 30 µM/L ascorbic acid for 30 minutes. A supplementary dose of 2 mM/L N-acetylcysteine was administered 12 hours after contrast medium treatment. Cell viability was determined by tetrazolium MTT assay.
  
  
  RESULTS
  All three contrast media caused significant reduction of cell viability at 24 hours (p<0.001). In the groups receiving iopromide or iodixanol, N-acetylcysteine pretreatment significantly improved cell viability compared with no N-acetylcysteine pretreatment (p<0.001). In the group receiving ioxitalamate, N-acetylcysteine pretreatment followed by a supplementary dose of N-acetylcysteine at 12 hours rather than N-acetylcysteine pretreatment alone significantly improved cell viability compared with no N-acetylcysteine pretreatment (p=0.038). Probucol or ascorbic acid pretreatment was unable to reduce cell death caused by the three contrast media.
  
  
  CONCLUSIONS
  Short-duration pretreatment with N-acetylcysteine significantly reduced contrast-medium-induced cytotoxicity. These findings provide new insight into the prevention of contrast-medium-induced nephropathy in clinical emergency scenarios.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiungm, Taiwan, R.O.C.
authors.forename: Hsiang-Chun
authors.initials: HC
authors.lastname: Lee
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
authors.forename: I-Hsin
authors.initials: IH
authors.lastname: Liu
authors.forename: Chien-Chih
authors.initials: CC
authors.lastname: Lee
authors.forename: Chong-Chao
authors.initials: CC
authors.lastname: Hsieh
authors.forename: Hsueh-Wei
authors.initials: HW
authors.lastname: Yen
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Jan-Gowth
authors.initials: JG
authors.lastname: Chang
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology; D000704:Analysis of Variance; D000975:Antioxidants / Q000494:pharmacology*; D017209:Apoptosis / Q000187:drug effects; D001205:Ascorbic Acid / Q000494:pharmacology; D002470:Cell Survival / Q000187:drug effects*; D002478:Cells, Cultured; D003287:Contrast Media / Q000009:adverse effects*; D016166:Free Radical Scavengers / Q000494:pharmacology*; D006801:Humans; D007472:Iohexol / Q000009:adverse effects / Q000031:analogs & derivatives; D007483:Iothalamic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D007668:Kidney / Q000166:cytology / Q000187:drug effects*; D011341:Probucol / Q000494:pharmacology; D013997:Time Factors; D014283:Triiodobenzoic Acids / Q000009:adverse effects
chemical_list: D000975:Antioxidants; D003287:Contrast Media; D016166:Free Radical Scavengers; D014283:Triiodobenzoic Acids; D007483:Iothalamic Acid; D007472:Iohexol; C038192:iopromide; C002587:ioxitalamic acid; C044834:iodixanol; D011341:Probucol; D001205:Ascorbic Acid; D000111:Acetylcysteine