Effects Of X-ray Contrast Media Research Articles

Ionic and non-ionic intravenous X-ray contrast media: antibacterial agents?

X-ray contrast media have been reported to have inhibitory effects on bacterial growth. Despite its potentially beneficial effect on patients, these features of contrast media have received relatively little attention in the medical literature in the past decades. The aim of this review is to evaluate the literature concerning the bactericidal and bacteriostatic effects of X-ray contrast media, specifically if there is a known difference concerning these effects between ionic and non-ionic contrast media. Systematic literature review was performed for the years of publication between 1911 and 2019. Since the publication of Grossich in 1911, the effect of iodine on the treatment of superficial infections in surgical procedures has been established clinical knowledge. Bacteriostatic and bactericidal effects of ionic X-ray contrast media are well established. However, non-ionic contrast agents have been the subject of little research in this respect. In past decades, the hypothesis emerged in the literature that mainly the concentration of free iodine might be responsible for any bacteriostatic or bactericidal effect of ionic X-ray contrast media. Nowadays, however, only non-ionic contrast media are used. The question regarding the mechanism and magnitude of bacteriostatic or bactericidal effects of these, non-ionic contrast media, could not be answered conclusively from this review. Non-ionic contrast media could be used intentionally when a local antibacterial effect is intended (e.g. in percutaneous abscess drainage), as well as to reduce the overall dose of antibiotics administered to a patient. Thus, this question remains relevant and might constitute the area of future research.

Nephrotoxic effects of X-ray contrast media.

The annual sale of x-ray contrast media (CM) now represents 60 million doses, and contrast nephropathy (CN) has been the third-leading cause of hospital-acquired acute renal failure. In this review article, physicochemical, pharmacokinetic, and pharmacodynamic properties of CM are surveyed. The definition of CN is presented, as well as the mechanisms involved in the pathogenesis. Low osmolar monomeric CM (LOCM) are less nephrotoxic than the older ionic high osmolar CM (HOCM), but in risk patients the incidence of CN is still high after intravascular administration of LOCM. Non-ionic dimeric CM are iso-osmolar to plasma (IOCM), and they have reduced the nephrotoxicity even more than LOCM. The most important risk factors for CN are diabetes mellitus and impaired renal function. Selection of patients, hydration, and type of CM are essential for prevention and prophylaxis of CN. We do not recommend routine prophylaxis with N-acetylcysteine (NAC) during CM investigations, but its use in high-risk patients should be considered.

Comparative cytotoxicity of low-osmolar nonionic and high-osmolar ionic contrast media to dog gallbladder epithelial cells

Background: Most studies of the adverse effects of x-ray contrast media used in ERCP have focused on post-ERCP pancreatitis. However, the biliary epithelial cells are also exposed to contrast media during ERCP and acute cholangitis is also a serious complication of ERCP. The present study compared the cytotoxicity with gallbladder epithelial cells of ionic and nonionic contrast agents. Methods: A high-osmolar ionic contrast agent (meglumine ioxithalamate) and a low-osmolar nonionic contrast agent (iopromide) were tested. Monolayer cell cultures of dog gallbladder epithelial cells were used. The cells were exposed to the 2 contrast agents with increasing iodine concentration and osmolality for 2 days. Cell number, S-phase fraction, aneuploidy, and supernatant LDH activities were measured each day. Results: Cell growth was more severely inhibited by ioxithalamate than iopromide (p < 0.05) and strongly dependent on the osmolality of contrast agent. The cytostatic effect estimated by S-phase fraction was more pronounced for ioxithalamate. Chromosomal damage determined by aneuploidy was more frequently detected with ioxithalamate. Conclusions: High-osmolar ionic contrast media are more cytotoxic than low-osmolar nonionic contrast media to gallbladder epithelial cells. Animal and clinical studies are needed to estimate the clinical implications of these findings. (Gastrointest Endosc 2002;55:382-6.)

Effect of X-Ray Contrast Media on Blood Flow Properties after Coronary Angiography

In vitro studies suggest that ionic and nonionic X-ray contrast media have different effects on rheological parameters. The risk of thrombotic complications in coronary interventions was reported to be lower using ionic contrast media. The aim of the present study was to compare the effects of different types of contrast media on rheological parameters after coronary angiography. Sixty patients were randomized to four groups: ioxaglate 320 (dimeric, ionic, n=18), iomeprol 400 (monomeric, nonionic, n=12), iobitridol 350 (monomeric, nonionic, n=12), and iodixanol 320 (dimeric, nonionic, n=18). Blood samples were collected via the side port of the arterial sheath immediately before and at the end of coronary angiography. In our study, all types of contrast media caused a significant decrease in haematocrit (Hct), plasma viscosity (PV), erythrocyte aggregation (EA), and in the platelet reactivity index (PRI). The most pronounced decrease in Hct was found using the ionic dimer ioxaglate. There were no significant differences between the contrast media with respect to their effects on PV, EA, and PRI.

Effects of X-ray contrast media and radiation on human vascular endothelial cellsin vitro

We have used cell culture techniques to study the effects of 16 contrast agents on human vascular endothelial cells (HUVEC) in vitro, where both the dose and duration of exposure are precisely known. Our results demonstrate that 1) exposure of HUVEC to radiographic contrast media can produce dose and time-dependent inhibition of the incorporation of [3H]leucine, [3H]thymidine, or [3H]uridine into macromolecules; 2) thymidine incorporation is the most affected; 3) the inhibition is not primarily due to osmotic effects; and 4) concomitant exposure to X-irradiation does not sensitize HUVEC to contrast agents. Where marked inhibition occurred, it was accompanied by changes in cell morphology and later, by loss of the cytoplasmic marker lactate dehydrogenase, indicating that under the conditions of our experiments the effects were cytotoxic, and not merely cytostatic.

Effect of X-ray contrast media on human red cell deformation

Effect of X-ray contrast media on human red cell deformation

Induction of mitotic micronuclei by X-ray contrast media in human peripheral lymphocytes

In vitro and in vivo cytogenetic effects of X-ray contrast media (CM) were determined by scoring micronuclei (MN) in 72-h cultures of human peripheral lymphocytes. Both ionic (sodium meglumine diatrizoate, methylglucamine diatrizoate, and sodium meglumine ioxaglate and nonionic CM (iosimide, iopromide, iohexol and iotrolan) were able to induce MN in lymphocytes. Based upon their calculated percent probabilities for MN induction, these agents could be ranked in their decreasing order of probability, as iosimide > sodium meglumine ioxaglate > iohexol > sodium meglumine diatrizoate > iopromide > methylglucamine diatrizoate > iotrolan. Stepwise logistic regression analysis of the data indicated that the frequency of MN in CM-exposed lymphocyte cultures was significantly higher than the frequency of MN in control cultures ( P < 0.001). In clinical studies where 14 patients were injected with an ionic CM methylglucamine diatrizoate, lymphocyte cultures from 10 patients showed higher frequencies of MN. The differences between pre- and post-CM counts of MN were significant in a Mann-Whitney U test ( P < 0.05). The effect of X-irradiation on MN formation in lymphocytes was separately determined and was found to be insignificant. These results indicate that irrespective of ionic and osmolality differences, X-ray contrast agents are capable of producing chromosomal damage in peripheral lymphocytes. Further studies are required to establish molecular mechanisms in the observed cytogenetic effects of CM in cell cultures.

Effect of X-ray contrast media on the action of chymopapain on the intervertebral disc: an in vitro study of cartilage degradation.

A representative selection of X-ray contrast media was tested for their effects on the action of chymopapain on cartilage proteoglycan in an in-vitro test system. Inhibition of the action of chymopapain was detected only at high concentrations of contrast media, and was more marked with ionic contrast media than with non-ionic media. A dose-response curve for the release of glycosaminoglycan by chymopapain was linear when the amount of enzyme was plotted on a logarithmic scale against glycosaminoglycan release. In view of our results, we suggest that there is no need for a delay between injection of contrast medium and enzyme, contrary to the instructions of the distributors of chymopapain, if small amounts of a non-ionic contrast medium are used.

Effect of x-ray contrast media on results for relative density of urine.

Effect of x-ray contrast media on results for relative density of urine.

Thyroid hormones in serum: effects of x-ray contrast media.

Serial changes in circulating thyroid hormones following the use of iodine containing x-ray contrast media have been monitored in 31 euthyroid subjects, 11 of whom were goitrous. All subjects remained clinically euthyroid for the duration of the study. Significant changes in serum concentrations of thyroid hormones were apparent. There was a striking early (3 day) rise in serum reverse triiodothyronine paralleled by a fall in triiodothyronine and a later (21 day) rise in serum triiodothyronine. In goitrous subjects, serum thyroxine was also significantly higher than basal at 21 days. Individual values outside the normal range were frequently found. The pattern of change is best explained by an iodine induced alteration in thyroxine monodeiodination by peripheral tissues. Thyroid function tests should be interpreted with caution in patients who have received x-ray contrast media in the preceding month.