The In Vitro Activation of Complement by Radiologic Contrast Materials and its Inhibition with ??-Aminocaproic Acid

Neoh, S. H.; Mr, Sage; Rb, Willis; Roberts‐Thomson, Peter; Bradley, J. Andrew

doi:10.1097/00004424-198103000-00014

Cited by 27 publications

(5 citation statements)

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“…Activation of factor XII, the complement system, and fibrinolysis has been reported after CM injection in several studies (5,10,20,22,24,28). Accelerated conversion of prekallikrein to kallikrein in reactors to CM has been re ported as well (4,21).…”

mentioning

confidence: 91%

Level of Plasma Prekallikrein and its Inhibitors in Reactors and Nonreactors during Intravenous Enhancement with Contrast Media

Aronen

Kivisaari²,

Torstila³

et al. 1992

Acta Radiol

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Complex contact activation systems may play a major role in the side effects of i.v. contrast media (CM). This is why quantitative measurements of several factors (plasma prekallikrein, hematocrit (hct), α-2-macroglobulin, α-1-antitrypsin, and Cl-esterase inhibitor) were determined prior to and following the injection of CM during body CT examination in 5 patient groups, each (n=10) receiving one of 5 different CM, including ioxaglate, meglumine iodamide, metrizamide, iohexol, and meglumine diatrizoate. The initial plasma prekallikrein level was available from 45 patients and was statis tically lower in reactors (mean 90.6 μιηοΐ TAMe/ml/h; n= 13) than in nonreactors (mean 107 μπιοΐ TAMe/ml/h; n = 32) (p = 0.006), but there was no statistically significant difference in the decrease of plasma prekallikrein before and at 5 min after the injection for those 2 groups. The initial plasma Cl-esterase inhibitor level was lower in reactors, while the plasma α-2-macroglobulin level was higher in that group than in nonreactors. The results indicate that the measurement of plasma prekallikrein combined with plasma Cl-esterase inhibitor and α-2-macroglobulin measurement could be useful when predicting which patients are prone to CM reactions.

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mentioning

confidence: 91%

Level of Plasma Prekallikrein and its Inhibitors in Reactors and Nonreactors during Intravenous Enhancement with Contrast Media

Aronen

Kivisaari²,

Torstila³

et al. 1992

Acta Radiol

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“…Till et al [10] used ioglycamate at a concentration which result ed in total consumption of hemolytic complement ac tivity, and showed the disappearance of /flA antigen (C3c) precipitation line in Ouchterlony double diffu sion, accompanied by a substantial generation of «2D antigen (C3d). In a recent study on iodipamide, Neoh et al [15] described the appearance of breakdown products of C3, C4 and B, quantitated by two dimen sional Laurell crossed electrophoresis. No details Table II were given concerning the pattern of electrophoresis for any protein; moreover, only indirect evidence of the appearance of breakdown products was provided, since it was deduced from the decrease in protein lev els in Laurell electrophoresis [23].…”

Section: Discussionmentioning

confidence: 99%

“…In humans, Arroyave et al [7] showed a significant drop in CH50 after RCM infusion in vivo in 5 out of 9 patients, which was confirmed by an in vitro study [8]. These effects were observed with all RCM tested, i.e., diatrizoate, iothalamate, iodipamide, metrizoate, and ioglycamate [5,[9][10][11][12][13][14][15] in both humans and animals; moreover, loss of total hemolytic activity was found regardless of the buffer used (EDTA/EGTA) and in the absence or presence of immunoglobulins, proper din or C2 [10,11], The involvement of a nonsequen tial activation pathway was therefore suggested [3].…”

Section: Introductionmentioning

confidence: 87%

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Absence of Complement Activation in vitro by Sodium Meglumine Ioxitalamate

Freyria

Billet

Eloy

et al. 1983

Int Arch Allergy Immunol

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The effect of radiographic contrast media on proteins of the complement system in vitro was investigated using protein level measurement and crossed immunoelectrophoresis. Despite the 20% loss of total serum hemolytic activity (CH50) induced by sodium meglumine ioxitalamate (0.5 M), no significant changes in C3c, C3N or B were detected by radial immunodiffusion. These contrast media did not cause electrophoretic conversion of C3, as assessed by the absence of split product, and the small degree of spontaneous C3 conversion (loss of 20% C3N antigen and the presence of two peaks with C3c antigen) which occurred when serum was incubated in polypropylene tubes, was inhibited by the contrast media. The effects of sodium meglumine ioxitalamate and zymosan in vitro on complement activation were compared.

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“…Exposure to contrast media results in direct release of vasoactive mediator substances such as histamine, or activation of the kallikrein-kinin complement of the coagulation system or of Hageman's factor XII; in addition, pulmonary angiotensin converting enzyme is inhibited (Lasser 1981(Lasser , 1987Lasser et al 1974;Moreau et al 1988;Neoh 1981;Ring & Rothenberger 1984).…”

Section: Allergic and Pseudoallergic Reactionsmentioning

confidence: 99%

The Adverse Effects of Angiographic Radiocontrast Media

1991

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Radiographic procedures which require the intravascular administration of water-soluble radiocontrast media are performed with increasing frequency. Each examination carries risks that are related either to the technique itself or to the opaque medium chosen. The pathogenesis of radiocontrast media-related adverse effects cannot be explained by a unique theory. The major factors implicated are direct chemotoxic effects and the physicochemical properties of contrast media, the latter being the basis for development of new contrast agents. With nonionic opaque media cardiovascular adverse effects, heat sensation and local pain are observed less frequently. However, it remains unclear whether the incidence of organ dysfunction or anaphylactic reactions with nonionic contrast media currently used can be reduced. This review compares ionic and nonionic contrast media, and current thoughts on the pathophysiology and treatment of adverse reactions are presented.

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The In Vitro Activation of Complement by Radiologic Contrast Materials and its Inhibition with ??-Aminocaproic Acid

Cited by 27 publications

References 0 publications

Level of Plasma Prekallikrein and its Inhibitors in Reactors and Nonreactors during Intravenous Enhancement with Contrast Media

Level of Plasma Prekallikrein and its Inhibitors in Reactors and Nonreactors during Intravenous Enhancement with Contrast Media

Absence of Complement Activation in vitro by Sodium Meglumine Ioxitalamate

The Adverse Effects of Angiographic Radiocontrast Media

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