Stanford Synchrotron Radiation Lightsource An Office of Science User Facility

Figure 1. Light and synchrotron x-ray fluorescence (SXRF) microscopy images of the skin tissue showing element distribution.

Nephrogenic systemic fibrosis, or NSF, is a relatively new disease in which the skin becomes hardened, joint movement becomes difficult and, in extreme cases, an excessive and sometimes fatal fibrosis tissue forms around organs. So far, NSF has only been observed in patients with kidney dysfunction who have undergone an MRI that required the injection of gadolinium-based contrast agents (GBCAs). Researchers speculate that the patient's kidneys cannot break down the gadolinium, causing NSF, but until now there has been no direct evidence for such a link.

To determine whether a causal relationship exists between contrast agents and NSF, a team of researchers recently studied the gadolinium deposits in a skin sample from a patient with NSF using SSRL's microXAS imaging facility on Beam Line 2-3. The researchers were able to see not only that the sample contained small gadolinium deposits-as previous studies had also shown-but also that the gadolinium ion deposits were chemically different from those originally injected as contrast agents. This first direct evidence for the chemical release of gadolinium from GBCA in human tissue suggests that the ions were released from the original, biologically inaccessible form included in the contrast agent, which in turn suggests that the original contrast agent is breaking down in unintended ways. This implies a causal link between the contrast agents and NSF, knowledge that may help chemists and physicians better treat patients with NSF.

This work was published in the November 2010 edition of the British Journal of Dermatology.