Cause of Rare Fibrosis Suggested

Scott Kappes

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Researchers from Wake Forest University have suggested a reason why some people with advanced renal failure develop Nephrogenic Systemic Fibrosis (NSF). Before now there has been no explanation for the rare skin condition characterized by tightening and swelling of skin and in some cases internal tissue and organs. There has been a previous link established between gadolinium based contrast agents used to enhance the image of an MRI and the development of the debilitating disease. Today scientists believe that they may understand why this happens.

The prevention and treatment of NSF may lie with the enzyme known as transglutaminase-2 (TG2). This is an enzyme that can be found throughout the body and is used in wound healing and blood clotting. After obtaining biopsies from five NSF patients and three healthy patients, the scientists noticed an elevated presence of TG2 was visible in the NSF patients. The researchers speculate that the gadolinium present in some MRI dye may activate the TG2 and cause NSF.

"Our research is a pilot study, but we believe the results warrant further research into the use of TG-2 inhibitors in the treatment and prevention of NSF," said Gil Yosipovitch, M.D., co-senior researcher, and a dermatologist. "Solving this puzzle might allow dialysis patients to take full advantage of the diagnostic capabilities of MRI."

The study will be posted in the October issue off the American Journal of Dermatopathogoly.

For more information on this subject, please refer to the section on Drugs, Medical Devices, and Implants.