In vitro Effects of Gadoteric Acid and Iobitridol Toxicity and Platelet-Rich Plasma-Mediated Protection in Human Annulus Fibrosus and Nucleus Pulposus Cells.

STUDY

DESIGN

Laboratory study.

OBJECTIVE

Intervertebral disc (IVD) degeneration, a major cause of chronic low back pain characterized by reduced viability of Annulus Fibrosus (AF) and Nucleus Pulposus (AP) cells, can be treated with platelet-rich plasma (PRP), although confirming needle placement with radiopaque contrast, commonly used for this purpose, may negatively affect cellular viability. The objective of this study was to evaluate the cytotoxic effects of gadoteric acid (GA) and iobitridol (IB), commonly used contrast agents, and the protective potential of two PRP formulations: standard PRP (sPRP) and balanced protein-concentrate plasma (BPCP).

METHODS

AF and NP cells were exposed to varying concentrations of GA and IB (0-100% v/v) for 1 and 2 hours, with or without 10% (v/v) PRP supplementation. PRP from five donors was pooled (n=1), and experiments were performed in technical triplicates (n=3). Cell viability was measured by luminescence-based RealTimeGlo MT assay. The difference among the groups was analysed and multivariable regression was performed.

RESULTS

Both contrast agents appeared to exert dose- and time-dependent cytotoxicity. PRP was associated with improved cell viability, with BPCP appearing to provide increased viability under exposure to higher contrast concentrations. Multivariate regression analyses indicated that contrast concentration, exposure time, and PRP type were key determinants of cell viability.

CONCLUSION

These findings appear to underline the importance of minimizing contrast agent exposure during IVD procedures and suggest that PRP formulations, particularly BPCP, may provide improved cell viability against contrast-induced cytotoxicity. Future in vitro and in vivo studies will be needed to further validate these results and assess their clinical applicability.