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Williams BB, Tebbutt NC, Buchert M, Putoczki TL, Doggett K, Bao S, Johnstone CN, Masson F, Hollande F, Burgess AW, Scott AM, Ernst M, Heath JK. Glycoprotein A33 deficiency: a new mouse model of impaired intestinal epithelial barrier function and inflammatory disease. Dis Model Mech 2015; 8:805-15. [PMID: 26035389 PMCID: PMC4527289 DOI: 10.1242/dmm.019935] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 05/05/2015] [Indexed: 12/20/2022] Open
Abstract
The cells of the intestinal epithelium provide a selectively permeable barrier between the external environment and internal tissues. The integrity of this barrier is maintained by tight junctions, specialised cell-cell contacts that permit the absorption of water and nutrients while excluding microbes, toxins and dietary antigens. Impairment of intestinal barrier function contributes to multiple gastrointestinal disorders, including food hypersensitivity, inflammatory bowel disease (IBD) and colitis-associated cancer (CAC). Glycoprotein A33 (GPA33) is an intestinal epithelium-specific cell surface marker and member of the CTX group of transmembrane proteins. Roles in cell-cell adhesion have been demonstrated for multiple CTX family members, suggesting a similar function for GPA33 within the gastrointestinal tract. To test a potential requirement for GPA33 in intestinal barrier function, we generated Gpa33−/− mice and subjected them to experimental regimens designed to produce food hypersensitivity, colitis and CAC. Gpa33−/− mice exhibited impaired intestinal barrier function. This was shown by elevated steady-state immunosurveillance in the colonic mucosa and leakiness to oral TRITC-labelled dextran after short-term exposure to dextran sodium sulphate (DSS) to injure the intestinal epithelium. Gpa33−/− mice also exhibited rapid onset and reduced resolution of DSS-induced colitis, and a striking increase in the number of colitis-associated tumours produced by treatment with the colon-specific mutagen azoxymethane (AOM) followed by two cycles of DSS. In contrast, Gpa33−/− mice treated with AOM alone showed no increase in sporadic tumour formation, indicating that their increased tumour susceptibility is dependent on inflammatory stimuli. Finally, Gpa33−/− mice displayed hypersensitivity to food allergens, a common co-morbidity in humans with IBD. We propose that Gpa33−/− mice provide a valuable model to study the mechanisms linking intestinal permeability and multiple inflammatory pathologies. Moreover, this model could facilitate preclinical studies aimed at identifying drugs that restore barrier function. Highlighted Article: We show that GPA33, an intestine-specific cell surface protein, plays a role in the maintenance of intestinal barrier function and the prevention of intestinal pathologies such as food hypersensitivity, inflammatory bowel disease and colitis-associated cancer.
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Rychert KM, Zhu G, Kmiec MM, Nemani VK, Williams BB, Flood AB, Swartz HM, Gimi B. Imaging tooth enamel using zero echo time (ZTE) magnetic resonance imaging. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2015; 9417:94171I. [PMID: 25914509 PMCID: PMC4405678 DOI: 10.1117/12.2083995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In an event where many thousands of people may have been exposed to levels of radiation that are sufficient to cause the acute radiation syndrome, we need technology that can estimate the absorbed dose on an individual basis for triage and meaningful medical decision making. Such dose estimates may be achieved using in vivo electron paramagnetic resonance (EPR) tooth biodosimetry, which measures the number of persistent free radicals that are generated in tooth enamel following irradiation. However, the accuracy of dose estimates may be impacted by individual variations in teeth, especially the amount and distribution of enamel in the inhomogeneous sensitive volume of the resonator used to detect the radicals. In order to study the relationship between interpersonal variations in enamel and EPR-based dose estimates, it is desirable to estimate these parameters nondestructively and without adding radiation to the teeth. Magnetic Resonance Imaging (MRI) is capable of acquiring structural and biochemical information without imparting additional radiation, which may be beneficial for many EPR dosimetry studies. However, the extremely short T2 relaxation time in tooth structures precludes tooth imaging using conventional MRI methods. Therefore, we used zero echo time (ZTE) MRI to image teeth ex vivo to assess enamel volumes and spatial distributions. Using these data in combination with the data on the distribution of the transverse radio frequency magnetic field from electromagnetic simulations, we then can identify possible sources of variations in radiation-induced signals detectable by EPR. Unlike conventional MRI, ZTE applies spatial encoding gradients during the RF excitation pulse, thereby facilitating signal acquisition almost immediately after excitation, minimizing signal loss from short T2 relaxation times. ZTE successfully provided volumetric measures of tooth enamel that may be related to variations that impact EPR dosimetry and facilitate the development of analytical procedures for individual dose estimates.
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Meaney PM, Williams BB, Geimer SD, Flood AB, Swartz HM. A Coaxial Dielectric Probe Technique for Distinguishing Tooth Enamel from Dental Resin. ACTA ACUST UNITED AC 2015; 3:8-17. [PMID: 27182531 DOI: 10.14355/aber.2015.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
For purposes of biodosimetry in the event of a large scale radiation disaster, one major and very promising point-of contact device is assessing dose using tooth enamel. This technique utilizes the capabilities of electron paramagnetic resonance to measure free radicals and other unpaired electron species, and the fact that the deposition of energy from ionizing radiation produces free radicals in most materials. An important stipulation for this strategy is that the measurements, need to be performed on a central incisor that is basically intact, i.e. which has an area of enamel surface that is as large as the probing tip of the resonator that is without decay or restorative care that replaces the enamel. Therefore, an important consideration is how to quickly assess whether the tooth has sufficient enamel to be measured for dose and whether there is resin present on the tooth being measured and to be able to characterize the amount of surface that is impacted. While there is a relatively small commercially available dielectric probe which could be used in this context, it has several disadvantages for the intended use. Therefore, a smaller, 1.19mm diameter 50 ohm, open-ended, coaxial dielectric probe has been developed as an alternative. The performance of the custom probe was validated against measurement results of known standards. Measurements were taken of multiple teeth enamel and dental resin samples using both probes. While the probe contact with the teeth samples was imperfect and added to measurement variability, the inherent dielectric contrast between the enamel and resin was sufficient that the probe measurements could be used as a robust means of distinguishing the two material types. The smaller diameter probe produced markedly more definitive results in terms of distinguishing the two materials.
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Flood AB, Boyle HK, Du G, Demidenko E, Nicolalde RJ, Williams BB, Swartz HM. Advances in a framework to compare bio-dosimetry methods for triage in large-scale radiation events. RADIATION PROTECTION DOSIMETRY 2014; 159:77-86. [PMID: 24729594 PMCID: PMC4067227 DOI: 10.1093/rpd/ncu120] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Planning and preparation for a large-scale nuclear event would be advanced by assessing the applicability of potentially available bio-dosimetry methods. Using an updated comparative framework the performance of six bio-dosimetry methods was compared for five different population sizes (100-1,000,000) and two rates for initiating processing of the marker (15 or 15,000 people per hour) with four additional time windows. These updated factors are extrinsic to the bio-dosimetry methods themselves but have direct effects on each method's ability to begin processing individuals and the size of the population that can be accommodated. The results indicate that increased population size, along with severely compromised infrastructure, increases the time needed to triage, which decreases the usefulness of many time intensive dosimetry methods. This framework and model for evaluating bio-dosimetry provides important information for policy-makers and response planners to facilitate evaluation of each method and should advance coordination of these methods into effective triage plans.
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Sugawara H, Hirata H, Petryakov S, Lesniewski P, Williams BB, Flood AB, Swartz HM. Design and Evaluation of a 1.1-GHz Surface Coil Resonator for Electron Paramagnetic Resonance-Based Tooth Dosimetry. IEEE Trans Biomed Eng 2014; 61:1894-901. [DOI: 10.1109/tbme.2014.2310217] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Swartz HM, Flood AB, Williams BB, Meineke V, Dörr H. Comparison of the needs for biodosimetry for large-scale radiation events for military versus civilian populations. HEALTH PHYSICS 2014; 106:755-763. [PMID: 24776910 DOI: 10.1097/hp.0000000000000069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this paper is to compare and contrast the needs for biodosimetry for initial triage for military forces and civilian populations when there are radiation exposures that involve potentially a large number of persons. Several differences in the likely scenarios for exposure of military forces include a greater likelihood of having higher rates of significant exposures, inhomogeneous exposures, significant doses from neutrons, and combined injury. Measurements will be able to begin sooner than for exposures in civilian settings because medical facilities usually are an integral part of the way military forces are deployed. It also will be very feasible to have personnel that will be trained and equipped specifically for rapid deployment to assess dose. As a consequence, the most appropriate biodosimetry techniques will include features that are not present or are less important for civilian settings; i.e., the need for changes that become measureable very soon after the radiation is received, the ability to complete measurements in very close proximity to the subjects (so samples do not need to be transported out and results returned), increased capability of resolving homogeneity of the exposure, ability to be carried out in an injured person, capability of determining whether neutrons have made a significant contribution to dose, and the ability to rely on more sophisticated equipment and trained personnel to carry out the measurements at the point of care.
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Williams BB, Flood AB, Salikhov I, Kobayashi K, Dong R, Rychert K, Du G, Schreiber W, Swartz HM. In vivo EPR tooth dosimetry for triage after a radiation event involving large populations. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2014; 53:335-46. [PMID: 24711003 PMCID: PMC11064839 DOI: 10.1007/s00411-014-0534-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 02/27/2014] [Indexed: 05/26/2023]
Abstract
The management of radiation injuries following a catastrophic event where large numbers of people may have been exposed to life-threatening doses of ionizing radiation will rely critically on the availability and use of suitable biodosimetry methods. In vivo electron paramagnetic resonance (EPR) tooth dosimetry has a number of valuable and unique characteristics and capabilities that may help enable effective triage. We have produced a prototype of a deployable EPR tooth dosimeter and tested it in several in vitro and in vivo studies to characterize the performance and utility at the state of the art. This report focuses on recent advances in the technology, which strengthen the evidence that in vivo EPR tooth dosimetry can provide practical, accurate, and rapid measurements in the context of its intended use to help triage victims in the event of an improvised nuclear device. These advances provide evidence that the signal is stable, accurate to within 0.5 Gy, and can be successfully carried out in vivo. The stability over time of the radiation-induced EPR signal from whole teeth was measured to confirm its long-term stability and better characterize signal behavior in the hours following irradiation. Dosimetry measurements were taken for five pairs of natural human upper central incisors mounted within a simple anatomic mouth model that demonstrates the ability to achieve 0.5 Gy standard error of inverse dose prediction. An assessment of the use of intact upper incisors for dose estimation and screening was performed with volunteer subjects who have not been exposed to significant levels of ionizing radiation and patients who have undergone total body irradiation as part of bone marrow transplant procedures. Based on these and previous evaluations of the performance and use of the in vivo tooth dosimetry system, it is concluded that this system could be a very valuable resource to aid in the management of a massive radiological event.
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Swartz HM, Williams BB, Flood AB. Overview of the principles and practice of biodosimetry. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2014; 53:221-32. [PMID: 24519326 PMCID: PMC5982531 DOI: 10.1007/s00411-014-0522-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 02/02/2014] [Indexed: 05/05/2023]
Abstract
The principle of biodosimetry is to utilize changes induced in the individual by ionizing radiation to estimate the dose and, if possible, to predict or reflect the clinically relevant response, i.e., the biological consequences of the dose. Ideally, the changes should be specific for ionizing radiation, and the response should be unaffected by prior medical or physiological variations among subjects, including changes that might be caused by the stress and trauma from a radiation event. There are two basic types of biodosimetry with different and often complementary characteristics: those based on changes in biological parameters such as gene activation or chromosomal abnormalities and those based on physical changes in tissues (detected by techniques such as EPR). In this paper, we consider the applicability of the various techniques for different scenarios: small- and large-scale exposures to levels of radiation that could lead to the acute radiation syndrome and exposures with lower doses that do not need immediate care, but should be followed for evidence of long-term consequences. The development of biodosimetry has been especially stimulated by the needs after a large-scale event where it is essential to have a means to identify those individuals who would benefit from being brought into the medical care system. Analyses of the conventional methods officially recommended for responding to such events indicate that these methods are unlikely to achieve the results needed for timely triage of thousands of victims. Emerging biodosimetric methods can fill this critically important gap.
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Swartz HM, Williams BB, Jarvis LA, Zaki BI, Gladstone DJ. Repeated monitoring of tumor oxygen while breathing carbogen to determine the therapeutic potential of hyperoxic therapy. Pract Radiat Oncol 2014; 3:S23-4. [PMID: 24674520 DOI: 10.1016/j.prro.2013.01.084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Swartz HM, Williams BB, Zaki BI, Hartford AC, Jarvis LA, Chen EY, Comi RJ, Ernstoff MS, Hou H, Khan N, Swarts SG, Flood AB, Kuppusamy P. Clinical EPR: unique opportunities and some challenges. Acad Radiol 2014; 21:197-206. [PMID: 24439333 DOI: 10.1016/j.acra.2013.10.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/03/2013] [Accepted: 10/14/2013] [Indexed: 11/29/2022]
Abstract
Electron paramagnetic resonance (EPR) spectroscopy has been well established as a viable technique for measurement of free radicals and oxygen in biological systems, from in vitro cellular systems to in vivo small animal models of disease. However, the use of EPR in human subjects in the clinical setting, although attractive for a variety of important applications such as oxygen measurement, is challenged with several factors including the need for instrumentation customized for human subjects, probe, and regulatory constraints. This article describes the rationale and development of the first clinical EPR systems for two important clinical applications, namely, measurement of tissue oxygen (oximetry) and radiation dose (dosimetry) in humans. The clinical spectrometers operate at 1.2 GHz frequency and use surface-loop resonators capable of providing topical measurements up to 1 cm depth in tissues. Tissue pO2 measurements can be carried out noninvasively and repeatedly after placement of an oxygen-sensitive paramagnetic material (currently India ink) at the site of interest. Our EPR dosimetry system is capable of measuring radiation-induced free radicals in the tooth of irradiated human subjects to determine the exposure dose. These developments offer potential opportunities for clinical dosimetry and oximetry, which include guiding therapy for individual patients with tumors or vascular disease by monitoring of tissue oxygenation. Further work is in progress to translate this unique technology to routine clinical practice.
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Swartz HM, Hou H, Khan N, Jarvis LA, Chen EY, Williams BB, Kuppusamy P. Advances in probes and methods for clinical EPR oximetry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 812:73-79. [PMID: 24729217 DOI: 10.1007/978-1-4939-0620-8_10] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
EPR oximetry, which enables reliable, accurate, and repeated measurements of the partial pressure of oxygen in tissues, provides a unique opportunity to investigate the role of oxygen in the pathogenesis and treatment of several diseases including cancer, stroke, and heart failure. Building on significant advances in the in vivo application of EPR oximetry for small animal models of disease, we are developing suitable probes and instrumentation required for use in human subjects. Our laboratory has established the feasibility of clinical EPR oximetry in cancer patients using India ink, the only material presently approved for clinical use. We now are developing the next generation of probes, which are both superior in terms of oxygen sensitivity and biocompatibility including an excellent safety profile for use in humans. Further advances include the development of implantable oxygen sensors linked to an external coupling loop for measurements of deep-tissue oxygenations at any depth, overcoming the current limitation of 10 mm. This paper presents an overview of recent developments in our ability to make meaningful measurements of oxygen partial pressures in human subjects under clinical settings.
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Demidenko E, Williams BB, Flood AB, Swartz HM. Standard error of inverse prediction for dose-response relationship: approximate and exact statistical inference. Stat Med 2012; 32:2048-61. [PMID: 23124816 DOI: 10.1002/sim.5668] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 10/01/2012] [Indexed: 11/12/2022]
Abstract
This paper develops a new metric, the standard error of inverse prediction (SEIP), for a dose-response relationship (calibration curve) when dose is estimated from response via inverse regression. SEIP can be viewed as a generalization of the coefficient of variation to regression problem when x is predicted using y-value. We employ nonstandard statistical methods to treat the inverse prediction, which has an infinite mean and variance due to the presence of a normally distributed variable in the denominator. We develop confidence intervals and hypothesis testing for SEIP on the basis of the normal approximation and using the exact statistical inference based on the noncentral t-distribution. We derive the power functions for both approaches and test them via statistical simulations. The theoretical SEIP, as the ratio of the regression standard error to the slope, is viewed as reciprocal of the signal-to-noise ratio, a popular measure of signal processing. The SEIP, as a figure of merit for inverse prediction, can be used for comparison of calibration curves with different dependent variables and slopes. We illustrate our theory with electron paramagnetic resonance tooth dosimetry for a rapid estimation of the radiation dose received in the event of nuclear terrorism.
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Swartz HM, Flood AB, Williams BB, Dong R, Swarts SG, He X, Grinberg O, Sidabras J, Demidenko E, Gui J, Gladstone DJ, Jarvis LA, Kmiec MM, Kobayashi K, Lesniewski PN, Marsh SDP, Matthews TP, Nicolalde RJ, Pennington PM, Raynolds T, Salikhov I, Wilcox DE, Zaki BI. Electron paramagnetic resonance dosimetry for a large-scale radiation incident. HEALTH PHYSICS 2012; 103:255-67. [PMID: 22850230 PMCID: PMC3649772 DOI: 10.1097/hp.0b013e3182588d92] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
With possibilities for radiation terrorism and intensified concerns about nuclear accidents since the recent Fukushima Daiichi event, the potential exposure of large numbers of individuals to radiation that could lead to acute clinical effects has become a major concern. For the medical community to cope with such an event and avoid overwhelming the medical care system, it is essential to identify not only individuals who have received clinically significant exposures and need medical intervention but also those who do not need treatment. The ability of electron paramagnetic resonance to measure radiation-induced paramagnetic species, which persist in certain tissues (e.g., teeth, fingernails, toenails, bone, and hair), has led to this technique becoming a prominent method for screening significantly exposed individuals. Although the technical requirements needed to develop this method for effective application in a radiation event are daunting, remarkable progress has been made. In collaboration with General Electric and through funding committed by the Biomedical Advanced Research and Development Authority, electron paramagnetic resonance tooth dosimetry of the upper incisors is being developed to become a Food and Drug Administration-approved and manufacturable device designed to carry out triage for a threshold dose of 2 Gy. Significant progress has also been made in the development of electron paramagnetic resonance nail dosimetry based on measurements of nails in situ under point-of-care conditions, and in the near future this may become a second field-ready technique. Based on recent progress in measurements of nail clippings, it is anticipated that this technique may be implementable at remotely located laboratories to provide additional information when the measurements of dose on-site need to be supplemented. The authors conclude that electron paramagnetic resonance dosimetry is likely to be a useful part of triage for a large-scale radiation incident.
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Flood AB, Nicolalde RJ, Demidenko E, Williams BB, Shapiro A, Wiley AL, Swartz HM. A Framework for Comparative Evaluation of Dosimetric Methods to Triage a Large Population Following a Radiological Event. RADIAT MEAS 2011; 46:916-922. [PMID: 21949481 PMCID: PMC3178340 DOI: 10.1016/j.radmeas.2011.02.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND: To prepare for a possible major radiation disaster involving large numbers of potentially exposed people, it is important to be able to rapidly and accurately triage people for treatment or not, factoring in the likely conditions and available resources. To date, planners have had to create guidelines for triage based on methods for estimating dose that are clinically available and which use evidence extrapolated from unrelated conditions. Current guidelines consequently focus on measuring clinical symptoms (e.g., time-to-vomiting), which may not be subject to the same verification of standard methods and validation processes required for governmental approval processes of new and modified procedures. Biodosimeters under development have not yet been formally approved for this use. Neither set of methods has been tested in settings involving large-scale populations at risk for exposure. OBJECTIVE: To propose a framework for comparative evaluation of methods for such triage and to evaluate biodosimetric methods that are currently recommended and new methods as they are developed. METHODS: We adapt the NIH model of scientific evaluations and sciences needed for effective translational research to apply to biodosimetry for triaging very large populations following a radiation event. We detail criteria for translating basic science about dosimetry into effective multi-stage triage of large populations and illustrate it by analyzing 3 current guidelines and 3 advanced methods for biodosimetry. CONCLUSIONS: This framework for evaluating dosimetry in large populations is a useful technique to compare the strengths and weaknesses of different dosimetry methods. It can help policy-makers and planners not only to compare the methods' strengths and weaknesses for their intended use but also to develop an integrated approach to maximize their effectiveness. It also reveals weaknesses in methods that would benefit from further research and evaluation.
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Swartz HM, Williams BB, Nicolalde RJ, Demidenko E, Flood AB. Overview of biodosimetry for management of unplanned exposures to ionizing radiation. RADIAT MEAS 2011. [DOI: 10.1016/j.radmeas.2011.03.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Williams BB, Dong R, Nicolalde RJ, Matthews TP, Gladstone DJ, Demidenko E, Zaki BI, Salikhov IK, Lesniewski PN, Swartz HM. Physically-based biodosimetry using in vivo EPR of teeth in patients undergoing total body irradiation. Int J Radiat Biol 2011; 87:766-75. [PMID: 21696339 DOI: 10.3109/09553002.2011.583316] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE The ability to estimate individual exposures to radiation following a large attack or incident has been identified as a necessity for rational and effective emergency medical response. In vivo electron paramagnetic resonance (EPR) spectroscopy of tooth enamel has been developed to meet this need. MATERIALS AND METHODS A novel transportable EPR spectrometer, developed to facilitate tooth dosimetry in an emergency response setting, was used to measure upper incisors in a model system, in unirradiated subjects, and in patients who had received total body doses of 2 Gy. RESULTS A linear dose response was observed in the model system. A statistically significant increase in the intensity of the radiation-induced EPR signal was observed in irradiated versus unirradiated subjects, with an estimated standard error of dose prediction of 0.9 ± 0.3 Gy. CONCLUSIONS These results demonstrate the current ability of in vivo EPR tooth dosimetry to distinguish between subjects who have not been irradiated and those who have received exposures that place them at risk for acute radiation syndrome. Procedural and technical developments to further increase the precision of dose estimation and ensure reliable operation in the emergency setting are underway. With these developments EPR tooth dosimetry is likely to be a valuable resource for triage following potential radiation exposure of a large population.
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Nicolalde RJ, Gougelet RM, Rea M, Williams BB, Dong R, Kmiec MM, Lesniewski PN, Swartz HM. The view from the trenches: part 2-technical considerations for EPR screening. HEALTH PHYSICS 2010; 98:128-35. [PMID: 20065674 PMCID: PMC4086326 DOI: 10.1097/01.hp.0000348461.00071.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
There is growing awareness of the need for methodologies that can be used retrospectively to provide the biodosimetry needed to carry out screening and triage immediately after an event in which large numbers of people have potentially received clinically significant doses of ionizing radiation. The general approach to developing such methodologies has been a technology centric one, often ignoring the system integrations considerations that are key to their effective use. In this study an integrative approach for the evaluation and development of a physical biodosimetry technology was applied based on in vivo electron paramagnetic resonance (EPR) dosimetry. The EPR measurements are based on physical changes in tissues whose magnitudes are not affected by the factors that can confound biologically-based assessments. In this study the use of a pilot simulation exercise to evaluate an experimental EPR system and gather stakeholders' feedback early on in the development process is described. The exercise involved: ten non-irradiated participants, representatives from a local fire department; Department of Homeland Security certified exercise evaluators, EPR experts, physicians; and a human factors engineer. Stakeholders were in agreement that the EPR technology in its current state of development could be deployed for the screening of mass casualties. Furthermore, stakeholders' recommendations will be prioritized and incorporated in future developments of the EPR technique. While the results of this exercise were aimed specifically at providing feedback for the development of EPR dosimetry for screening mass casualties, the methods and lessons learned are likely to be applicable to other biodosimetric methods.
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Wilcox DE, He X, Gui J, Ruuge AE, Li H, Williams BB, Swartz HM. Dosimetry based on EPR spectral analysis of fingernail clippings. HEALTH PHYSICS 2010; 98:309-17. [PMID: 20065699 PMCID: PMC2818093 DOI: 10.1097/hp.0b013e3181b27502] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Exposure of fingernails and toenails to ionizing radiation creates radicals that are stable over a relatively long period (days to weeks) and characterized by an isotropic EPR signal at g = 2.003 (so-called radiation-induced signal, RIS). This signal in readily obtained fingernail parings has the potential to be used in screening a population for exposure to radiation and determining individual dose to guide medical treatment. However, the mechanical harvesting of fingernail parings also creates radicals, and their EPR signals (so-called mechanically-induced signals, MIS) overlap the g approximately 2.0 region, interfering with efforts to quantify the RIS and, therefore, the radiation dose. Careful analysis of the time evolution and power-dependence of the EPR spectra of freshly cut fingernail parings has now resolved the MIS into three major components, including one that is described for the first time. It dominates the MIS soon after cutting, but decays within the first hour and consists of a unique doublet that can be resolved from the RIS. The MIS obtained within the first few minutes after cutting is consistent among fingernail samples and provides an opportunity to achieve the two important dosimetry objectives. First, perturbation of the initial MIS by the presence of RIS in fingernails that have received a threshold dose of radiation leads to spectral signatures that can be used for rapid screening. Second, decomposition of the EPR spectra from irradiated fingernails into MIS and RIS components can be used to isolate and thus quantify the RIS for determining individual exposure dose.
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Williams BB, Dong R, Kmiec M, Burke G, Demidenko E, Gladstone D, Nicolalde RJ, Sucheta A, Lesniewski P, Swartz HM. Development of in vivo tooth EPR for individual radiation dose estimation and screening. HEALTH PHYSICS 2010; 98:327-38. [PMID: 20065702 PMCID: PMC2821193 DOI: 10.1097/hp.0b013e3181a6de5d] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The development of in vivo EPR has made it feasible to perform tooth dosimetry measurements in situ, greatly expanding the potential for using this approach for immediate screening after radiation exposures. The ability of in vivo tooth dosimetry to provide estimates of absorbed dose has been established through a series of experiments using unirradiated volunteers with specifically irradiated molar teeth placed in situ within gaps in their dentition and in natural canine teeth of patients who have completed courses of radiation therapy for head and neck cancers. Multiple measurements in patients who have received radiation therapy demonstrate the expected heterogeneous dose distributions. Dose-response curves have been generated using both populations and, using the current methodology and instrument, the standard error of prediction based on single 4.5-min measurements is approximately 1.5 Gy for inserted molar teeth and between 2.0 and 2.5 Gy in the more irregularly shaped canine teeth. Averaging of independent measurements can reduce this error significantly to values near 1 Gy. Developments to reduce these errors are underway, focusing on geometric optimization of the resonators, detector positioning techniques, and optimal data averaging approaches. In summary, it seems plausible that the EPR dosimetry techniques will have an important role in retrospective dosimetry for exposures involving large numbers of individuals.
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Swartz HM, Flood AB, Gougelet RM, Rea ME, Nicolalde RJ, Williams BB. A critical assessment of biodosimetry methods for large-scale incidents. HEALTH PHYSICS 2010; 98:95-108. [PMID: 20065671 PMCID: PMC4086260 DOI: 10.1097/hp.0b013e3181b8cffd] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Recognition is growing regarding the possibility that terrorism or large-scale accidents could result in potential radiation exposure of hundreds of thousands of people and that the present guidelines for evaluation after such an event are seriously deficient. Therefore, there is a great and urgent need for after-the-fact biodosimetric methods to estimate radiation dose. To accomplish this goal, the dose estimates must be at the individual level, timely, accurate, and plausibly obtained in large-scale disasters. This paper evaluates current biodosimetry methods, focusing on their strengths and weaknesses in estimating human radiation exposure in large-scale disasters at three stages. First, the authors evaluate biodosimetry's ability to determine which individuals did not receive a significant exposure so they can be removed from the acute response system. Second, biodosimetry's capacity to classify those initially assessed as needing further evaluation into treatment-level categories is assessed. Third, we review biodosimetry's ability to guide treatment, both short- and long-term, is reviewed. The authors compare biodosimetric methods that are based on physical vs. biological parameters and evaluate the features of current dosimeters (capacity, speed and ease of getting information, and accuracy) to determine which are most useful in meeting patients' needs at each of the different stages. Results indicate that the biodosimetry methods differ in their applicability to the three different stages, and that combining physical and biological techniques may sometimes be most effective. In conclusion, biodosimetry techniques have different properties, and knowledge of their properties for meeting the different needs for different stages will result in their most effective use in a nuclear disaster mass-casualty event.
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Pollock JD, Williams BB, Sidabras JW, Grinberg O, Salikhov I, Lesniewski P, Kmiec M, Swartz HM. Surface loop resonator design for in vivo EPR tooth dosimetry using finite element analysis. HEALTH PHYSICS 2010; 98:339-44. [PMID: 20065703 PMCID: PMC4086293 DOI: 10.1097/hp.0b013e3181a6dd08] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Finite element analysis is used to evaluate and design L-band surface loop resonators for in vivo electron paramagnetic resonance (EPR) tooth dosimetry. This approach appears to be practical and useful for the systematic examination and evaluation of resonator configurations to enhance the precision of dose estimates. The effects of loop positioning in the mouth are examined, and it is shown that the sensitivity to loop position along a row of molars is decreased as the loop is moved away from the teeth.
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Li H, Hou H, Sucheta A, Williams BB, Lariviere JP, Khan MN, Lesniewski PN, Gallez B, Swartz HM. Implantable resonators--a technique for repeated measurement of oxygen at multiple deep sites with in vivo EPR. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2010; 662:265-72. [PMID: 20204802 PMCID: PMC3806631 DOI: 10.1007/978-1-4419-1241-1_38] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
EPR oximetry using implantable resonators allows measurements at much deeper sites than are possible with surface resonators (> 80 vs. 10 mm) and achieves greater sensitivity at any depth. We report here the development of an improved technique that enables us to obtain the information from multiple sites and at a variety of depths. The measurements from the various sites are resolved using a simple magnetic field gradient. In the rat brain multi-probe implanted resonators measured pO(2) at several sites simultaneously for over 6 months under normoxic, hypoxic, and hyperoxic conditions. This technique also facilitates measurements in moving parts of the animal such as the heart, because the orientation of the paramagnetic material relative to the sensing loop is not altered by the motion. The measured response is fast, enabling measurements in real time of physiological and pathological changes such as experimental cardiac ischemia in the mouse heart. The technique also is quite useful for following changes in tumor pO(2), including applications with simultaneous measurements in tumors and adjacent normal tissues.
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Demidenko E, Williams BB, Swartz HM. Radiation dose prediction using data on time to emesis in the case of nuclear terrorism. Radiat Res 2009; 171:310-9. [PMID: 19267558 DOI: 10.1667/rr1552.1] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A rigorous statistical analysis of the retrospective estimation of radiation dose received using time to emesis and its uncertainty is provided based on 108 observations associated with accidents with significant exposures to ionizing radiation in the period 1956-2001. The standard error, confidence interval, specificity and sensitivity, and Receiver Operating Characteristic (ROC) curve are used to characterize the uncertainty of the dose prediction. The relative error of the dose prediction using time to emesis data is about 200%. Consequently, if D is the dose assessment, the 95% confidence interval is approximately (D/4, 4D). Our assessment of the precision is applied to computation of the probabilities in triage medical management in the case of a nuclear terrorism event. We also note several factors that indicate that there are additional problems in the use of time to emesis for triage, including a lack of consideration of individuals that do not vomit, differences between the conditions under which the data were obtained and the conditions under which they are likely to be used, and the potential for the incidence of vomiting to be altered by factors unrelated to radiation exposure such as psychogenic factors and the use of emetic agents. In summary, while time to emesis is a rapid and inexpensive method for estimating the radiation dose, it should be used with caution because it is imprecise and may lead to a very high false positive rate. More reliable methods for after-the-fact assessment of radiation dose are needed to complement the use of time to emesis.
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Williams BB, Wall M, Miao RY, Williams B, Bertoncello I, Kershaw MH, Mantamadiotis T, Haber M, Norris MD, Gautam A, Darcy PK, Ramsay RG. Induction of T cell-mediated immunity using a c-Myb DNA vaccine in a mouse model of colon cancer. Cancer Immunol Immunother 2008; 57:1635-45. [PMID: 18386000 PMCID: PMC11030567 DOI: 10.1007/s00262-008-0497-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Accepted: 02/26/2008] [Indexed: 10/22/2022]
Abstract
Overexpression of the proto-oncogene c-Myb occurs in more than 80% of colorectal cancer (CRC) and is associated with aggressive disease and poor prognosis. To test c-Myb as a therapeutic target in CRC we devised a DNA fusion vaccine to generate an anti-CRC immune response. c-Myb, like many tumor antigens, is weakly immunogenic as it is a "self" antigen and subject to tolerance. To break tolerance, a DNA fusion vaccine was generated comprising wild-type c-Myb cDNA flanked by two potent Th epitopes derived from tetanus toxin. Vaccination was performed targeting a highly aggressive, weakly immunogenic, subcutaneous, syngeneic, colon adenocarcinoma cell line MC38 which highly expresses c-Myb. Prophylactic intravenous vaccination significantly suppressed tumor growth, through the induction of anti-tumor immunity for which the tetanus epitopes were essential. Vaccination generated anti-tumor immunity mediated by both CD4+ and CD8+ T cells and increased infiltration of immune effector cells at the tumor site. Importantly, no evidence of autoimmune pathology in endogenous c-Myb expressing tissues was detected as a consequence of breaking tolerance. In summary, these results establish c-Myb as a potential antigen for immune targeting in CRC and serve to provide proof of principle for the continuing development of DNA vaccines targeting c-Myb to bring this approach to the clinic.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/immunology
- Adenocarcinoma/therapy
- Animals
- Base Sequence
- Blotting, Western
- Bone Marrow/immunology
- Bone Marrow/metabolism
- Cancer Vaccines/genetics
- Cancer Vaccines/immunology
- Cancer Vaccines/therapeutic use
- Colonic Neoplasms/genetics
- Colonic Neoplasms/immunology
- Colonic Neoplasms/therapy
- Disease Models, Animal
- Female
- Flow Cytometry
- Genes, MHC Class I/physiology
- Genes, myb/genetics
- Green Fluorescent Proteins/genetics
- Humans
- Immunity
- Lymphocyte Activation
- Lymphocytes, Tumor-Infiltrating/immunology
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Molecular Sequence Data
- Peptide Fragments/immunology
- Proto-Oncogene Mas
- Stem Cells/cytology
- Stem Cells/immunology
- Stem Cells/metabolism
- Survival Rate
- T-Lymphocytes/immunology
- T-Lymphocytes/pathology
- T-Lymphocytes, Cytotoxic/immunology
- Tetanus Toxin/genetics
- Tetanus Toxin/immunology
- Tumor Cells, Cultured
- Vaccination
- Vaccines, DNA/therapeutic use
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Grinberg OY, Williams BB, Ruuge AE, Grinberg SA, Wilcox DE, Swartz HM, Freed JH. Oxygen effects on the EPR signals from wood charcoals: experimental results and the development of a model. J Phys Chem B 2007; 111:13316-24. [PMID: 17973414 DOI: 10.1021/jp072656l] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Charcoals prepared from certain tropical woods contain stable paramagnetic centers, and these have been characterized by EPR spectroscopy in the absence and presence of oxygen. The EPR-detectable spin density has been determined, as has been the temperature- and frequency-dependence of the oxygen broadening of the EPR signal, which is orders of magnitude larger than that observed with other materials, such as lithium phthalocyanine. Three Lorentzian components are required to fit the char EPR spectrum in the presence of oxygen, and the oxygen-dependence of the line width, intensity, and resonance position of the three components have been quantified. These results and the properties of porous carbonaceous materials are used to develop a model to explain the effect of oxygen on the char EPR spectral properties. The model is based on oxygen adsorption on the char surface according to a Langmuir isotherm and a dipolar interaction between the paramagnetic adsorbed gas and the charcoal spins. The three EPR components are correlated with the three known classes (sizes) of pores in charcoal, with the largest line broadening attributed to dipolar relaxation of spins in micropores, which have a larger specific surface area and a higher concentration of adsorbed oxygen. An attenuated, but similar, EPR response to oxygen by chars when they are immersed in aqueous solution is attributed to water competition with oxygen for adsorption on the char surface.
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