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Hanekamp YN, Giordano J, Hanekamp JC, Khan MK, Limper M, Venema CS, Vergunst SD, Verhoeff JJC, Calabrese EJ. Immunomodulation Through Low-Dose Radiation for Severe COVID-19: Lessons From the Past and New Developments. Dose Response 2020; 18:1559325820956800. [PMID: 33013251 PMCID: PMC7513398 DOI: 10.1177/1559325820956800] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Low-dose radiation therapy (LD-RT) has historically been a successful treatment for pneumonia and is clinically established as an immunomodulating therapy for inflammatory diseases. The ongoing COVID-19 pandemic has elicited renewed scientific interest in LD-RT and multiple small clinical trials have recently corroborated the historical LD-RT findings and demonstrated preliminary efficacy and immunomodulation for the treatment of severe COVID-19 pneumonia. The present review explicates archival medical research data of LD-RT and attempts to translate this into modernized evidence, relevant for the COVID-19 crisis. Additionally, we explore the putative mechanisms of LD-RT immunomodulation, revealing specific downregulation of proinflammatory cytokines that are integral to the development of the COVID-19 cytokine storm induced hyperinflammatory state. Radiation exposure in LD-RT is minimal compared to radiotherapy dosing standards in oncology care and direct toxicity and long-term risk for secondary disease are expected to be low. The recent clinical trials investigating LD-RT for COVID-19 confirm initial treatment safety. Based on our findings we conclude that LD-RT could be an important treatment option for COVID-19 patients that are likely to progress to severity. We advocate the further use of LD-RT in carefully monitored experimental environments to validate its effectiveness, risks and mechanisms of LD-RT.
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Affiliation(s)
- Yannic N. Hanekamp
- University Medical Centre Groningen, University of Groningen, the
Netherlands
| | - James Giordano
- Departments of Neurology and Biochemistry, and Pellegrino Center for
Clinical Bioethics, Georgetown University Medical Center, Washington, DC, USA
| | - Jaap C. Hanekamp
- University College Roosevelt, Middelburg, the Netherlands
- Department of Environmental Health Sciences, University of
Massachusetts, Amherst, MA, USA
| | - Mohammad K. Khan
- Department of Radiation Oncology, Winship Cancer Institute, Emory
University School of Medicine, Atlanta, GA, USA
| | - Maarten Limper
- Department of Rheumatology and Clinical Immunology, University
Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | - Samuel D. Vergunst
- University Medical Centre Groningen, University of Groningen, the
Netherlands
| | - Joost J. C. Verhoeff
- Department of Radiation Oncology, University Medical Center Utrecht,
Utrecht University, Utrecht, the Netherlands
| | - Edward J. Calabrese
- Department of Environmental Health Sciences, University of
Massachusetts, Amherst, MA, USA
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Pandey VK, Shankar BS. Radiation-induced augmentation in dendritic cell function is mediated by apoptotic bodies/STAT5/Zbtb46 signaling. Int J Radiat Biol 2020; 96:988-998. [PMID: 32396024 DOI: 10.1080/09553002.2020.1767818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To evaluate the effect of ionizing radiation (IR) exposure on differentiation and maturation of dendritic cells (DC).Materials and methods: Bone marrow progenitor cells irradiated in vitro or isolated from mice exposed to whole body or localized tumor irradiation were differentiated into DC. Phenotypic maturation of DC was characterized by labeling with specific antibodies and flow cytometry analysis. Cytokines were estimated by ELISA.Results: Splenic and bone marrow-derived DC (BMDC) from tumor-bearing mice exposed to localized irradiation showed abrogation of tumor-induced immunosuppression. This was not due to the effect of radiation on tumor cells as DC derived from normal mice exposed to whole-body irradiation (WBI) also showed increase in immune-activating potential of DC. This was observed in terms of increased phenotypic and functional activation of DCs. This phenomenon was also recapitulated if DC were differentiated from in vitro irradiated progenitor cells and was found to be due to STAT5/Zbtb46 signaling mediated by the irradiation-induced apoptotic bodies (ABs). When these ABs were depleted using annexin-beads, these effects were reversed confirming the involvement of this pathway. The role of ABs was further validated in DC derived from mice exposed to WBI in adaptive response experiments with 0.1 Gy priming dose prior to 2 Gy challenge dose. A corresponding reduction in DC maturation markers was observed with decrease in apoptosis in vivo. Further, these DCs derived from irradiated progenitors (IP) could resist the suppressive effects of tumor conditioned medium (TCM) and had increased immune-activating potential as seen in the tumor-bearing mice.Conclusions: Though radiation is the most commonly used therapeutic modality for cancer, its effects on dendritic cell differentiation is not completely understood. We demonstrate here for the first time that exposure to select doses of IR can increase immune-activating potential of DC through ABs. This can have implications in selection of appropriate doses of IR during radiotherapy of cancer patients.
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Affiliation(s)
- Vipul K Pandey
- Immunology Section, Radiation Biology & Health Sciences Division, Bio-Science Group, Bhabha Atomic Research Centre, Mumbai, India
| | - Bhavani S Shankar
- Immunology Section, Radiation Biology & Health Sciences Division, Bio-Science Group, Bhabha Atomic Research Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
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53
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Cosset JM, Deutsch É, Bazire L, Mazeron JJ, Chargari C. [Low dose lung radiotherapy for COVID-19-related cytokine storm syndrome: Why not?]. Cancer Radiother 2020; 24:179-181. [PMID: 32389579 PMCID: PMC7252150 DOI: 10.1016/j.canrad.2020.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/21/2022]
Affiliation(s)
- J-M Cosset
- Centre de radiothérapie Charlebourg, groupe Amethyst, 65, avenue Foch, 92250 La Garenne-Colombes, France
| | - É Deutsch
- Département d'oncologie radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94600 Villejuif, France; Inserm, U1030 radiothérapie moléculaire et innovations thérapeutiques, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Université Paris-Saclay, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
| | - L Bazire
- Centre de radiothérapie Charlebourg, groupe Amethyst, 65, avenue Foch, 92250 La Garenne-Colombes, France
| | - J-J Mazeron
- Centre Antoine-Béclère, 47, rue de la Colonie, 75013 Paris, France
| | - C Chargari
- Département d'oncologie radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94600 Villejuif, France; Inserm, U1030 radiothérapie moléculaire et innovations thérapeutiques, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Université Paris-Saclay, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Service de santé des armées, école du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France; Institut de recherche biomédicale des armées, D19, 91220 Bretigny-sur-Orge, France
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Evaluation of Anti-Tumor Effects of Whole-Body Low-Dose Irradiation in Metastatic Mouse Models. Cancers (Basel) 2020; 12:cancers12051126. [PMID: 32365904 PMCID: PMC7281283 DOI: 10.3390/cancers12051126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/09/2023] Open
Abstract
Low-dose irradiation (LDI) has recently been shown to have various beneficial effects on human health, such as on cellular metabolic activities, DNA repair, antioxidant activity, homeostasis potency, and immune activation. Although studies on the immunogenic effects of LDI are rapidly accumulating, clinical trials for cancer treatment are considered premature owing to the lack of available preclinical results and protocols. Here, we aim to investigate anti-tumor and anti-metastatic effects of whole-body LDI in several tumor-bearing mouse models. Mice were exposed to single or fractionated whole-body LDI prior to tumor transplantation, and tumor growth and metastatic potential were determined, along with analysis of immune cell populations and expression of epithelial-mesenchymal transition (EMT) markers. Whole-body fractionated-LDI decreased tumor development and lung metastasis not only by infiltration of CD4+, CD8+ T-cells, and dendritic cells (DCs) but also by attenuating EMT. Moreover, a combination of whole-body LDI with localized high-dose radiation therapy reduced the non-irradiated abscopal tumor growth and increased infiltration of effector T cells and DCs. Therefore, whole-body LDI in combination with high-dose radiation therapy could be a potential therapeutic strategy for treating cancer.
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Is low dose radiation therapy a potential treatment for COVID-19 pneumonia? Radiother Oncol 2020; 147:221. [PMID: 32342871 PMCID: PMC7194710 DOI: 10.1016/j.radonc.2020.04.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 11/24/2022]
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Low doses of ionizing radiation enhance angiogenesis and consequently accelerate post-embryonic development but not regeneration in zebrafish. Sci Rep 2020; 10:3137. [PMID: 32081879 PMCID: PMC7035379 DOI: 10.1038/s41598-020-60129-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/31/2020] [Indexed: 11/28/2022] Open
Abstract
Low doses of ionizing radiation (LDIR) activate endothelial cells inducing angiogenesis. In zebrafish, LDIR induce vessel formation in the sub-intestinal vessels during post-embryonic development and enhance the inter-ray vessel density in adult fin regeneration. Since angiogenesis is a crucial process involved in both post-embryonic development and regeneration, herein we aimed to understand whether LDIR accelerate these physiological conditions. Our data show that LDIR upregulate the gene expression of several pro-angiogenic molecules, such as flt1, kdr, angpt2a, tgfb2, fgf2 and cyr61in sorted endothelial cells from zebrafish larvae and this effect was abrogated by using a vascular endothelial growth factor receptor (VEGFR)-2 tyrosine kinase inhibitor. Irradiated zebrafish present normal indicators of developmental progress but, importantly LDIR accelerate post-embryonic development in a VEGFR-2 dependent signaling. Furthermore, our data show that LDIR do not accelerate regeneration after caudal fin amputation and the gene expression of the early stages markers of regeneration are not modulated by LDIR. Even though regeneration is considered as a recapitulation of embryonic development and LDIR induce angiogenesis in both conditions, our findings show that LDIR accelerate post-embryonic development but not regeneration. This highlights the importance of the physiological context for a specific phenotype promoted by LDIR.
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57
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Álvarez B, Montero Á, Aramburu F, Calvo E, Ángel de la Casa M, Valero J, Hernando O, López M, Ciérvide R, García-Aranda M, Rodríguez S, Sánchez E, Chen X, Alonso R, García de la Peña P, Rubio C. Radiotherapy for ostheoarticular degenerative disorders: When nothing else works. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 1:100016. [DOI: 10.1016/j.ocarto.2019.100016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 11/27/2019] [Indexed: 01/05/2023] Open
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Effect of Ionizing Radiation on Human EA.hy926 Endothelial Cells under Inflammatory Conditions and Their Interactions with A549 Tumour Cells. J Immunol Res 2019; 2019:9645481. [PMID: 31565662 PMCID: PMC6745109 DOI: 10.1155/2019/9645481] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/23/2019] [Accepted: 07/15/2019] [Indexed: 12/17/2022] Open
Abstract
Purpose Most tumours are characterized by an inflammatory microenvironment, and correlations between inflammation and cancer progression have been shown. Endothelial cells (ECs), as part of the tumour microenvironment, play a crucial role in inflammatory processes as well as in angiogenesis and could be critical targets of cancer therapy like irradiation. Therefore, in the present study we investigated the effect of ionizing radiation on endothelial cells under inflammatory conditions and their interactions with tumour cells. Methods Nonactivated and TNF-α treatment-activated human EC EA.hy926 were irradiated with doses between 0.1 Gy and 6 Gy with a linear accelerator. Using a multiplex assay, the accumulation of various chemokines (IL-8, MCP-1, E-selectin, and P-selectin) and soluble adhesion molecules (sICAM-1 and VCAM-1) as well as protein values of the vascular endothelial growth factor (VEGF) was measured in the supernatant at different time points. The adhesion capability of irradiated and nonirradiated A549 tumour cells to EA.hy926 cells was measured using flow cytometry, and the migration of tumour cells was investigated with a scratch motility assay. Results In contrast to unirradiated cells, IR of ECs resulted in a modified release of chemokines IL-8 and MCP-1 as well as the adhesion molecules sICAM-1 and VCAM-1 in the EC, whereas concentrations of E-selectin and P-selectin as well as VEGF were not influenced. IR always affected the adhesion capability of tumour cells to ECs with the effect dependent on the IR-treated cell type. TNF-α treatment generally increased adhesion ability of the tumour cells. Tumour cell migration was clearly inhibited after IR. This inhibitory effect was eliminated for radiation doses from 0.5 to 2 Gy when, additionally, an inflammatory environment was predominant. Conclusions Our results support past findings suggesting that ECs, as part of the inflammatory microenvironment of tumours, are important regulators of the actual tumour response to radiation therapy.
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59
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Dhawan G, Kapoor R, Dhamija A, Singh R, Monga B, Calabrese EJ. Necrotizing Fasciitis: Low-Dose Radiotherapy as a Potential Adjunct Treatment. Dose Response 2019; 17:1559325819871757. [PMID: 31496924 PMCID: PMC6716184 DOI: 10.1177/1559325819871757] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/11/2019] [Accepted: 07/18/2019] [Indexed: 12/27/2022] Open
Abstract
Necrotizing fasciitis (NF) is a rapidly spreading bacterial infection causing extensive tissue necrosis and destruction. Despite appropriate therapy, the disease results in significant morbidity/mortality and substantial treatment costs. Several studies published in the early 1900s demonstrated the effective use of low-dose X-ray radiotherapy (RT) for the treatment of many diverse inflammatory conditions and diseases (eg, gas gangrene, sinus infections, arthritis, tendonitis, and serious inflammatory lung conditions). The mechanism by which therapeutic RT doses produce positive patient outcomes is related at least in part to its capacity to induce tissue-based anti-inflammatory responses. This action is due to the polarization of macrophages to an anti-inflammatory or M2 phenotype via optimized low-dose RT. Low-dose RT has the potential to significantly reduce debilitating surgeries and aggressive treatments required for NF, providing a 3-prong benefit in terms of patient mortality, length of hospitalization stays, and cost of health care (both short term and long term). Low cost and easy availability of low-dose RT makes it a potentially useful option for patients of every age-group. In addition, low-dose RT may be a particularly useful option in countries treating many patients who are unable to afford surgeries, antibiotics, and hyperbaric oxygen.
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Affiliation(s)
- Gaurav Dhawan
- Human Research Protection Office, University of Massachusetts, Amherst, MA, USA
| | - Rachna Kapoor
- Saint Francis Hospital and Medical Center, Hartford, CT, USA
| | | | | | - Bharat Monga
- Division of Hospital Medicine, Mount Sinai St Luke's Hospital, New York, NY, USA
| | - Edward J Calabrese
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
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60
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Low-Dose Irradiation Differentially Impacts Macrophage Phenotype in Dependence of Fibroblast-Like Synoviocytes and Radiation Dose. J Immunol Res 2019; 2019:3161750. [PMID: 31485459 PMCID: PMC6710796 DOI: 10.1155/2019/3161750] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/01/2019] [Accepted: 07/11/2019] [Indexed: 12/17/2022] Open
Abstract
Rheumatoid arthritis (RA) is a multifactorial autoimmune disease whose main hallmark is inflammation and destruction of the joints. Two cell types within the synovium that play an important role in RA are fibroblast-like synoviocytes (FLS) and macrophages. The latter innate immune cells show a high plasticity in their phenotype and are central in inflammatory processes. Low-dose radiotherapy (LD-RT) with particularly a single dose of 0.5 Gy has been demonstrated to have a positive impact on pain, inflammation, and bone in inflamed joints. We now examined for the first time how LD-RT influences FLS and bone marrow-derived macrophages in co-culture systems of an experimental model of RA to reveal further mechanisms of immune modulatory effects of low and intermediate dose of ionizing radiation. For this, the bone marrow of hTNF-α tg mice was differentiated either with cytokines to obtain key macrophage phenotypes (M0, M1, and M2) or with supernatants (SN) of untreated or irradiated FLS. Flow cytometry analyses were used to analyse the impact of radiation (0.1, 0.5, 1.0, and 2.0 Gy) on the phenotype of macrophages in the presence or absence of SN of FLS. LD-RT had no impact on cytokine-mediated macrophage polarization in M0, M1, or M2 macrophages. However, SN of irradiated FLS particularly reduced CD206 expression on macrophages. Macrophage phenotype was stable when being in contact with SN of nonirradiated FLS, but significantly increased surface expression of CD206 and slightly decreased CD80 and CD86 expression were observed when macrophage themselves were irradiated with 0.5 Gy under these microenvironmental conditions, again highlighting discontinuous dose dependencies in the low and intermediate dose range. One can conclude that FLS-dependent microenvironmental conditions have a slight influence on the modulation of macrophage phenotype under radiation exposure conditions. Future studies are needed to reveal the impact of radiation exposure on the functions of treated macrophages under such microenvironmental conditions.
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Zhang W, Haylock RGE, Gillies M, Hunter N. Mortality from heart diseases following occupational radiation exposure: analysis of the National Registry for Radiation Workers (NRRW) in the United Kingdom. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2019; 39:327-353. [PMID: 30860078 DOI: 10.1088/1361-6498/ab02b2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Statistically significant increases in heart disease (HD) mortality with cumulative recorded occupational radiation dose from external sources were observed among 174 541 subjects, who were predominately exposed to protracted low doses over a number of years, and were followed up until the end of 2011 in the UK National Registry for Radiation Workers (NRRW) cohort. Amongst the subtypes of HD, the increasing trends with cumulative dose arose for ischaemic heart disease (IHD) and other HD (which includes pulmonary HD, valve disorders, cardiomyopathy, cardiac dysrhythmias, carditis, conduction disorder and ill-defined HD). For IHD, the increased mortality appears to be at least 20 years after first exposure and the excess risk peaked between 30 and 40 years after the first exposure. There was no evidence of excess risk of IHD mortality for cumulative radiation doses below 0.1 Sv. A categorical analysis also showed that the risk falls below the expected value based on a linear trend, for cumulative doses greater than 0.4 Sv; this smaller risk appears to be primarily associated with workers who started employment at a younger age and who were employed for longer than 30 years, reflecting possible healthy worker survivor effect. This analysis provided further evidence that low doses of radiation exposure may be associated with increased risk of IHD. For other HD, the data suggest an increased risk starting around 40 years after the first exposure. The risk was statistically significant raised only for cumulative doses above 0.4 Sv. However, the number of deaths in this group was small and the results need to be interpreted with caution.
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Brown S, Abana CO, Hammad H, Brown A, Mhlanga J, Binder C, Nabavizadeh N, Thomas C, Mitin T, Gilbert EW. Low-Dose Radiation Therapy is an Effective Treatment for Refractory Postoperative Chylous Ascites: A Case Report. Pract Radiat Oncol 2019; 9:153-157. [DOI: 10.1016/j.prro.2018.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/20/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022]
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63
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Kullmann M, Rühle PF, Harrer A, Donaubauer A, Becker I, Sieber R, Klein G, Fournier C, Fietkau R, Gaipl US, Frey B. Temporarily increased TGFβ following radon spa correlates with reduced pain while serum IL-18 is a general predictive marker for pain sensitivity. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:129-135. [PMID: 30456560 DOI: 10.1007/s00411-018-0768-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/12/2018] [Indexed: 05/03/2023]
Abstract
Sustained pain relief following radon spa therapy in patients suffering from chronic painful diseases has been well described. But still, the underlying mechanisms are not fully understood. We conducted the prospective and explorative RAD-ON01 study which included 103 patients who suffered from chronic painful musculoskeletal disorders of the spine and/or joints and present here the data of the examination of pro- and anti-inflammatory cytokines in the serum of the patients before and at weeks 6, 12 and 30 after therapy. While TNFα, IL-1β, IFNγ, IL-1Ra and IL-10 were not altered, TGFβ was temporarily significantly (p = 0.013) elevated 6 weeks after therapy. Importantly, this elevation positively correlated with lowered pain sensitivity (r = 0.41). Further, the amount of IL-18 in the serum positively correlated with lowered pain sensitivity. Therefore, IL-18 can be considered as predictive marker for pain sensitivity of radon spa patients. We conclude that alterations in TGFβ and general IL-18 levels in serum have prognostic and predictive value in situations of lowered pain by exposure of patients to very low-doses of radiation as it is the case in radon spa.
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Affiliation(s)
- Miriam Kullmann
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Paul F Rühle
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Alexandra Harrer
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Anna Donaubauer
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Ina Becker
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Renate Sieber
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | | | - Claudia Fournier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Udo S Gaipl
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany.
| | - Benjamin Frey
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
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Baselet B, Sonveaux P, Baatout S, Aerts A. Pathological effects of ionizing radiation: endothelial activation and dysfunction. Cell Mol Life Sci 2019; 76:699-728. [PMID: 30377700 PMCID: PMC6514067 DOI: 10.1007/s00018-018-2956-z] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 01/13/2023]
Abstract
The endothelium, a tissue that forms a single layer of cells lining various organs and cavities of the body, especially the heart and blood as well as lymphatic vessels, plays a complex role in vascular biology. It contributes to key aspects of vascular homeostasis and is also involved in pathophysiological processes, such as thrombosis, inflammation, and hypertension. Epidemiological data show that high doses of ionizing radiation lead to cardiovascular disease over time. The aim of this review is to summarize the current knowledge on endothelial cell activation and dysfunction after ionizing radiation exposure as a central feature preceding the development of cardiovascular diseases.
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Affiliation(s)
- Bjorn Baselet
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK•CEN), Mol, Belgium
- Institute of Experimental and Clinical Research (IREC), Pole of Pharmacology and Therapeutics, Université catholique de Louvain (UCL), Brussels, Belgium
| | - Pierre Sonveaux
- Institute of Experimental and Clinical Research (IREC), Pole of Pharmacology and Therapeutics, Université catholique de Louvain (UCL), Brussels, Belgium
| | - Sarah Baatout
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK•CEN), Mol, Belgium
- Department of Molecular Biotechnology, Ghent University, Ghent, Belgium
| | - An Aerts
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK•CEN), Mol, Belgium.
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Montero A, Sabater S, Rödel F, Gaipl US, Ott OJ, Seegenschmiedt MH, Arenas M. Is it time to redefine the role of low-dose radiotherapy for benign disease? Ann Rheum Dis 2018; 79:e34. [DOI: 10.1136/annrheumdis-2018-214873] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/08/2018] [Indexed: 01/09/2023]
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66
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Deloch L, Rückert M, Fietkau R, Frey B, Gaipl US. Low-Dose Radiotherapy Has No Harmful Effects on Key Cells of Healthy Non-Inflamed Joints. Int J Mol Sci 2018; 19:ijms19103197. [PMID: 30332826 PMCID: PMC6214021 DOI: 10.3390/ijms19103197] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/08/2018] [Accepted: 10/10/2018] [Indexed: 02/02/2023] Open
Abstract
Low-dose radiotherapy (LD-RT) for benign inflammatory and/or bone destructive diseases has been used long. Therefore, mechanistic investigations on cells being present in joints are mostly made in an inflammatory setting. This raises the question whether similar effects of LD-RT are also seen in healthy tissue and thus might cause possible harmful effects. We performed examinations on the functionality and phenotype of key cells within the joint, namely on fibroblast-like synoviocytes (FLS), osteoclasts and osteoblasts, as well as on immune cells. Low doses of ionizing radiation showed only a minor impact on cytokine release by healthy FLS as well as on molecules involved in cartilage and bone destruction and had no significant impact on cell death and migration properties. The bone resorbing abilities of healthy osteoclasts was slightly reduced following LD-RT and a positive impact on bone formation of healthy osteoblasts was observed after in particular exposure to 0.5 Gray (Gy). Cell death rates of bone-marrow cells were only marginally increased and immune cell composition of the bone marrow showed a slight shift from CD8+ to CD4+ T cell subsets. Taken together, our results indicate that LD-RT with particularly a single dose of 0.5 Gy has no harmful effects on cells of healthy joints.
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Affiliation(s)
- Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Michael Rückert
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
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Deloch L, Derer A, Hueber AJ, Herrmann M, Schett GA, Wölfelschneider J, Hahn J, Rühle PF, Stillkrieg W, Fuchs J, Fietkau R, Frey B, Gaipl US. Low-Dose Radiotherapy Ameliorates Advanced Arthritis in hTNF-α tg Mice by Particularly Positively Impacting on Bone Metabolism. Front Immunol 2018; 9:1834. [PMID: 30279685 PMCID: PMC6153886 DOI: 10.3389/fimmu.2018.01834] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 07/25/2018] [Indexed: 11/29/2022] Open
Abstract
Inflammation and bone erosion are central in rheumatoid arthritis (RA). Even though effective medications for control and treatment of RA are available, remission is only seen in a subset of patients. Treatment with low-dose radiotherapy (LD-RT) which has been already successfully used for amelioration of symptoms in benign diseases should be a promising approach to reduce pain, inflammation, and particularly bone erosion in patients with RA. Even though anti-inflammatory effects of LD-RT are already described with non-linear dose response relationships, and pain-reducing effects have been clinically observed, the underlying mechanisms are widely unknown. Besides immune cells many other cell types, such as fibroblast-like synoviocytes (FLS), osteoclasts, and osteoblast are present in the affected joint and might be modulated by LD-RT. For this study, these cell types were obtained from human tumor necrosis factor-α transgenic (hTNF-α tg) mice and were consecutively exposed to different doses of ionizing radiation (0.1, 0.5, 1.0, and 2.0 Gy, respectively) in vitro. In order to study the in vivo effects of LD-RT within the arthritic joint, hind paws of arthritic hTNF-α tg mice were locally irradiated with 0.5 Gy, a single dose per fraction that is known for good clinical responses. Starting at a dose of 0.5 Gy, proliferation of FLS was reduced and apoptosis significantly enhanced with no changes in necrosis. Further, expression of RANK-L was slightly reduced following irradiation with particularly 0.5 Gy. Starting from 0.5 Gy, the numbers of differentiated osteoclasts were significantly reduced, and a lower bone resorbing activity of treated osteoclasts was also observed, as monitored via pit formation and Cross Laps presence. LD-RT had further a positive effect on osteoblast-induced mineralization in a discontinuous dose response relationship with 0.5 Gy being most efficient. An increase of the gene expression ratio of OPG/RANK-L at 0.1 and 0.5 Gy and of production of OPG at 0.5 and 1.0 Gy was observed. In vivo, LD-RT resulted in less severe arthritis in arthritic hTNF-α tg mice and in significant reduction of inflammatory and erosive area with reduced osteoclasts and neutrophils. Locally applied LD-RT can, therefore, induce a beneficial micro-environment within arthritic joints by predominantly positively impacting on bone metabolism.
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Affiliation(s)
- Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Anja Derer
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Axel J Hueber
- Department of Internal Medicine 3 and Institute for Clinical Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum, Erlangen, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3 and Institute for Clinical Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum, Erlangen, Germany
| | - Georg Andreas Schett
- Department of Internal Medicine 3 and Institute for Clinical Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum, Erlangen, Germany
| | - Jens Wölfelschneider
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jonas Hahn
- Department of Internal Medicine 3 and Institute for Clinical Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum, Erlangen, Germany
| | - Paul-Friedrich Rühle
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Willi Stillkrieg
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jana Fuchs
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Moore A, Kramer MR, Silvern D, Shtraichman O, Allen AM. Endobronchial brachytherapy-A novel approach for the management of airway amyloidosis. Brachytherapy 2018; 17:966-972. [PMID: 30082189 DOI: 10.1016/j.brachy.2018.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/14/2018] [Accepted: 07/03/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Airway amyloidosis is an uncommon condition and may have variable clinical course. There is no proven systemic therapy, and the management mainly relies on local invasive treatments. Several reports have found external beam radiotherapy to produce durable responses. The optimal dose and fractionation has not been determined. Endobronchial brachytherapy (EBB) has never been reported to affect this disease. METHODS The study includes a retrospective chart review of all patients with airway amyloidosis treated with EBB at the Davidoff Cancer Center. Data include symptoms, radiotherapy method and dose, treatment outcomes, and toxicities. RESULTS Three patients were included. Patients were either symptomatic with extensive airway involvement or have undergone multiple local procedures with rapid recurrence of the amyloid deposits. Two patients had upper and 1 patient had lower airway involvement. Two were treated with external beam radiotherapy and EBB and 1 was treated with EBB only. All patients achieved rapid improvement of symptoms with visible improvement in followup bronchoscopies. EBB doses ranged from 7.5 to 10 Gy. Of the seven lesions treated with EBB, only one lesion recurred 6 months from treatment. No major toxicities were reported. CONCLUSIONS EBB is effective and safe for the management of airway amyloidosis and can offer long-term control. This is the first report of EBB for this indication. EBB should be further explored as means of minimizing the irradiated lung volume.
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Affiliation(s)
- Assaf Moore
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Petach Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mordechai R Kramer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Institute of Pulmonary Medicine, Rabin Medical Center, Petach Tiqva, Israel
| | - David Silvern
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Petach Tiqva, Israel
| | - Osnat Shtraichman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Institute of Pulmonary Medicine, Rabin Medical Center, Petach Tiqva, Israel
| | - Aaron M Allen
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Petach Tiqva, Israel; The Institute of Pulmonary Medicine, Rabin Medical Center, Petach Tiqva, Israel.
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Brand C, Arnoldussen M. IRay therapy as an adjuvant therapy in newly diagnosed patients with neovascular age-related macular degeneration. Eye (Lond) 2018; 32:1345-1352. [PMID: 29662155 PMCID: PMC6085287 DOI: 10.1038/s41433-018-0080-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 02/15/2018] [Accepted: 02/18/2018] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES To determine the safety and efficacy at 12 months of follow-up after stereotactic radiotherapy in combination therapy with intravitreal ranibizumab injections in treatment naïve patients with neovascular age-related macular degeneration. METHODS Retrospective data analysis in patients who received stereotactic radiotherapy (IRay Therapy) during the induction phase of intravitreal ranibizumab injections and a monotherapy control group. RESULTS The baseline VA in the IRay and control group was 59.87 and 59.12 letters respectively. The real world visual acuity outcomes for the IRay group showed a mean gain of +3.0 letters at 12 months. The historical control group had a mean change of - 0.3 letters. The average number of injections for the IRay group and control group over 12 months was 4.45 and 5.64, respectively with three loading injections. Excluding the loading phase, the difference over 12 months was a 45.2% reduction in injections (P < 0.001). The number of subjects in the IRay group that didn't require further injections following the loading phase was 45.5 vs. 24.0% control group (P = 0.005). The difference in mean change in central macular thickness from baseline is significant at 6 (P = 0.010) and 12 months (P < 0.01). There were no safety concerns with the IRay therapy group. CONCLUSIONS Stereotactic radiotherapy in the induction phase of intravitreal injections of ranibizumab for treatment naïve patients with neovascular age-related macular degeneration, resulted in improved visual outcome, statistically fewer injections and statistically drier macular at 12 months, compared to historical controls treated with monotherapy intravitreal ranibizumab injections.
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Affiliation(s)
- Christopher Brand
- Eye Department, Sheffield Hospitals NHS Foundation Trust, Sheffield, UK.
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Modulation of Inflammatory Reactions by Low-Dose Ionizing Radiation: Cytokine Release of Murine Endothelial Cells Is Dependent on Culture Conditions. J Immunol Res 2018; 2018:2856518. [PMID: 29967799 PMCID: PMC6008836 DOI: 10.1155/2018/2856518] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/14/2018] [Accepted: 04/05/2018] [Indexed: 01/04/2023] Open
Abstract
Background In many European countries, patients with a variety of chronical inflammatory diseases are treated with low-dose radiotherapy (LD-RT). In contrast to high-dose irradiation given to tumor patients, little is known about radiobiological mechanisms underlying this clinical successful LD-RT application. The objective of this study was to gain a better insight into the modulation of inflammatory reactions after LD-RT on the basis of endothelial cells (EC) as major participants and regulators of inflammation. Methods Three murine EC lines were cultivated under 2D and 3D culture conditions and irradiated with doses from 0.01 Gy to 2 Gy. To simulate an inflammatory situation, cells were activated with TNF-α. After LD-RT, a screening of numerous inflammatory markers was determined by multiplex assay, followed by detailed analyses of four cytokines (KC, MCP-1, RANTES, and G-CSF). Additionally, the monocyte binding to EC was analyzed. Results Cytokine concentrations were dependent on culture condition, IR dose, time point after IR, and EC origin. IR caused nonlinear dose-dependent effects on secretion of the proinflammatory cytokines KC, MCP-1, and RANTES. The monocyte adhesion was significantly enhanced after IR as well as activation. Conclusions The study shows that LD-RT, also using very low radiation doses, has a clear immunomodulatory effect on EC as major participants and regulators of inflammation.
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71
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Frey B, Rückert M, Deloch L, Rühle PF, Derer A, Fietkau R, Gaipl US. Immunomodulation by ionizing radiation-impact for design of radio-immunotherapies and for treatment of inflammatory diseases. Immunol Rev 2018; 280:231-248. [PMID: 29027224 DOI: 10.1111/imr.12572] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ionizing radiation is often regarded as an element of danger. But, danger responses on the cellular and molecular level are often beneficial with regard to the induction of anti-tumor immunity and for amelioration of inflammation. We outline how in dependence of radiation dose and fraction, radiation itself-and especially in combination with immune modulators-impacts on the innate and adaptive immune system. Focus is set on radiation-induced changes of the tumor cell phenotype and the cellular microenvironment including immunogenic cancer cell death. Mechanisms how anti-tumor immune responses are triggered by radiotherapy in combination with hyperthermia, inhibition of apoptosis, the adjuvant AnnexinA5, or vaccination with high hydrostatic pressure-killed autologous tumor cells are discussed. Building on this, feasible multimodal radio-immunotherapy concepts are reviewed including overcoming immune suppression by immune checkpoint inhibitors and by targeting TGF-β. Since radiation-induced tissue damage, inflammation, and anti-tumor immune responses are interconnected, the impact of lower doses of radiation on amelioration of inflammation is outlined. Closely meshed immune monitoring concepts based on the liquid biopsy blood are suggested for prognosis and prediction of cancer and non-cancer inflammatory diseases. Finally, challenges and visions for the design of cancer radio-immunotherapies and for treatment of benign inflammatory diseases are given.
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Affiliation(s)
- Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Rückert
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Paul F Rühle
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Anja Derer
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Rossi F, Cancedda S, Leone VF, Rohrer Bley C, Laganga P. Megavoltage Radiotherapy for the Treatment of Degenerative Joint Disease in Dogs: Results of a Preliminary Experience in an Italian Radiotherapy Centre. Front Vet Sci 2018; 5:74. [PMID: 29692993 PMCID: PMC5903029 DOI: 10.3389/fvets.2018.00074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 03/26/2018] [Indexed: 12/26/2022] Open
Abstract
The aim of the study was to evaluate the efficacy and toxicity of a low-dose radiotherapy treatment in dogs with osteoarthritis (OA). Inclusion criteria were dogs affected by OA of one or multiple joints, with lameness, previously treated with medical therapy and referred for radiotherapy because of chronic unresponsive pain. After suspension of medical therapy, dogs underwent external beam radiotherapy treatments delivered in three fractions of 2 Gy each. Four of these dogs had one (three dogs) to four (one dog) additional courses of radiation. Medical records were reviewed and follow-up information was collected by clinical recheck and owners interview. Twenty-five dogs matched the inclusion criteria; among them, 21 had one course of RT and 4 underwent multiple treatments, respectively 218, 266, 39, and 1,384 days after the first treatment. Clinical improvement was observed in 92% of patients with median benefit duration of 356 days after the first treatment, and 418 days after the second treatment. No side effects were recorded. In this group of patients, radiotherapy was effective, well tolerated, and repeatable, leading to an improvement of quality of life in dogs with degenerative joint disease unresponsive to medical treatments.
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Affiliation(s)
- Federica Rossi
- Centro Oncologico Veterinario, Sasso Marconi, Italy.,Clinica Veterinaria dell'Orologio, Sasso Marconi, Italy
| | | | | | - Carla Rohrer Bley
- Centro Oncologico Veterinario, Sasso Marconi, Italy.,Division of Radiation Oncology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Apeke S, Gaubert L, Boussion N, Lambin P, Visvikis D, Rodin V, Redou P. Multi-Scale Modeling and Oxygen Impact on Tumor Temporal Evolution: Application on Rectal Cancer During Radiotherapy. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:871-880. [PMID: 29610067 DOI: 10.1109/tmi.2017.2771379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We present a multi-scale approach of tumor modeling in order to predict its evolution during radiotherapy. Within this context we focus on three different scales of tumor modeling: microscopic (individual cells in a voxel), mesoscopic (population of cells in a voxel) and macroscopic (whole tumor), with transition interfaces between these three scales. At the cellular level, the description is based on phase transfer probabilities in the cellular cycle. At the mesoscopic scale we represent populations of cells according to different stages in a cell cycle. Finally, at the macroscopic scale, the tumor description is based on the use of FDG PET image voxels. These three scales exist naturally: biological data are collected at the macroscopic scale, but the pathological behavior of the tumor is based on an abnormal cell-cycle at the microscopic scale. On the other hand, the introduction of a mesoscopic scale is essential in order to reduce the gap between the two extreme, in terms of resolution, description levels. It also reduces the computational burden of simulating a large number of individual cells. As an application of the proposed multi-scale model, we simulate the effect of oxygen on tumor evolution during radiotherapy. Two consecutive FDG PET images of 17 rectal cancer patients undergoing radiotherapy are used to simulate the tumor evolution during treatment. The simulated results are compared with those obtained on a third FDG PET image acquired two weeks after the beginning of the treatment.
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74
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Rühle PF, Klein G, Rung T, Tiep Phan H, Fournier C, Fietkau R, Gaipl US, Frey B. Impact of radon and combinatory radon/carbon dioxide spa on pain and hypertension: Results from the explorative RAD-ON01 study. Mod Rheumatol 2018; 29:165-172. [DOI: 10.1080/14397595.2018.1442640] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Paul F. Rühle
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Gerhart Klein
- Practice for Cardiology, Bad Steben, Germany
- Health Resort Research Association, Bad Steben, Germany
| | | | | | - Claudia Fournier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Udo S. Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Ministro A, de Oliveira P, Nunes RJ, Dos Santos Rocha A, Correia A, Carvalho T, Rino J, Faísca P, Becker JD, Goyri-O'Neill J, Pina F, Poli E, Silva-Santos B, Pinto F, Mareel M, Serre K, Constantino Rosa Santos S. Low-dose ionizing radiation induces therapeutic neovascularization in a pre-clinical model of hindlimb ischemia. Cardiovasc Res 2018; 113:783-794. [PMID: 28444128 DOI: 10.1093/cvr/cvx065] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 03/29/2017] [Indexed: 11/12/2022] Open
Abstract
Aims We have previously shown that low-dose ionizing radiation (LDIR) induces angiogenesis but there is no evidence that it induces neovascularization in the setting of peripheral arterial disease. Here, we investigated the use of LDIR as an innovative and non-invasive strategy to stimulate therapeutic neovascularization using a model of experimentally induced hindlimb ischemia (HLI). Methods and results After surgical induction of unilateral HLI, both hindlimbs of female C57BL/6 mice were sham-irradiated or irradiated with four daily fractions of 0.3 Gy, in consecutive days and allowed to recover. We demonstrate that LDIR, significantly improved blood perfusion in the murine ischemic limb by stimulating neovascularization, as assessed by laser Doppler flow, capillary density, and collateral vessel formation. LDIR significantly increased the circulating levels of VEGF, PlGF, and G-CSF, as well as the number of circulating endothelial progenitor cells (EPCs) mediating their incorporation to ischemic muscles. These effects were dependent upon LDIR exposition on the ischemic niche (thigh and shank regions). In irradiated ischemic muscles, these effects were independent of the recruitment of monocytes and macrophages. Importantly, LDIR induced a durable and simultaneous up-regulation of a repertoire of pro-angiogenic factors and their receptors in endothelial cells (ECs), as evident in ECs isolated from the irradiated gastrocnemius muscles by laser capture microdissection. This specific mechanism was mediated via vascular endothelial growth factor (VEGF) receptor signaling, since VEGF receptor inhibition abrogated the LDIR-mediated gene up-regulation and impeded the increase in capillary density. Finally, the vasculature in an irradiated non-ischemic bed was not affected and after 52 week of LDIR exposure no differences in the incidence of morbidity and mortality were seen. Conclusions These findings disclose an innovative, non-invasive strategy to induce therapeutic neovascularization in a mouse model of HLI, emerging as a novel approach in the treatment of critical limb ischemia patients.
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Affiliation(s)
- Augusto Ministro
- Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal.,Centro Hospitalar Lisboa Norte, Avenida Prof. Egas Moniz, 1649-035 Lisbon, Portugal
| | - Paula de Oliveira
- Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Raquel J Nunes
- Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - André Dos Santos Rocha
- Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Adriana Correia
- Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Tânia Carvalho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - José Rino
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Pedro Faísca
- Research Center for Biosciences & Health Technologies, Faculdade de Medicina Veterinária, Universidade Lusófona de Humanidades e Tecnologias. Campo Grande 376, 1749-024 Lisbon, Portugal
| | - Jorg D Becker
- Instituto Gulbenkian de Ciência, Rua Quinta Grande 6, 2780-156 Oeiras, Portugal
| | - João Goyri-O'Neill
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisbon, Portugal
| | - Filomena Pina
- Centro Hospitalar Lisboa Norte, Avenida Prof. Egas Moniz, 1649-035 Lisbon, Portugal
| | - Esmeralda Poli
- Centro Hospitalar Lisboa Norte, Avenida Prof. Egas Moniz, 1649-035 Lisbon, Portugal
| | - Bruno Silva-Santos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Fausto Pinto
- Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal.,Centro Hospitalar Lisboa Norte, Avenida Prof. Egas Moniz, 1649-035 Lisbon, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Marc Mareel
- University Hospital Ghent, De Pintelaan, 185, B-9000 Ghent, Belgium
| | - Karine Serre
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Susana Constantino Rosa Santos
- Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisbon, Portugal
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Park CH, Shin MR, An BK, Joh HW, Lee JC, Roh SS, Yokozawa T. Heat-Processed Scutellariae Radix Protects Hepatic Inflammation through the Amelioration of Oxidative Stress in Lipopolysaccharide-Induced Mice. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2017; 45:1233-1252. [DOI: 10.1142/s0192415x17500689] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The present study evaluated the effects of heat-processed Scutellariae Radix (Scutellaria baicalensis) on lipopolysaccharide (LPS)-induced liver injury in mice. Scutellariae Radix heat-processed at 160[Formula: see text]C or 180[Formula: see text]C was orally administered at a dose of 100 mg/kg body weight for three days before the intraperitoneal injection of LPS, and the effects were compared with those of vehicle-treated LPS administered to control mice. The administration of Scutellariae Radix decreased the elevated serum monocyte chemotactic protein-1 (MCP-1), interleukin-6 (IL-6), reactive oxygen species (ROS), nitrite/nitrate, peroxynitrite, and hepatic functional parameters, and reduced the increased ROS in the liver. The augmented expressions of hepatic oxidative stress and inflammation-related proteins, phospho-p38, phosphorylated extracellular signal-regulated kinase, phosphorylated c-Jun N-terminal kinase, nuclear factor-[Formula: see text] B p65, activator protein-1, cyclooxygenase-2, inducible nitric oxide synthase, MCP-1, intercellular adhesion molecule-1, tumor necrosis factor-[Formula: see text], and IL-6, were downregulated by the heat-processed Scutellariae Radix. Hematoxylin-eosin staining showed that the increased hepatocellular damage in the liver of LPS-treated mice improved with the administration of heat-processed Scutellariae Radix. Overall, the ameliorative effects of Scutellariae Radix were superior to those when heat-processed at 180[Formula: see text]C. Our results indicate that heat-processed Scutellariae Radix acts as an anti-inflammatory agent by ameliorating oxidative stress in the liver of mice with LPS-induced liver injury.
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Affiliation(s)
- Chan Hum Park
- Department of Medicinal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration, Eumseong 369-873, Republic of Korea
- College of Korean Medicine, Daegu Haany University, Daegu 706-060, Republic of Korea
| | - Mi-Rae Shin
- College of Korean Medicine, Daegu Haany University, Daegu 706-060, Republic of Korea
| | - Byung Kwan An
- School of Korean Medicine, Pusan National University, Gyeongnam 626-870, Republic of Korea
| | - Hyun Woo Joh
- School of Korean Medicine, Pusan National University, Gyeongnam 626-870, Republic of Korea
| | - Jang Cheon Lee
- Jeollanamdo Development Institute for Korean Traditional Medicine, Jeollanamdo 529-851, Republic of Korea
| | - Seong-Soo Roh
- College of Korean Medicine, Daegu Haany University, Daegu 706-060, Republic of Korea
| | - Takako Yokozawa
- Graduate School of Science and Engineering for Research, University of Toyama, Toyama 930-8555, Japan
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Gillies M, Richardson DB, Cardis E, Daniels RD, O’Hagan JA, Haylock R, Laurier D, Leuraud K, Moissonnier M, Schubauer-Berigan MK, Thierry-Chef I, Kesminiene A. Mortality from Circulatory Diseases and other Non-Cancer Outcomes among Nuclear Workers in France, the United Kingdom and the United States (INWORKS). Radiat Res 2017; 188:276-290. [PMID: 28692406 PMCID: PMC5651512 DOI: 10.1667/rr14608.1] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Positive associations between external radiation dose and non-cancer mortality have been found in a number of published studies, primarily of populations exposed to high-dose, high-dose-rate ionizing radiation. The goal of this study was to determine whether external radiation dose was associated with non-cancer mortality in a large pooled cohort of nuclear workers exposed to low-dose radiation accumulated at low dose rates. The cohort comprised 308,297 workers from France, United Kingdom and United States. The average cumulative equivalent dose at a tissue depth of 10 mm [Hp(10)] was 25.2 mSv. In total, 22% of the cohort were deceased by the end of follow-up, with 46,029 deaths attributed to non-cancer outcomes, including 27,848 deaths attributed to circulatory diseases. Poisson regression was used to investigate the relationship between cumulative radiation dose and non-cancer mortality rates. A statistically significant association between radiation dose and all non-cancer causes of death was observed [excess relative risk per sievert (ERR/Sv) = 0.19; 90% CI: 0.07, 0.30]. This was largely driven by the association between radiation dose and mortality due to circulatory diseases (ERR/Sv = 0.22; 90% CI: 0.08, 0.37), with slightly smaller positive, but nonsignificant, point estimates for mortality due to nonmalignant respiratory disease (ERR/Sv = 0.13; 90% CI: -0.17, 0.47) and digestive disease (ERR/Sv = 0.11; 90% CI: -0.36, 0.69). The point estimate for the association between radiation dose and deaths due to external causes of death was nonsignificantly negative (ERR = -0.12; 90% CI: <-0.60, 0.45). Within circulatory disease subtypes, associations with dose were observed for mortality due to cerebrovascular disease (ERR/Sv = 0.50; 90% CI: 0.12, 0.94) and mortality due to ischemic heart disease (ERR/Sv = 0.18; 90% CI: 0.004, 0.36). The estimates of associations between radiation dose and non-cancer mortality are generally consistent with those observed in atomic bomb survivor studies. The findings of this study could be interpreted as providing further evidence that non-cancer disease risks may be increased by external radiation exposure, particularly for ischemic heart disease and cerebrovascular disease. However, heterogeneity in the estimated ERR/Sv was observed, which warrants further investigation. Further follow-up of these cohorts, with the inclusion of internal exposure information and other potential confounders associated with lifestyle factors, may prove informative, as will further work on elucidating the biological mechanisms that might cause these non-cancer effects at low doses.
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Affiliation(s)
- Michael Gillies
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, United Kingdom
| | - David B. Richardson
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Elisabeth Cardis
- ISGlobal, Center for Research in Environmental Epidemiology (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Jacqueline A. O’Hagan
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, United Kingdom
| | - Richard Haylock
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, United Kingdom
| | - Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SRBE/LEPID, 92262 Fontenay-aux-Roses, France
| | - Klervi Leuraud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SRBE/LEPID, 92262 Fontenay-aux-Roses, France
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Song KH, Jung SY, Kho SH, Hwang SG, Ha H, Nam SY, Song JY. Effects of low-dose irradiation on mice with Escherichia coli-induced sepsis. Toxicol Appl Pharmacol 2017; 333:17-25. [PMID: 28818514 DOI: 10.1016/j.taap.2017.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/08/2017] [Accepted: 08/11/2017] [Indexed: 11/19/2022]
Abstract
Although favorable immune responses to low-dose irradiation (LDI) have been observed in normal mice, i.e., a hormesis effect, little is known about the effects of LDI in infectious diseases. In this study, we examined the effects of LDI on mice with sepsis, a severe and often lethal hyperinflammatory response to bacteria. Female C57BL/6 mice were whole-body irradiated with 10cGy 48h before Escherichia coli infection, and survival, bacterial clearance, cytokines, and antioxidants were quantified. LDI pretreatment significantly increased survival from 46.7% in control mice to 75% in mice with sepsis. The bacterial burden was significantly lower in the blood, spleen, and kidney of LDI-treated mice than in those of control septic mice. The levels of pro-inflammatory cytokines, e.g., IL-1β and IL-6, as well as anti-inflammatory IL-10 were markedly reduced in pre-LDI septic mice. Nitric oxide production by peritoneal macrophages was also reduced in pre-LDI septic mice. Immune cells in the spleen increased and Nrf2 and HO-1 were induced in pre-LDI septic mice. LDI stimulates the immune response and minimizes lethality in septic mice via enhanced bacterial clearance and reduced initial proinflammatory responses.
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Affiliation(s)
- Kyung-Hee Song
- Division of Applied Radiation Bioscience, Korea Institute of Radiological & Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul 01812, Republic of Korea; Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Republic of Korea
| | - Seung-Youn Jung
- Division of Applied Radiation Bioscience, Korea Institute of Radiological & Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul 01812, Republic of Korea
| | - Seong-Ho Kho
- Division of Applied Radiation Bioscience, Korea Institute of Radiological & Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul 01812, Republic of Korea
| | - Sang-Gu Hwang
- Division of Applied Radiation Bioscience, Korea Institute of Radiological & Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul 01812, Republic of Korea
| | - Hunjoo Ha
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Republic of Korea
| | - Seon Young Nam
- Low-Dose Radiation Research Team, Radiation Health Institute, Korea Hydro & Nuclear Power Co., Ltd., Seoul 01450, Republic of Korea
| | - Jie-Young Song
- Division of Applied Radiation Bioscience, Korea Institute of Radiological & Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul 01812, Republic of Korea.
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79
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Pawlick R, Gala-Lopez B, Pepper AR, Abualhassan N, Bruni A, Suzuki K, Rayat G, Elliott JF, Shapiro AMJ. Low energy X-ray (grenz ray) treatment of purified islets prior to allotransplant markedly decreases passenger leukocyte populations. Islets 2017; 9:e1330742. [PMID: 28692319 PMCID: PMC5510618 DOI: 10.1080/19382014.2017.1330742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Grenz rays, or minimally penetrating X-rays, are known to be an effective treatment of certain recalcitrant immune-mediated skin diseases, but their use in modulating allograft rejection has not been tested. We examined the capacity of grenz ray treatment to minimize islet immunogenicity and extend allograft survival in a mouse model. In a preliminary experiment, 1 of 3 immunologically intact animals demonstrated long-term acceptance of their grenz ray treated islet allograft. Further experiments revealed that 28.6% (2 of 7) grenz ray treated islet allografts survived >60 d. A low dose of 20Gy, was important; a 4-fold increase in radiation resulted in rapid graft failure, and transplanting a higher islet mass did not alter this outcome. To determine whether increased islet allograft survival after grenz treatment would be masked by immunosuppression, we treated the recipients with CTLA-4 Ig, and found an additive effect, whereby 17.5% more animals accepted the graft long-term versus those with CTLA-4 Ig alone. Cell viability assays verified that islet integrity was maintained after treatment with 20Gy. As well, through splenocyte infiltration analysis, donor CD4+ T cell populations 24-hours after transplant were decreased by more than16-fold in recipients receiving irradiated islets compared with control. Donor CD8+ T cell populations, although less prevalent, decreased in all treatment groups compared with control. Our results suggest that brief treatment of isolated islets with low energy grenz rays before allotransplantation can significantly reduce passenger leukocytes and promote graft survival, possibly by inducing donor dendritic cells to differentiate toward a tolerogenic phenotype.
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MESH Headings
- Animals
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- CTLA-4 Antigen/antagonists & inhibitors
- Cell Survival/radiation effects
- Combined Modality Therapy/adverse effects
- Diabetes Mellitus, Experimental/drug therapy
- Diabetes Mellitus, Experimental/immunology
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/surgery
- Dose-Response Relationship, Drug
- Dose-Response Relationship, Radiation
- Graft Rejection/immunology
- Graft Rejection/metabolism
- Graft Rejection/pathology
- Graft Rejection/prevention & control
- Graft Survival/drug effects
- Graft Survival/radiation effects
- Hyperglycemia/prevention & control
- Immunosuppression Therapy/adverse effects
- Immunosuppressive Agents/administration & dosage
- Immunosuppressive Agents/adverse effects
- Immunosuppressive Agents/therapeutic use
- Islets of Langerhans/immunology
- Islets of Langerhans/metabolism
- Islets of Langerhans/radiation effects
- Islets of Langerhans Transplantation/adverse effects
- Islets of Langerhans Transplantation/immunology
- Islets of Langerhans Transplantation/pathology
- Leukocytes/immunology
- Leukocytes/metabolism
- Leukocytes/pathology
- Leukocytes/radiation effects
- Male
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Recombinant Proteins/administration & dosage
- Recombinant Proteins/adverse effects
- Recombinant Proteins/therapeutic use
- Tissue Culture Techniques
- X-Rays
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Affiliation(s)
- Rena Pawlick
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
- Canadian National Transplant Research Program, Edmonton, AB, Canada
| | - Boris Gala-Lopez
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
- Canadian National Transplant Research Program, Edmonton, AB, Canada
| | - Andrew R. Pepper
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
- Canadian National Transplant Research Program, Edmonton, AB, Canada
| | - Nasser Abualhassan
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
- Canadian National Transplant Research Program, Edmonton, AB, Canada
| | - Antonio Bruni
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
- Canadian National Transplant Research Program, Edmonton, AB, Canada
| | - Kunimasa Suzuki
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB, Canada
| | - Gina Rayat
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - John F. Elliott
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
- Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB, Canada
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - A. M. James Shapiro
- Alberta Diabetes Institute, Department of Surgery, University of Alberta, Edmonton, AB, Canada
- Canadian National Transplant Research Program, Edmonton, AB, Canada
- Clinical Islet Transplant Program, University of Alberta, Edmonton, AB, Canada
- CONTACT A. M. James Shapiro, MD, PhD, FRCS(Eng), FRCSC, DSc (Hon), MSM Professor of Surgery, Director of Clinical Islet Transplant Program, AHFMR Clinical Senior Scholar, Hepatobiliary, Oncology, Pancreatic, Transplant Surgery, Roberts Centre, 2000 College Plaza, Edmonton, Alberta, Canada T6G 2C8
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80
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Erbeldinger N, Rapp F, Ktitareva S, Wendel P, Bothe AS, Dettmering T, Durante M, Friedrich T, Bertulat B, Meyer S, Cardoso MC, Hehlgans S, Rödel F, Fournier C. Measuring Leukocyte Adhesion to (Primary) Endothelial Cells after Photon and Charged Particle Exposure with a Dedicated Laminar Flow Chamber. Front Immunol 2017; 8:627. [PMID: 28620384 PMCID: PMC5451490 DOI: 10.3389/fimmu.2017.00627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/11/2017] [Indexed: 12/12/2022] Open
Abstract
The vascular endothelium interacts with all types of blood cells and is a key modulator of local and systemic inflammatory processes, for example, in the adhesion of blood leukocytes to endothelial cells (EC) and the following extravasation into the injured tissue. The endothelium is constantly exposed to mechanical forces caused by blood flow, and the resulting shear stress is essential for the maintenance of endothelial function. Changes in local hemodynamics are sensed by EC, leading to acute or persistent changes. Therefore, in vitro assessment of EC functionality should include shear stress as an essential parameter. Parallel-plate flow chambers with adjustable shear stress can be used to study EC properties. However, commercially available systems are not suitable for radiation experiments, especially with charged particles, which are increasingly used in radiotherapy of tumors. Therefore, research on charged-particle-induced vascular side effects is needed. In addition, α-particle emitters (e.g., radon) are used to treat inflammatory diseases at low doses. In the present study, we established a flow chamber system, applicable for the investigation of radiation induced changes in the adhesion of lymphocytes to EC as readout for the onset of an inflammatory reaction or the modification of a pre-existing inflammatory state. In this system, primary human EC are cultured under physiological laminar shear stress, subjected to a proinflammatory treatment and/or irradiation with X-rays or charged particles, followed by a coincubation with primary human lymphocytes (peripheral blood lymphocytes (PBL)). Analysis is performed by semiautomated quantification of fluorescent staining in microscopic pictures. First results obtained after irradiation with X-rays or helium ions indicate decreased adhesion of PBL to EC under laminar conditions for both radiation qualities, whereas adhesion of PBL under static conditions is not clearly affected by irradiation. Under static conditions, no radiation-induced changes in surface expression of adhesion molecules and activation of nuclear factor kappa B (NF-κB) signaling were observed after single cell-based high-throughput analysis. In subsequent studies, these investigations will be extended to laminar conditions.
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Affiliation(s)
- Nadine Erbeldinger
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany.,Department of Biology, Technical University Darmstadt, Darmstadt, Germany
| | - Felicitas Rapp
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
| | - Svetlana Ktitareva
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
| | - Philipp Wendel
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
| | - Anna S Bothe
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
| | - Till Dettmering
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
| | - Marco Durante
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
| | - Thomas Friedrich
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
| | - Bianca Bertulat
- Department of Biology, Technical University Darmstadt, Darmstadt, Germany
| | - Stephanie Meyer
- Department of Biology, Technical University Darmstadt, Darmstadt, Germany
| | - M C Cardoso
- Department of Biology, Technical University Darmstadt, Darmstadt, Germany
| | - Stephanie Hehlgans
- Department of Radiotherapy and Oncology, University of Frankfurt, Frankfurt, Germany
| | - Franz Rödel
- Department of Radiotherapy and Oncology, University of Frankfurt, Frankfurt, Germany
| | - Claudia Fournier
- Department of Biophysics, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
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81
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Rühle PF, Wunderlich R, Deloch L, Fournier C, Maier A, Klein G, Fietkau R, Gaipl US, Frey B. Modulation of the peripheral immune system after low-dose radon spa therapy: Detailed longitudinal immune monitoring of patients within the RAD-ON01 study. Autoimmunity 2017; 50:133-140. [DOI: 10.1080/08916934.2017.1284819] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Paul F. Rühle
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,
| | - Roland Wunderlich
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,
- Research Unit of Radiation Cytogenetics, Helmholtz Center Munich, Neuherberg, Germany,
| | - Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,
| | - Claudia Fournier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany, and
| | - Andreas Maier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany, and
| | | | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,
| | - Udo S. Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,
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82
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Valduvieco I, Biete A, Moreno LA, Gallart X, Rovirosa A, Saez J, Plana C, Peris P. Is anti-inflammatory radiotherapy an effective treatment in trochanteritis? Br J Radiol 2016; 90:20160520. [PMID: 27885851 DOI: 10.1259/bjr.20160520] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the analgesic efficacy of low-dose radiotherapy in refractory cases of trochanteritis. METHODS We evaluated a total of 60 consecutive patients who received low-dose radiotherapy to achieve an anti-inflammatory and analgesic effect for recurrent trochanteritis following scarce response to conventional therapy. All patients were evaluated at baseline (prior to radiotherapy) and at 1 and 4 months after radiotherapy and then yearly thereafter for pain assessment using a visual analogue scale (VAS) and to determine the administration of analgesic treatment. RESULTS An improvement in the symptomatology was observed in 62% of the patients with a significant reduction in the VAS (8 ± 2 vs 4 ± 2; p < 0.0001), which was largely maintained until the second evaluation at 4 months. In the cases responding to radiotherapy, the probability of maintaining improvement beyond 24 months was 70%. CONCLUSION Low-dose anti-inflammatory radiation may be used in the treatment of the recurrent cases of relapse or no response of trochanteritis to conventional treatments, with a high probability of remission of pain. These preliminary results indicate the need for evaluating the use of radiotherapy in patients with trochanteritis refractory to conventional treatment in a long-term controlled study. Advances in knowledge: Radiotherapy provides effective analgesic treatment for patients refractory to standard treatment for trochanteritis.
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Affiliation(s)
- Izaskun Valduvieco
- 1 Department of Radiation Oncology, Hospital Clínic, Institute of Haematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Albert Biete
- 1 Department of Radiation Oncology, Hospital Clínic, Institute of Haematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Luis A Moreno
- 2 Surgical Area, Anesthesia Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Xavier Gallart
- 3 Traumatology Service, Hospital Clínic, Institute of Medical and Surgical Specialties, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Angels Rovirosa
- 1 Department of Radiation Oncology, Hospital Clínic, Institute of Haematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Jordi Saez
- 2 Surgical Area, Anesthesia Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Carlos Plana
- 4 Department of Rheumatology, Hospital Clínic, Institute of Medical and Surgical Specialties, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Pilar Peris
- 4 Department of Rheumatology, Hospital Clínic, Institute of Medical and Surgical Specialties, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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83
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Dietzel CT, Schäfer C, Vordermark D. Successful treatment of chronic recurrent multifocal osteomyelitis using low-dose radiotherapy : A case report. Strahlenther Onkol 2016; 193:229-233. [PMID: 27822735 DOI: 10.1007/s00066-016-1065-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 10/06/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease, which lacks an infectious genesis and predominantly involves the metaphysis of long bones. Common treatments range from nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids at first onset of disease, to immunosuppressive drugs and bisphosphonates in cases of insufficient remission. The therapeutic use of low-dose radiotherapy for CRMO constitutes a novelty. CASE REPORT A 67-year-old female patient presented with radiologically proven CRMO affecting the right tibia/talus and no response to immunosuppressive therapy. Two treatment series of radiation therapy were applied with an interval of 6 weeks. Each series contained six fractions (three fractions per week) with single doses of 0.5 Gy, thus the total applied dose was 6 Gy. Ten months later, pain and symptoms of osteomyelitis had completely vanished. CONCLUSION Radiotherapy seems to be an efficient and feasible complementary treatment option for conventional treatment refractory CRMO in adulthood. The application of low doses per fraction is justified by the inflammatory pathomechanism of disease.
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Affiliation(s)
- Christian T Dietzel
- Universitätslinik und Poliklinik für Strahlentherapie, Klinikum der Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany.
| | - Christoph Schäfer
- Universitätsklinik und Poliklinik für Innere Medizin II, Klinikum der Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Dirk Vordermark
- Universitätslinik und Poliklinik für Strahlentherapie, Klinikum der Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany
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84
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Baselet B, Rombouts C, Benotmane AM, Baatout S, Aerts A. Cardiovascular diseases related to ionizing radiation: The risk of low-dose exposure (Review). Int J Mol Med 2016; 38:1623-1641. [PMID: 27748824 PMCID: PMC5117755 DOI: 10.3892/ijmm.2016.2777] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 09/07/2016] [Indexed: 12/27/2022] Open
Abstract
Traditionally, non-cancer diseases are not considered as health risks following exposure to low doses of ionizing radiation. Indeed, non-cancer diseases are classified as deterministic tissue reactions, which are characterized by a threshold dose. It is judged that below an absorbed dose of 100 mGy, no clinically relevant tissue damage occurs, forming the basis for the current radiation protection system concerning non-cancer effects. Recent epidemiological findings point, however, to an excess risk of non-cancer diseases following exposure to lower doses of ionizing radiation than was previously thought. The evidence is the most sound for cardiovascular disease (CVD) and cataract. Due to limited statistical power, the dose-risk relationship is undetermined below 0.5 Gy; however, if this relationship proves to be without a threshold, it may have considerable impact on current low-dose health risk estimates. In this review, we describe the CVD risk related to low doses of ionizing radiation, the clinical manifestation and the pathology of radiation-induced CVD, as well as the importance of the endothelium models in CVD research as a way forward to complement the epidemiological data with the underlying biological and molecular mechanisms.
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Affiliation(s)
- Bjorn Baselet
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK•CEN), Mol, Belgium
| | - Charlotte Rombouts
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK•CEN), Mol, Belgium
| | - Abderrafi Mohammed Benotmane
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK•CEN), Mol, Belgium
| | - Sarah Baatout
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK•CEN), Mol, Belgium
| | - An Aerts
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK•CEN), Mol, Belgium
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Oestreicher E, Bartsch H, Mayr D, Schubert M, Weber B, Kneschaurek P, Assmann W, Sroka R, Betz CS. Preclinical study investigating the potential of low-dose-rate brachytherapy with 32P stents for the prevention of restenosis of paranasal neo-ostia. Brachytherapy 2016; 16:207-214. [PMID: 27693170 DOI: 10.1016/j.brachy.2016.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 08/29/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE Ostial restenosis is a common cause of failures in paranasal sinus surgery. The aim of the current study was to investigate the use of low-dose-rate brachytherapy to prevent neo-ostial restenosis in an animal model. METHODS AND MATERIALS In 14 rabbits, maxillary neo-ostia were created and measured. One side each was stented with a regular silicone stent, the other side was either not stented (n = 7) or stented with a phosphorous-32 implanted stent depositing a low-dose radiation of 15 Gy (n = 7) within 1 week, after which all stents were removed. After a period of additional 12 weeks of recovery, the animals were sacrificed, the neo-ostia were again measured, and the areas and histopathologic changes compared in between the groups. RESULTS After 15-Gy stenting, the mean ostial areas were even slightly enlarged by 5.1% compared to the area at stent removal, whereas a significant reduction in area, indicating a process of restenosis, by 56.1% or 54.0% was seen in the control groups with no stent and normal stent, respectively. Furthermore, no indication for adverse histopathologic radiation effects was seen in the 15-Gy group. CONCLUSIONS Low-dose-rate brachytherapy with phosphorous-32 doped silicone stents showed promising results in the prevention of neo-ostium restenosis in this proof-of-concept study, indicating that further preclinical and clinical testing may be warranted.
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Affiliation(s)
- Elmar Oestreicher
- Department of Otorhinolaryngology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Harald Bartsch
- Institute of Pathology, Ludwig Maximilian University, Munich, Germany
| | - Doris Mayr
- Institute of Pathology, Ludwig Maximilian University, Munich, Germany
| | - Mario Schubert
- Department of Medical Physics, Ludwig Maximilian University, Garching, Germany
| | - Barbara Weber
- Department of Otorhinolaryngology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Peter Kneschaurek
- Department of Radiotherapy and Radiation Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Walter Assmann
- Department of Medical Physics, Ludwig Maximilian University, Garching, Germany
| | - Ronald Sroka
- Laser Research Laboratory, LIFE Centre, Klinikum der Universität München, Munich, Germany; Department of Urology, Klinikum der Universität München, Munich, Germany
| | - Christian Stephan Betz
- Laser Research Laboratory, LIFE Centre, Klinikum der Universität München, Munich, Germany; Department of Otorhinolaryngology, Klinikum der Universität München, Munich, Germany.
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Arenas M, Sabater S, Jiménez PL, Rovirosa À, Biete A, Linares V, Belles M, Panés J. Radiotherapy for Graves' disease. The possible role of low-dose radiotherapy. Rep Pract Oncol Radiother 2016; 21:213-8. [PMID: 27601953 DOI: 10.1016/j.rpor.2016.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 02/06/2016] [Indexed: 10/22/2022] Open
Abstract
Immunomodulatory effects of low-dose radiotherapy (LD-RT) have been used for the treatment of several benign diseases, including arthrodegenerative and inflammatory pathologies. Graves' disease is an autoimmune disease and radiotherapy (RT) is a therapeutic option for ocular complications. The dose recommended in the clinical practice is 20 Gy (2 Gy/day). We hypothesized that lower doses (<10 Gy total dose, <1 Gy/day) could results in higher efficacy if we achieved anti-inflammatory and immunomodulatory effects of LD-RT. We review current evidence on the effects of RT in the treatment of Graves' disease and the possible use of LD-RT treatment strategy.
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Affiliation(s)
- Meritxell Arenas
- Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Institut d'Investigacions Sanitàries Pere Virgili (IISPV), Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Sebastià Sabater
- Radiation Oncology Department, Complejo Hospitalario Universitario Albacete (CHUA), Spain
| | - Pedro Lara Jiménez
- Radiation Oncology Department, Hospital Universitario Dr Negrín, Universidad Las Palmas de Gran Canaria (LPGC), Las Palmas de Gran Canaria, Spain
| | - Àngels Rovirosa
- Radiation Oncology Department, Hospital Universitari Clínic de Barcelona, Spain
| | - Albert Biete
- Radiation Oncology Department, Hospital Universitari Clínic de Barcelona, Spain
| | - Victoria Linares
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, URV, Reus, Spain
| | - Montse Belles
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, URV, Reus, Spain
| | - Julià Panés
- Gastroenterology Department, Hospital Universitari Clínic de Barcelona, Spain
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di Chio F, Cecere A, Troiano M, Mardighian A, Parisi S, Guglielmi G. Persistent Haglund's disease after conventional treatments: the innovative role of radiotherapy. BJR Case Rep 2016; 2:20150272. [PMID: 30363604 PMCID: PMC6180870 DOI: 10.1259/bjrcr.20150272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 12/09/2015] [Accepted: 12/14/2015] [Indexed: 12/03/2022] Open
Abstract
Haglund’s disease, an inflammation of the retrocalcaneal bursa and a bone enlargement on the back of the heel, is a painful syndrome mainly caused by the exostotic prominence of the posterior calcaneus. Conventional treatment consists of rest, shoewear modification, medical therapy and, in selected cases, surgery. We report the case of a 59-year-old male with a history of severe atraumatic monolateral heel pain treated with foot orthotics, rest and surgery with partial regression of symptoms. Owing to the persistent heel pain and physical impairment after surgery, the patient underwent radiotherapy, which was successful in relieving his symptoms.
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Affiliation(s)
| | | | - Michele Troiano
- Department of Radiation Oncology, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy
| | | | - Salvatore Parisi
- Department of Radiation Oncology, Scientific Institute Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy
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89
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Brückner M, Lenz P, Mücke MM, Gohar F, Willeke P, Domagk D, Bettenworth D. Diagnostic imaging advances in murine models of colitis. World J Gastroenterol 2016; 22:996-1007. [PMID: 26811642 PMCID: PMC4716050 DOI: 10.3748/wjg.v22.i3.996] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/09/2015] [Accepted: 11/13/2015] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis are chronic-remittent inflammatory disorders of the gastrointestinal tract still evoking challenging clinical diagnostic and therapeutic situations. Murine models of experimental colitis are a vital component of research into human IBD concerning questions of its complex pathogenesis or the evaluation of potential new drugs. To monitor the course of colitis, to the present day, classical parameters like histological tissue alterations or analysis of mucosal cytokine/chemokine expression often require euthanasia of animals. Recent advances mean revolutionary non-invasive imaging techniques for in vivo murine colitis diagnostics are increasingly available. These novel and emerging imaging techniques not only allow direct visualization of intestinal inflammation, but also enable molecular imaging and targeting of specific alterations of the inflamed murine mucosa. For the first time, in vivo imaging techniques allow for longitudinal examinations and evaluation of intra-individual therapeutic response. This review discusses the latest developments in the different fields of ultrasound, molecularly targeted contrast agent ultrasound, fluorescence endoscopy, confocal laser endomicroscopy as well as tomographic imaging with magnetic resonance imaging, computed tomography and fluorescence-mediated tomography, discussing their individual limitations and potential future diagnostic applications in the management of human patients with IBD.
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90
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Treatment of folliculitis decalvans using intensity-modulated radiation via tomotherapy. Strahlenther Onkol 2015; 191:883-8. [DOI: 10.1007/s00066-015-0891-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/19/2015] [Indexed: 01/28/2023]
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Song KH, Kim MH, Kang SM, Jung SY, Ahn J, Woo HJ, Nam SY, Hwang SG, Ryu SY, Song JY. Analysis of immune cell populations and cytokine profiles in murine splenocytes exposed to whole-body low-dose irradiation. Int J Radiat Biol 2015; 91:795-803. [PMID: 26136089 DOI: 10.3109/09553002.2015.1068461] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE In contrast to high-dose therapeutic irradiation, definitive research detailing the physiological effects of low-dose irradiation is limited. Notably, the immunological response elicited after low-dose irradiation remains controversial. MATERIALS AND METHODS Female C57BL/6 mice were whole- body-irradiated with a single or three daily fractions up to a total dose of 0.1, 1, or 10 cGy. Blood and spleen were harvested 2, 7 and 14 days after irradiation. RESULTS The splenic CD4(+) T cell subpopulations were temporarily increased at 2 days after single or fractionated irradiation, whereas the percentage of dendritic cells (DC) and macrophages was decreased. Whereas CD8(+) T cell populations were decreased in single-dose irradiated mice at day 7, early and sustained reduction of CD8(+) T cell numbers was observed in fractionated- dose-irradiated mice from day 2 until day 14. In addition, single-dose irradiation resulted in a Th1 cytokine expression profile, whereas fractionated-dose irradiation drove a Th2 shift. Additionally, increased expression of immune-related factors was observed at early time-points with single-dose irradiation, in contrast to the dose-independent induction following fractionated-dose irradiation. CONCLUSIONS Our results demonstrate that low-dose irradiation modulates the immune response in mice, where the sensitivity and kinetics of the induced response vary according to the dosing method.
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Affiliation(s)
- Kyung-Hee Song
- a Division of Radiation Cancer Research, Korea Institute of Radiological & Medical Sciences , Seoul , Republic of Korea
| | - Mi-Hyoung Kim
- a Division of Radiation Cancer Research, Korea Institute of Radiological & Medical Sciences , Seoul , Republic of Korea.,b Laboratory of Immunology, College of Veterinary Medicine, Seoul National University , Seoul , Republic of Korea
| | - Seong-Mook Kang
- a Division of Radiation Cancer Research, Korea Institute of Radiological & Medical Sciences , Seoul , Republic of Korea
| | - Seung-Youn Jung
- a Division of Radiation Cancer Research, Korea Institute of Radiological & Medical Sciences , Seoul , Republic of Korea
| | - Jiyeon Ahn
- a Division of Radiation Cancer Research, Korea Institute of Radiological & Medical Sciences , Seoul , Republic of Korea
| | - Hee-Jong Woo
- b Laboratory of Immunology, College of Veterinary Medicine, Seoul National University , Seoul , Republic of Korea
| | - Seon Young Nam
- c Radiation Effect Research Team, Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd , Seoul , Republic of Korea
| | - Sang-Gu Hwang
- a Division of Radiation Cancer Research, Korea Institute of Radiological & Medical Sciences , Seoul , Republic of Korea
| | - Sang-Young Ryu
- d Department of Obstetrics and Gynecology , Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences , Seoul , Republic of Korea
| | - Jie-Young Song
- a Division of Radiation Cancer Research, Korea Institute of Radiological & Medical Sciences , Seoul , Republic of Korea
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Yao JJ, Zhou GQ, Yu XL, Tang LL, Chen L, Mao YP, Lin L, Zhang LL, Shao JY, Guo Y, Ma J, Sun Y. Incidence of and Risk Factors for Mastoiditis after Intensity Modulated Radiotherapy in Nasopharyngeal Carcinoma. PLoS One 2015; 10:e0131284. [PMID: 26114761 PMCID: PMC4483256 DOI: 10.1371/journal.pone.0131284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 06/01/2015] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To report the incidence of and risk factors for mastoiditis after intensity-modulated radiotherapy (IMRT) in nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS Retrospective analysis of pretreatment and follow-up magnetic resonance imaging (MRI) data for 451 patients with NPC treated with IMRT at a single institution. The diagnosis of mastoiditis was based on MRI; otomastoid opacification was rated as Grade 0 (none), 1 (mild), 2 (moderate) or 3 (severe) by radiologists blinded to clinical outcome. This study mainly focused on severe mastoiditis; patients were divided into three groups: the G0M (Grade 0 mastoiditis before treatment) group, G1-2M (Grade 1 to 2 mastoiditis before treatment) group and G3M (Grade 3 mastoiditis before treatment) group. The software SAS9.3 program was used to analyze the data. RESULTS For the entire cohort, the incidence of Grade 3 mastoiditis was 20% before treatment and 31%, 19% and 17% at 3, 12 and 24 months after radiotherapy, respectively. In the G0M group, the incidence of severe mastoiditis was 0% before treatment and 23%, 15% and 13% at 3, 12 and 24 months after radiotherapy, respectively. Multivariate analysis revealed T category (OR=0.68, 95% CI = 0.469 to 0.984), time (OR=0.668, 95% CI = 0.59 to 0.757) and chemotherapy (OR=0.598, 95% CI = 0.343 to 0.934) were independent factors associated with severe mastoiditis in the G0M group after treatment. CONCLUSIONS Mastoiditis, as diagnosed by MRI, occurs as a progressive process that regresses and resolves over time in patients with NPC treated using IMRT.
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Affiliation(s)
- Ji-Jin Yao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Guan-Qun Zhou
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Xiao-Li Yu
- Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Ling-Long Tang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Lei Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Li Lin
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Lu-Lu Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Jian-Yong Shao
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Ying Guo
- Department of Medical Statistics and Epidemiology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, People’s Republic of China
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External Beam Radiation Therapy: A Treatment Modality in Diffuse Tracheobronchial Amyloidosis. Arch Bronconeumol 2015; 51:607-8. [PMID: 26093798 DOI: 10.1016/j.arbres.2015.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 05/05/2015] [Accepted: 05/06/2015] [Indexed: 11/21/2022]
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94
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Brachytherapy in Neovascular AMD. CURRENT OPHTHALMOLOGY REPORTS 2015. [DOI: 10.1007/s40135-014-0061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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95
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Morgan WF, Sowa MB. Non-targeted effects induced by ionizing radiation: Mechanisms and potential impact on radiation induced health effects. Cancer Lett 2015; 356:17-21. [DOI: 10.1016/j.canlet.2013.09.009] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 08/27/2013] [Accepted: 09/08/2013] [Indexed: 01/08/2023]
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96
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Low dose radiotherapy for plantar fasciitis. Treatment outcome of 171 patients. Foot (Edinb) 2014; 24:172-5. [PMID: 25201122 DOI: 10.1016/j.foot.2014.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 07/14/2014] [Accepted: 07/16/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although the effectiveness of low-dose radiotherapy for chronic degenerative and inflammatory diseases has been documented in previous studies, patient-reported clinical outcomes are rarely available. OBJECTIVE This study aimed to determine the effect of low-dose radiotherapy on patients with painful plantar fasciitis. METHOD From 2002 to 2008, 200 patients older than 65 years of age with painful plantar fasciitis were treated in our hospital. Records from 171 of these patients were available for analysis. All patients were treated with an identical dose of 3Gy using identical equipment and techniques. Response was evaluated with patient-reported questionnaires and clinical visits. RESULTS Minimum-term follow-up was 18 months, with mean follow-up at 54 months. Three months after receiving low-dose radiotherapy, 67.3% of patients had no or mild pain, and 57.9% had no or discrete mobility restriction. At a mean of 54 months, 61.4% of patients had no or mild pain and 64.9% of patients had no or discrete mobility restriction; 60.8% of patients reported improved quality of life. CONCLUSION Low-dose radiotherapy is effective in most patients with painful plantar fasciitis. Due to minimal side effects and low costs, it represents an excellent treatment option compared to conventional therapies or surgery.
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97
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Introini U, Casalino G, Triolo G, O'Shaughnessy D, Shusterman EM, Chakravarthy U, Slakter JS, Bandello F. Stereotactic radiotherapy for polypoidal choroidal vasculopathy: a pilot study. Ophthalmologica 2014; 233:82-8. [PMID: 25402871 DOI: 10.1159/000368561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/17/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate low-voltage X-ray stereotactic radiotherapy (SRT) delivered in conjunction with intravitreal ranibizumab for the treatment of active macular polypoidal choroidal vasculopathy (PCV). METHODS At baseline, all eyes received an intravitreal injection of ranibizumab, followed by 16-Gy X-ray SRT to the macula. Further ranibizumab injections were given pro re nata. The primary outcome measure was regression of the polyps assessed by indocyanine green angiography. Secondary outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT) changes on optical coherence tomography. Local or systemic adverse events were evaluated as well. RESULTS We examined 12 eyes of 12 patients with PCV. At month 12, an angiographic regression of the polyps was observed in 10 of the 12 eyes. The mean BCVA improved by 7.6 letters: from 65.08 ± 11.4 to 72.7 ± 14.75 letters on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. The mean CFT decreased from 372.3 ± 79.6 to 215.9 ± 57.9 µm (p < 0.01). No local or systemic adverse events were reported. CONCLUSIONS The preliminary data support the safety of low-voltage X-ray SRT for the treatment of macular PCV and show polyp closure, reduction in CFT and improvement in the mean BCVA. Additional research is warranted to confirm the efficacy and longer-term safety of this therapy in this population.
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Affiliation(s)
- Ugo Introini
- Department of Ophthalmology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
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Kon Graversen V, Chavala SH. MDM2 inhibitors in the search for an optimized neovascular age-related macular degeneration treatment. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/17469899.2014.952225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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99
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Lee KF, Weng JTY, Hsu PWC, Chi YH, Chen CK, Liu IY, Chen YC, Wu LSH. Gene expression profiling of biological pathway alterations by radiation exposure. BIOMED RESEARCH INTERNATIONAL 2014; 2014:834087. [PMID: 25276823 PMCID: PMC4170887 DOI: 10.1155/2014/834087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/21/2014] [Indexed: 11/18/2022]
Abstract
Though damage caused by radiation has been the focus of rigorous research, the mechanisms through which radiation exerts harmful effects on cells are complex and not well-understood. In particular, the influence of low dose radiation exposure on the regulation of genes and pathways remains unclear. In an attempt to investigate the molecular alterations induced by varying doses of radiation, a genome-wide expression analysis was conducted. Peripheral blood mononuclear cells were collected from five participants and each sample was subjected to 0.5 Gy, 1 Gy, 2.5 Gy, and 5 Gy of cobalt 60 radiation, followed by array-based expression profiling. Gene set enrichment analysis indicated that the immune system and cancer development pathways appeared to be the major affected targets by radiation exposure. Therefore, 1 Gy radioactive exposure seemed to be a critical threshold dosage. In fact, after 1 Gy radiation exposure, expression levels of several genes including FADD, TNFRSF10B, TNFRSF8, TNFRSF10A, TNFSF10, TNFSF8, CASP1, and CASP4 that are associated with carcinogenesis and metabolic disorders showed significant alterations. Our results suggest that exposure to low-dose radiation may elicit changes in metabolic and immune pathways, potentially increasing the risk of immune dysfunctions and metabolic disorders.
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Affiliation(s)
- Kuei-Fang Lee
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
- Laboratory for Cytogenetics, Center for Genetic Counseling, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan
| | - Julia Tzu-Ya Weng
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, Chungli 32003, Taiwan
- Department of Computer Science and Engineering, Yuan Ze University, Chungli 32003, Taiwan
| | - Paul Wei-Che Hsu
- Bioinformatics Core Laboratory, Institute of Molecular Biology, Academia Sinica, Taipei 11529, Taiwan
| | - Yu-Hsiang Chi
- Department of Computer Science and Engineering, Yuan Ze University, Chungli 32003, Taiwan
| | - Ching-Kai Chen
- Department of Computer Science and Engineering, Yuan Ze University, Chungli 32003, Taiwan
| | - Ingrid Y. Liu
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien 970, Taiwan
| | - Yi-Cheng Chen
- Department of Computer Science & Information Engineering, Tamkang University, New Taipei City 25137, Taiwan
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Laiakis EC, Strassburg K, Bogumil R, Lai S, Vreeken RJ, Hankemeier T, Langridge J, Plumb RS, Fornace AJ, Astarita G. Metabolic phenotyping reveals a lipid mediator response to ionizing radiation. J Proteome Res 2014; 13:4143-54. [PMID: 25126707 PMCID: PMC4156265 DOI: 10.1021/pr5005295] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Exposure to ionizing radiation has dramatically increased in modern society, raising serious health concerns. The molecular response to ionizing radiation, however, is still not completely understood. Here, we screened mouse serum for metabolic alterations following an acute exposure to γ radiation using a multiplatform mass-spectrometry-based strategy. A global, molecular profiling revealed that mouse serum undergoes a series of significant molecular alterations following radiation exposure. We identified and quantified bioactive metabolites belonging to key biochemical pathways and low-abundance, oxygenated, polyunsaturated fatty acids (PUFAs) in the two groups of animals. Exposure to γ radiation induced a significant increase in the serum levels of ether phosphatidylcholines (PCs) while decreasing the levels of diacyl PCs carrying PUFAs. In exposed mice, levels of pro-inflammatory, oxygenated metabolites of arachidonic acid increased, whereas levels of anti-inflammatory metabolites of omega-3 PUFAs decreased. Our results indicate a specific serum lipidomic biosignature that could be utilized as an indicator of radiation exposure and as novel target for therapeutic intervention. Monitoring such a molecular response to radiation exposure might have implications not only for radiation pathology but also for countermeasures and personalized medicine.
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Affiliation(s)
- Evagelia C Laiakis
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University , Washington DC 20057, United States
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