Mining the past to treat the present, ever mindful of the future: Low-dose radiotherapy and COVID-19 pneumonia

What Would Become of Nuclear Risk if Governments Changed Their Regulations to Recognize the Evidence of Radiation's Beneficial Health Effects for Exposures That Are Below the Thresholds for Detrimental Effects?

The 1953 Atoms for Peace Speech to the United Nations proposed applying nuclear energy to essential needs, including abundant electrical energy. The widespread fear of ionizing radiation from nuclear facilities and medical procedures began after the United States National Academy of Sciences performed a study of radiation dangers to the human genome. This study, initiated and managed by an oil industry benefactor, recommended in 1956 that the risk of radiation-induced mutations be assessed using the linear no-threshold dose-response model instead of the threshold model. It was followed by a study that wrongly linked low radiation to cancer among the atomic bomb survivors. The ensuing controversy resulted in a compromise. The National Committee on Radiation Protection adopted the precautionary principle policy in 1959, justified by fear of cancer and lack of knowledge. The United States and all other countries followed this recommendation, which remains unchanged 62 years later. Its impact on nuclear energy and medicine has been profound. Many costly regulations have been enacted to prevent very unlikely human or equipment failures-failures that would lead to radiation exposures that are below the dose thresholds for lasting harmful effects. Potential low-dose radiation therapies, against inflammation, cancer, autoimmune, and neurodegenerative diseases, are shunned.

The systemic pro-inflammatory response: targeting the dangerous liaison between COVID-19 and cancer

Inflammation is an established driver of severe SARS-CoV-2 infection and a mechanism linked to the increased susceptibility to fatal COVID-19 demonstrated by patients with cancer. As patients with cancer exhibit a higher level of inflammation compared with the general patient population, patients with cancer and COVID-19 may uniquely benefit from strategies targeted at overcoming the unrestrained pro-inflammatory response. Targeted and non-targeted anti-inflammatory therapies may prevent end-organ damage in SARS-CoV-2-infected patients with cancer and decrease mortality. Here, we review the clinical role of selective inhibition of pro-inflammatory interleukins, tyrosine kinase modulation, anti-tumor necrosis factor agents, and other non-targeted approaches including corticosteroids in their roles as disease-modulating agents in patients with COVID-19 and cancer. Investigation of these therapeutics in this highly vulnerable patient group is posited to facilitate the development of tailored therapeutics for this patient population, aiding the transition of systemic inflammation from a prognostic domain to a source of therapeutic targets.

Mining the past to treat the present, ever mindful of the future: Low-dose radiotherapy and COVID-19 pneumonia

This editorial discusses an interim analysis of the clinical trial by Hess et al. The trial examines the use of low‐dose radiotherapy in the treatment of patients with coronavirus disease 2019 (COVID‐19) pneumonia.