Hormesis, an update of the present position

222Rn and 226Ra concentrations in selected shallow circulation groundwaters from the Fore-Sudetic Monocline area

Natural radioactive isotopes occur in various components of the natural environment, including groundwater. The general population, not always aware of possible threats, can use its resources. The activity concentration of some of the radioactive isotopes should be monitored, especially in those intakes from which it is possible to obtain water for human consumption, e.g. in domestic wells. The conducted research was innovative due to the fact that in many countries, including Poland, there are no regulations on waters exploited from home wells using as a drinking water source. As the groundwaters from this area have not been examined for radon (²²²Rn) and radium (²²⁶Ra) occurrence yet, the goal of this research was to perform screening tests in this part of the Fore-Sudetic Monocline. For this purpose, the authors have measured the concentration of ²²²Rn and ²²⁶Ra activity in groundwater collected from this geological unit located in south-western Poland. ²²²Rn and ²²⁶Ra occurrence was researched, and specific electrolytic conductivity, redox potential, pH and temperature were measured in 52 groundwater samples. ²²²Rn activity concentration ranged from 0.18 to 19.78 Bq/dm³. Only in three cases, ²²⁶Ra activity concentration reached a value above the lower detection limit of the applied method, i.e. 0.05 Bq/dm³ (max. 0.77 Bq/dm³). The authors present completely new data on the occurrence of these radioactive isotopes in the waters of the first aquifer in the Fore-Sudetic Monocline, which is not without significance for the health of consumers of these waters.

Eliminating the stigma: A systematic review of the health effects of low-dose radiation within the diagnostic imaging department and its implications for the future of medical radiation

BACKGROUND

Low-dose radiation exposure to Canadians is exponentially increasing due to the influx of diagnostic imaging and medical procedures that utilize radiation. Despite the use of medical radiation since 1896, the standardized acceptable dose for the Canadian public is still debated. The current annual dose limit for the public is set at 1 millisievert (mSv). This set dose limit intrinsically restricts the use of medical radiation for diagnosis due to concerns of public health.

METHODS

This systematic review is in the form of a retrospective meta-analysis of previous experimental studies and observational reviews of low-dose radiation health effects. A database search using PubMed and Medscape identified 1,296 articles using the terms "low-dose radiation", "radiation hormesis", "radiation safety", "dose exposure", and "medical radiation". Full text articles were excluded for the following reasons: radiation dose level not <100mSv, results of radiation effects not included, or no inclusion of biologic effects on living tissue. After screening, 15 studies were selected for inclusion.

RESULTS

The concerns of radiation exposure are based on epidemiological and experimental studies that have indicated that high-dose ionizing radiation has toxic effects and increases cancer risk. In contrast, low-dose radiation has experimentally demonstrated various beneficial effects through a combination of molecular and cohort studies, randomized control trials, and observational analysis. The limitation of radiation in medical imaging is founded on the assumption that low-dose radiation health risks are a linear extrapolation of high-dose radiation.

DISCUSSION/CONCLUSIONS

Through a systematic review of research, it is proposed that the current dose-response extrapolation for radiation-related health risks cannot be linearly based on the effects at high doses. By altering this knowledge, we could effectively improve patient diagnosis and public health by redefining the restrictions of current radiation limits within diagnostic imaging.

Radon: a radioactive therapeutic element

This paper presents selected issues related to the use of 222Rn in therapeutic treatments. Radon is a radioactive element whose usage in medicine for more than 100 years is based on the radiation hormesis theory. However, owing to the radioactive character of this element and the fact that its alpha-radioactive decay is the source of other radionuclides, its therapeutic application has been raising serious doubts. The author points to potential sources and carriers of radon in the environment that could supply radon for use in a variety of therapies. Except for centuries-long tradition of using radon groundwaters, and later also the air in caves and underground workings, the author would also like to focus on soil air, which is still underestimated as a source of radon. The text presents different methods of obtaining this radioactive gas from groundwaters, the air in caves, mining galleries and soil air, and it presents new possibilities in this field. The author also discusses problems related to the transportation and storage of radon obtained from the environment.

Within radon-prone areas, it is often necessary to de-radon groundwaters that are intended for human consumption and household usage. Also, dry radon wells are used to prevent radon migration from the ground into residential buildings. The author proposes using radon released from radon groundwaters and amassed in dry radon wells for radonotherapy treatments. Thanks to this, it is possible to reduce the cost of radiological protection of people within radon-prone areas while still exploiting the 222Rn obtained for a variety of therapies.

With regard to the ongoing and still unsettled dispute concerning the beneficial or detrimental impact of radon on the human organism, the author puts special emphasis on the necessity of strictly monitoring both the activity concentration of 222Rn in media used for therapeutic treatments and of its radioactive decay products. Monitoring should be also extended to the environments in which such treatments are delivered (inhalatoriums, baths, saunas, showers, pools and other facilities), as well as to the patients – during and after the radonotherapy treatments. It is also essential to monitor the dose of radon and its daughters that is received by persons undergoing radon therapy. This should facilitate the assessment of the effectiveness of these treatments, which may contribute to a fuller understanding of the mechanisms of radon impact, and ionizing radiation in general, on the human organism. This will make it easier to ultimately confirm or reject the radiation hormesis theory. It is also essential to monitor the effective dose that is received by medical and technical staff employed to deliver the radonotherapy treatments.

Hormetic use of stress in gerontological interventions requires a cautious approach

Hormesis as a general principle is conceivable only for factors that are present in the natural environment. For such factors, existence of an optimal level can be assumed, which would correspond to the current environmental level or some average of historic levels. Theoretic basis of some hormetic mechanisms has been discussed within the scope of stress response pathways. Impacts of multiple stressing agents may produce combined effects larger than those expected from isolated impacts i.e. act synergistically. Adding the effect of a damaging stress to another damaging stress would possibly augment the damage; but if two mild stresses have positive hormetic effects, their combination can have additive positive effects. Potential adverse effects of excessive doses of hormetic agents should be pointed out particularly for senile age or a state close to decompensation when minor stimuli might be damaging. In conclusion, a hormetic use of stress in gerontological interventions requires a cautious approach.

Improving the in vitro ethoxyresorufin-O-deethylase (EROD) assay with RTL-W1 by metabolic normalization and use of β-naphthoflavone as the reference substance

The ethoxyresorufin-O-deethylase (EROD) assay is a widely applied method for the evaluation of the dioxin-like activity of single substances and environmental samples. As for most enzyme assays, the specific activity is normally related to total protein contents, the determination of which has clear limitations in high-throughput assays. EROD induction potentials are usually expressed as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) equivalents, a substance highly toxic to humans. In order to compensate for these shortcomings, two modifications of the EROD protocol are proposed: (1) EROD activity is normalized to the metabolic activity of the cells as determined by a modified thiazolyl blue tetrazolium (MTT) assay and expressed as metabolic cell equivalents (MCE) based on MTT data rather than to protein contents. Via MCE data, cytotoxicity information can always be reported in parallel to EROD data; with the protocol presented here, MTT and EROD data are collected simultaneously. (2) Among several reference substances tested (2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), β-naphthoflavone and benzo[a]pyrene), β-naphthoflavone proved to be the most suitable reference for the routine in vitro EROD assay, although TCDD has generally been preferred for purely scientific reasons.

Hormesis and radiation safety norms

Today's radiation safety norms are based on the linear no-threshold theory (LNT): extrapolation of the dose-response relationships down to the minimal doses, where such relationships are unproven and can be inverse due to hormesis. The most promising way to obtaining reliable data on the dose-effect relationships for low radiation doses would be large-scale animal experiments. Outstanding published data on carcinogenic effects of the doses e.g. below 100 mSv should be verified by experiments. Arguments against applicability of the LNT to the doses comparable to those from the natural radiation background are discussed. Furthermore it is stressed that medical consequences of the Chernobyl accident have been overestimated; and this theme has been exploited to strangle development of atomic energy and to elevate prices for fossil fuels. Worldwide introduction of nuclear energy will be possible only after a concentration of authority within a powerful international executive. It would enable the construction of nuclear reactors in optimally suitable places, considering all sociopolitical, geographical, and geological conditions, which would contribute to the prevention of accidents like in Japan in 2011. A concluding point is that radiation safety norms are exceedingly restrictive and should be revised to become more realistic and workable. Elevation of the limits must be accompanied by measures guaranteeing their strict observance. It is also concluded that there are no evidence-based contraindications to fivefold elevation of the total equivalent effective doses to individual members of the public (up to 5 mSv/year), and doubling of the limits for professional exposures.

Stress and fish reproduction: the roles of allostasis and hormesis

This paper is a review of the effects of stress on reproduction in fishes. I hope to further the development of the concepts of allostasis and hormesis as relevant to understanding reproduction in general and in fish in particular. The main contentions I derive in this review are the following: Stressors affect fish reproduction in a variety of ways depending on the nature and severity of the stressor. The effects are transduced through a hormonal cascade initiated by perception of the stressor and involving the hypothalamus-pituitary-interrenal axis, the catecholamines, and also cytokines. Mounting a stress response and resisting a stressor is an energetically costly process, including costs associated with allostasis, attempting to reset homeostatic norms. Responses in emergency situations (e.g., being chased by a predator or a net) can be different from those where fish can cope (e.g., being in a more crowded environment) with a stressor, but both situations involve energy re-budgeting. Emergency responses happen in concert with the onset of energy limitations (e.g., the fish may not eat), while coping with allostatic overload can happen in a more energy-rich environment (e.g., the fish can continue to eat). Low levels of stress may have a positive effect on reproductive processes while greater stress has negative effects on fish reproduction. The concept of hormesis is a useful way to think about the effect of stressors on fish reproduction since responses can be nonmonotonal, often biphasic.

The Benefits of Calorie Restriction and Calorie Restriction Mimetics as Related to the Eye

The effects of calorie restriction without malnutrition seem to possess many beneficial effects in numerous disease states. Recently, studies related to calorie restriction mimetics that biochemically mimic the effects of calorie restriction are also becoming increasingly popular. Both calorie restriction and calorie restriction mimetics trigger an adaptive response reminiscent of mild-stress or low-dose toxic response, which is frequently referred to as hormesis in the toxicology literature. Although some benefits of calorie restriction and calorie restriction mimetics have been studied, the role of hormesis-related pathways in the eye has not been given a special attention. This review will present the current literature on calorie restriction and calorie restriction mimetics as related to most prominent eye diseases and provide insights on the therapeutic role of hormesis in eye diseases.

Update on linear non-threshold dose-response model and implications for diagnostic radiology procedures

Cancer risk estimates are used in the setting of radiation protection standards by international and national organizations, and for this purpose need to be developed for low doses of radiation. The approach has involved extrapolation from cancer mortality and incidence values at higher doses to predict the low-dose estimates. Such an extrapolation has generally involved the use of the linear non-threshold (LNT) theory. Recent reports from the National Research Council (BEIR VII) and the International Commission on Radiological Protection (ICRP) have considered the appropriateness of the use of LNT for the purposes of radiation protection standard setting. The overall conclusion from both committees was that current scientific evidence remains consistent with the LNT hypothesis, while appreciating that this might not rule out the possibility that other extrapolation models might well be valid but require further evaluation and additional research to establish their validity. The dose and dose-rate effectiveness factor (DDREF) is used for adjustment in the extrapolation from high to low doses and from high to low dose rates. The BEIR VII committee proposed a new Bayesian approach for estimating DDREF and concluded that a value of 1.5 best fit the data. This is a departure from the previously used value of 2, which is still proposed by ICRP in its most recent recommendations. The current cancer risk estimation process as utilized by ICRP and BEIR VII is used here to assess the potential risks from annual whole-body computed tomography (CT) screens using information and an approach published by Brenner and Ellington. The major conclusion is that potential radiation risks need to be considered along with the pros and cons of the detection limits of the procedure and the impact of false positives.

Low-dose radiation and its clinical implications: diabetes

Induction of hormesis and adaptive response by low-dose radiation (LDR) has been extensively indicated. Adaptive response induced by LDR was not only resistant to damage caused by a subsequently high-dose radiation, but also cross-resistant to other non-radiation challenges, such as chemicals. Mechanisms by which LDR induces the preventive effect on radiation- or chemical-induced tissue damage include induced or up-regulated expression of protective proteins, such as heat shock proteins and antioxidants. Since oxidative damage to tissues is a major pathogenesis of many human diseases including diabetes, this review will summarize the available data with an emphasis of the preventive effect of LDR on the development of diabetes and the therapeutic effect of LDR on diabetic cardiovascular complications. The available data indicated that pre-exposure of mice to LDR reduced the incidence of alloxan-induced diabetes, and also delayed the onset of hyperglycaemia in diabetes-prone non-obese diabetic mice. Experiments with animals indicated the effectively therapeutic effect of low-intensity or power laser (LIL or LPL) radiation on skin wound healing, which has stimulated clinical use of LIL to cure skin ulcer in diabetic patients. Mechanisms by which LDR prevents diabetes, though are unclear now, may include the induction of pancreatic antioxidants to prevent beta cell from oxidative damage and immunomodulation to preserve pancreatic function. For LIL therapeutic effect on diabetic wound healing, mechanisms may include its antioxidant action, immunomodulation, cell proliferation stimulation as well as improvement of systemic and wound-regional microcirculation. Therefore, although only a few studies indicating LDR prevention of the development of diabetes, many studies have demonstrated LDR, specifically LIL, therapeutic effectiveness of diabetic wound healing. These preliminary results are really encouraging for us to further pursue the clinical implication of LDT to diabetes-related areas.

Hormesis and its place in nonmonotonic dose-response relationships: some scientific reality checks

OBJECTIVE

This analysis is a critical assessment of current hormesis literature. I discuss definitions, characterization, generalizability, mechanisms, absence of empirical data specific for hormesis hypothesis testing, and arguments that hormesis be the "default assumption" in risk assessment.

DATA SOURCES

Hormesis, a biological phenomenon typically described as low-dose stimulation from substances producing higher-dose inhibition, has recently garnered interest in several quarters. The principal sources of published materials for this analysis are the writings of certain proponents of hormesis. Surprisingly few systematic critiques of current hormesis literature exist. Limits to the phenomenon's appropriate role in risk assessment and health policy have been published.

DATA SYNTHESIS

Serious gaps in scientific understanding remain: a stable definition; generalizability, especially for humans; a clear mechanistic basis; limitations in the presence of multiple toxic end points, target organs, and mechanisms. Absence of both arms-length, consensus-driven, scientific evaluations and empirical data from studies specifically designed for hormesis testing have limited its acceptance.

CONCLUSIONS

Definition, characterization, occurrence, and mechanistic rationale for hormesis will remain speculative, absent rigorous studies done specifically for hormesis testing. Any role for hormesis in current risk assessment and regulatory policies for toxics remains to be determined.

Adaptive responses induced by low dose radiation in dentate gyrus of rats

The purpose of this study is to investigate the mechanism of alternative responses to low dose irradiation for neuronal cell proliferation in the dentate gyrus of rats. To determine the effect of a single exposure to radiation, rats were irradiated with a single dose of 0.1, 1, 10 or 20 Gy. To determine the effect of the cumulative dose, the animals were irradiated daily with 0.01 Gy or 0.1 Gy from 1 to 4 days. The neuronal cell proliferation was evaluated using immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU), Ki-67 and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining. Four consecutive daily irradiations with a 0.01 Gy/fraction increased the number of BrdU-positive and Ki-67-positive cells in a dose dependent manner, but this did not affect the number of TUNEL-positive cells. However, there was not a dose dependent relationship for the 0.1 Gy/fraction irradiation with the number of BrdU, Ki-67 and TUNEL positive cells. Our data support the explanation that the adaptive response, induced by low-dose radiation, in the hippocampus of rats is more likely a reflection of the perturbations of cell cycle progression.

p27Cip/Kip is involved in hsp25 or inducible hsp70 mediated adaptive response by low dose radiation

Thermoresistant (TR) clone of radiation-induced fibrosarcoma (RIF) cells have been reported to show adaptive response to 1 cGy of low dose radiation, and hsp25 and inducible hsp70 are involved in this process. In the present study, to further elucidate the mechanism of how hsp25 and inducible hsp70 regulate the adaptive response, hsp25 or inducible hsp70 overexpressed RIF cells were irradiated with 1 cGy and cell cycle was analyzed. Hsp25 or inducible hsp70 overexpressed cells as well as TR cells showed increase of G1 phase population after gamma-irradiation at 1 cGy, while the parent RIF cells did not. [3H]-Thymidine and BrdU incorporation also indicated that both hsp25 and inducible hsp70 were involved in G1 arrest after 1 cGy irradiation. Molecular analysis revealed upregulation of p27Cip/Kip protein in hsp25 and inducible hsp70 overexpressed cells, and cotransfection of p27Cip/Kip antisense abolished the induction of adaptive response and 1 cGy-mediated G1 arrest. The above results indicate that induction of adaptive response by hsp25 and inducible hsp70 is mediated by upregulation of p27Cip/Kip protein, resulting in low dose radiation-induced G1 arrest.

Influence of soil and buildings on outdoor gamma dose rates in São Paulo, Brazil

This work analyzes the influence of the most abundant natural gamma emitters in soil (226Ra, 232Th, and 40K) on the total outdoor gamma dose rate in the city of São Paulo, Brazil. A new method is introduced to determine gamma dose rates due to soil 1 m above the ground through measurements performed deep in the soil. This allows evaluation of the soil component even in places where the measurement at 1 m height is influenced by other sources (mainly the presence of buildings). The methodology was tested in non-urbanized areas by comparing direct dose rate measurements in air with those deep in soil. In addition, high-resolution gamma ray spectrometry of soil samples collected throughout the city was used to determine the natural radionuclide concentrations, allowing the comparison with the in-situ dose rate results. Measurements deep in soil followed a log-normal distribution. The fitted geometric mean (median) and geometric standard deviation of the soil contribution to the ambient dose equivalent rate at 1 m height were, respectively, 80.9(6) and 0.642(4) nSv h(-1). Compared to previous data, these values show that buildings enhance about 35% the outdoor gamma dose rate expected only from soil. The specific activities of 226Ra, 232Th, and 40K in dry soil, given by their medians, were, respectively, 41, 75, and 176 Bq k(-1). These results reveal that the terrestrial gamma dose rates in São Paulo are higher than the world average, a fact that can be attributed to high thorium concentration. Direct measurements of dose rates were compared to the corresponding values determined from radionuclide concentrations in soil. Good agreement between methods was found.

Oxidative stress, radiation-adaptive responses, and aging

Organisms living in an aerobic environment were forced to evolve effective cellular strategies to detoxify reactive oxygen species. Besides diverse antioxidant enzymes and compounds, DNA repair enzymes, and disassembly systems, which remove damaged proteins, regulation systems that control transcription, translation, and activation have also been developed. The adaptive responses, especially those to radiation, are defensive regulation mechanisms by which oxidative stress (conditioning irradiation) elicits a response against damage because of subsequent stress (challenging irradiation). Although many researchers have investigated these molecular mechanisms, they remain obscure because of their complex signaling pathways and the involvement of various proteins. This article reviews the factors concerned with radiation-adaptive response, the signaling pathways activated by conditioning irradiation, and the effects of aging on radiation-adaptive response. The proteomics approach is also introduced, which is a useful method for studying stress response in cells.