Recent reports on the effect of low doses of ionizing radiation and its dose-effect relationship

Involvement of UV-C-induced genomic instability in stimulation рlant long-term protective reactions

The study of the mechanisms affecting single stress factor impact on long-term metabolic rearrangements is necessary for understanding the principles of plant protective reactions. The objective of the study was to assess the involvement of UV-C-induced genomic instability in induction рlant long-term protective reactions. The study was carried out on two genotypes of chamomile, Perlyna Lisostepu (PL) variety and its mutant, using UV-C pre-sowing seed radiation exposure at dose levels 5-15 kJ/m2. Multiple DNA damages under different exposure doses were studied on plant tissues during the flowering stage using - ISSR-RAPD DNA marker PCR. In the cluster analysis of changes within the amplicon spectra as an integral group the Jacquard similarity index was used. The results of the study suggest that genomic instability is a link between the direct effects of UV-C exposure and stimulation of metabolic rearrangements at the final stages of ontogeny. A hypothetical scheme for the transformation of primary UV-C DNA damage into long-term maintenance of genomic instability signs has been proposed.

The scientific basis for the use of the linear no-threshold (LNT) model at low doses and dose rates in radiological protection

The linear no-threshold (LNT) model was introduced into the radiological protection system about 60 years ago, but this model and its use in radiation protection are still debated today. This article presents an overview of results on effects of exposure to low linear-energy-transfer radiation in radiobiology and epidemiology accumulated over the last decade and discusses their impact on the use of the LNT model in the assessment of radiation-related cancer risks at low doses. The knowledge acquired over the past 10 years, both in radiobiology and epidemiology, has reinforced scientific knowledge about cancer risks at low doses. In radiobiology, although certain mechanisms do not support linearity, the early stages of carcinogenesis comprised of mutational events, which are assumed to play a key role in carcinogenesis, show linear responses to doses from as low as 10 mGy. The impact of non-mutational mechanisms on the risk of radiation-related cancer at low doses is currently difficult to assess. In epidemiology, the results show excess cancer risks at dose levels of 100 mGy or less. While some recent results indicate non-linear dose relationships for some cancers, overall, the LNT model does not substantially overestimate the risks at low doses. Recent results, in radiobiology or in epidemiology, suggest that a dose threshold, if any, could not be greater than a few tens of mGy. The scientific knowledge currently available does not contradict the use of the LNT model for the assessment of radiation-related cancer risks within the radiological protection system, and no other dose-risk relationship seems more appropriate for radiological protection purposes.

Relationship of radiation-induced genomic instability and antioxidant production in the chamomile plant

PURPOSE

To verify the hypothesis about the preservation of signs of radiation-induced genomic instability at the flowering stage of the chamomile plant after pre-sowing seed irradiation, the interaction of dose-dependent changes in the level of DNA damage and stimulation of antioxidant production.

MATERIALS AND METHODS

The study was carried out on two genotypes of chamomile, Perlyna Lisostepu variety and its mutant, using pre-sowing seed radiation exposure at dose levels 5-15 Gy. Studies of the rearrangement of the primary DNA structure of under different doses were studied on plant tissues at the flowering stage using - ISSR and RAPD DNA markers. Dose-dependent changes relative to the control of the amplicons' spectra were analyzed using the Jacquard similarity index. Antioxidants such as flavonoids and phenols were isolated from pharmaceutical raw materials (inflorescences) using traditional methods.

RESULTS

Preservation of multiple DNA damages at the stage of plant flowering under pre-sowing seed irradiation at low doses was confirmed. It was found that the largest rearrangements of the primary DNA structure of both genotypes, manifested in reduced similarity with the control spectra of amplicons, were observed under irradiation dose levels 5-10 Gy. There was a tendency to approach this indicator to the control under 15 Gy dose, which means increasing efficiency of the reparative processes. The relationship between the polymorphism of the primary structure of DNA by ISSR-RAPD-markers in different genotypes and the nature of its rearrangement under radiation exposure was shown. Dose dependences of changes in the specific content of antioxidants were non-monotonic with a maximum at 5-10 Gy.

CONCLUSIONS

Comparison of dose dependences of changes in the coefficient of similarity of the spectrum of amplicons between irradiated and control variants with nonmonotonic dose curves in the specific content of antioxidants allowed to suggest that there was the antioxidant protection stimulation under the doses corresponding to low efficiency of repair processes. The decrease in the specific content of antioxidants followed the restoration of the genetic material normal state. The interpretation of the identified phenomenon has been based on both known connection between the effects of genomic instability and the increasing yield of the reactive oxygen species and general principles of antioxidant protection.

Working with Convex Responses: Antifragility from Finance to Oncology

We extend techniques and learnings about the stochastic properties of nonlinear responses from finance to medicine, particularly oncology, where it can inform dosing and intervention. We define antifragility. We propose uses of risk analysis for medical problems, through the properties of nonlinear responses (convex or concave). We (1) link the convexity/concavity of the dose-response function to the statistical properties of the results; (2) define "antifragility" as a mathematical property for local beneficial convex responses and the generalization of "fragility" as its opposite, locally concave in the tails of the statistical distribution; (3) propose mathematically tractable relations between dosage, severity of conditions, and iatrogenics. In short, we propose a framework to integrate the necessary consequences of nonlinearities in evidence-based oncology and more general clinical risk management.

Carcinogenesis induced by space radiation: A systematic review

The carcinogenic risk from space radiation has always been a health risk issue of great concern during space exploration. In recent years, a large number of cellular and animal experiments have demonstrated that space radiation, composed of high-energy protons and heavy ions, has shown obvious carcinogenicity. However, different from radiation on Earth, space radiation has the characteristics of high energy and low dose rate. It is rich in high-atom-number and high-energy particles and, as it is combined with other space environmental factors such as microgravity and a weak magnetic field, the study of its carcinogenic effects and mechanisms of action is difficult, which leads to great uncertainty in its carcinogenic risk assessment. Here, we review the latest progress in understanding the effects and mechanisms of action related to cell transformation and carcinogenesis induced by space radiation in recent years and summarize the prediction models of cancer risk caused by space radiation and the methods to reduce the uncertainty of prediction to provide reference for the research and risk assessment of space radiation.

Biological and cellular responses of humans to high-level natural radiation: A clarion call for a fresh perspective on the linear no-threshold paradigm

There remains considerable uncertainty in obtaining risk estimates of adverse health outcomes of chronic low-dose radiation. In the absence of reliable direct data, extrapolation through the linear no-threshold (LNT) hypothesis forms the cardinal tenet of all risk assessments for low doses (≤ 100 mGy) and for the radiation protection principle of As Low As Reasonably Achievable (ALARA). However, as recent evidences demonstrate, LNT assumptions do not appropriately reflect the biology of the cell at the low-dose end of the dose-response curve. In this regard, human populations living in high-level natural radiation areas (HLNRA) of the world can provide valuable insights into the biological and cellular effects of chronic radiation to facilitate improved precision of the dose-response relationship at low doses. Here, data obtained over decades of epidemiological and radiobiological studies on HLNRA populations is summarized. These studies do not show any evidence of unfavourable health effects or adverse cellular effects that can be correlated with high-level natural radiation. Contrary to the assumptions of LNT, no excess cancer risks or untoward pregnancy outcomes have been found to be associated with cumulative radiation dose or in-utero exposures. Molecular biology-driven studies demonstrate that chronic low-dose activates several cellular defence mechanisms that help cells to sense, recover, survive, and adapt to radiation stress. These mechanisms include stress-response signaling, DNA repair, immune alterations and most importantly, the radiation-induced adaptive response. The HLNRA data is consistent with the new evolving paradigms of low-dose radiobiology and can help develop the theoretical framework of an alternate dose-response model. A rational integration of radiobiology with epidemiology data is imperative to reduce uncertainties in predicting the potential health risks of chronic low doses of radiation.

Risk factors for second primary malignancies following thyroid cancer: a nationwide cohort study

OBJECTIVE

Thyroid cancer survivors have a high risk of second primary malignancies (SPMs). We aimed to evaluate the site-specific incidence, prognosis, and risk factors for metachronous SPMs following thyroid cancer.

DESIGN

A nationwide cohort study.

METHODS

This study included data from the Korea National Health Insurance Service (between 2002 and 2018). Exposure to diagnostic radiation was defined by the number of computed tomography (CT) and positron emission tomography-CT scans after the index date. A cumulative radioactive iodine (RAI) dose >100 mCi was considered high-dose RAI.

RESULTS

During the median 6 years of follow-up, among 291 640 patients, 13 083 (4.5%) developed SPMs. Thyroid cancer survivors had a 26% increased risk of SPMs compared with the general population (standardized incidence ratio: 1.26; 95% CI: 1.22-1.29). Furthermore, those with SPMs had a significantly poorer survival rate than those without SPMs (hazard ratio: 11.85; 95% CI: 11.21-12.54; P < 0.001). Significantly elevated risks were observed in myeloid leukemia and 13 solid cancer sites: lip, salivary gland, small intestine, larynx, lung, mediastinum and pleura, mesothelium, breast, corpus uteri, ovary, prostate, kidney, and bladder. Frequent diagnostic medical radiation exposure and high-dose RAI therapy were independent risk factors for several SPMs, including the cancer of salivary gland, lung, mediastinum and pleura, breast, kidney, and bladder, as well as myeloid leukemia.

CONCLUSIONS

Frequent diagnostic radiation exposure and high-dose RAI therapy are independent risk factors for SPM following thyroid cancer. Clinicians need to consider minimizing unnecessary diagnostic radiation exposure and administering a high dose RAI only when justified in patients with thyroid cancer.

Cohort profile - MSK radiation workers: a feasibility study to establish a deceased worker sub-cohort as part of a multicenter medical radiation worker component in the million person study of low-dose radiation health effects

BACKGROUND

The National Council on Radiation Protection and Measurements (NCRP) is coordinating an expansive epidemiologic effort entitled the Million Person Study of Low-Dose Radiation Health Effects (MPS). Medical workers constitute the largest occupational radiation-exposed group whose doses are typically received gradually over time.

METHODS

A unique opportunity exists to establish an Institutional Review Board/Privacy Board (IRB/PB) approved, retrospective feasibility sub-cohort of diseased Memorial Sloan Kettering Cancer Center (MSK) medical radiation workers to reconstruct occupational/work history, estimate organ-specific radiation absorbed doses, and review existing publicly available records for mortality from cancer (including leukemia) and other diseases. Special emphasis will be placed on dose reconstruction approaches as a means to provide valid organ dose estimates that are as accurate and precise as possible based on the available data, and to allow proper evaluation of accompanying uncertainties. Such a study that includes validated dose measurements and information on radiation exposure conditions would significantly reduce dose uncertainties and provided greatly improved information on chronic low-dose risks.

RESULTS

The feasibility sub-cohort will include deceased radiation workers from MSK who worked during the nearly seventy-year timeframe from 1946 through 2010 and were provided individual personal radiation dosimetry monitors. A feasibility assessment focused on obtaining records for about 25-30,000 workers, with over 124,000 annual doses, including personnel/work histories, specific dosimetry data, and appropriate information for epidemiologic mortality tracing will be conducted. MSK radiation dosimetry measurements have followed stringent protocols complying with strict worker protection standards in order to provide accurate dose information for radiation workers that include detailed records of work practices (including specific task exposure conditions, radiation type, energy, geometry, personal protective equipment usage, badge position, and missed doses), as well as recorded measurements. These dose measurements have been ascertained through a variety of techniques that have evolved over the years, from film badges to thermoluminescent dosimetry technology to optically stimulated luminescent methodologies. It is expected that individual total doses for the sub-cohort will have a broad range from <10 mSv to > =1000 mSv.

CONCLUSIONS

MSK has pioneered the use of novel radiation diagnostic and therapeutic approaches over time (including initial work with x-rays, radium, and radon), with workplace safety in mind, resulting in a variety of radiation worker exposure scenarios. The results of this feasibility sub-cohort of deceased radiation workers, and associated lessons learned may potentially be applied to an expanded multicenter study of about 170,000 medical radiation worker component of the MPS.

Machine learning for evolutive lymphoma and residual masses recognition in whole body diffusion weighted magnetic resonance images

BACKGROUND

After the treatment of the patients with malignant lymphoma, there may persist lesions that must be labeled either as evolutive lymphoma requiring new treatments or as residual masses. We present in this work, a machine learning-based computer-aided diagnosis (CAD) applied to whole-body diffusion-weighted magnetic resonance images.

METHODS

The database consists of a total of 1005 MRI images with evolutive lymphoma and residual masses. More specifically, we propose a novel approach that leverages: (1)-The complementarity of the functional and anatomical criteria of MRI images through a fusion step based on the discrete wavelet transforms (DWT). (2)- The automatic segmentation of the lesions, their localization, and their enumeration using the Chan-Vese algorithm. (3)- The generation of the parametric image which contains the apparent diffusion coefficient value named ADC map. (4)- The features selection through the application of the sequential forward selection (SFS), Entropy, Symmetric uncertainty and Gain Ratio algorithm on 72 extracted features. (5)- The classification of the lesions by applying five well known supervised machine learning classification algorithms: the back-propagation artificial neural network (ANN), the support vector machine (SVM), the K-nearest neighbours (K-NN), Relevance Vectors Machine (RVM), and the random forest (RF) compared to deep learning based on convolutional neural network (CNN). Moreover, this study is achieved with an evaluation of the classification using 335 DW-MR images where 80% of them are used for the training and the remaining 20% for the test.

RESULTS

The obtained accuracy for the five classifiers recorded a slight superiority to the proposed method based on the back-propagation 3-9-1 ANN model which reaches 96,5%. In addition, we compared the proposed method to five other works from the literature. The proposed method gives much better results in terms of SE, SP, accuracy, F₁-measure, and geometric-mean which reaches respectively 96.4%, 90.9%, 95.5%, 0.97, and 91.61%.

CONCLUSIONS

Our initial results suggest that Combining functional, anatomical, and morphological features of ROI's have very good accuracy (97.01%) for evolutive lymphoma and residual masses recognition when we based on the new proposed approach using the back-propagation 3-9-1 ANN model. Proposed method based on machine learning gives less than Deep learning CNN, which is 98.5%.

Indoor radon levels in Hungarian kindergartens

Annual average indoor radon activity concentration was studied in 88 Hungarian kindergartens in 76 towns of 10 different counties. Annual average indoor radon activity concentration in the kindergartens was 61 Bq m− 3, maximum was 160 Bq m− 3. In the kindergartens the seasonal variation of radon is not so strong like in dwellings, because of the permanent ventilation and the closed period during the summer break.

Younger North Americans are exposed to more radon gas due to occupancy biases within the residential built environment

Residential buildings can concentrate radioactive radon gas, exposing occupants to particle radiation that increases lung cancer risk. This has worsened over time in North America, with newer residences containing greater radon. Using data from 18,971 Canadian households, we calculated annual particle radiation dose rates due to long term residential radon exposure, and examined this as a function of occupant demographics. The current particle radiation dose rate to lungs from residential radon in Canada is 4.08 mSv/y from 108.2 Bq/m3, with 23.4% receiving 100-2655 mSv doses that are known to elevate human cancer risk. Notably, residences built in the twenty-first century are occupied by significantly younger people experiencing greater radiation dose rates from radon (mean age of 46 at 5.01 mSv/y), relative to older groups more likely to occupy twentieth century-built properties (mean age of 53 at 3.45-4.22 mSv/y). Newer, higher radon-containing properties are also more likely to have minors, pregnant women and an overall higher number of occupants living there full time. As younger age-of-exposure to radon equates to greater lifetime lung cancer risk, these data reveal a worst case scenario of exposure bias. This is of concern as, if it continues, it forecasts serious future increases in radon-induced lung cancer in younger people.

The Response of Living Organisms to Low Radiation Environment and Its Implications in Radiation Protection

Life has evolved on Earth for about 4 billion years in the presence of the natural background of ionizing radiation. It is extremely likely that it contributed, and still contributes, to shaping present form of life. Today the natural background radiation is extremely small (few mSv/y), however it may be significant enough for living organisms to respond to it, perhaps keeping memory of this exposure. A better understanding of this response is relevant not only for improving our knowledge on life evolution, but also for assessing the robustness of the present radiation protection system at low doses, such as those typically encountered in everyday life. Given the large uncertainties in epidemiological data below 100 mSv, quantitative evaluation of these health risk is currently obtained with the aid of radiobiological models. These predict a health detriment, caused by radiation-induced genetic mutations, linearly related to the dose. However a number of studies challenged this paradigm by demonstrating the occurrence of non-linear responses at low doses, and of radioinduced epigenetic effects, i.e., heritable changes in genes expression not related to changes in DNA sequence. This review is focused on the role that epigenetic mechanisms, besides the genetic ones, can have in the responses to low dose and protracted exposures, particularly to natural background radiation. Many lines of evidence show that epigenetic modifications are involved in non-linear responses relevant to low doses, such as non-targeted effects and adaptive response, and that genetic and epigenetic effects share, in part, a common origin: the reactive oxygen species generated by ionizing radiation. Cell response to low doses of ionizing radiation appears more complex than that assumed for radiation protection purposes and that it is not always detrimental. Experiments conducted in underground laboratories with very low background radiation have even suggested positive effects of this background. Studying the changes occurring in various living organisms at reduced radiation background, besides giving information on the life evolution, have opened a new avenue to answer whether low doses are detrimental or beneficial, and to understand the relevance of radiobiological results to radiation protection.

The long-term effects of γ-radiation on the growth of Allium cepa plants

PURPOSE

The purpose of this study was to assess the long-term effects of gamma-radiation, including low-dose radiation, on growth parameters of onion (Allium cepa) seedling roots 6-10 days after irradiation.

MATERIALS AND METHODS

Onion seedlings were exposed to a ¹³⁷Cs gamma source at doses ranging from 0.1 to 10 grays (Gy). Responses of root and shoot length growth were studied 6 and 10 days after irradiation.

RESULTS

Our results showed inhibition of the root and shoot length growth 6 days after exposure at all doses, including the low dose - 0.1 Gy. At a later point in time (day 10), root and shoot inhibition was only observed after irradiation at high doses (above 5 Gy), and that suggested the occurrence of cell repair after irradiation at low doses. The results indicated that the length of seedling roots was more sensitive to gamma-irradiation than the shoot length.

CONCLUSION

The results of the study suggested that short-term gamma-irradiation of onion seedlings (absorbed doses of 0.1-10 Gy) caused inhibition of plant growth 6 and 10 days after irradiation. The dose dependence of the onion root length was linear. The present study showed for the first time that short-term low-dose gamma-irradiation could induce long-term negative effects on plant growth.

What Can Chemical Carcinogenesis Shed Light on the LNT Hypothesis in Radiation Carcinogenesis?

To protect the public’s health from exposure to physical, chemical, and microbiological agents, it is important that any policy be based on rigorous scientifically based research. The concept of “linear no-threshold” (LNT) has been implemented to provide guideline exposures to these agents. The practical limitation to testing this hypothesis is to provide sufficient samples for experimental or epidemiological studies. While there is no universally accepted understanding of most human diseases, there seems to be better understanding of cancer that might help resolve the “LNT” model. The public’s concern, after being exposed to radiation, is the potential of producing cancer. The most rigorous hypothesis of human carcinogenesis is the “multistage, multimechanism” chemical carcinogenesis model. The radiation carcinogenesis LNT model, rarely, if ever, built it into their support. It will be argued that this multistage, multimechanism model of carcinogenesis, involving the “initiation” of a single cell by a mutagen event, followed by chronic exposure to threshold levels of epigenetic agents or conditions that stimulate the clonal expansion of the “initiated” cell, can convert these benign cells to become invasive and metastatic. This “promotion” process can be interrupted, thereby preventing these initiated cells from transitioning to the “progression” process of invasion and metastasis.

The LNT model for cancer induction is not supported by radiobiological data

The hallmarks of cancer have been the focus of much research and have influenced the development of risk models for radiation-induced cancer. However, natural defenses against cancer, which constitute the hallmarks of cancer prevention, have largely been neglected in developing cancer risk models. These natural defenses are enhanced by low doses and dose rates of ionizing radiation, which has aided in the continuation of human life over many generations. Our natural defenses operate at the molecular, cellular, tissue, and whole-body levels and include epigenetically regulated (epiregulated) DNA damage repair and antioxidant production, selective p53-independent apoptosis of aberrant cells (e.g. neoplastically transformed and tumor cells), suppression of cancer-promoting inflammation, and anticancer immunity (both innate and adaptive components). This publication reviews the scientific bases for the indicated cancer-preventing natural defenses and evaluates their implication for assessing cancer risk after exposure to low radiation doses and dose rates. Based on the extensive radiobiological evidence reviewed, it is concluded that the linear-no-threshold (LNT) model (which ignores natural defenses against cancer), as it relates to cancer risk from ionizing radiation, is highly implausible. Plausible models include dose-threshold and hormetic models. More research is needed to establish when a given model (threshold, hormetic, or other) applies to a given low-dose-radiation exposure scenario.

Low-Dose Ionizing Radiation Affects Mesenchymal Stem Cells via Extracellular Oxidized Cell-Free DNA: A Possible Mediator of Bystander Effect and Adaptive Response

We have hypothesized that the adaptive response to low doses of ionizing radiation (IR) is mediated by oxidized cell-free DNA (cfDNA) fragments. Here, we summarize our experimental evidence for this model. Studies involving measurements of ROS, expression of the NOX (superoxide radical production), induction of apoptosis and DNA double-strand breaks, antiapoptotic gene expression and cell cycle inhibition confirm this hypothesis. We have demonstrated that treatment of mesenchymal stem cells (MSCs) with low doses of IR (10 cGy) leads to cell death of part of cell population and release of oxidized cfDNA. cfDNA has the ability to penetrate into the cytoplasm of other cells. Oxidized cfDNA, like low doses of IR, induces oxidative stress, ROS production, ROS-induced oxidative modifications of nuclear DNA, DNA breaks, arrest of the cell cycle, activation of DNA reparation and antioxidant response, and inhibition of apoptosis. The MSCs pretreated with low dose of irradiation or oxidized cfDNA were equally effective in induction of adaptive response to challenge further dose of radiation. Our studies suggest that oxidized cfDNA is a signaling molecule in the stress signaling that mediates radiation-induced bystander effects and that it is an important component of the development of radioadaptive responses to low doses of IR.

Characterization of a novel scale maille contralateral breast shield: SMART Armor

During breast radiotherapy treatment, the contralateral breast receives radiation doses to the skin and subcutaneous tissue caused mainly from incident electron contamination and low energy photon scatter radiation. Measurements have shown that for a typical hybrid tangential treatment, these dose levels can be up to 17% of maximum applied prescription dose if no shielding is used during the treatment process. This work examined the use of different shielding metals, aluminum, copper, and lead to reduce peripheral radiation dose to evaluate the optimal metal to form the basis of a contralateral breast radiation shield. This work also shows a simple but novel method to substantially reduce this unwanted radiation dose with the use of a copper scale maille sheet which can be easily and accurately draped over a patient's contralateral breast during treatment. The copper scale maille is flexible and can thus conform around typical breast shapes. It can also form irregular shaped edges to match those outlined by typical tangential treatment fields. As the shield is made from copper, it is nontoxic and can potentially be used directly on patients for treatment. The designed copper scale maille has shown to reduce contralateral breast skin and subcutaneous dose by up to 80% for typical radiation fields used in breast radiotherapy.

Distinct Sets of lncRNAs are Differentially Modulated after Exposure to High and Low Doses of X Rays

High- and low-dose X rays are used in medicine as therapeutic and diagnostic tools, respectively. While the cellular response to high-dose radiation is well known, studies on the effects of low-dose radiation and its ability to trigger a proper DNA damage response have had contradictory results. The functions of many signaling and effector proteins of the DNA damage response (DDR) have been described, and are attributed to well-known DDR pathways. However, there has been little known about the contribution of long noncoding RNAs (lncRNAs) to DDR, although there is recent evidence that lncRNAs may be associated with almost all biological functions, including DDR. In this work, we investigated the participation of lncRNAs in the response to different X-ray doses. By microarray analysis, we observed that in human breast epithelial cells, distinct sets of coding and noncoding transcripts are differentially regulated after moderate- and high-dose irradiation compared to those regulated after low-dose irradiation. While the modulated coding and noncoding genes at low doses relate to cell signaling pathways, those affected by moderate and high doses are mostly enriched for cell cycle regulation and apoptotic pathways. Quantification using qPCR of the lncRNAs identified by microarrays allowed the validation of 75% of those regulated at the higher doses. These results indicate that lncRNA expression is regulated by ionizing radiation and that this expression is dose dependent.

Current Evidence for Developmental, Structural, and Functional Brain Defects following Prenatal Radiation Exposure

Ionizing radiation is omnipresent. We are continuously exposed to natural (e.g., radon and cosmic) and man-made radiation sources, including those from industry but especially from the medical sector. The increasing use of medical radiation modalities, in particular those employing low-dose radiation such as CT scans, raises concerns regarding the effects of cumulative exposure doses and the inappropriate utilization of these imaging techniques. One of the major goals in the radioprotection field is to better understand the potential health risk posed to the unborn child after radiation exposure to the pregnant mother, of which the first convincing evidence came from epidemiological studies on in utero exposed atomic bomb survivors. In the following years, animal models have proven to be an essential tool to further characterize brain developmental defects and consequent functional deficits. However, the identification of a possible dose threshold is far from complete and a sound link between early defects and persistent anomalies has not yet been established. This review provides an overview of the current knowledge on brain developmental and persistent defects resulting from in utero radiation exposure and addresses the many questions that still remain to be answered.

Time to Reject the Linear-No Threshold Hypothesis and Accept Thresholds and Hormesis: A Petition to the U.S. Nuclear Regulatory Commission

On February 9, 2015, I submitted a petition to the U.S. Nuclear Regulatory Commission (NRC) to reject the linear-no threshold (LNT) hypothesis and ALARA as the bases for radiation safety regulation in the United States, using instead threshold and hormesis evidence. In this article, I will briefly review the history of LNT and its use by regulators, the lack of evidence supporting LNT, and the large body of evidence supporting thresholds and hormesis. Physician acceptance of cancer risk from low dose radiation based upon federal regulatory claims is unfortunate and needs to be reevaluated. This is dangerous to patients and impedes good medical care. A link to my petition is available: http://radiationeffects.org/wp-content/uploads/2015/03/Hormesis-Petition-to-NRC-02-09-15.pdf, and support by individual physicians once the public comment period begins would be extremely important.

Global Gene Expression Alterations as a Crucial Constituent of Human Cell Response to Low Doses of Ionizing Radiation Exposure

Exposure to ionizing radiation (IR) is inevitable to humans in real-life scenarios; the hazards of IR primarily stem from its mutagenic, carcinogenic, and cell killing ability. For many decades, extensive research has been conducted on the human cell responses to IR delivered at a low dose/low dose (LD) rate. These studies have shown that the molecular-, cellular-, and tissue-level responses are different after low doses of IR (LDIR) compared to those observed after a short-term high-dose IR exposure (HDIR). With the advent of high-throughput technologies in the late 1990s, such as DNA microarrays, changes in gene expression have also been found to be ubiquitous after LDIR. Very limited subset of genes has been shown to be consistently up-regulated by LDIR, including CDKN1A. Further research on the biological effects and mechanisms induced by IR in human cells demonstrated that the molecular and cellular processes, including transcriptional alterations, activated by LDIR are often related to protective responses and, sometimes, hormesis. Following LDIR, some distinct responses were observed, these included bystander effects, and adaptive responses. Changes in gene expression, not only at the level of mRNA, but also miRNA, have been found to crucially underlie these effects having implications for radiation protection purposes.

Assessment of annual average effective dose status in the cohort of medical staff in Lithuania during 1991-2013

The use of radiation sources for various medical purposes is closely related to irradiation of the medical staff, which causes harmful effects to health and an increased risk of cancer. In total, 1463 medical staff who have been occupationally exposed to sources of ionising radiation (IR) had been monitored. Records with annual dose measurements (N = 19 157) were collected and regularly analysed for a 23-y period: from 01 January 1991 to 31 December 2013. The collected annual average effective dose (AAED) data have been analysed according to different socio-demographic parameters and will be used in future investigation in order to assess cancer risk among medical staff occupationally exposed to sources of IR. A thorough analysis of data extracted from medical staff's dose records allows one to conclude that the average annual effective dose of Lithuanian medical staff occupationally exposed to sources of IR was consistently decreased from 1991 (1.75 mSv) to 2013 (0.27 mSv) (p < 0.0001).

Integrative analysis of gene expression in response to low-dose ionizing radiation in a human skin model

The advance in medical imaging and utilization has raised the concern about exposure to low-dose ionizing radiation (LDIR). Cellular and molecular responses to high-dose ionizing radiation have been characterized, but in the range of low dose, these responses are poorly understood. Here, we investigate the gene expression in response to LDIR (10 cGy) in the EpiDermFT human skin model. We identified 3299 differentially expressed genes (DEGs) in response to LDIR. Among these DEGs, we noted several well-characterized long noncoding RNAs. Gene Ontology and KEGG pathway analysis were performed to detect altered molecular response. GO and KEGG pathway results showed that genes corresponding to "regulation of cell proliferation" were enriched. Gene set enrichment analysis showed that KRAS signaling pathway was enriched in response to LDIR and transcription targets of NF-κB were also enriched when exposed to LDIR.

Variable activation of the DNA damage response pathways in patients undergoing single-photon emission computed tomography myocardial perfusion imaging

BACKGROUND

Although single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) has improved the diagnosis and risk stratification of patients with suspected coronary artery disease, it remains a primary source of low-dose radiation exposure for cardiac patients. To determine the biological effects of low-dose radiation from SPECT MPI, we measured the activation of the DNA damage response pathways using quantitative flow cytometry and single-cell gene expression profiling.

METHODS AND RESULTS

Blood samples were collected from patients before and after SPECT MPI (n=63). Overall, analysis of all recruited patients showed no marked differences in the phosphorylation of proteins (H2AX, protein 53, and ataxia telangiectasia mutated) after SPECT. The majority of patients also had either downregulated or unchanged expression in DNA damage response genes at both 24 and 48 hours post-SPECT. Interestingly, a small subset of patients with increased phosphorylation had significant upregulation of genes associated with DNA damage, whereas those with no changes in phosphorylation had significant downregulation or no difference, suggesting that some patients may potentially be more sensitive to low-dose radiation exposure.

CONCLUSIONS

Our findings showed that SPECT MPI resulted in a variable activation of the DNA damage response pathways. Although only a small subset of patients had increased protein phosphorylation and elevated gene expression postimaging, continued care should be taken to reduce radiation exposure to both the patients and operators.

Antibiotics exposure and health risks: chloramphenicol

The antibiotic chloramphenicol (CAP) is banned from food production. Besides being a medicinal product, CAP is also a natural product, produced by Streptomyces Venezuelae. The lack of scientific data hampers setting of an Acceptable Daily Intake (ADI). Consequently, a maximum residue limit (MRL) in food could not be established. This was then translated into a zero tolerance using the so-called Minimum Required Performance Limit (MRPL) level, viz. the achievable detection limit in food, to guide the zero tolerance policy. The MRPL is clearly not relevant to food safety and human health but is solely related to analytical technological capabilities. The increase in the latter enables detection at ever-lower levels and ignores toxicological relevance. We here provide arguments to use a Threshold of Toxicological Concern (TTC) for CAP that can accommodate developing toxicological insights.

Life-span carcinogenicity studies on Sprague-Dawley rats exposed to γ-radiation: design of the project and report on the tumor occurrence after post-natal radiation exposure (6 weeks of age) delivered in a single acute exposure

BACKGROUND

Experimental long-term carcinogenicity bioassays conducted on rats and mice proved that ionizing radiation can induce a variety of tumor types. However few studies have been conducted on rats.

METHODS

This report deals with the effects of γ-radiation in groups of 416-1,051 6-weeks old Sprague-Dawley rats exposed to 0, 0.1, 1, or 3 Gy of γ-radiation delivered in a single acute exposure. The experiment lasted for the animals' lifespan and all were necropsied and underwent full histopathological evaluation.

RESULTS

The results confirm the dose-related carcinogenic effects of γ-radiation for several organs and tissues. Moreover they indicate that exposure to 0.1 Gy induces a statistically significant increased incidence in Zymbal gland carcinomas and pancreas islet cell carcinomas in females.

CONCLUSIONS

Our data show that exposure to γ-radiation induces carcinogenic effects at all tested doses.

Genome-based, mechanism-driven computational modeling of risks of ionizing radiation: The next frontier in genetic risk estimation?

Research activity in the field of estimation of genetic risks of ionizing radiation to human populations started in the late 1940s and now appears to be passing through a plateau phase. This paper provides a background to the concepts, findings and methods of risk estimation that guided the field through the period of its growth to the beginning of the 21st century. It draws attention to several key facts: (a) thus far, genetic risk estimates have been made indirectly using mutation data collected in mouse radiation studies; (b) important uncertainties and unsolved problems remain, one notable example being that we still do not know the sensitivity of human female germ cells to radiation-induced mutations; and (c) the concept that dominated the field thus far, namely, that radiation exposures to germ cells can result in single gene diseases in the descendants of those exposed has been replaced by the concept that radiation exposure can cause DNA deletions, often involving more than one gene. Genetic risk estimation now encompasses work devoted to studies on DNA deletions induced in human germ cells, their expected frequencies, and phenotypes and associated clinical consequences in the progeny. We argue that the time is ripe to embark on a human genome-based, mechanism-driven, computational modeling of genetic risks of ionizing radiation, and we present a provisional framework for catalyzing research in the field in the 21st century.

Advances in radiation biology: effect on nuclear medicine

Over the past 15 years and more, extensive research has been conducted on the responses of biological systems to radiation delivered at a low dose or low dose rate. This research has demonstrated that the molecular-, cellular-, and tissue-level responses are different following low doses than those observed after a single short-term high-dose radiation exposure. Following low-dose exposure, 3 unique responses were observed, these included bystander effects, adaptive protective responses, and genomic instability. Research on the mechanisms of action for each of these observations demonstrates that the molecular and cellular processes activated by low doses of radiation are often related to protective responses, whereas high-dose responses are often associated with extensive damage such as cell killing, tissue disruption, and inflammatory diseases. Thus, the mechanisms of action are unique for low-dose radiation exposure. When the dose is delivered at a low dose rate, the responses typically differ at all levels of biological organization. These data suggest that there must be a dose rate effectiveness factor that is greater than 1 and that the risk following low-dose rate exposure is likely less than that for single short-term exposures. All these observations indicate that using the linear no-threshold model for radiation protection purposes is conservative. Low-dose research therefore supports the current standards and practices. When a nuclear medical procedure is justified, it should be carried out with optimization (lowest radiation dose commensurate with diagnostic or therapeutic outcome).

Low-dose radiation from 18F-FDG PET does not increase cancer frequency or shorten latency but reduces kidney disease in cancer-prone Trp53+/- mice

There is considerable interest in the health effects associated with low-level radiation exposure from medical imaging procedures. Concerns in the medical community that increased radiation exposure from imaging procedures may increase cancer risk among patients are confounded by research showing that low-dose radiation exposure can extend lifespan by increasing the latency period of some types of cancer. The most commonly used radiopharmaceutical for positron emission tomography (PET) scans is 2-[(18)F] fluoro-2-deoxy-d-glucose ((18)F-FDG), which exposes tissue to a low-dose, mixed radiation quality: 634 keV β+ and 511 keV γ-rays. The goal of this research was to investigate how modification of cancer risk associated with exposure to low-dose ionising radiation in cancer-prone Trp53+/- mice is influenced by radiation quality from PET. At 7-8 weeks of age, Trp53+/- female mice were exposed to one of five treatments: 0 Gy, 10 mGy γ-rays, 10 mGy (18)F-FDG, 4 Gy γ-rays, 10 mGy (18)F-FDG + 4 Gy γ-rays (n > 185 per group). The large 4-Gy radiation dose significantly reduced the lifespan by shortening the latency period of cancer and significantly increasing the number of mice with malignancies, compared with unirradiated controls. The 10 mGy γ-rays and 10 mGy PET doses did not significantly modify the frequency or latency period of cancer relative to unirradiated mice. Similarly, the PET scan administered prior to a large 4-Gy dose did not significantly modify the latency or frequency of cancer relative to mice receiving a dose of only 4 Gy. The relative biological effectiveness of radiation quality from (18)F-FDG, with respect to malignancy, is approximately 1. However; when non-cancer endpoints were studied, it was found that the 10-mGy PET group had a significant reduction in kidney lesions (P < 0.021), indicating that a higher absorbed dose (20 ± 0.13 mGy), relative to the whole-body average, which occurs in specific tissues, may not be detrimental.

Radiation-induced DNA damage and the relative biological effectiveness of 18F-FDG in wild-type mice

Clinically, the most commonly used positron emission tomography (PET) radiotracer is the glucose analog 2-[(18)F] fluoro-2-deoxy-D-glucose ((18)F-FDG), however little research has been conducted on the biological effects of (18)F-FDG injections. The induction and repair of DNA damage and the relative biological effectiveness (RBE) of radiation from (18)F-FDG relative to 662 keV γ-rays were investigated. The study also assessed whether low-dose radiation exposure from (18)F-FDG was capable of inducing an adaptive response. DNA damage to the bone marrow erythroblast population was measured using micronucleus formation and lymphocyte γH2A.X levels. To test the RBE of (18)F-FDG, mice were injected with a range of activities of (18)F-FDG (0-14.80 MBq) or irradiated with Cs-137 γ-rays (0-100 mGy). The adaptive response was investigated 24h after the (18)F-FDG injection by 1 Gy in vivo challenge doses for micronucleated reticulocyte (MN-RET) formation or 1, 2 and 4 Gy in vitro challenges doses for γH2A.X formation. A significant increase in MN-RET formation above controls occurred following injection activities of 3.70, 7.40 or 14.80 MBq (P < 0.001) which correspond to bone marrow doses of ~35, 75 and 150 mGy, respectively. Per unit dose, the Cs-137 radiation exposure induced significantly more damage than the (18)F-FDG injections (RBE = 0.79 ± 0.04). A 20% reduction in γH2A.X fluorescence was observed in mice injected with a prior adapting low dose of 14.80 MBq (18)F-FDG relative to controls (P < 0.019). A 0.74 MBq (18)F-FDG injection, which gives mice a dose approximately equal to a typical human PET scan, did not cause a significant increase in DNA damage nor did it generate an adaptive response. Typical (18)F-FDG injection activities used in small animal imaging (14.80 MBq) resulted in a decrease in DNA damage, as measured by γH2A.X formation, below spontaneous levels observed in control mice. The (18)F-FDG RBE was <1.0, indicating that the mixed radiation quality and/or low dose rate from PET scans is less damaging than equivalent doses of gamma radiation.

Genes and environment: effects on the development of second malignancies in retinoblastoma survivors

Although it is a rare cancer, retinoblastoma has served as an important model in our understanding of genetic cancer syndromes. All patients with a germinal rb1 mutation possess a risk of the development of second malignancies. Approximately 40-50% of all retinoblastoma cases are considered germinal cases and recent work has indicated that nearly all retinoblastoma patients probably demonstrate a degree of mosaicism for the rb1 mutation, and thus are at risk of secondary malignancies. The risk of the development of these cancers continues throughout the patients' lives due to the loss of a functional RB1 protein and its critical tumor suppressive function in all cells. These cancers can develop in diverse anatomic locations, including the skull and long bones, soft tissues, nasal cavity, skin, orbit, brain, breast and lung. Treatments used for retinoblastoma such as external-beam radiation and chemotherapy can have a significant impact on the risk for and pattern of development of these secondary cancers. Second malignancies are the leading cause of death in germinal retinoblastoma survivors in the USA and thus continue to be an important subject of study in this patient population. Second malignancies following the germinal form of retinoblastoma are the subject of this review.

Effects of low doses of ionizing radiation exposures on stress-responsive gene expression in human embryonic stem cells

There is a great deal of uncertainty on how low (≤0.1 Gy) doses of ionizing radiation (IR) affect human cells, partly due to a lack of suitable experimental model systems for such studies. The uncertainties arising from low-dose IR human data undermine practical societal needs to predict health risks emerging from diagnostic medical tests’ radiation, natural background radiation, and environmental radiological accidents. To eliminate a variability associated with remarkable differences in radioresponses of hundreds of differentiated cell types, we established a novel, human embryonic stem cell (hESC)-based model to examine the radiobiological effects in human cells. Our aim is to comprehensively elucidate the gene expression changes in a panel of various hESC lines following low IR doses of 0.01; 0.05; 0.1 Gy; and, as a reference, relatively high dose of 1 Gy of IR. Here, we examined the dynamics of transcriptional changes of well-established IR-responsive set of genes, including CDKN1A, GADD45A, etc. at 2 and 16 h post-IR, representing “early” and “late” radioresponses of hESCs. Our findings suggest the temporal- and hESC line-dependence of stress gene radioresponses with no statistically significant evidence for a linear dose-response relationship within the lowest doses of IR exposures.

Current knowledge on tumour induction by computed tomography should be carefully used

Risks associated to ionising radiation from medical imaging techniques have focused the attention of the medical society and general population. This risk is aimed to determine the probability that a tumour is induced as a result of a computed tomography (CT) examination since it makes nowadays the biggest contribution to the collective dose. Several models of cancer induction have been reported in the literature, with diametrically different implications. This article reviews those models, focusing on the ones used by the scientific community to estimate CT detriments. Current estimates of the probability that a CT examination induces cancer are reported, highlighting its low magnitude (near the background level) and large sources of uncertainty. From this objective review, it is concluded that epidemiological data with more accurate dosimetric estimates are needed. Prediction of the number of tumours that will be induced in population exposed to ionising radiation should be avoided or, if given, it should be accompanied by a realistic evaluation of its uncertainty and of the advantages of CTs. Otherwise they may have a negative impact in both the medical community and the patients. Reducing doses even more is not justified if that compromises clinical image quality in a necessary investigation. Key Points • Predictions of radiation-induced cancer should be discussed alongside benefits of imaging. • Estimates of induced cancers have noticeable uncertainties that should always be highlighted. • There is controversy about the acceptance of the linear no-threshold model. • Estimated extra risks of cancer are close to the background level. • Patients should not be alarmed by potential cancer induction by CT examinations.

In vivo γ-irradiation low dose threshold for suppression of DNA double strand breaks below the spontaneous level in mouse blood and spleen cells

There is a considerable controversy as to whether DNA damage induced by low doses and low dose rates of ionizing radiation is treated by cellular defence mechanisms in ways similar to that induced at high doses and high dose rates, and what downstream delayed effects may be caused by low doses compared to moderate and high doses. This constitutes the major challenge for the linear no-threshold model currently used for radiological risk estimates. Among the various DNA lesions induced by ionizing radiation, DNA double strand breaks (DSBs) are considered the most important due to their potential to cause cell death, mutagenesis and carcinogenesis. This study examined the accumulation of DNA DSBs in mouse blood leucocytes and splenocytes after long-term, chronic low dose γ-irradiation in vivo, and how this exposure may alter cell sensitivity to acute high dose irradiation. Animals were irradiated for 40, 80 or 120 days at a dose rate of 0.15mGy/h, with total accumulated doses of 144, 288 and 432mGy. DNA DSBs were measured in blood leucocytes and splenocytes using the neutral comet assay. We found that after an initial slight increase in the level of DNA DSBs at 40 days of exposure compared to controls, there was a subsequent drop after either 80 (P<0.01) or 120 days of exposure (P=0.066 for blood leucocytes; P=0.024 for splenocytes). Interestingly, the DNA breaks level after both 80 and 120 days of exposure was lower than in control. Similarly, the cells exposed to the chronic radiation for 80 and 120 days were less sensitive to the induction of DNA DSBs by acute 4Gy irradiation, whereas 40 days of exposure did not significantly modify the radiosensitivity. Our results indirectly indicate that low level ionizing radiation in vivo may trigger inducible repair of both endogenous and exogenous DNA DSBs, and that there is a dose threshold for this inducible defence mechanism, below which it does not occur. These data provide new evidence, now at the molecular level in vivo, that the dose-response for DNA DSBs at very low doses and dose rates is not linear.