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Ma Y, Guo L, Fang L, Hou D, Chen R, Wang X, Mao X, Zhao Z, Chen Y. Assessment of radiation doses and DNA damage in pediatric patients undergoing interventional procedures for vascular anomalies. MUTATION RESEARCH. GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2023; 889:503653. [PMID: 37491112 DOI: 10.1016/j.mrgentox.2023.503653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/07/2023] [Accepted: 06/22/2023] [Indexed: 07/27/2023]
Abstract
Interventional procedures (IPs) have been widely used to treat vascular anomalies (VA) in recent years. However, patients are exposed to low-dose X-ray ionizing radiation (IR) during these fluoroscopy-guided IPs. We collected clinical information and IR doses during IPs and measured biomarkers including γ-H2AX, chromosome aberrations (CA), and micronuclei (MN), which underpin radiation-induced DNA damage, from 74 pediatric patients before and after IPs. For the 74 children, the range of dose-area product (DAP) values was from 1.2 to 1754.6 Gy∙cm2, with a median value of 27.1 Gy∙cm2. DAP values were significantly higher in children with lesions in the head and neck than in the limbs and trunk; the age and weight of children revealed a strong positive correlation with DAP values. The treated patients as a group demonstrated an increase in all three endpoints relative to baseline following IPs. Children with vascular tumors have a higher risk of dicentric chromosome + centric ring (dic+r) and cytokinesis-block micronucleus (CBMN) after IPs than children with vascular malformations. The younger the patient, the greater the risk of CA after IPs. Moreover, rogue cells (RCs) were found in five children (approximately 10%) after IPs, and the rates of dic+r and CBMN were significantly higher than those of other children (Z = -3.576, p < 0.001). These results suggest that there may be some children with VA who are particularly sensitive to IR, but more data and more in-depth experiments will be needed to verify this in the future.
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Affiliation(s)
- Ya Ma
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Lei Guo
- Jinan Children's Hospital, No. 23976 Jingshi Road, Jinan 250022, PR China
| | - Lianying Fang
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Dianjun Hou
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Rui Chen
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Xiaoshan Wang
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Xuesong Mao
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China
| | - Zihan Zhao
- High School Attached to Shandong Normal University, No. 3 Shanshi North Street, Jinan 250014, PR China
| | - Yingmin Chen
- School of Preventive Medicine Sciences (Institute of Radiation Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences), No. 6699 Qingdao Road, Jinan 250117, PR China.
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Habibi M, Karyofyllis PK, Nikolakopoulou A, Papagiannis P, Karaiskos P, Georgakilas AG, Hatzi VI, Malakos I, Kollaros N, Mastorakou I, Voudris V, Terzoudi GI. The Use of Genotoxicity Endpoints as Biomarkers of Low Dose Radiation Exposure in Interventional Cardiology. Front Public Health 2021; 9:701878. [PMID: 34368064 PMCID: PMC8342993 DOI: 10.3389/fpubh.2021.701878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/25/2021] [Indexed: 11/23/2022] Open
Abstract
The effect of the reportedly low ionizing radiation doses, such as those very often delivered to patients in interventional cardiology, remains ambiguous. As interventional cardiac procedures may have a significant impact on total collective effective dose, there are radiation protection concerns for patients and physicians regarding potential late health effects. Given that very low doses (<100 mSv) are expected to be delivered during these procedures, the purpose of this study was to assess the potency and suitability of current genotoxicity biomarkers to detect and quantitate biological effects essential for risk estimation in interventional cardiology. Specifically, the biomarkers γ-H2AX foci, dicentric chromosomes, and micronuclei, which underpin radiation-induced DNA damage, were studied in blood lymphocytes of 25 adult patients before and after interventional cardiac procedures. Even though the mean values of all patients as a group for all three endpoints tested show increased yields relative to baseline following medical exposure, our results demonstrate that only the γ-H2AX biomarker enables detection of statistically significant differences at the individual level (p < 0.001) for almost all patients (91%). Furthermore, 24 h after exposure, residual γ-H2AX foci were still detectable in irradiated lymphocytes. Their decline was found to vary significantly among the individuals and the repair kinetics of γ-H2AX foci was found to range from 25 to 95.6% of their maximum values obtained.
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Affiliation(s)
- Martha Habibi
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety (INRASTES), National Centre for Scientific Research "Demokritos", Athens, Greece.,Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Aggeliki Nikolakopoulou
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety (INRASTES), National Centre for Scientific Research "Demokritos", Athens, Greece.,Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Papagiannis
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Pantelis Karaiskos
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros G Georgakilas
- DNA Damage Laboratory, Department of Physics, School of Applied Mathematical and Physical Sciences, National Technical University of Athens (NTUA), Athens, Greece
| | - Vasiliki I Hatzi
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety (INRASTES), National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Ioannis Malakos
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | | | - Irene Mastorakou
- Imaging Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Vassilis Voudris
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | - Georgia I Terzoudi
- Laboratory of Health Physics, Radiobiology & Cytogenetics, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety (INRASTES), National Centre for Scientific Research "Demokritos", Athens, Greece
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3
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Tanaka Y, Furuta M. Biological effects of low-dose γ-ray irradiation on chromosomes and DNA of Drosophila melanogaster. JOURNAL OF RADIATION RESEARCH 2021; 62:1-11. [PMID: 33290547 PMCID: PMC7779362 DOI: 10.1093/jrr/rraa108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/27/2020] [Indexed: 06/12/2023]
Abstract
While the damage to chromosomes and genes induced by high-dose radiation (HDR) has been well researched in many organisms, the effects of low-dose radiation (LDR), defined as a radiation dose of ≤100 mSv, are still being debated. Recent research has suggested that the biological effects of LDR differ from those observed in HDR. To detect the effect of LDR on genes, we selected a gene of Drosophila melanogaster, known as the multiple wing hair (mwh) gene. The hatched heterozygous larvae with genotype mwh/+ were irradiated by γ-rays of a 60Co source. After eclosion, the wing hairs of the heterozygous flies were observed. The area of only one or two mwh cells (small spot) and that of more than three mwh cells (large spot) were counted. The ratio of the two kinds of spots were compared between groups irradiated by different doses including a non-irradiated control group. For the small spot in females, the eruption frequency increased in the groups irradiated with 20-75 mGy, indicating hypersensitivity (HRS) to LDR, while in the groups irradiated with 200 and 300 mGy, the frequency decreased, indicating induced radioresistance (IRR), while in males, 50 and 100 mGy conferred HRS and 75 and 200 mGy conferred IRR. For the large spot in females, 75 mGy conferred HRS and 100-800 mGy conferred IRR. In conclusion, HRS and IRR to LDR was found in Drosophila wing cells by delimiting the dose of γ-rays finely, except in the male large spot.
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Affiliation(s)
- Yoshiharu Tanaka
- Corresponding author. Radiation Biology and Molecular Genetics, Division of Quantum Radiation, Faculty of Technology and Biology and Cultural Sciences, Faculty of Liberal Arts and Sciences, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531, Japan. Tel: 81-72-254-9750;
| | - Masakazu Furuta
- Radiation Biology and Molecular Genetics, Division of Quantum Radiation, Faculty of Technology and Department of Radiation Research Center, Osaka Prefecture University, 1-2 Gakuencho, Naka-ku, Sakai 591-8531, Japan
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4
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Visweswaran S, Joseph S, Dhanasekaran J, Paneerselvam S, Annalakshmi O, Jose MT, Perumal V. Exposure of patients to low doses of X-radiation during neuro-interventional imaging and procedures: Dose estimation and analysis of γ-H2AX foci and gene expression in blood lymphocytes. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2020; 856-857:503237. [PMID: 32928370 DOI: 10.1016/j.mrgentox.2020.503237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/19/2022]
Abstract
Radiation has widespread applications in medicine. However, despite the benefits of medical radiation exposures, adverse long-term health effects are cause for concern. Protein and gene biomarkers are early indicators of cellular response after low-dose exposure. We examined DNA damage by quantifying γ-H2AX foci and expression of twelve candidate genes in the blood lymphocytes of patients exposed to low doses of X-radiation during neuro-interventional procedures. Entrance surface dose (ESD; 10.92-1062.55 mGy) was measured by thermoluminescence dosimetry (TLD). Absorbed dose was estimated using γ-H2AX focus frequency and gene expression, with in vitro dose-response curves generated for the same biomarkers. γ-H2AX foci in post-exposure samples were significantly higher than in pre-exposure samples. Among the genes analysed, FDXR, ATM, BCL2, MDM2, TNFSF9, and PCNA showed increased expression; CDKN1A, DDB2, SESN1, BAX, and TNFRSF10B showed unchanged or decreased expression. Absorbed dose, estimated based on γ-H2AX focus frequency and gene expression changes, did not show any correlation with measured ESD. Patients undergoing interventional procedures receive considerable radiation doses, resulting in DNA damage and altered gene expression. Medical procedures should be carried out using the lowest radiation doses possible without compromising treatment.
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Affiliation(s)
- Shangamithra Visweswaran
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India
| | - Santhosh Joseph
- Department of Neuro-Radiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India
| | - Jagadeesan Dhanasekaran
- Department of Neuro-Radiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India
| | - S Paneerselvam
- Department of Neuro-Radiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India
| | - O Annalakshmi
- Radiation Safety Division Unit, Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, 603102, Tamil Nadu, India
| | - M T Jose
- Radiation Safety Division Unit, Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, 603102, Tamil Nadu, India
| | - Venkatachalam Perumal
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, 600116, India.
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5
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Cuiju W, Shibiao S, Ying T, Rongzong L, Haijuan X, Huifeng C, Tianjian W. IL-2 and IL-2R gene polymorphisms and immune function in people residing in areas with high background radiation, Yangjiang, China. Int J Radiat Biol 2020; 96:1466-1472. [PMID: 32910717 DOI: 10.1080/09553002.2020.1820607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Long-term exposure to low dose radiation may trigger immune response and stimulate hormesis. Interleukin-2 (IL-2) and interleukin-2 receptor (IL-2R) play a crucial role in immune function. We aimed to explore the possible association of IL-2 and IL-2R gene polymorphisms with low dose radiation exposure, as well as the relationship with IL-2 gene expression in people residing in areas with a high background radiation in Yangjiang, China. MATERIALS AND METHODS We recruited and assigned 54 native men residing in Yangxi County, Yangjiang city to the high natural background radiation (HNBR) group, and 53 native men residing in Hengpi County, Enping city to the control area (CA) group. All the participants wore a thermoluminescent dosimeter (TLD) for 90 days, and answered questionnaires. The serum levels of IL2, IL4, IL5, sIL2R, and tumor growth factor (TGF), and expression levels of IL2RA, IL2RB, IL2RG, and IL2 were also analyzed. Additionally, we tested 10 polymorphic loci associated with the IL-2 gene. RESULTS The annual effective radiation doses in the HNBR and CA groups were 6.24 mSv y-1 and 1.95 mSv y-1, respectively. After adjusting for potential confounding factors, the serum levels of IL-2 and IL-5 were higher in the HNBR group than the CA group (p < .05), while the serum level of TGFβ was lower in the HNBR group (p < .05). The IL-2 gene mRNA expression level was higher in the HNBR group than the CA group (p < .05). The IL-2RB rs76206423 AA allele showed significant variations in the HNBR group (p = .0381). CONCLUSIONS Long-term exposure to low dose radiation may enhance immune function, and IL-2RB rs76206423 may be related to the expression of IL-2 by other coding variants. Moreover, our data provide a better understanding of the molecular mechanism of the immune response to low dose radiation.
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Affiliation(s)
- Wen Cuiju
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong, China
| | - Su Shibiao
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong, China
| | - Tang Ying
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong, China
| | - Li Rongzong
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong, China
| | - Xu Haijuan
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong, China
| | - Chen Huifeng
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong, China
| | - Wang Tianjian
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong, China
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6
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Berrington de Gonzalez A, Daniels RD, Cardis E, Cullings HM, Gilbert E, Hauptmann M, Kendall G, Laurier D, Linet MS, Little MP, Lubin JH, Preston DL, Richardson DB, Stram D, Thierry-Chef I, Schubauer-Berigan MK. Epidemiological Studies of Low-Dose Ionizing Radiation and Cancer: Rationale and Framework for the Monograph and Overview of Eligible Studies. J Natl Cancer Inst Monogr 2020; 2020:97-113. [PMID: 32657348 PMCID: PMC7610154 DOI: 10.1093/jncimonographs/lgaa009] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/13/2020] [Indexed: 12/21/2022] Open
Abstract
Whether low-dose ionizing radiation can cause cancer is a critical and long-debated question in radiation protection. Since the Biological Effects of Ionizing Radiation report by the National Academies in 2006, new publications from large, well-powered epidemiological studies of low doses have reported positive dose-response relationships. It has been suggested, however, that biases could explain these findings. We conducted a systematic review of epidemiological studies with mean doses less than 100 mGy published 2006-2017. We required individualized doses and dose-response estimates with confidence intervals. We identified 26 eligible studies (eight environmental, four medical, and 14 occupational), including 91 000 solid cancers and 13 000 leukemias. Mean doses ranged from 0.1 to 82 mGy. The excess relative risk at 100 mGy was positive for 16 of 22 solid cancer studies and 17 of 20 leukemia studies. The aim of this monograph was to systematically review the potential biases in these studies (including dose uncertainty, confounding, and outcome misclassification) and to assess whether the subset of minimally biased studies provides evidence for cancer risks from low-dose radiation. Here, we describe the framework for the systematic bias review and provide an overview of the eligible studies.
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Affiliation(s)
| | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Elisabeth Cardis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Ethel Gilbert
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, Bethesda, MD, USA
| | - Michael Hauptmann
- Department of Epidemiology and Biostatistics, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Brandenburg Medical School Theodor Fontane, Institute of Biostatistics and Registry Research, Neuruppin, Germany
| | | | | | - Martha S Linet
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, Bethesda, MD, USA
| | - Mark P Little
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, Bethesda, MD, USA
| | - Jay H Lubin
- Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch, Bethesda, MD, USA
| | | | | | - Daniel Stram
- University of Southern California, Los Angeles, CA
| | - Isabelle Thierry-Chef
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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7
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Fahl WE, Jermusek F, Guerin T, Albrecht DM, Fahl CJS, Dreischmeier E, Benedict C, Back S, Eickhoff J, Halberg RB. Impact of the PrC-210 Radioprotector Molecule on Cancer Deaths in p53-Deficient Mice. Radiat Res 2019; 193:88-94. [PMID: 31738662 DOI: 10.1667/rr15439.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Radiation-induced cancer is an ongoing and significant problem, with sources that include clinics worldwide in which 3.1 billion radiology exams are performed each year, as well as a variety of other scenarios such as space travel and nuclear cleanup. These radiation exposures are typically anticipated, and the exposure is typically well below 1 Gy. When radiation-induced (actually ROS-induced) DNA mutation is prevented, then so too are downstream radiation-induced cancers. Currently, there is no protection available against the effects of such <1 Gy radiation exposures. In this study, we address whether the new PrC-210 ROS-scavenger is effective in protecting p53-deficient (p53-/-) mice against X-ray-induced accelerated tumor mortality; this is the most sensitive radiation tumorigenesis model currently known. Six-day-old p53-/- pups received a single intraperitoneal PrC-210 dose [0.5 maximum tolerated dose (MTD)] or vehicle, and 25 min later, pups received 4.0 Gy X-ray irradiation. At 5 min postirradiation, blood was collected to quantify white blood cell c-H2AX foci. Over the next 250 days, tumor-associated deaths were recorded. Findings revealed that when administered 25 min before 4 Gy X-ray irradiation, PrC-210 reduced DNA damage (c-H2AX foci) by 40%, and in a notable coincidence, caused a 40% shift in tumor latency/incidence, and the 0.5 MTD PrC210 dose had no discernible toxicities in these p53-/- mice. Essentially, the moles of PrC-210 thiol within a single 0.5 MTD PrC-210 dose suppressed the moles of ROS generated by 40% of the 4 Gy X-ray dose administered to p53-/- pups, and in doing so, eliminated the lifetime leukemia/lymphoma risk normally residing "downstream" of that 40% of the 4 Gy dose. In conclusion: 1. PrC-210 is readily tolerated by the 6-day-old p53-/- mice, with no discernible lifetime toxicities; 2. PrC-210 does not cause the nausea, emesis or hypotension that preclude clinical use of earlier aminothiols; and 3. PrC-210 significantly increased survival after 4 Gy irradiation in the p53-/- mouse model.
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Affiliation(s)
| | | | - Thomas Guerin
- Department of Medicine, Department of Oncology, UW Carbone Cancer Center
| | - Dawn M Albrecht
- Department of Medicine, Department of Oncology, UW Carbone Cancer Center
| | | | | | | | - Susan Back
- Wisconsin Institutes for Medical Research
| | - Jens Eickhoff
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Richard B Halberg
- Department of Medicine, Department of Oncology, UW Carbone Cancer Center
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8
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Seibold P, Auvinen A, Averbeck D, Bourguignon M, Hartikainen JM, Hoeschen C, Laurent O, Noël G, Sabatier L, Salomaa S, Blettner M. Clinical and epidemiological observations on individual radiation sensitivity and susceptibility. Int J Radiat Biol 2019; 96:324-339. [PMID: 31539290 DOI: 10.1080/09553002.2019.1665209] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose: To summarize existing knowledge and to understand individual response to radiation exposure, the MELODI Association together with CONCERT European Joint Programme has organized a workshop in March 2018 on radiation sensitivity and susceptibility.Methods: The workshop reviewed the current evidence on this matter, to inform the MELODI Strategic Research Agenda (SRA), to determine social and scientific needs and to come up with recommendations for suitable and feasible future research initiatives to be taken for the benefit of an improved medical diagnosis and treatment as well as for radiation protection.Results: The present paper gives an overview of the current evidence in this field, including potential effect modifiers such as age, gender, genetic profile, and health status of the exposed population, based on clinical and epidemiological observations.Conclusion: The authors conclude with the following recommendations for the way forward in radiation research: (a) there is need for large (prospective) cohort studies; (b) build upon existing radiation research cohorts; (c) use data from well-defined cohorts with good exposure assessment and biological material already collected; (d) focus on study quality with standardized data collection and reporting; (e) improve statistical analysis; (f) cooperation between radiobiology and epidemiology; and (g) take consequences of radiosensitivity and radiosusceptibility into account.
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Affiliation(s)
- Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anssi Auvinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland.,STUK - Radiation and Nuclear Safety Authority, Helsinki, Finland
| | - Dietrich Averbeck
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), DRF, Fontenay-aux-Roses Cedex, France
| | - Michel Bourguignon
- Department of Biophysics, Université Paris Saclay (UVSQ), Versailles, France
| | - Jaana M Hartikainen
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.,Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Christoph Hoeschen
- Faculty of Electrical Engineering and Information Technology, Otto-von-Guericke University, Magdeburg, Germany
| | - Olivier Laurent
- Laboratoire d'épidémiologie des Rayonnements Ionisants, Institut de Radioprotection et de Sûreté Nucléaire, PSE-SANTE/SESANE/LEPID, BP17, 92260, Fontenay aux Roses, France
| | - Georges Noël
- Département Universitaire de Radiothérapie, Centre Paul-Strauss, Unicancer, Strasbourg cedex, France
| | - Laure Sabatier
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), DRF, Fontenay-aux-Roses Cedex, France
| | - Sisko Salomaa
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Mainz, Germany
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9
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Pawel D, Boyd M. Studies of radiation health effects inform EPA actions. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2019; 39:S40-S57. [PMID: 31085816 PMCID: PMC7158982 DOI: 10.1088/1361-6498/ab2197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In 1970, the US Environmental Protection Agency (EPA) was given the responsibility to provide guidance to other federal agencies in the formulation of radiation protection standards. To carry out its federal guidance responsibilities and protect human health, the EPA must estimate risk at low doses to limit the risk of radiogenic cancers from environmental exposures. These risk estimates are based on models which conform to the linear no threshold (LNT) hypothesis. A cancer risk model conforms to the LNT hypothesis if the excess risk of cancer at low doses increases approximately proportional to dose, with no threshold. Risk models with a linear-quadratic dose response can satisfy the LNT hypothesis. Based on careful review of evidence from epidemiological and radiobiological studies, authoritative scientific bodies have repeatedly endorsed the use of LNT models for estimating and regulating risk and concluded that despite uncertainties at low dose and dose rates, the LNT model remains the most practical and implementable model for radiation protection. This article describes the rationale underlying the use of LNT models for calculating risk for low dose and dose rate exposures and discusses some of the epidemiological evidence which inform on its continued use.
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10
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Brand M, Sommer M, Jermusek F, Fahl WE, Uder M. Reduction of X-ray-induced DNA damage in normal human cells treated with the PrC-210 radioprotector. Biol Open 2018; 7:bio.035113. [PMID: 30135082 PMCID: PMC6215412 DOI: 10.1242/bio.035113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The aim of our study was to determine the protective efficacy of the PrC-210 aminothiol radioprotector against X-ray-induced DNA damage in normal human cells and to establish dose- and time-effect models for future PrC-210 use in humans. The PrC-210 structure has a branched structure which enables scavenging of reactive oxygen species (ROS) away from DNA. Normal human blood lymphocytes, fibroblasts and naked genomic DNA were exposed to PrC-210 seconds to hours prior to irradiation. Biological (γ-H2AX foci), chemical (8-oxo-deoxyguanosine) and physical (genomic DNA electrophoretic migration) DNA damage endpoints were scored to determine the ability of PrC-210 to suppress radiation-induced DNA damage. X-ray-induced γ-H2AX foci in blood lymphocytes were reduced by 80% after irradiation with 10, 50 and 100 mGy, and DNA double-strand breaks in fibroblasts were reduced by 60% after irradiation with 20 Gy. Additionally, we observed a reduction of 8-oxo-deoxyguanosine (an ROS-mediated, DNA damage marker) in human genomic DNA to background in a PrC-210 dose-dependent manner. PrC-210 also eliminated radiation-induced cell death in colony formation assays after irradiation with 1 Gy. The protective efficacy of PrC-210 in each of these assay systems supports its development as a radioprotector for humans in multiple radiation exposure settings. Summary: A new strategy is decribed, using a new radioprotector (PrC-210) to significantly reduce radiation-induced DNA damage.
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Affiliation(s)
- Michael Brand
- Department of Radiology, Maximiliansplatz 3, University of Erlangen, 91054 Erlangen, Germany
| | - Matthias Sommer
- Department of Radiology, Maximiliansplatz 3, University of Erlangen, 91054 Erlangen, Germany
| | - Frank Jermusek
- Wisconsin Institutes of Medical Research, University of Wisconsin-Madison, Madison, Wisconsin 53705 USA
| | - William E Fahl
- Wisconsin Institutes of Medical Research, University of Wisconsin-Madison, Madison, Wisconsin 53705 USA
| | - Michael Uder
- Department of Radiology, Maximiliansplatz 3, University of Erlangen, 91054 Erlangen, Germany
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11
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Jermusek F, Benedict C, Dreischmeier E, Brand M, Uder M, Jeffery JJ, Ranallo FN, Fahl WE. Significant Suppression of CT Radiation-Induced DNA Damage in Normal Human Cells by the PrC-210 Radioprotector. Radiat Res 2018; 190:133-141. [PMID: 29781766 DOI: 10.1667/rr14928.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
While computed tomography (CT) is now commonly used and considered to be clinically valuable, significant DNA double-strand breaks (γ-H2AX foci) in white blood cells from adult and pediatric CT patients have been frequently reported. In this study to determine whether γ-H2AX foci and X-ray-induced naked DNA damage are suppressed by administration of the PrC-210 radioprotector, human blood samples were irradiated in a CT scanner at 50-150 mGy with or without PrC-210, and γ-H2AX foci were scored. X-ray-induced naked DNA damage was also studied, and the DNA protective efficacy of PrC-210 was compared against 12 other common "antioxidants." PrC-210 reduced CT radiation-induced γ-H2AX foci in white blood cells to near background ( P < 0.0001) at radiation doses of 50-150 mGy. PrC-210 was most effective among the 13 "antioxidants" in reducing naked DNA X-ray damage, and its addition at 30 s before an •OH pulse reduced to background the •OH insult that otherwise induced >95% DNA damage. A systemic PrC-210 dose known to confer 100% survival in irradiated mice had no discernible effect on micro-CT image signal-to-noise ratio and CT image integrity. PrC-210 suppressed DNA damage to background or near background in each of these assay systems, thus supporting its development as a radioprotector for humans in multiple radiation exposure settings.
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Affiliation(s)
| | | | | | - Michael Brand
- d Department of Radiology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Uder
- d Department of Radiology, University of Erlangen-Nürnberg, Erlangen, Germany
| | | | - Frank N Ranallo
- c Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
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12
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Murakami M. Importance of risk comparison for individual and societal decision-making after the Fukushima disaster. JOURNAL OF RADIATION RESEARCH 2018; 59:ii23-ii30. [PMID: 29420739 PMCID: PMC5941137 DOI: 10.1093/jrr/rrx094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/07/2017] [Indexed: 05/14/2023]
Abstract
Risk comparison is essential for effective societal and individual decision-making. After the Fukushima disaster, studies compared radiation and other disaster-related risks to determine the effective prioritizing of measures for response. Evaluating the value of risk comparison information can enable effective risk communication. In this review, the value of risk comparison after the Fukushima disaster for societal and individual decision-making is discussed while clarifying the concept of radiation risk assessment at low doses. The objectives of radiation risk assessment are explained within a regulatory science framework, including the historical adoption of the linear non-threshold theory. An example of risk comparison (i.e. radiation risk versus evacuation-related risk in nursing homes) is used to discuss the prioritization of pre-disaster measures. The effective communication of risk information by authorities is discussed with respect to group-based and face-to-face approaches. Furthermore, future perspectives regarding radiation risk comparisons are discussed.
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Affiliation(s)
- Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, 960-1295, Japan
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13
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Abstract
PURPOSE OF REVIEW Ionizing radiation poses important health risks. The per capita annual dose rate has increased in the United States and there is increasing concern for the risks posed by low-dose occupational exposure among workers in nuclear industries and healthcare. Recent nuclear accidents and concern for terrorism have heightened concern for catastrophic, high-dose ionizing radiation exposure. This review will highlight recent research into the risks to lung health posed by ionizing radiation exposure and into potential treatments. RECENT FINDINGS Angiotensin-converting enzyme inhibitors and some antioxidants have shown promise as mitigators, to decrease pneumonitis and fibrosis when given after exposure. Studies of survivors of nuclear catastrophes have shown increased risk for lung cancer, especially in nonsmokers. There is evidence for increased lung cancer risk in industrial radiation workers, especially those who process plutonium and may inhale radioactive particles. There does not seem to be an increased risk of lung cancer in healthcare workers who perform fluoroscopic procedures. SUMMARY High-dose ionizing radiation exposure causes pneumonitis and fibrosis, and more research is needed to develop mitigators to improve outcomes in nuclear catastrophes. Long-term, low-dose occupational radiation may increase lung cancer risk. More research to better define this risk could lead to improved safety protocols and screening programs.
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14
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Fujishiro A, Miura Y, Iwasa M, Fujii S, Sugino N, Andoh A, Hirai H, Maekawa T, Ichinohe T. Effects of acute exposure to low-dose radiation on the characteristics of human bone marrow mesenchymal stromal/stem cells. Inflamm Regen 2017; 37:19. [PMID: 29259718 PMCID: PMC5725824 DOI: 10.1186/s41232-017-0049-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 07/10/2017] [Indexed: 12/26/2022] Open
Abstract
Background In recent years, increasing attention has been paid to the effects of low-dose irradiation on human health. We examined whether low-dose irradiation affected the functions of mesenchymal stromal/stem cells (MSCs), which are tissue/organ-supportive stem cells, derived from bone marrow (BM). Methods Normal human BM-MSCs from five healthy individuals were used in this study. Culture-expanded BM-MSCs were exposed to 0.1 gray (Gy) of γ-radiation (Cesium-137) at a rate of 0.8 Gy/min (Ir-MSCs), and their expansion, multi-differentiation, and hematopoiesis-supportive capabilities were investigated. Results The expansion of BM-MSCs was transiently delayed after low-dose γ-irradiation compared with that of non-irradiated BM-MSCs (non-Ir-MSCs) in two out of five lots. Adipogenic and osteogenic differentiation capabilities were not significantly affected by low-dose irradiation, although one lot of BM-MSCs tended to have transiently reduced differentiation. When human BM hematopoietic stem/progenitor cells (HPCs) were co-cultured with Ir-MSCs, the generation of CD34+CD38+ cells from HPCs was enhanced compared with that in co-cultures with non-Ir-MSCs in two out of five lots. The mRNA expression level of interleukin (IL)-6 was increased and those of stem cell factor (SCF) and fms-related tyrosine kinase 3 ligand (Flt3L) were decreased in the affected lots of Ir-MSCs. In the other three lots of BM-MSCs, a cell growth delay, enhanced generation of CD34+CD38+ cells from HPCs in co-culture, and a combination of increased expression of IL-6 and decreased expression of SCF and Flt3L were not observed. Of note, the characteristics of these affected Ir-MSCs recovered to a similar level as those of non-Ir-MSCs following culture for 3 weeks. Conclusions Our results suggest that acute exposure to low-dose (0.1 Gy) radiation can transiently affect the functional characteristics of human BM-MSCs.
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Affiliation(s)
- Aya Fujishiro
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan.,Division of Gastroenterology and Hematology, Department of Medicine, Shiga University of Medical Science, Setatsukinowacho, Otsu, Shiga 520-2192 Japan
| | - Yasuo Miura
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan.,Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8553 Japan
| | - Masaki Iwasa
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan.,Division of Gastroenterology and Hematology, Department of Medicine, Shiga University of Medical Science, Setatsukinowacho, Otsu, Shiga 520-2192 Japan
| | - Sumie Fujii
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan.,Department of Hematology/Oncology, Graduate School for Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Noriko Sugino
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan.,Department of Hematology/Oncology, Graduate School for Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Akira Andoh
- Division of Gastroenterology and Hematology, Department of Medicine, Shiga University of Medical Science, Setatsukinowacho, Otsu, Shiga 520-2192 Japan
| | - Hideyo Hirai
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Taira Maekawa
- Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8553 Japan
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15
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Lubin JH, Adams MJ, Shore R, Holmberg E, Schneider AB, Hawkins MM, Robison LL, Inskip PD, Lundell M, Johansson R, Kleinerman RA, de Vathaire F, Damber L, Sadetzki S, Tucker M, Sakata R, Veiga LHS. Thyroid Cancer Following Childhood Low-Dose Radiation Exposure: A Pooled Analysis of Nine Cohorts. J Clin Endocrinol Metab 2017; 102:2575-2583. [PMID: 28323979 PMCID: PMC5505197 DOI: 10.1210/jc.2016-3529] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/02/2017] [Indexed: 12/18/2022]
Abstract
CONTEXT The increased use of diagnostic and therapeutic procedures that involve radiation raises concerns about radiation effects, particularly in children and the radiosensitive thyroid gland. OBJECTIVES Evaluation of relative risk (RR) trends for thyroid radiation doses <0.2 gray (Gy); evidence of a threshold dose; and possible modifiers of the dose-response, e.g., sex, age at exposure, time since exposure. DESIGN AND SETTING Pooled data from nine cohort studies of childhood external radiation exposure and thyroid cancer with individualized dose estimates, ≥1000 irradiated subjects or ≥10 thyroid cancer cases, with data limited to individuals receiving doses <0.2 Gy. PARTICIPANTS Cohorts included the following: childhood cancer survivors (n = 2); children treated for benign diseases (n = 6); and children who survived the atomic bombings in Japan (n = 1). There were 252 cases and 2,588,559 person-years in irradiated individuals and 142 cases and 1,865,957 person-years in nonirradiated individuals. INTERVENTION There were no interventions. MAIN OUTCOME MEASURE Incident thyroid cancers. RESULTS For both <0.2 and <0.1 Gy, RRs increased with thyroid dose (P < 0.01), without significant departure from linearity (P = 0.77 and P = 0.66, respectively). Estimates of threshold dose ranged from 0.0 to 0.03 Gy, with an upper 95% confidence bound of 0.04 Gy. The increasing dose-response trend persisted >45 years after exposure, was greater at younger age at exposure and younger attained age, and was similar by sex and number of treatments. CONCLUSIONS Our analyses reaffirmed linearity of the dose response as the most plausible relationship for "as low as reasonably achievable" assessments for pediatric low-dose radiation-associated thyroid cancer risk.
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Affiliation(s)
- Jay H. Lubin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892
| | - M. Jacob Adams
- University of Rochester School of Medicine and Dentistry, Department of Public Health Sciences, Rochester, New York 14642
| | - Roy Shore
- Radiation Effects Research Foundation, Hiroshima 732-0815, Japan
| | - Erik Holmberg
- Department of Oncology and Radiation Physics and the Oncological Centre, Sahlgrenska University Hospital, S-413-45 Goteborg, Sweden
| | - Arthur B. Schneider
- University of Illinois College of Medicine, Section of Endocrinology, Diabetes, and Metabolism, Chicago, Illinois 60612
| | - Michael M. Hawkins
- Centre for Childhood Cancer Survivor Studies, Department of Public Health and Epidemiology, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-3678
| | - Peter D. Inskip
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892
| | - Marie Lundell
- Department of Medical Physics, Radiumhemmet, Karolinska University Hospital and Karolinska Institute, SE-171 76 Stockholm, Sweden
| | - Robert Johansson
- Oncology, Department of Radiation Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Ruth A. Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892
| | - Florent de Vathaire
- Cancer Epidemiology Research Unit, National Institute for Health and Medical Research–Institut Gustave Roussy, 94 805 Villejuif, France
| | - Lena Damber
- Oncology, Department of Radiation Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Tel Hashomer, 52621 Israel
| | - Margaret Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892
| | - Ritsu Sakata
- Radiation Effects Research Foundation, Hiroshima 732-0815, Japan
| | - Lene H. S. Veiga
- Institute for Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, 22783-127 Rio de Janeiro, Brazil
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16
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Williams JP, Calvi L, Chakkalakal JV, Finkelstein JN, O’Banion MK, Puzas E. Addressing the Symptoms or Fixing the Problem? Developing Countermeasures against Normal Tissue Radiation Injury. Radiat Res 2016; 186:1-16. [PMID: 27332954 PMCID: PMC4991354 DOI: 10.1667/rr14473.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Jacqueline P. Williams
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York
| | - Laura Calvi
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Joe V. Chakkalakal
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York
| | - Jacob N. Finkelstein
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York
- Department of Pediatrics and Neonatology, University of Rochester Medical Center, Rochester, New York
| | - M. Kerry O’Banion
- Department of Neuroscience, University of Rochester Medical Center, Rochester, New York
| | - Edward Puzas
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York
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17
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Kopp VJ, Stavas JM. Rebuttal From Drs Kopp and Stavas. Chest 2016; 149:308-309. [DOI: 10.1016/j.chest.2015.10.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 10/21/2015] [Indexed: 10/22/2022] Open
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