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Donaubauer AJ, Becker I, Klein G, Voll RE, Weikl L, Klieser M, Barzangi S, Zhou JG, Fietkau R, Gaipl US, Frey B. Effects of serial radon spa therapy on pain and peripheral immune status in patients suffering from musculoskeletal disorders- results from a prospective, randomized, placebo-controlled trial. Front Immunol 2024; 15:1307769. [PMID: 38380316 PMCID: PMC10876773 DOI: 10.3389/fimmu.2024.1307769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
In this randomized, placebo-controlled cross-over trial we aimed to investigate if radon spa therapy exerts more pain relief than exposure to warm water alone. In addition, immunological parameters were assessed in both treatment groups. In the RAD-ON02 trial, 116 patients suffering from musculoskeletal disorders (MSDs) received either serial radon spa or solely warm water baths. Pain intensity was assessed by determination of different pain parameters on a visual analogue scale and by pressure point dolorimetry at baseline and at weeks 4, 12 and 24. The longitudinal immune status of the patients was analyzed by a flow cytometry-based assay from peripheral blood at the time points of pain assessments. There were no side effects attributable to radon exposure observed. However, radon spa was superior to warm water applications at week 4 in terms of pain reduction. Pain and morning stiffness at the time of assessment were significantly reduced after radon spa (p<0.001, p<0.01) but not after warm water baths. The dolorimetry resulted in a significantly higher exerted pressure strength in patients after radon spa (p<0.001), but not after warm water applications. During the long-term follow-up, both treatment modalities reduced pain to a similar degree and pain modulation was not distorted by the participants' intake of analgesics. No significant changes in the immune status attributable specifically to radon were found, even though the increase in regulatory T cell counts occurs earlier after radon baths than after sole warm water baths and a higher level of significance is reached after radon spa at week 24. Serial radon spa has additive pain-relieving effects. The immunological parameters assessed in our study appear not to be directly linked to the pain reduction caused by radon exposure, at least in MSD patients with predominantly degenerative diseases. Clinical trial registration https://www.clinicaltrialsregister.eu/ctr-search/search?query=rad-on02, identifier 2016-002085-31; https://drks.de/search/de/trial, identifier DRKS00016019.
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Affiliation(s)
- Anna-Jasmina Donaubauer
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ina Becker
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Gerhart Klein
- Association for Radon Spa Research and Medical Practice for Cardiology, Bad Steben, Germany
| | - Reinhard E. Voll
- Department of Rheumatology and Clinical Immunology, Medical Centre – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lena Weikl
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Martin Klieser
- Association for Radon Spa Research and Medical Practice for Cardiology, Bad Steben, Germany
| | - Shakar Barzangi
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jian-Guo Zhou
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Udo S. Gaipl
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Benjamin Frey
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Eckert D, Evic M, Schang J, Isbruch M, Er M, Dörrschuck L, Rapp F, Donaubauer AJ, Gaipl US, Frey B, Fournier C. Osteo-immunological impact of radon spa treatment: due to radon or spa alone? Results from the prospective, thermal bath placebo-controlled RAD-ON02 trial. Front Immunol 2024; 14:1284609. [PMID: 38292488 PMCID: PMC10824901 DOI: 10.3389/fimmu.2023.1284609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Musculoskeletal disorders (MSDs) are associated with pain and lead to reduced mobility and quality of life for patients. Radon therapy is used as alternative or complementary to pharmaceutical treatments. According to previous reports, radon spa leads to analgesic and anti-inflammatory effects, but the cellular and molecular mechanisms are widely unknown. A previous study (RAD-ON01) revealed, that bone erosion markers like collagen fragments (C-terminal telopeptide, CTX) are reduced after radon spa treatment in serum of patients with degenerative MSDs. Within the scope of the prospective, placebo-controlled RAD-ON02 trial presented here, we analyzed the influence of radon and thermal spa treatment on osteoclastogenesis. From patient blood, we isolate monocytes, seeded them on bone slices and differentiated them in the presence of growth factors into mature osteoclasts (mOCs). Subsequent analysis showed a smaller fraction of mOCs after both treatments, which was even smaller after radon spa treatment. A significantly reduced resorbed area on bone slices reflects this result. Only after radon spa treatment, we detected in the serum of patients a significant decrease of receptor activator of NF-κB ligand (RANKL), which indicates reduced differentiation of OCs. However, other markers for bone resorption (CTX) and bone formation (OPG, OCN) were not altered after both treatments. Adipokines, such as visfatin and leptin that play a role in some MSD-types by affecting osteoclastogenesis, were not changed after both treatments. Further, also immune cells have an influence on osteoclastogenesis, by inhibiting and promoting terminal differentiation and activation of OCs, respectively. After radon treatment, the fraction of Treg cells was significantly increased, whereas Th17 cells were not altered. Overall, we observed that both treatments had an influence on osteoclastogenesis and bone resorption. Moreover, radon spa treatment affected the Treg cell population as well as the Th17/Treg ratio were affected, pointing toward a contribution of the immune system after radon spa. These data obtained from patients enrolled in the RAD-ON02 trial indicate that radon is not alone responsible for the effects on bone metabolism, even though they are more pronounced after radon compared to thermal spa treatment.
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Affiliation(s)
- Denise Eckert
- Department of Biophysics, GSI Helmholtzzentrum Für Schwerionenforschung, Darmstadt, Germany
| | - Megi Evic
- Department of Biophysics, GSI Helmholtzzentrum Für Schwerionenforschung, Darmstadt, Germany
| | - Jasmin Schang
- Department of Biophysics, GSI Helmholtzzentrum Für Schwerionenforschung, Darmstadt, Germany
| | - Maike Isbruch
- Department of Biophysics, GSI Helmholtzzentrum Für Schwerionenforschung, Darmstadt, Germany
| | - Melissa Er
- Department of Biophysics, GSI Helmholtzzentrum Für Schwerionenforschung, Darmstadt, Germany
| | - Lea Dörrschuck
- Department of Biophysics, GSI Helmholtzzentrum Für Schwerionenforschung, Darmstadt, Germany
| | - Felicitas Rapp
- Department of Biophysics, GSI Helmholtzzentrum Für Schwerionenforschung, Darmstadt, Germany
| | - Anna-Jasmina Donaubauer
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Udo S. Gaipl
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Benjamin Frey
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Claudia Fournier
- Department of Biophysics, GSI Helmholtzzentrum Für Schwerionenforschung, Darmstadt, Germany
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Au NPB, Wu T, Kumar G, Jin Y, Li YYT, Chan SL, Lai JHC, Chan KWY, Yu KN, Wang X, Ma CHE. Low-dose ionizing radiation promotes motor recovery and brain rewiring by resolving inflammatory response after brain injury and stroke. Brain Behav Immun 2024; 115:43-63. [PMID: 37774892 DOI: 10.1016/j.bbi.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/24/2023] [Accepted: 09/22/2023] [Indexed: 10/01/2023] Open
Abstract
Traumatic brain injury (TBI) and stroke share a common pathophysiology that worsens over time due to secondary tissue injury caused by sustained inflammatory response. However, studies on pharmacological interventions targeting the complex secondary injury cascade have failed to show efficacy. Here, we demonstrated that low-dose ionizing radiation (LDIR) reduced lesion size and reversed motor deficits after TBI and photothrombotic stroke. Magnetic resonance imaging demonstrated significant reduction of infarct volume in LDIR-treated mice after stroke. Systems-level transcriptomic analysis showed that genes upregulated in LDIR-treated stoke mice were enriched in pathways associated with inflammatory and immune response involving microglia. LDIR induced upregulation of anti-inflammatory- and phagocytosis-related genes, and downregulation of key pro-inflammatory cytokine production. These findings were validated by live-cell assays, in which microglia exhibited higher chemotactic and phagocytic capacities after LDIR. We observed substantial microglial clustering at the injury site, glial scar clearance and reversal of motor deficits after stroke. Cortical microglia/macrophages depletion completely abolished the beneficial effect of LDIR on motor function recovery in stroke mice. LDIR promoted axonal projections (brain rewiring) in motor cortex and recovery of brain activity detected by electroencephalography recordings months after stroke. LDIR treatment delayed by 8 h post-injury still maintained full therapeutic effects on motor recovery, indicating that LDIR is a promising therapeutic strategy for TBI and stroke.
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Affiliation(s)
| | - Tan Wu
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China; Department of Surgery, Chinese University of Hong Kong, Hong Kong, China
| | - Gajendra Kumar
- Department of Neuroscience, City University of Hong Kong, Hong Kong, China
| | - Yuting Jin
- Department of Neuroscience, City University of Hong Kong, Hong Kong, China
| | | | - Shun Lam Chan
- Department of Neuroscience, City University of Hong Kong, Hong Kong, China
| | - Joseph Ho Chi Lai
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Kannie Wai Yan Chan
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China; City University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Kwan Ngok Yu
- Department of Physics, City University of Hong Kong, Hong Kong, China
| | - Xin Wang
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China; Department of Surgery, Chinese University of Hong Kong, Hong Kong, China
| | - Chi Him Eddie Ma
- Department of Neuroscience, City University of Hong Kong, Hong Kong, China; City University of Hong Kong Shenzhen Research Institute, Shenzhen, China.
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van der Zee-Neuen A, Fuchs J, Wildburger S, Gaisberger M, Kloppenburg M, Fioravanti A, Stamm T, Offenbaecher M, Radlmueller R, Foisner W, Hoelzl B, Ritter M. Improvement of Pain Symptoms in Musculoskeletal Diseases After Multimodal Spa Therapy in the Austrian Gastein Valley-A Study Based on Longitudinal Registry Data. Int J Public Health 2023; 68:1605931. [PMID: 37361027 PMCID: PMC10285078 DOI: 10.3389/ijph.2023.1605931] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Objective: The study aim was to investigate the course of pain in rest and motion in seven different rheumatic diseases (RMD), prior and after multimodal spa therapy including low-dose radon treatment and at 3-, 6-; and 9-month follow up. Methods: Complete data from the radon indication registry including information on 561 subjects with RMD were analysed to explore the association of timepoint of measurement with pain in rest and motion. For this purpose, linear regression models adjusted for RMD-type, age, sex and body mass index (BMI) were applied. Results: The mean age of the sample was 55 years, the average body mass index was 26.8, and 275 subjects were women. Pain scores were significantly improved at all-time points compared to baseline. Pain courses were different for each RMD with the largest improvement seen in fibromyalgia. Conclusion: Timing spa facility visits according to RMD-specific pain courses may result in sustained pain reduction.
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Affiliation(s)
- Antje van der Zee-Neuen
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Salzburg, Austria
- Center for Public Health and Healthcare Research, Paracelsus Medical University, Salzburg, Austria
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology, Pathophysiology and Biophysics, Nuremberg, Germany
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Julia Fuchs
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Salzburg, Austria
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology, Pathophysiology and Biophysics, Nuremberg, Germany
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Sonja Wildburger
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Salzburg, Austria
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology, Pathophysiology and Biophysics, Nuremberg, Germany
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Martin Gaisberger
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | | | - Tanja Stamm
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
- Institute for Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Bertram Hoelzl
- Gastein Healing Gallery, Bad Gastein, Austria
- Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria
| | - Markus Ritter
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Salzburg, Austria
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology, Pathophysiology and Biophysics, Nuremberg, Germany
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
- Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
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Tamás B, Gabriella K, Kristóf Á, Anett I, János Pál K, Bálint T, Péter L, Márton P, Katalin N. The Effects of Lakitelek Thermal Water and Tap Water on Skin Microbiome, a Randomized Control Pilot Study. Life (Basel) 2023; 13:life13030746. [PMID: 36983902 PMCID: PMC10051609 DOI: 10.3390/life13030746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023] Open
Abstract
The beneficial effects of balneotherapy have been proven by numerous clinical studies on locomotor disorders. To date, there is only scant data on changes in the microbiome system of the skin during balneotherapy. The aim of this study was to compare the effects of thermal water and tap water on the skin’s microbiome in healthy volunteers. 30 healthy female volunteers participated in the study. The experimental group (of 15 women) spent 30-min 10 times, in Gabriella Spring’s thermal baths (i.e., mineral water containing sodium hydrogen carbonate).The controlled group (15 women) had the same, but in tap water. The results of this study have proven that there is a difference in the influencing effects of tap water and medicinal water on the microbiome of the skin. After bathing in the thermal water of Lakitelek, Deinococcus increased significantly at the genus level, and the tendency for Rothia mucilaginosa bacteria also increased. At the species level, Rothia mucilaginosa increased significantly, while Paracoccus aminovorans and the tendency for Paracoccus marcusii decreased. When the values of the two trial groups after bathing at the genus level were compared, Rothia bacteria increased significantly, while Haemophilus tended to increase, Pseudomonas tended to decrease, Neisseria tended to increase significantly, and Flavobacterium tended to decrease. At the species level, Geobacillus vulcani decreased significantly, and the tendency for Burkholderia gladioli decreased. The growth of Rothia mucilaginosa and the decrease in the tendency of Paracoccus, Pseudomonas, Flavobacteroium, and Burkholderia gladioli confirm the beneficial effect of balneotherapy. In this study, trends are represented by the uncorrected p value. The main result was that the thermal water changed certain bacteria of the skin, both on the genus and species levels, but there were no significant changes in the tap water used, either at the genus or species level. We first compared the worlds of thermal water and tap water’s microbiome systems. The thermal water decreased the number of certain inflammatory infectious agents and could enhance some of their positive effects, which have been proven at the molecular level. Our results can provide an important clue in the treatment of certain skin diseases. The research of the skin microbiome during balneotherapy can be one of the most intriguing and exciting topics of the future and can bring us closer to understanding the mechanism of action of balneotherapy.
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Affiliation(s)
- Bender Tamás
- Polyclinic of the Hospitaller Brothers of St John of God, Árpád Fejedelem Útja 7, H-1023 Budapest, Hungary
- Correspondence:
| | - Kalics Gabriella
- Ligetszépe Health Center, Folk College Foundation of Lakitelek, H-6065 Lakitelek, Hungary; (K.G.); (N.K.)
| | - Árvai Kristóf
- Vascular Diagnostics Kft., Lechner Ödön Fasor 3. C. lház. 3. em. 1, H-1095 Budapest, Hungary; (Á.K.); (K.J.P.); (T.B.); (L.P.)
| | - Illés Anett
- Department of Medicine and Oncology, Faculty of Medicine, Semmelweis University, Korányi Sándor u. 2/a, H-1083 Budapest, Hungary;
| | - Kósa János Pál
- Vascular Diagnostics Kft., Lechner Ödön Fasor 3. C. lház. 3. em. 1, H-1095 Budapest, Hungary; (Á.K.); (K.J.P.); (T.B.); (L.P.)
- Department of Medicine and Oncology, Faculty of Medicine, Semmelweis University, Korányi Sándor u. 2/a, H-1083 Budapest, Hungary;
- Endocrine Molecular Pathology Research Group, Eötvös Lóránd Research Network, Korányi Sándor u. 2/a, H-1083 Budapest, Hungary
| | - Tobiás Bálint
- Vascular Diagnostics Kft., Lechner Ödön Fasor 3. C. lház. 3. em. 1, H-1095 Budapest, Hungary; (Á.K.); (K.J.P.); (T.B.); (L.P.)
- Department of Medicine and Oncology, Faculty of Medicine, Semmelweis University, Korányi Sándor u. 2/a, H-1083 Budapest, Hungary;
- Endocrine Molecular Pathology Research Group, Eötvös Lóránd Research Network, Korányi Sándor u. 2/a, H-1083 Budapest, Hungary
| | - Lakatos Péter
- Vascular Diagnostics Kft., Lechner Ödön Fasor 3. C. lház. 3. em. 1, H-1095 Budapest, Hungary; (Á.K.); (K.J.P.); (T.B.); (L.P.)
- Department of Medicine and Oncology, Faculty of Medicine, Semmelweis University, Korányi Sándor u. 2/a, H-1083 Budapest, Hungary;
- Endocrine Molecular Pathology Research Group, Eötvös Lóránd Research Network, Korányi Sándor u. 2/a, H-1083 Budapest, Hungary
| | - Papp Márton
- Centre for Bioinformatics, University of Veterinary Medicine Budapest, István u. 2, H-1078 Budapest, Hungary;
| | - Nemes Katalin
- Ligetszépe Health Center, Folk College Foundation of Lakitelek, H-6065 Lakitelek, Hungary; (K.G.); (N.K.)
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Kataoka T, Naoe S, Murakami K, Fujimoto Y, Yukimine R, Tanaka A, Yamaoka K. Immunomodulatory Effects of Radon Inhalation on Lipopolysaccharide-Induced Inflammation in Mice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10632. [PMID: 36078348 PMCID: PMC9518351 DOI: 10.3390/ijerph191710632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Typical indications for radon therapy include autoimmune diseases such as rheumatoid arthritis (RA). We had previously reported that radon inhalation inhibits Th17 immune responses in RA mice by activating Th1 and Th2 immune responses. However, there are no reports on how radon inhalation affects the activated Th1 and Th17 immune responses, and these findings may be useful for identifying new indications for radon therapy. Therefore, in this study, we investigated the effect of radon inhalation on the lipopolysaccharide (LPS)-induced inflammatory response, focusing on the expression of related cytokines and antioxidant function. Male BALB/c mice were exposed to 2000 Bq/m3 radon for one day. Immediately after radon inhalation, LPS was administered intraperitoneally at 1.0 mg/kg body weight for 4 h. LPS administration increased the levels of Th1- and Th17-prone cytokines, such as interleukin-2, tumor necrosis factor-α, and granulocyte-macrophage colony-stimulating factor, compared to no treatment control (sham). However, these effects were suppressed by radon inhalation. IL-10 levels were significantly increased by LPS administration, with or without radon inhalation, compared to sham. However, radon inhalation did not inhibit oxidative stress induced by LPS administration. These findings suggest that radon inhalation has immunomodulatory but not antioxidative functions in LPS-induced injury.
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Affiliation(s)
- Takahiro Kataoka
- Faculty of Health Sciences, Okayama University, 5-1 Shikata-cho 2-chome, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Shota Naoe
- Graduate School of Health Sciences, Okayama University, 5-1 Shikata-cho 2-chome, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Kaito Murakami
- Graduate School of Health Sciences, Okayama University, 5-1 Shikata-cho 2-chome, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Yuki Fujimoto
- Graduate School of Health Sciences, Okayama University, 5-1 Shikata-cho 2-chome, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Ryohei Yukimine
- Graduate School of Health Sciences, Okayama University, 5-1 Shikata-cho 2-chome, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Ayumi Tanaka
- Graduate School of Health Sciences, Okayama University, 5-1 Shikata-cho 2-chome, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Kiyonori Yamaoka
- Faculty of Health Sciences, Okayama University, 5-1 Shikata-cho 2-chome, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
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7
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van der Zee-Neuen A, Strobl V, Dobias H, Fuchs J, Untner J, Foisner W, Knapp M, Edtinger S, Offenbächer M, Ritter M, Hölzl B, Gaisberger M. Sustained improvements in EQ-5D utility scores and self-rated health status in patients with ankylosing spondylitis after spa treatment including low-dose radon - an analysis of prospective radon indication registry data. BMC Musculoskelet Disord 2022; 23:743. [PMID: 35922780 PMCID: PMC9347130 DOI: 10.1186/s12891-022-05691-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/20/2022] [Indexed: 12/02/2022] Open
Abstract
Background Patients with ankylosing spondylitis (AS) have significantly lower quality of life (QoL) than the general population. Holistic interventions addressing QoL comprise spa- or balneotherapy including radon. These interventions have shown to be beneficial in reducing pain and improving QoL in AS-patients. We explored the association of spa-therapy including low-dose radon with QoL in AS-patients over an extended time period. Methods Registry data collected for the “Radon indication registry” in the Austrian Gastein valley comprising data on QoL (EuroQol EQ-5D) directly before the treatment (baseline), directly(t1), 3 (t2); 6(t3) and 9(t4) months after the treatment, age, sex and body mass index (BMI) were analysed. Linear regression models explored the association of measurement time with 1) EQ-5D-5L utilities and 2) EuroQol visual analogue scale (VAS) score. Alterations of 0.05 (utilities) and 5.00 (VAS) were considered clinically relevant. Results Two-hundred-ninety-one AS-patients were included in the analyses. Forty-four percent (n = 128) were women, the mean age was 52 (SD 10) and the average BMI was 26 (SD 4). Utilities (t1: 0.09 [0.07;0.11]; t2: 0.08 [0.06; 0.10]; t3: 0.06 [0.05;0.09]; t4: 0.04 [0.02;0.06]) and VAS (t1: 11.68 [9.38; 13.97]; t2: 12.20 [9.78; 14.61]; t3: 9.70 [7.24; 12.17]; t4: 6.11 [3.57; 8.65]) were significantly higher at all timepoints compared to baseline. Improvements were clinically relevant at all timepoints in case of the VAS and until 6 months after treatment for the utilities. Conclusion AS-patients who received spa therapy including radon show significantly and clinically relevant improvements in Qol until 6–9 months after treatment.
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Affiliation(s)
- Antje van der Zee-Neuen
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Salzburg, Austria. .,Gastein Research Institute, Paracelsus Medical University, Strubergasse 22, 5020, Salzburg, Austria. .,Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria. .,Center for Public Health and Healthcare Research, Paracelsus Medical University, Salzburg, Austria.
| | - Victoria Strobl
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Salzburg, Austria.,Gastein Research Institute, Paracelsus Medical University, Strubergasse 22, 5020, Salzburg, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria
| | - Heidemarie Dobias
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Salzburg, Austria.,Gastein Research Institute, Paracelsus Medical University, Strubergasse 22, 5020, Salzburg, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria
| | - Julia Fuchs
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Salzburg, Austria.,Gastein Research Institute, Paracelsus Medical University, Strubergasse 22, 5020, Salzburg, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria
| | | | | | | | - Sebastian Edtinger
- Baerenhof Health Care & Rehabilitation Center, Bad Gastein, Austria.,Department of Physical Medicine and Rehabilitation, Kardinal Schwarzenberg Klinikum, Schwarzach Im Pongau, Austria
| | | | - Markus Ritter
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Salzburg, Austria.,Gastein Research Institute, Paracelsus Medical University, Strubergasse 22, 5020, Salzburg, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria.,Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology, Pathophysiology and Biophysics, Nuremberg, Germany.,Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Bertram Hölzl
- Gastein Healing Gallery, Bad Gastein, Austria.,Department of Internal Medicine, Landesklinik St. Veit Im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria
| | - Martin Gaisberger
- Center for Physiology, Pathophysiology and Biophysics, Institute for Physiology and Pathophysiology, Salzburg, Austria. .,Gastein Research Institute, Paracelsus Medical University, Strubergasse 22, 5020, Salzburg, Austria. .,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria.
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8
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Eckert D, Rapp F, Tsedeke AT, Kraft D, Wente I, Molendowska J, Basheer S, Langhans M, Meckel T, Friedrich T, Donaubauer AJ, Becker I, Frey B, Fournier C. Modulation of Differentiation and Bone Resorbing Activity of Human (Pre-) Osteoclasts After X-Ray Exposure. Front Immunol 2022; 13:817281. [PMID: 35603191 PMCID: PMC9116137 DOI: 10.3389/fimmu.2022.817281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
Low-dose radiotherapy (LD-RT) is a local treatment option for patients with chronic degenerative and inflammatory diseases, in particular musculoskeletal diseases. Despite reported analgesic and anti-inflammatory effects, cellular and molecular mechanisms related to osteoimmunological effects are still elusive. Here we test the hypothesis that X-irradiation inhibits the differentiation of precursor osteoclasts into mature osteoclasts (mOC) and their bone resorbing activity. Circulating monocytes from healthy donors were isolated and irradiated after attachment with single or fractionated X-ray doses, comparable to an LD-RT treatment scheme. Then monocytes underwent ex vivo differentiation into OC during cultivation up to 21 days, under conditions mimicking the physiological microenvironment of OC on bone. After irradiation, apoptotic frequencies were low, but the total number of OC precursors and mOC decreased up to the end of the cultivation period. On top, we observed an impairment of terminal differentiation, i.e. a smaller fraction of mOC, reduced resorbing activity on bone, and release of collagen fragments. We further analyzed the effect of X-irradiation on multinucleation, resulting from the fusion of precursor OC, which occurs late during OC differentiation. At 21 days after exposure, the observation of smaller cellular areas and a reduced number of nuclei per mOC suggest an impaired fusion of OC precursors to form mOC. Before, at 14 days, the nuclear translocation of Nuclear Factor Of Activated T Cells 1 (NFATc1), a master regulator of osteoclast differentiation and fusion, was decreased. In first results, obtained in the frame of a longitudinal LD-RT study, we previously reported a pain-relieving effect in patients. However, in a subgroup of patients suffering from Calcaneodynia or Achillodynia, we did not observe a consistent decrease of established blood markers for resorption and formation of bone, or modified T cell subtypes involved in regulating these processes. To assess the relevance of changes in bone metabolism for other diseases treated with LD-RT will be subject of further studies. Taken together, we observed that in vitro X-irradiation of monocytes results in an inhibition of the differentiation into bone-resorbing OC and a concomitant reduction of resorbing activity. The detected reduced NFATc1 signaling could be one underlying mechanism.
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Affiliation(s)
- Denise Eckert
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Felicitas Rapp
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Ayele Taddese Tsedeke
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Daniela Kraft
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Isabell Wente
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Jessica Molendowska
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Sidra Basheer
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Markus Langhans
- Department of Macromolecular and Paper Chemistry and Membrane Dynamics, Technical University Darmstadt, Darmstadt, Germany
| | - Tobias Meckel
- Department of Macromolecular and Paper Chemistry and Membrane Dynamics, Technical University Darmstadt, Darmstadt, Germany
| | - Thomas Friedrich
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Anna-Jasmina Donaubauer
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ina Becker
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Benjamin Frey
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Claudia Fournier
- Department of Biophysics, Gesellschaft für Schwerionenforschung (GSI) Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
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9
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Papenfuß F, Maier A, Fournier C, Kraft G, Friedrich T. In-vivo dose determination in a human after radon exposure: proof of principle. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2022; 61:279-292. [PMID: 35377069 PMCID: PMC9021097 DOI: 10.1007/s00411-022-00972-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/09/2022] [Indexed: 05/27/2023]
Abstract
Radon-222 is pervasive in our environment and the second leading cause of lung cancer induction after smoking while it is simultaneously used to mediate anti-inflammatory effects. During exposure, radon gas distributes inhomogeneously in the body, making a spatially resolved dose quantification necessary to link physical exposure conditions with accompanying risks and beneficial effects. Current dose predictions rely on biokinetic models based on scarce input data from animal experiments and indirect exhalation measurements of a limited number of humans, which shows the need for further experimental verification. We present direct measurements of radon decay in the abdomen and thorax after inhalation as proof of principle in one patient. At both sites, most of the incorporated radon is removed within ~ 3 h, whereas a smaller fraction is retained longer and accounts for most of the deposited energy. The obtained absorbed dose values were [Formula: see text] µGy (abdomen, radon gas) and [Formula: see text] µGy (thorax, radon and progeny) for a one-hour reference exposure at a radon activity concentration of 55 kBq m-3. The accumulation of long-retained radon in the abdomen leads to higher dose values at that site than in the thorax. Contrasting prior work, our measurements are performed directly at specific body sites, i.e. thorax and abdomen, which allows for direct spatial distinction of radon kinetics in the body. They show more incorporated and retained radon than current approaches predict, suggesting higher doses. Although obtained only from one person, our data may thus represent a challenge for the barely experimentally benchmarked biokinetic dose assessment model.
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Affiliation(s)
- Franziska Papenfuß
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstraße 1, 64291, Darmstadt, Germany
| | - Andreas Maier
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstraße 1, 64291, Darmstadt, Germany
| | - Claudia Fournier
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstraße 1, 64291, Darmstadt, Germany
| | - Gerhard Kraft
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstraße 1, 64291, Darmstadt, Germany
| | - Thomas Friedrich
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstraße 1, 64291, Darmstadt, Germany.
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10
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Deloch L, Hehlgans S, Rückert M, Maier A, Hinrichs A, Flohr AS, Eckert D, Weissmann T, Seeling M, Nimmerjahn F, Fietkau R, Rödel F, Fournier C, Frey B, Gaipl US. Radon Improves Clinical Response in an Animal Model of Rheumatoid Arthritis Accompanied by Increased Numbers of Peripheral Blood B Cells and Interleukin-5 Concentration. Cells 2022; 11:689. [PMID: 35203348 PMCID: PMC8870723 DOI: 10.3390/cells11040689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 11/23/2022] Open
Abstract
Radon treatment is used as an established therapy option in chronic painful inflammatory diseases. While analgesic effects are well described, little is known about the underlying molecular effects. Among the suspected mechanisms are modulations of the anti-oxidative and the immune system. Therefore, we aimed for the first time to examine the beneficial effects of radon exposure on clinical outcome as well as the underlying mechanisms by utilizing a holistic approach in a controlled environment of a radon chamber with an animal model: K/BxN serum-induced arthritic mice as well as isolated cells were exposed to sham or radon irradiation. The effects on the anti-oxidative and the immune system were analyzed by flow-cytometry, qPCR or ELISA. We found a significantly improved clinical disease progression score in the mice, alongside significant increase of peripheral blood B cells and IL-5. No significant alterations were visible in the anti-oxidative system or regarding cell death. We conclude that neither cell death nor anti-oxidative systems are responsible for the beneficial effects of radon exposure in our preclinical model. Rather, radon slightly affects the immune system. However, more research is still needed in order to fully understand radon-mediated effects and to carry out reasonable risk-benefit considerations.
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Affiliation(s)
- Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (M.R.); (A.-S.F.); (T.W.); (R.F.); (B.F.); (U.S.G.)
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Stephanie Hehlgans
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (S.H.); (F.R.)
| | - Michael Rückert
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (M.R.); (A.-S.F.); (T.W.); (R.F.); (B.F.); (U.S.G.)
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Andreas Maier
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (A.M.); (A.H.); (D.E.); (C.F.)
| | - Annika Hinrichs
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (A.M.); (A.H.); (D.E.); (C.F.)
- Department of Physics, Goethe Universität Frankfurt am Main, 60323 Frankfurt am Main, Germany
| | - Ann-Sophie Flohr
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (M.R.); (A.-S.F.); (T.W.); (R.F.); (B.F.); (U.S.G.)
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Denise Eckert
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (A.M.); (A.H.); (D.E.); (C.F.)
| | - Thomas Weissmann
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (M.R.); (A.-S.F.); (T.W.); (R.F.); (B.F.); (U.S.G.)
| | - Michaela Seeling
- Department of Biology, Institute of Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany; (M.S.); (F.N.)
| | - Falk Nimmerjahn
- Department of Biology, Institute of Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany; (M.S.); (F.N.)
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (M.R.); (A.-S.F.); (T.W.); (R.F.); (B.F.); (U.S.G.)
| | - Franz Rödel
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (S.H.); (F.R.)
| | - Claudia Fournier
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (A.M.); (A.H.); (D.E.); (C.F.)
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (M.R.); (A.-S.F.); (T.W.); (R.F.); (B.F.); (U.S.G.)
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Udo S. Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (M.R.); (A.-S.F.); (T.W.); (R.F.); (B.F.); (U.S.G.)
- Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
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11
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Weissmann T, Rückert M, Zhou JG, Seeling M, Lettmaier S, Donaubauer AJ, Nimmerjahn F, Ott OJ, Hecht M, Putz F, Fietkau R, Frey B, Gaipl US, Deloch L. Low-Dose Radiotherapy Leads to a Systemic Anti-Inflammatory Shift in the Pre-Clinical K/BxN Serum Transfer Model and Reduces Osteoarthritic Pain in Patients. Front Immunol 2022; 12:777792. [PMID: 35046940 PMCID: PMC8763318 DOI: 10.3389/fimmu.2021.777792] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022] Open
Abstract
Osteoarthritis (OA) is the leading degenerative joint disease in the western world and leads, if left untreated, to a progressive deterioration of joint functionality, ultimately reducing quality of life. Recent data has shown, that especially OA of the ankle and foot are among the most frequently affected regions. Current research in OA points towards a complex involvement of various cell and tissue types, often accompanied by inflammation. Low-dose radiotherapy (LDRT) is widely used for the treatment of degenerative and inflammatory diseases. While the reported analgesic effects are well known, the underlying molecular mechanisms are only poorly understood. We therefore correlated a clinical approach, looking at pain reduction in 196 patients treated with LDRT with a pre-clinical approach, utilizing the K/BxN serum transfer mouse model using flow cytometry and multiplex ELISA for analysis. While an improvement of symptoms in the majority of patients was found, patients suffering from symptoms within the tarsi transversa show a significantly lower level of improvement. Further, a significant impact of therapy success was detected depending on whether only one or both feet were affected. Further, patients of younger age showed a significantly better outcome than older ones while needing fewer treatment series. When looking on a cellular level within the mouse model, a systemic alteration of immune cells namely a shift from CD8+ to CD4+ T cells and reduced numbers of DCs was observed. A general reduction of inflammatory cytokines was detected, with significant alterations in IL-4 and IL-17 levels, all of which could potentially be responsible for the highly effective clinical improvement in patients. Taken together our data indicate that LDRT can be regarded as a highly effective treatment option for patients suffering from OA of the foot and ankle, in terms of analgesic effects, especially in younger patients. Furthermore, the observed effects are mediated by an interplay of cellular and soluble immune factors, as observed in the K/BxN serum transfer model. With this interdisciplinary approach we aim to encourage the usage of LDRT as an additive treatment strategy not only as a last resort, but also earlier in the course of disease.
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Affiliation(s)
- Thomas Weissmann
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Rückert
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jian-Guo Zhou
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Department of Oncology, The second affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Michaela Seeling
- Department of Biology, Institute of Genetics, Friedrich-Alexander-Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sebastian Lettmaier
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anna-Jasmina Donaubauer
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Falk Nimmerjahn
- Department of Biology, Institute of Genetics, Friedrich-Alexander-Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Oliver J Ott
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Markus Hecht
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Florian Putz
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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12
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Abergel R, Aris J, Bolch WE, Dewji SA, Golden A, Hooper DA, Margot D, Menker CG, Paunesku T, Schaue D, Woloschak GE. The enduring legacy of Marie Curie: impacts of radium in 21st century radiological and medical sciences. Int J Radiat Biol 2022; 98:267-275. [PMID: 35030065 PMCID: PMC9723808 DOI: 10.1080/09553002.2022.2027542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE This review is focused on radium and radionuclides in its decay chain in honor of Marie Curie, who discovered this element. MATERIALS AND METHODS We conglomerated current knowledge regarding radium and its history predating our present understanding of this radionuclide. RESULTS An overview of the properties of radium and its dose assessment is shown followed by discussions about both the negative detrimental and positive therapeutic applications of radium with this history and its evolution reflecting current innovations in medical science. CONCLUSIONS We hope to remind all those who are interested in the progress of science about the vagaries of the process of scientific discovery. In addition, we raise the interesting question of whether Marie Curie's initial success was in part possible due to her tight alignment with her husband Pierre Curie who pushed the work along.
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Affiliation(s)
- Rebecca Abergel
- Nuclear Engineering Department, University of California, Berkeley; Chemical Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - John Aris
- J. Crayton Pruitt Family Department of Biomedical Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, Florida, USA
| | - Wesley E. Bolch
- J. Crayton Pruitt Family Department of Biomedical Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, Florida, USA
| | - Shaheen A. Dewji
- Nuclear and Radiological Engineering and Medical Physics Programs, George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Ashley Golden
- Oak Ridge Associated Universities, Oak Ridge, Tennessee, USA
| | - David A. Hooper
- Nuclear Nonproliferation Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA
| | - Dmitri Margot
- Nuclear and Radiological Engineering and Medical Physics Programs, George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Carly G. Menker
- Departments of Radiation Oncology, Radiology, and Cell and Molecular Biology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Tatjana Paunesku
- Departments of Radiation Oncology, Radiology, and Cell and Molecular Biology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Dörthe Schaue
- Department of Radiation Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Gayle E. Woloschak
- Departments of Radiation Oncology, Radiology, and Cell and Molecular Biology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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13
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Exploration and Investigation of High-Level Radon Medicinal Springs in the Crystalline Units: Lugicum. WATER 2022. [DOI: 10.3390/w14020200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Radioactive (radon) groundwaters are highly valued among mineral waters for their healing effects. Between 2005 and 2015, a large exploratory event for prospecting and documenting radon water springs took place in the crystalline area of Lugicum (Bohemian Massif) under Czech–Polish cooperation. For these purposes, an exploration method was developed as a combination of GIS (ArcMap 9.1–10.2) area preparation followed by field radiohydrogeochemical mapping at a scale of 1:10,000. The gamma indication method was optimized and used for the selection of water samples. A total of 2354 water sources were examined. Radon activity concentrations were measured at 660 sources found throughout the territory. Of those, 111 sources exhibited 222Rn activity above 1500 Bq/L and, thus, were categorized as sources of mineral radioactive waters according to Czech legislation. The highest 222Rn activity was found in the Michael spring near Nové Město pod Smrkem (up to 6237 Bq/L 222Rn). Many discovered sources with high balneological potential are significant and, therefore, are quickly becoming popular among the public.
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ROS- and Radiation Source-Dependent Modulation of Leukocyte Adhesion to Primary Microvascular Endothelial Cells. Cells 2021; 11:cells11010072. [PMID: 35011634 PMCID: PMC8750044 DOI: 10.3390/cells11010072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/17/2021] [Accepted: 12/24/2021] [Indexed: 02/07/2023] Open
Abstract
Anti-inflammatory effects of low-dose irradiation often follow a non-linear dose–effect relationship. These characteristics were also described for the modulation of leukocyte adhesion to endothelial cells. Previous results further revealed a contribution of reactive oxygen species (ROS) and anti-oxidative factors to a reduced leukocyte adhesion. Here, we evaluated the expression of anti-oxidative enzymes and the transcription factor Nrf2 (Nuclear factor-erythroid-2-related factor 2), intracellular ROS content, and leukocyte adhesion in primary human microvascular endothelial cells (HMVEC) upon low-dose irradiation under physiological laminar shear stress or static conditions after irradiation with X-ray or Carbon (C)-ions (0–2 Gy). Laminar conditions contributed to increased mRNA expression of anti-oxidative factors and reduced ROS in HMVEC following a 0.1 Gy X-ray and 0.5 Gy C-ion exposure, corresponding to reduced leukocyte adhesion and expression of adhesion molecules. By contrast, mRNA expression of anti-oxidative markers and adhesion molecules, ROS, and leukocyte adhesion were not altered by irradiation under static conditions. In conclusion, irradiation of endothelial cells with low doses under physiological laminar conditions modulates the mRNA expression of key factors of the anti-oxidative system, the intracellular ROS contents of which contribute at least in part to leucocyte adhesion, dependent on the radiation source.
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15
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Chromosome Aberrations in Lymphocytes of Patients Undergoing Radon Spa Therapy: An Explorative mFISH Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010757. [PMID: 34682498 PMCID: PMC8535331 DOI: 10.3390/ijerph182010757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 01/06/2023]
Abstract
In the present exploratory study, we aim to elucidate the action of radon in vivo and to assess the possible health risks. Chromosome aberrations were analyzed in lymphocytes of two patients (P1, P2) undergoing radon spa therapy in Bad Steben (Germany). Both patients, suffering from painful chronic degenerative disorders of the spine and joints, received nine baths (1.2 kBq/L at 34 °C) over a 3-week period. Chromosome aberrations were analyzed before and 6, 12 and 30 weeks after the start of therapy using the high-resolution multiplex fluorescence in situ hybridization (mFISH) technique. For comparison, the lymphocytes from two healthy donors (HD1, HD2) were examined. P1 had a higher baseline aberration frequency than P2 and both healthy donors (5.3 ± 1.3 vs. 2.0 ± 0.8, 1.4 ± 0.3 and 1.1 ± 0.1 aberrations/100 analyzed metaphases, respectively). Complex aberrations, biomarkers of densely ionizing radiation, were found in P1, P2 and HD1. Neither the aberration frequency nor the fraction of complex aberrations increased after radon spa treatment, i.e., based on biological dosimetry, no increased health risk was found. It is worth noting that a detailed breakpoint analysis revealed potentially clonal aberrations in both patients. Altogether, our data show pronounced inter-individual differences with respect to the number and types of aberrations, complicating the risk analysis of low doses such as those received during radon therapy.
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16
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Javadinia SA, Nazeminezhad N, Ghahramani-Asl R, Soroosh D, Fazilat-Panah D, PeyroShabany B, Saberhosseini SN, Mehrabian A, Taghizadeh-Hesary F, Nematshahi M, Dhawan G, Welsh JS, Calabrese EJ, Kapoor R. Low-dose radiation therapy for osteoarthritis and enthesopathies: a review of current data. Int J Radiat Biol 2021; 97:1352-1367. [PMID: 34259615 DOI: 10.1080/09553002.2021.1956000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Osteoarthritis (OA), the most common degenerative joint disease, is associated with severe functional limitation and impairment of quality of life. Numerous reports have documented the clinical efficacy of low-dose radiotherapy (LD-RT) in the management of various inflammatory disorders, including OA. In this paper, we assessed the clinical literature involving the use of LD-RT in the treatment of OA, its dose-response features, possible underlying mechanistic features, and optimal therapeutic dose range. METHODS We carried out a systematic review based on the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statements and evaluated articles meeting the inclusion criteria for this review. RESULTS A total of 361 articles were identified from databases, such as Scopus, PubMed, Embase, and Science Direct out of which 224 articles were duplicates and were discarded. Of the remaining 137 articles, 74 articles were un-related, 27 articles were review articles, eight were conference abstracts, three were letters, two were editorials, two were notes, and one was a book chapter. Finally, 20 articles met all the inclusion criteria and were included in this systematic review. DISCUSSION Several single-arm retrospective/prospective studies showed advantages for LD-RT in the management of OA in terms of pain relief, improvement of mobility and function, and showed minimal side effects. Mechanistic considerations involve positive subcellular effects mediated by the activation of a nuclear factor erythroid 2-related transcription factor (Nrf2) mediated antioxidant response. Further research on both the short- and long-term effects of LD-RT on OA and other inflammatory disorders is recommended.
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Affiliation(s)
- Seyed Alireza Javadinia
- Clinical Research Development Unit, Hospital Research Development Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Ruhollah Ghahramani-Asl
- Clinical Research Development Unit, Hospital Research Development Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Davood Soroosh
- Clinical Research Development Unit, Hospital Research Development Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Babak PeyroShabany
- Department of Internal Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Arezoo Mehrabian
- Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Nematshahi
- Department of Anesthesiology and Critical Care, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Gaurav Dhawan
- Sri Guru Ram Das University of Health Sciences, Amritsar, India
| | - James S Welsh
- Edward Hines Jr. VA Hospital, Loyola University Chicago Stritch School of Medicine, Chicago, IL, USA
| | - Edward J Calabrese
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Rachna Kapoor
- Saint Francis Hospital and Medical Center, Hartford, CT, USA
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17
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Widodo SS, Hutchinson RA, Fang Y, Mangiola S, Neeson PJ, Darcy PK, Barrow AD, Hovens CM, Dinevska M, Stylli SS, Mantamadiotis T. Toward precision immunotherapy using multiplex immunohistochemistry and in silico methods to define the tumor immune microenvironment. Cancer Immunol Immunother 2021; 70:1811-1820. [PMID: 33389014 PMCID: PMC10991574 DOI: 10.1007/s00262-020-02801-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/12/2020] [Indexed: 12/18/2022]
Abstract
Recent developments in cancer immunotherapy promise better outcomes for cancer patients, although clinical trials for difficult to treat cancers such as malignant brain cancer present special challenges, showing little response to first generation immunotherapies. Reasons for differences in immunotherapy response in some cancer types are likely due to the nature of tumor microenvironment, which harbors multiple cell types which interact with tumor cells to establish immunosuppression. The cell types which appear to hold the key in regulating tumor immunosuppression are the tumor-infiltrating immune cells. The current standard treatment for difficult to treat cancer, including the most malignant brain cancer, glioblastoma, continues to offer a bleak outlook for patients. Immune-profiling and correlation with pathological and clinical data will lead to a deeper understanding of the tumor immune microenvironment and contribute toward the selection, optimization and development of novel precision immunotherapies. Here, we review the current understanding of the tumor microenvironmental landscape in glioblastoma with a focus on next-generation technologies including multiplex immunofluorescence and computational approaches to map the brain tumor microenvironment to decipher the role of the immune system in this lethal malignancy.
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Affiliation(s)
- Samuel S Widodo
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Australia
| | - Ryan A Hutchinson
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Australia
- Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Parkville, Australia
| | - Yitong Fang
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Australia
| | - Stefano Mangiola
- Bioinformatics Division, The Walter and Eliza Hall Institute, Parkville, Australia
| | - Paul J Neeson
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Phillip K Darcy
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Alexander D Barrow
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Australia
| | | | - Marija Dinevska
- Department of Surgery, The University of Melbourne, Parkville, Australia
| | - Stanley S Stylli
- Department of Surgery, The University of Melbourne, Parkville, Australia
- Department of Neurosurgery, Royal Melbourne Hospital, Parkville, Australia
| | - Theo Mantamadiotis
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Australia.
- Department of Surgery, The University of Melbourne, Parkville, Australia.
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18
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Gaisberger M, Fuchs J, Riedl M, Edtinger S, Reischl R, Grasmann G, Hölzl B, Landauer F, Dobias H, Eckstein F, Offenbächer M, Ritter M, Winklmayr M. Endogenous anandamide and self-reported pain are significantly reduced after a 2-week multimodal treatment with and without radon therapy in patients with knee osteoarthritis: a pilot study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1151-1160. [PMID: 33649972 PMCID: PMC8213596 DOI: 10.1007/s00484-021-02095-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 05/12/2023]
Abstract
Multimodal therapies comprising spa applications are widely used as non-pharmaceutical treatment options for musculoskeletal diseases. The purpose of this randomized, controlled, open pilot study was to elucidate the involvement of the endocannabinoid system in a multimodal therapy approach. Twenty-five elderly patients with knee osteoarthritis (OA) received a 2-week spa therapy with or without combination of low-dose radon therapy in the Bad Gastein radon gallery. A 10-point numerical rating scale (pain in motion and at rest), WOMAC questionnaire, and the EuroQol-5D (EQ-5D) questionnaire were recorded at baseline, and during treatment period at weeks one and two, and at 3-month and 6-month follow-ups. Plasma levels of the endocannabinoid anandamide (AEA) were determined at baseline and at 2 weeks, and serum levels of several cartilage metabolism markers at all five time-points. A significant and sustained reduction of self-reported knee pain was observed in the study population, but no further significant effect of the additional radon therapy up and above base therapy. This pain reduction was accompanied by a significant reduction of AEA plasma levels during treatment in both groups. No significant differences were seen in serum marker concentrations between the groups treated with or without radon, but a small reduction of serum cartilage degradation markers was observed during treatment in both groups. This is the first study investigating AEA levels in the context of a non-pharmacological OA treatment. Since the endocannabinoid system represents a potential target for the development of new therapeutics, further studies will have to elucidate its involvement in OA pain.
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Affiliation(s)
- M. Gaisberger
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Strubergasse 21, A-5020 Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - J. Fuchs
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Strubergasse 21, A-5020 Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Austria
| | - M. Riedl
- Dept. of Orthopaedics and Traumatology, Paracelsus Medical University, Salzburg, Austria
| | - S. Edtinger
- Department of Physical Medicine and Rehabilitation, Kardinal Schwarzenberg Klinikum, Schwarzach im Pongau, Austria
| | - R. Reischl
- Bioanalytical Research Labs, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - G. Grasmann
- Bioanalytical Research Labs, Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - B. Hölzl
- Department of Internal Med., Landesklinik St. Veit im Pongau, SALK, Paracelsus Med. Univ., Salzburg, Austria
| | - F. Landauer
- Dept. of Orthopaedics and Traumatology, Paracelsus Medical University, Salzburg, Austria
| | - H. Dobias
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Strubergasse 21, A-5020 Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Austria
| | - F. Eckstein
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
- Chondrometrics GmbH, Ainring, Germany
| | | | - M. Ritter
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Strubergasse 21, A-5020 Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - M. Winklmayr
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Strubergasse 21, A-5020 Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
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19
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Cattin S, Fellay B, Calderoni A, Christinat A, Negretti L, Biggiogero M, Badellino A, Schneider AL, Tsoutsou P, Pellanda AF, Rüegg C. Circulating immune cell populations related to primary breast cancer, surgical removal, and radiotherapy revealed by flow cytometry analysis. Breast Cancer Res 2021; 23:64. [PMID: 34090509 PMCID: PMC8180078 DOI: 10.1186/s13058-021-01441-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advanced breast cancer (BC) impact immune cells in the blood but whether such effects may reflect the presence of early BC and its therapeutic management remains elusive. METHODS To address this question, we used multiparametric flow cytometry to analyze circulating leukocytes in patients with early BC (n = 13) at the time of diagnosis, after surgery, and after adjuvant radiotherapy, compared to healthy individuals. Data were analyzed using a minimally supervised approach based on FlowSOM algorithm and validated manually. RESULTS At the time of diagnosis, BC patients have an increased frequency of CD117+CD11b+ granulocytes, which was significantly reduced after tumor removal. Adjuvant radiotherapy increased the frequency of CD45RO+ memory CD4+ T cells and CD4+ regulatory T cells. FlowSOM algorithm analysis revealed several unanticipated populations, including cells negative for all markers tested, CD11b+CD15low, CD3+CD4-CD8-, CD3+CD4+CD8+, and CD3+CD8+CD127+CD45RO+ cells, associated with BC or radiotherapy. CONCLUSIONS This study revealed changes in blood leukocytes associated with primary BC, surgical removal, and adjuvant radiotherapy. Specifically, it identified increased levels of CD117+ granulocytes, memory, and regulatory CD4+ T cells as potential biomarkers of BC and radiotherapy, respectively. Importantly, the study demonstrates the value of unsupervised analysis of complex flow cytometry data to unravel new cell populations of potential clinical relevance.
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Affiliation(s)
- Sarah Cattin
- Pathology, Department of Oncology, Microbiology and Immunology, Faculty of Science and Medicine, University of Fribourg, CH-1700, Fribourg, Switzerland
| | - Benoît Fellay
- Central Laboratory, Hôpital Fribourgeois, CH-1700, Fribourg, Switzerland
| | | | | | - Laura Negretti
- Radiation Oncology Department, Clinica Luganese Moncucco, CH-6900, Lugano, Switzerland
| | - Maira Biggiogero
- Radiation Oncology Department, Clinica Luganese Moncucco, CH-6900, Lugano, Switzerland.,Clinical Research unit, Clinica Luganese Moncucco, CH-6900, Lugano, Switzerland
| | - Alberto Badellino
- Radiation Oncology Department, Clinica Luganese Moncucco, CH-6900, Lugano, Switzerland.,Clinical Research unit, Clinica Luganese Moncucco, CH-6900, Lugano, Switzerland
| | - Anne-Lise Schneider
- Breast and Oncology Center, Hôpital Neuchatelois, CH-2300, La Chaux-de-Fonds, Switzerland
| | - Pelagia Tsoutsou
- Breast and Oncology Center, Hôpital Neuchatelois, CH-2300, La Chaux-de-Fonds, Switzerland.,Present Address: Service de Radio-Oncologie, Hôpitaux Universitaires de Genève, CH-1205, Geneva, Switzerland
| | - Alessandra Franzetti Pellanda
- Radiation Oncology Department, Clinica Luganese Moncucco, CH-6900, Lugano, Switzerland.,Clinical Research unit, Clinica Luganese Moncucco, CH-6900, Lugano, Switzerland
| | - Curzio Rüegg
- Pathology, Department of Oncology, Microbiology and Immunology, Faculty of Science and Medicine, University of Fribourg, CH-1700, Fribourg, Switzerland.
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20
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Lumniczky K, Impens N, Armengol G, Candéias S, Georgakilas AG, Hornhardt S, Martin OA, Rödel F, Schaue D. Low dose ionizing radiation effects on the immune system. ENVIRONMENT INTERNATIONAL 2021; 149:106212. [PMID: 33293042 PMCID: PMC8784945 DOI: 10.1016/j.envint.2020.106212] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/20/2020] [Accepted: 09/03/2020] [Indexed: 05/03/2023]
Abstract
Ionizing radiation interacts with the immune system in many ways with a multiplicity that mirrors the complexity of the immune system itself: namely the need to maintain a delicate balance between different compartments, cells and soluble factors that work collectively to protect, maintain, and restore tissue function in the face of severe challenges including radiation damage. The cytotoxic effects of high dose radiation are less relevant after low dose exposure, where subtle quantitative and functional effects predominate that may go unnoticed until late after exposure or after a second challenge reveals or exacerbates the effects. For example, low doses may permanently alter immune fitness and therefore accelerate immune senescence and pave the way for a wide spectrum of possible pathophysiological events, including early-onset of age-related degenerative disorders and cancer. By contrast, the so called low dose radiation therapy displays beneficial, anti-inflammatory and pain relieving properties in chronic inflammatory and degenerative diseases. In this review, epidemiological, clinical and experimental data regarding the effects of low-dose radiation on the homeostasis and functional integrity of immune cells will be discussed, as will be the role of immune-mediated mechanisms in the systemic manifestation of localized exposures such as inflammatory reactions. The central conclusion is that ionizing radiation fundamentally and durably reshapes the immune system. Further, the importance of discovery of immunological pathways for modifying radiation resilience amongst other research directions in this field is implied.
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Affiliation(s)
- Katalin Lumniczky
- National Public Health Centre, Department of Radiation Medicine, Budapest, Albert Florian u. 2-6, 1097, Hungary.
| | - Nathalie Impens
- Belgian Nuclear Research Centre, Biosciences Expert Group, Boeretang 200, 2400 Mol, Belgium.
| | - Gemma Armengol
- Unit of Biological Anthropology, Department of Animal Biology, Plant Biology and Ecology, Faculty of Biosciences, Universitat Autònoma de Barcelona, 08193-Bellaterra, Barcelona, Catalonia, Spain.
| | - Serge Candéias
- Université Grenoble-Alpes, CEA, CNRS, IRIG-LCBM, 38000 Grenoble, France.
| | - Alexandros G Georgakilas
- DNA Damage Laboratory, Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens (NTUA), Zografou 15780, Athens, Greece.
| | - Sabine Hornhardt
- Federal Office for Radiation Protection (BfS), Ingolstaedter Landstr.1, 85764 Oberschleissheim, Germany.
| | - Olga A Martin
- Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne 3052, Victoria, Australia.
| | - Franz Rödel
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
| | - Dörthe Schaue
- Department of Radiation Oncology, David Geffen School of Medicine, University of California at Los Angeles (UCLA), Los Angeles, CA 90095-1714, USA.
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21
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Kardeş S, Karagülle M. PATHOPHYSIOLOGICAL MECHANISMS OF BALNEOTHERAPY WITH POTENTIAL IMPLICATIONS FOR CENTRAL ASIAN SPAS AND SANATORIUMS. CENTRAL ASIAN JOURNAL OF MEDICAL HYPOTHESES AND ETHICS 2021. [DOI: 10.47316/cajmhe.2020.1.2.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Spa therapy includes all modalities/ treatments based on evidence that are administered in spas or sanatoriums. Balneotherapy, the immersion in mineral water, is the main balneological modality in spa therapy programs. Clinical trials performed in Europe, Turkey, and Israel have shown clinical benefits of spa therapy/ balneotherapy in several diseases mainly pertaining to rheumatic and musculoskeletal diseases and dermatological diseases as well. However, mechanisms by which balneotherapy may improve the clinical symptoms of patients have been less evaluated/ documented in the literature. Although the literature on mechanisms of action of balneotherapy has still been evolving and accumulating, some evidence from preliminary studies paves the way for generating a hypothesis that balneotherapy has an influence on physiological mechanisms, immune system, inflammation, and oxidative stress. Extrapolation of the evidence-based clinical practice and scientific experience of Europe, Turkey, and Israel to Central Asian spas and sanatoriums is although possible; future studies investigating clinical efficacy, safety profile, and possible mechanisms of action of balneotherapy of regional spas are needed to better understand the role of balneotherapy and whether it has any local differences.
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22
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Maier A, Wiedemann J, Rapp F, Papenfuß F, Rödel F, Hehlgans S, Gaipl US, Kraft G, Fournier C, Frey B. Radon Exposure-Therapeutic Effect and Cancer Risk. Int J Mol Sci 2020; 22:ijms22010316. [PMID: 33396815 PMCID: PMC7796069 DOI: 10.3390/ijms22010316] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 01/18/2023] Open
Abstract
Largely unnoticed, all life on earth is constantly exposed to low levels of ionizing radiation. Radon, an imperceptible natural occurring radioactive noble gas, contributes as the largest single fraction to radiation exposure from natural sources. For that reason, radon represents a major issue for radiation protection. Nevertheless, radon is also applied for the therapy of inflammatory and degenerative diseases in galleries and spas to many thousand patients a year. In either case, chronic environmental exposure or therapy, the effect of radon on the organism exposed is still under investigation at all levels of interaction. This includes the physical stage of diffusion and energy deposition by radioactive decay of radon and its progeny and the biological stage of initiating and propagating a physiologic response or inducing cancer after chronic exposure. The purpose of this manuscript is to comprehensively review the current knowledge of radon and its progeny on physical background, associated cancer risk and potential therapeutic effects.
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Affiliation(s)
- Andreas Maier
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Julia Wiedemann
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Felicitas Rapp
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Franziska Papenfuß
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Franz Rödel
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Goethe-Universität Frankfurt am Main, 60590 Frankfurt am Main, Germany; (F.R.); (S.H.)
| | - Stephanie Hehlgans
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Goethe-Universität Frankfurt am Main, 60590 Frankfurt am Main, Germany; (F.R.); (S.H.)
| | - Udo S. Gaipl
- Translational Radiation Biology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Gerhard Kraft
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Claudia Fournier
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany; (A.M.); (J.W.); (F.R.); (F.P.); (G.K.); (C.F.)
| | - Benjamin Frey
- Translational Radiation Biology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany;
- Correspondence:
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The Influence of Radiation on Bone and Bone Cells-Differential Effects on Osteoclasts and Osteoblasts. Int J Mol Sci 2020; 21:ijms21176377. [PMID: 32887421 PMCID: PMC7504528 DOI: 10.3390/ijms21176377] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 02/06/2023] Open
Abstract
The bone is a complex organ that is dependent on a tight regulation between bone formation by osteoblasts (OBs) and bone resorption by osteoclasts (OCs). These processes can be influenced by environmental factors such as ionizing radiation (IR). In cancer therapy, IR is applied in high doses, leading to detrimental effects on bone, whereas radiation therapy with low doses of IR is applied for chronic degenerative and inflammatory diseases, with a positive impact especially on bone homeostasis. Moreover, the effects of IR are of particular interest in space travel, as astronauts suffer from bone loss due to space radiation and microgravity. This review summarizes the current state of knowledge on the effects of IR on bone with a special focus on the influence on OCs and OBs, as these cells are essential in bone remodeling. In addition, the influence of IR on the bone microenvironment is discussed. In summary, the effects of IR on bone and bone remodeling cells strongly depend on the applied radiation dose, as differential results are provided from in vivo as well as in vitro studies with varying doses of IR. Furthermore, the isolated effects of IR on a single cell type are difficult to determine, as the bone cells and bone microenvironment are building a tightly regulated network, influencing on one another. Therefore, future research is necessary in order to elucidate the influence of different bone cells on the overall radiation-induced effects on bone.
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Maccarone M, Magro G, Solimene U, Masiero S. The effects of balneotherapy on human immune gunction: should baths and mud applications have a role during covid-19 pandemic? ACTA ACUST UNITED AC 2020. [DOI: 10.38025/2078-1962-2020-97-3-22-24] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Recent evidences show that balneotherapy applications can affect the immune system, which has an important role in the containment of Covid-19 infection outcomes. It is interesting to consider if balneotherapy, through medical water baths and mud applications can be a suitable treatment in order to influence human immunity in people who have not acquired the infection and in subjects discharged from hospital after Covid-19 recovery. In particular, balneotherapy seems to improve the immune response efficacy, with an effect mediated by mental stress reduction and a direct action, consisting in the modulation of the abnormal inflammation and the enhancement of the immune system, through changes in both cell-mediated and humoral immunity. The main changes demonstrated on human immunity, after balneotherapy, are linked to an increase in the levels and the activity of cells involved in the immune response such as neutrophils and monocytes and to a reduction of the pro-inflammatory cytokines produced by a dysregulated inflammation. Even if further in vitro researches and clinical trials on this topic should be conducted, at present Spa centres, if hygienically controlled according to WHO and national recommendations, may be considered safe places to attend and useful settings to counteract the outcomes of residual unbalanced immunity after Covid-19 infection.
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Affiliation(s)
- M.C. Maccarone
- Physical Medicine and Rehabilitation School, University of Padova
| | - G. Magro
- Physical Medicine and Rehabilitation School, University of Padova
| | - U. Solimene
- World Federation of Hydrotherapy and Climatotherapy
| | - S. Masiero
- Rehabilitation Unit, Department of Neuroscience, University of Padova
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Mirsch J, Hintz L, Maier A, Fournier C, Löbrich M. An Assessment of Radiation Doses From Radon Exposures Using a Mouse Model System. Int J Radiat Oncol Biol Phys 2020; 108:770-778. [PMID: 32473181 DOI: 10.1016/j.ijrobp.2020.05.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/08/2020] [Accepted: 05/18/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Radon and its progenies contribute significantly to the natural background radiation and cause several thousands of lung cancer cases per year worldwide. Moreover, patients with chronic inflammatory joint diseases are treated in radon galleries. Due to the complex nature of radon exposure, the doses associated with radon exposures are difficult to assess. Hence, there is a clear need to directly measure dose depositions from radon exposures to provide reliable risk estimates for radiation protection guidelines. OBJECTIVES We aimed to assess tissue-specific radiation doses associated with radon activity concentrations, that deposit similar dose levels as the annual natural radon exposure or radon gallery visits. METHODS We exposed mice to defined radon concentrations, quantified the number of 53BP1 foci as a measure of induced DNA damage, and compared it with the number of foci induced by known doses of reference-type radiations. An image-based analysis of the 3-dimensional foci pattern provided information about the radiation type inflicting the DNA damage. RESULTS A 1-hour exposure to 440 kBq/m3 radon-induced DNA damage corresponding to a dose of ∼10 mGy in the lung and ∼3.3 mGy in the kidney, heart, and liver. A 1-hour exposure to 44 kBq/m3 provided values consistent with a linear relationship between dose and radon concentration. Two-thirds of the dose in the lung was caused by α-particles. The dose in the kidney, heart, and liver and one-third of the dose in the lung likely resulted from β- and γ-rays. DISCUSSION We found that radon exposures mainly lead to α-particle-induced DNA damage in the lung, consistent with the lung cancer risk obtained in epidemiologic studies. Our presented biodosimetric approach can be used to benchmark risk model calculations for radiation protection guidelines and can help to understand the therapeutic success of radon gallery treatments.
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Affiliation(s)
- Johanna Mirsch
- Radiation Biology and DNA Repair, Technical University of Darmstadt, Darmstadt, Germany
| | - Lisa Hintz
- Radiation Biology and DNA Repair, Technical University of Darmstadt, Darmstadt, Germany
| | - Andreas Maier
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Claudia Fournier
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Markus Löbrich
- Radiation Biology and DNA Repair, Technical University of Darmstadt, Darmstadt, Germany.
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Piao C, Tian M, Gao H, Gao Y, Ruan J, Wu L, Gao G, Yi L, Liu J. Effects of Radon From Hot Springs on Lymphocyte Subsets in Peripheral Blood. Dose Response 2020; 18:1559325820902338. [PMID: 32071595 PMCID: PMC6997968 DOI: 10.1177/1559325820902338] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/18/2019] [Accepted: 12/31/2019] [Indexed: 12/14/2022] Open
Abstract
Objective: To analyze changes in immune functions by detecting lymphocyte subsets in the
peripheral blood of residents in the vicinity of radon from hot springs. Methods: Two groups were randomly selected; 61 residents in the vicinity of the hot
springs were assigned to the radon group, and 51 residents with a similar
lifestyle and habits but no contact with hot springs were assigned to the
control group. The percentages of lymphocyte subsets (CD3+,
CD4+CD8−, CD4−CD8+,
CD4+/CD8+, and TCR/CD3) in the 2 groups were
evaluated on a FACS Aria flow cytometer. The absolute values of lymphocytes
(LYMPH#) and percentages of lymphocytes (LYMPH%) were measured by an
automatic blood analyzer. Results: In the radon group, the numbers of CD3+ (Z =
−0.140, P > .05) and CD4+CD8−
(Z = −0.964, P > .05) T cells were
higher, as compared with the controls, but this difference was not
significant. In addition, the number of CD4−CD8+
(t = −2.141, P < .05) T cells was
significantly lower in the radon group. Furthermore, the average ratios of
CD4+/CD8+ (t = −2.201,
P < .05) and TCR/CD3 (t = 2.047,
P < .05) cells were significantly higher in the
radon group than in the controls. Compared with the control group, the
LYMPH# (t = −0.485, P > .05) and LYMPH%
(Z = −0.835, P > .05) showed no significant change. Conclusion: Radon-rich hot springs could alter the proportions of lymphocyte subsets and
possibly affect immunologic functions.
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Affiliation(s)
- Chunnan Piao
- Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mei Tian
- Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongjun Gao
- Department of Clinical Laboratory, Emergency General Hospital, Beijing, China
| | - Yanxiao Gao
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, China
| | - Jianlei Ruan
- Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lina Wu
- Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gang Gao
- Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lirong Yi
- Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianxiang Liu
- Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
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27
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C-Reactive Protein (CRP) and Health Resort Reaction. J CHEM-NY 2020. [DOI: 10.1155/2020/7059319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Incident tissue-damaging factors trigger a systemic response manifested by inflammatory reaction. Acute-phase proteins are a diagnostic and prognostic marker in various systemic homeostasis disorders. In the course of health resort therapy, a so-called health resort reaction is observed presenting with, e.g., exacerbation of organ-related disorders, elevated body temperature, increased erythrocyte sedimentation rate, and leukocyte counts. The objective of the study was to demonstrate a change in the concentration of C-reactive protein (CRP) as a result of health resort radon therapy as well as to determine the relationship between this change and the phenomenon known as health resort reaction. The study was conducted in Swieradow-Zdroj resort. The study population consisted of patients undergoing radon-active water bath treatment. Standard tests were used to determine CRP levels before the treatment as well as 5 and 18 days into the treatment. The study group consisted of n = 34 patients with osteoarthritis and spondyloarthritis. The control group consisted of 17 employees of the health resort who were also burdened with osteoarthritis or spondyloarthritis yet did not undergo radon therapy and had absolutely no contact with radon materials. The study revealed no statistically significant increase in the concentration of CRP. This trial is registered with NCT03274128. The study was carried out as part of the statutory task SUB.E060.19.001.
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Radiobiological Principles of Radiotherapy for Benign Diseases. Radiat Oncol 2020. [DOI: 10.1007/978-3-319-52619-5_133-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Abstract
The hormesis concept demonstrates that in contrast to the toxic effect of high doses of materials, irradiation, etc., low doses of them are beneficial and, in addition, help to eliminate (prevent) the deleterious effect of high doses given after it. By this effect, it is an important factor of (human) evolution protecting man from harmful impacts, similarly to the role of immunity. However, immunity is also continuously influenced by hormetic effects of environmental [chemical (pollutions), physical (background irradiations and heat), etc.] and medical (drugs and therapeutic irradiations) and food interactions. In contrast to earlier beliefs, the no-threshold irradiation dogma is not valid in low-dose domains and here the hormesis concept is valid. Low-dose therapeutic irradiation, as well as background irradiations (by radon spas or moderately far from the epicenter of atomic bomb or nuclear facilities), is rather beneficial than destructive and the fear from them seems to be unreasonable from immunological point of view. Practically, all immune parameters are beneficially influenced by all forms of low-dose radiations.
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Affiliation(s)
- György Csaba
- 1 Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
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30
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Kullmann M, Rühle PF, Harrer A, Donaubauer A, Becker I, Sieber R, Klein G, Fournier C, Fietkau R, Gaipl US, Frey B. Temporarily increased TGFβ following radon spa correlates with reduced pain while serum IL-18 is a general predictive marker for pain sensitivity. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:129-135. [PMID: 30456560 DOI: 10.1007/s00411-018-0768-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/12/2018] [Indexed: 05/03/2023]
Abstract
Sustained pain relief following radon spa therapy in patients suffering from chronic painful diseases has been well described. But still, the underlying mechanisms are not fully understood. We conducted the prospective and explorative RAD-ON01 study which included 103 patients who suffered from chronic painful musculoskeletal disorders of the spine and/or joints and present here the data of the examination of pro- and anti-inflammatory cytokines in the serum of the patients before and at weeks 6, 12 and 30 after therapy. While TNFα, IL-1β, IFNγ, IL-1Ra and IL-10 were not altered, TGFβ was temporarily significantly (p = 0.013) elevated 6 weeks after therapy. Importantly, this elevation positively correlated with lowered pain sensitivity (r = 0.41). Further, the amount of IL-18 in the serum positively correlated with lowered pain sensitivity. Therefore, IL-18 can be considered as predictive marker for pain sensitivity of radon spa patients. We conclude that alterations in TGFβ and general IL-18 levels in serum have prognostic and predictive value in situations of lowered pain by exposure of patients to very low-doses of radiation as it is the case in radon spa.
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Affiliation(s)
- Miriam Kullmann
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Paul F Rühle
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Alexandra Harrer
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Anna Donaubauer
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Ina Becker
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Renate Sieber
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | | | - Claudia Fournier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
| | - Udo S Gaipl
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany.
| | - Benjamin Frey
- Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany
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Mahler EAM, Minten MJ, Leseman-Hoogenboom MM, Poortmans PMP, Leer JW, Boks SS, van den Hoogen FHJ, den Broeder AA, van den Ende CH. Response to: 'Is it time to redefine the role of low-dose radiotherapy for benign disease?' by Montero et al. Ann Rheum Dis 2019; 79:e35. [PMID: 30709815 DOI: 10.1136/annrheumdis-2018-214896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 01/20/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Elien A M Mahler
- Department of Rheumatology, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands
| | - Michiel Jm Minten
- Department of Rheumatology, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands
| | | | - Philip M P Poortmans
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Radiation Oncology, Institut Curie, Paris, France
| | - Jan Willem Leer
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Simone S Boks
- Department of Radiology, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands
| | | | - Alfons A den Broeder
- Department of Rheumatology, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands
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32
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Montero A, Sabater S, Rödel F, Gaipl US, Ott OJ, Seegenschmiedt MH, Arenas M. Is it time to redefine the role of low-dose radiotherapy for benign disease? Ann Rheum Dis 2018; 79:e34. [DOI: 10.1136/annrheumdis-2018-214873] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/08/2018] [Indexed: 01/09/2023]
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Clinically Relevant Radiation Exposure Differentially Impacts Forms of Cell Death in Human Cells of the Innate and Adaptive Immune System. Int J Mol Sci 2018; 19:ijms19113574. [PMID: 30428512 PMCID: PMC6274975 DOI: 10.3390/ijms19113574] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/05/2018] [Accepted: 11/10/2018] [Indexed: 12/21/2022] Open
Abstract
In cancer treatments, especially high-dose radiotherapy (HDRT) is applied. Patients suffering from chronic inflammatory diseases benefit from low-dose radiation therapy (LDRT), but exposure to very low radiation doses can still steadily increase for diagnostic purposes. Yet, little is known about how radiation impacts on forms of cell death in human immune cells. In this study, the radiosensitivity of human immune cells of the peripheral blood was examined in a dose range from 0.01 to 60 Gy with regard to induction of apoptosis, primary necrosis, and secondary necrosis. Results showed that immune cells differed in their radiosensitivity, with monocytes being the most radioresistant. T cells mainly died by necrosis and were moderately radiosensitive. This was followed by B and natural killer (NK) cells, which died mainly by apoptosis. X-radiation had no impact on cell death in immune cells at very low doses (≤0.1 Gy). Radiation doses of LDRT (0.3–0.7 Gy) impacted on the more radiosensitive NK and B cells, which might contribute to attenuation of inflammation. Even single doses applied during RT of tumors did not erase the immune cells completely. These in vitro studies can be considered as the basis to optimize individual radiation therapy schemes in multimodal settings and to define suited time points for further inclusion of immunotherapies.
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Deloch L, Rückert M, Fietkau R, Frey B, Gaipl US. Low-Dose Radiotherapy Has No Harmful Effects on Key Cells of Healthy Non-Inflamed Joints. Int J Mol Sci 2018; 19:ijms19103197. [PMID: 30332826 PMCID: PMC6214021 DOI: 10.3390/ijms19103197] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/08/2018] [Accepted: 10/10/2018] [Indexed: 02/02/2023] Open
Abstract
Low-dose radiotherapy (LD-RT) for benign inflammatory and/or bone destructive diseases has been used long. Therefore, mechanistic investigations on cells being present in joints are mostly made in an inflammatory setting. This raises the question whether similar effects of LD-RT are also seen in healthy tissue and thus might cause possible harmful effects. We performed examinations on the functionality and phenotype of key cells within the joint, namely on fibroblast-like synoviocytes (FLS), osteoclasts and osteoblasts, as well as on immune cells. Low doses of ionizing radiation showed only a minor impact on cytokine release by healthy FLS as well as on molecules involved in cartilage and bone destruction and had no significant impact on cell death and migration properties. The bone resorbing abilities of healthy osteoclasts was slightly reduced following LD-RT and a positive impact on bone formation of healthy osteoblasts was observed after in particular exposure to 0.5 Gray (Gy). Cell death rates of bone-marrow cells were only marginally increased and immune cell composition of the bone marrow showed a slight shift from CD8+ to CD4+ T cell subsets. Taken together, our results indicate that LD-RT with particularly a single dose of 0.5 Gy has no harmful effects on cells of healthy joints.
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Affiliation(s)
- Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Michael Rückert
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
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Impact of X-ray Exposure on the Proliferation and Differentiation of Human Pre-Adipocytes. Int J Mol Sci 2018; 19:ijms19092717. [PMID: 30208657 PMCID: PMC6163807 DOI: 10.3390/ijms19092717] [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] [Received: 08/06/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 01/20/2023] Open
Abstract
Radiotherapy is a widely used treatment option for cancer patients as well as for patients with musculoskeletal disorders. Adipocytes, the dominant cell type of adipose tissue, are known to constitute an active part of the tumor microenvironment. Moreover, adipocytes support inflammatory processes and cartilage degradation in chronic inflammatory diseases, i.e., rheumatoid and osteoarthritis. Since the production of inflammatory factors is linked to their differentiation stages, we set out to explore the radiation response of pre-adipocytes that may influence their inflammatory potential and differentiation capacity. This is the first study investigating the effects of X-ray irradiation on the proliferation and differentiation capacity of human primary pre-adipocytes, in comparison to Simpson–Golabi–Behmel Syndrome (SGBS) pre-adipocytes, an often-used in vitro model of human primary pre-adipocytes. Our results demonstrate a dose-dependent reduction of the proliferation capacity for both cell strains, whereas the potential for differentiation was mostly unaffected by irradiation. The expression of markers of adipogenic development, such as transcription factors (PPARγ, C/EBPα and C/EBPβ), as well as the release of adipokines (visfatin, adiponectin and leptin) were not significantly changed upon irradiation. However, after irradiation with high X-ray doses, an increased lipid accumulation was observed, which suggests a radiation-induced response of adipocytes related to inflammation. Our results indicate that pre-adipocytes are radio-resistant, and it remains to be elucidated whether this holds true for the overall inflammatory response of adipocytes upon irradiation.
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Wunderlich R, Rühle PF, Deloch L, Rödel F, Fietkau R, Gaipl US, Frey B. Ionizing radiation reduces the capacity of activated macrophages to induce T-cell proliferation, but does not trigger dendritic cell-mediated non-targeted effects. Int J Radiat Biol 2018; 95:33-43. [DOI: 10.1080/09553002.2018.1490037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Roland Wunderlich
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Research Unit Radiation Cytogenetics, Helmholtz Center Munich, Neuherberg, Germany
| | - Paul Friedrich Rühle
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Franz Rödel
- Department of Radiotherapy and Oncology, Goethe-University Frankfurt am Main, Frankfurt, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Udo S. Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Rückert M, Deloch L, Fietkau R, Frey B, Hecht M, Gaipl US. Immune modulatory effects of radiotherapy as basis for well-reasoned radioimmunotherapies. Strahlenther Onkol 2018; 194:509-519. [PMID: 29500551 DOI: 10.1007/s00066-018-1287-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/19/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Radiotherapy (RT) has been known for decades as a local treatment modality for malign and benign disease. In order to efficiently exploit the therapeutic potential of RT, an understanding of the immune modulatory properties of ionizing radiation is mandatory. These should be used for improvement of radioimmunotherapies for cancer in particular. METHODS We here summarize the latest research and review articles about immune modulatory properties of RT, with focus on radiation dose and on combination of RT with selected immunotherapies. Based on the knowledge of the manifold immune mechanisms that are triggered by RT, thought-provoking impulse for multimodal radioimmunotherapies is provided. RESULTS It has become obvious that ionizing radiation induces various forms of cell death and associated processes via DNA damage initiation and triggering of cellular stress responses. Immunogenic cell death (ICD) is of special interest since it activates the immune system via release of danger signals and via direct activation of immune cells. While RT with higher single doses in particular induces ICD, RT with a lower dose is mainly responsible for immune cell recruitment and for attenuation of an existing inflammation. The counteracting immunosuppression emanating from tumor cells can be overcome by combining RT with selected immunotherapies such as immune checkpoint inhibition, TGF-β inhibitors, and boosting of immunity with vaccination. CONCLUSION In order to exploit the full power of RT and thereby develop efficient radioimmunotherapies, the dose per fraction used in RT protocols, the fractionation, the quality, and the quantity of certain immunotherapies need to be qualitatively and chronologically well-matched to the individual immune status of the patient.
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Affiliation(s)
- Michael Rückert
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstr. 27, 91054, Erlangen, Germany
| | - Lisa Deloch
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstr. 27, 91054, Erlangen, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstr. 27, 91054, Erlangen, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstr. 27, 91054, Erlangen, Germany
| | - Markus Hecht
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstr. 27, 91054, Erlangen, Germany
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstr. 27, 91054, Erlangen, Germany.
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Rühle PF, Klein G, Rung T, Tiep Phan H, Fournier C, Fietkau R, Gaipl US, Frey B. Impact of radon and combinatory radon/carbon dioxide spa on pain and hypertension: Results from the explorative RAD-ON01 study. Mod Rheumatol 2018; 29:165-172. [DOI: 10.1080/14397595.2018.1442640] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Paul F. Rühle
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Gerhart Klein
- Practice for Cardiology, Bad Steben, Germany
- Health Resort Research Association, Bad Steben, Germany
| | | | | | - Claudia Fournier
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Udo S. Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Karagülle M, Kardeş S, Dişçi R, Karagülle MZ. Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:195-205. [PMID: 28884308 DOI: 10.1007/s00484-017-1441-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 06/07/2023]
Abstract
This study aims to investigate whether 2-week spa therapy, as an adjunct to usual pharmacological therapy, has any beneficial effect in patients with rheumatoid arthritis (RA). In this single-blind crossover study, 50 patients were randomly assigned in a 1:1 manner to receive usual pharmacological therapy plus 2-week spa therapy or usual pharmacological therapy alone (period 1.6 months); after a 9-month washout, patients were crossed over to the opposite assignment (period 2.6 months). Spa therapy program included a daily saline balneotherapy session at 36-37 °C for 20 min except Sundays. The clinical outcomes were evaluated at baseline, after spa therapy (2 weeks) and 3 and 6 months after the spa therapy in both period and were pain (Visual Analogue Scale (VAS)), patient and physician global assessments (VAS), Health Assessment Questionnaire (HAQ), and Disease Activity Score (DAS28). Spa therapy was superior to control therapy in improving all the assessed clinical outcomes at the end of the spa therapy. This superiority persisted significantly in physician global assessment (p = 0.010) and with a trend in favor of spa group in patient global assessment (p = 0.058), function (p = 0.092), and disease activity (p = 0.098) at 3 months. Statistically significant improvements were found in spa therapy compared to control in disease activity (p = 0.006) and patient (p = 0.020) and physician global (p = 0.011) assessments, and a trend toward improvements in pain (p = 0.069) and swollen joints (p = 0.070) at 6 months. A 2-week spa therapy adjunct to usual pharmacological therapy provided beneficial clinical effects compared to usual pharmacological therapy alone, in RA patients treated with traditional disease-modifying antirheumatic drugs. These beneficial effects may last for 6 months.
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Affiliation(s)
- Mine Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih, Capa, 34093, İstanbul, Turkey.
| | - Sinan Kardeş
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih, Capa, 34093, İstanbul, Turkey
| | - Rian Dişçi
- Department of Biostatistics, İstanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Müfit Zeki Karagülle
- Department of Medical Ecology and Hydroclimatology, İstanbul Faculty of Medicine, İstanbul University, Tıbbi Ekoloji ve Hidroklimatoloji A.B.D. İstanbul Tıp Fakültesi Fatih, Capa, 34093, İstanbul, Turkey
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Long-term efficacy of spa therapy in patients with rheumatoid arthritis. Rheumatol Int 2018; 38:353-362. [PMID: 29327104 DOI: 10.1007/s00296-017-3926-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/29/2017] [Indexed: 12/14/2022]
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De Ruysscher D, Jin J, Lautenschlaeger T, She JX, Liao Z, Kong FMS. Blood-based biomarkers for precision medicine in lung cancer: precision radiation therapy. Transl Lung Cancer Res 2017; 6:661-669. [PMID: 29218269 DOI: 10.21037/tlcr.2017.09.12] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Both tumors and patients are complex and models that determine survival and toxicity of radiotherapy or any other treatment ideally must take into account this variability as well as its dynamic state. The genetic features of the tumor and the host, and increasingly also the epi-genetic and proteomic characteristics, are being unraveled. Multiple techniques, including histological examination, blood sampling, measurement of circulating tumor cells (CTCs), and functional and molecular imaging, can be used for this purpose. However, the effects of radiation on the tumor and on organs at risk (OARs) are also influenced by the applied dose and volume of irradiated tissues. Combining all these biological, clinical, imaging, and dosimetric parameters in a validated prognostic or predictive model poses a major challenge. Here we aimed to provide an objective review of the potential of blood markers to guide high precision radiation therapy. A combined biological-mathematical approach opens new doors beyond prognostication of patients, as it allows truly precise oncological treatment. Indeed, the core for individualized and precision medicine is not only selection of patients, but even more the optimization of the therapeutic window on an individual basis. A holistic model will allow for determination of an individual dose-response relationship for each organ at risk for each tumor in each individual patient for the complete oncological treatment package. This includes, but is not limited to, radiotherapy alone. Individualized dose-response curves will allow for consideration of different doses of radiation and combinations with other drugs to plan for both optimal toxicity and complete response. Insights into the interactions between a multitude of parameters will lead to the discovery of new pathways and networks that will fuel new biological research on target discovery.
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Affiliation(s)
- Dirk De Ruysscher
- Department of Radiation Oncology (Maastro Clinic), GROW School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.,KU Leuven Radiation Oncology, Leuven, Belgium
| | - Jianyue Jin
- Department of Radiation Oncology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Tim Lautenschlaeger
- Department of Radiation Oncology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Jin-Xiong She
- Center for Biotechnology and Genomic Medicine and Department of OB/GYN, Augusta University, Augusta, GA, USA
| | - Zhongxing Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Feng-Ming Spring Kong
- Department of Radiation Oncology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
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Cucu A, Shreder K, Kraft D, Rühle PF, Klein G, Thiel G, Frey B, Gaipl US, Fournier C. Decrease of Markers Related to Bone Erosion in Serum of Patients with Musculoskeletal Disorders after Serial Low-Dose Radon Spa Therapy. Front Immunol 2017; 8:882. [PMID: 28791026 PMCID: PMC5524779 DOI: 10.3389/fimmu.2017.00882] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 07/11/2017] [Indexed: 12/29/2022] Open
Abstract
Musculoskeletal disorders (MSDs) are the most frequent cause of disability in Europe. Reduced mobility and quality of life of the patients are often associated with pain due to chronic inflammation. The inflammatory process, accompanied by a destruction of the cartilage and bone tissue, is discussed as a result of (A) the infiltration of immune cells into the joints, (B) an altered homeostasis of the joint cavity (synovium) with a critical role of bone remodeling cells, and (C) release of inflammatory factors including adipokines in the arthritic joint. In addition to the classical medication, low-dose radiation therapy using photons or radon spa treatments has shown to reduce pain and improve the mobility of the patients. However, the cellular and molecular mechanisms of anti-inflammatory effects of radon are yet poorly understood. We analyzed blood and serum samples from 32 patients, suffering from MSDs, who had been treated in the radon spa in Bad Steben (Germany). Before and after therapy, we measured the levels of markers related to bone metabolism (collagen fragments type-1, cartilage oligomeric matrix protein, receptor activator of NFκB ligand, and osteoprotegerin) in the serum of patients. In addition, adipokines related to inflammation (visfatin, leptin, resistin, and adiponectin) were analyzed. Some of these factors are known to correlate with disease activity. Since T cells play an important role in the progression of the disease, we further analyzed in blood samples the frequency of pro- and anti-inflammatory T cell subpopulations (CD4+IL17+ T cells and CD4+FoxP3+ regulatory T cells). Overall, we found a decrease of collagen fragments (CTX-I), indicating decreased bone resorption, presumably by osteoclasts, in the serum of MSD patients. We also observed reduced levels of visfatin and a consistent trend toward an increase of regulatory T cells in the peripheral blood, both indicating attenuation of inflammation. However, key proteins of bone metabolism were unchanged on a systemic level, suggesting that these factors act locally after radon spa therapy of patients with MSDs.
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Affiliation(s)
- Aljona Cucu
- GSI Helmholtz Center for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
| | - Kateryna Shreder
- GSI Helmholtz Center for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
| | - Daniela Kraft
- GSI Helmholtz Center for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
| | - Paul Friedrich Rühle
- Department of Radiation Oncology, Universitätklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Gerhart Klein
- Association for Spa Research and Medical Practice for Cardiology, Bad Steben, Germany
| | - Gerhard Thiel
- Membrane Biophysics Group, Department of Biology, Technical University Darmstadt, Darmstadt, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Claudia Fournier
- GSI Helmholtz Center for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
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Rödel F, Fournier C, Wiedemann J, Merz F, Gaipl US, Frey B, Keilholz L, Seegenschmiedt MH, Rödel C, Hehlgans S. Basics of Radiation Biology When Treating Hyperproliferative Benign Diseases. Front Immunol 2017; 8:519. [PMID: 28515727 PMCID: PMC5413517 DOI: 10.3389/fimmu.2017.00519] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/18/2017] [Indexed: 01/08/2023] Open
Abstract
For decades, low- and moderate-dose radiation therapy (RT) has been shown to exert a beneficial therapeutic effect in a multitude of non-malignant conditions including painful degenerative muscoloskeletal and hyperproliferative disorders. Dupuytren and Ledderhose diseases are benign fibroproliferative diseases of the hand/foot with fibrotic nodules and fascial cords, which determine debilitating contractures and deformities of fingers/toes, while keloids are exuberant scar formations following burn damage, surgery, and trauma. Although RT has become an established and effective option in the management of these diseases, experimental studies to illustrate cellular composites and factors involved remain to be elucidated. More recent findings, however, indicate the involvement of radiation-sensitive targets like mitotic fibroblasts/myofibroblasts as well as inflammatory cells. Radiation-related molecular mechanisms affecting these target cells include the production of free radicals to hamper proliferative activity and interference with growth factors and cytokines. Moreover, an impairment of activated immune cells involved in both myofibroblast proliferative and inflammatory processes may further contribute to the clinical effects. We here aim at briefly describing mechanisms contributing to a modulation of proliferative and inflammatory processes and to summarize current concepts of treating hyperproliferative diseases by low and moderate doses of ionizing radiation.
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Affiliation(s)
- Franz Rödel
- Department of Radiotherapy and Oncology, University Hospital of Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - Claudia Fournier
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research, Darmstadt, Germany
| | - Julia Wiedemann
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research, Darmstadt, Germany
| | - Felicitas Merz
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research, Darmstadt, Germany
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Benjamin Frey
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ludwig Keilholz
- Department of Radiotherapy, Clinical Center Bayreuth, Bayreuth, Germany
| | | | - Claus Rödel
- Department of Radiotherapy and Oncology, University Hospital of Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - Stephanie Hehlgans
- Department of Radiotherapy and Oncology, University Hospital of Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
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