Diagnosis and treatment of polonium poisoning

Metabolomic Changes in Plasma of Preterminal Stage of Rhesus Nonhuman Primates Exposed to Lethal Dose of Radiation

Ionizing radiation exposure is known to induce molecular and cellular injury, inflicting a cascade of potentially catastrophic events leading to tissue and organ damage. Metabolomic analysis allows for the identification and quantification of small molecules downstream of genomic changes induced by radiation exposure. We aimed to characterize metabolomic changes that underscore the prefinal stage of lethally irradiated rhesus nonhuman primates (NHPs). Peripheral blood was drawn at baseline, post-exposure, as well as at the preterminal stage in NHPs (immediately prior to death in moribund NHPs) that did not survive exposure with 7.2 Gy total-body radiation (LD70/60). Herein, we analyzed global metabolomic changes using ultra-performance liquid chromatography (UPLC) quadrupole time-of-flight mass spectrometry (QTOF-MS) in plasma samples of NHPs collected at various timepoints in relation to irradiation. The overall goal was to identify metabolic shifts present immediately prior to death. Our findings showed radiation induced significant time-dependent metabolic perturbations when compared to pre-irradiation profiles, particularly in glycerophospholipid metabolism and steroid hormone biosynthesis and metabolism pathways. These findings provide valuable insights for identifying biomarkers for lethality, which may be helpful for triage during a mass casualty scenario.

Characteristics of 210Po in Asian overbite clam (Potamocorbula laevis) from the coastal area at Thai Binh province, Vietnam

210Po concentration in the edible muscle tissue and digestive diverticulum organs of Asian overbite clam at the near-shore Thai Binh, Vietnam was analyzed using alpha detectors. The 210Po activity in muscle tissue and digestive diverticulum organs ranged from 5 ± 1 to 178 ± 10 and from 118 ± 7 to 812 ± 12 Bq.kg-1 with the average value of 25 and 324 Bq.kg-1, respectively. Results showed that 210Po activity in the digestive diverticulum was significantly higher than in the muscle tissue. There was a slightly inverse correlation between 210Po activity in muscle tissue, digestive diverticulum, and clam weight and size. The annual committed effective dose was calculated from 210Po due to the consumption of Asian overbite clam for adults in the study area was higher than the guideline value of 0.2 - 1 mSv.y-1.

Study of Polonium (210Po) Activity Concentration in Fruit Wines Derived from Different Locations in Poland

This study aimed at assessing the activity concentration and the annual effective dose of polonium-210 (210Po) in fruit wines derived from four locations in Poland (Warmian−Masurian, Podlaskie, Lubelskie and Małopolskie voivodeships). The fruit wines differed significantly (p < 0.05) in 210Po activity depending on the production site, with the Małopolskie site having the highest activity (61.4−221.4 mBq/L) and the Podlaskie having the lowest (3.5−97.1 mBq/L). The site differentiation was due to environmental conditions—soil parameters (uranium concentration), precipitations and terrain characteristics, e.g., the proximity of the lakes. The increased activity concentration of 210Po in samples from Małopolska compared with the other sites probably derived from the environment polluted with aqueous wastes and particulate air pollution. The annual effective dose due to the ingestion of fruit wines ranged from 0.112 to 1.214 µSv/year. These levels of exposure are safe according to the WHO criterion (0.1 mSv per year for ingestion) and to the IAEA reference level for public exposure including food (1 mSv per year). Summing up, the data obtained provide information on the activity concentration of 210Po in fruit wines and increase databases on the natural radioactivity of foodstuffs. Future work is needed to examine 210Po activity in samples from all vineyard regions in Poland.

Gene Expression Changes in a Prefinal Health Stage of Lethally Irradiated Male and Female Rhesus Macaques

Radiation-induced gene expression (GE) changes can be used for early and high-throughput biodosimetry within the first three days postirradiation. However, is the method applicable in situations such as the Alexander Litvinenko case or the Goiania accident, where diagnosis occurred in a prefinal health stage? We aimed to characterize gene expression changes in a prefinal health stage of lethally irradiated male and female rhesus macaques. Peripheral blood was drawn pre-exposure and at the prefinal stage of male and female animals, which did not survive whole-body exposure with 700 cGy (LD66/60). RNA samples originated from a blinded randomized Good Laboratory Practice study comprising altogether 142 irradiated rhesus macaques of whom 60 animals and blood samples (15 samples for both time points and sexes) were used for this analysis. We evaluated GE on 34 genes widely used in biodosimetry and prediction of the hematological acute radiation syndrome severity (H-ARS) employing quantitative real-time polymerase chain reaction (qRT-PCR). These genes were run in duplicate and triplicate and altogether 96 measurements per time point and sex could be performed. In addition, 18S ribosomal RNA (rRNA) was measured to depict the ribosome/transcriptome status as well as for normalization purposes and 16S rRNA was evaluated as a surrogate for bacteremia. Mean differential gene expression (DGE) was calculated for each gene and sex including all replicate measurements and using pre-exposure samples as the reference. From 34 genes, altogether 27 genes appeared expressed. Pre-exposure samples revealed no signs of bacteremia and 18S rRNA GE was in the normal range in all 30 samples. Regarding prefinal samples, 46.7% and 40% of animals appeared infected in females and males, respectively, and for almost all males this was associated with out of normal range 18S rRNA values. The total number of detectable GE measurements was sixfold (females) and 15-fold (males) reduced in prefinal relative to pre-exposure samples and about tenfold lower in 80% of prefinal compared to pre-exposure samples (P < 0.0001). An overall 11-fold (median) downregulation in prefinal compared to pre-exposure samples was identified for most of the 27 genes and even FDXR appeared 4-14-fold downregulated in contrast to a pronounced up-regulation according to cited work. This pattern of overall downregulation of almost all genes and the rapid reduction of detectable genes at a prefinal stage was found in uninfected animals with normal range 18S rRNA as well. In conclusion, in a prefinal stage after lethal radiation exposure, the ribosome/transcriptome status remains present (based on normal range 18S rRNA values) in 60-67% of animals, but the whole transcriptome activity in general appears silenced and cannot be used for biodosimetry purposes, but probably as an indicator for an emerging prefinal health stage.

Selected Political Criminal Poisonings in the Years 1978-2020: Detection and Treatment

Criminal poisonings are among the least frequently detected crimes in the world. Lack of suspicion of this type of event by police officers and prosecutors, clinical symptoms imitating many somatic diseases and technical difficulties in diagnostics, as well as high research costs make the actual frequency of these events difficult to estimate. The substance used for criminal poisoning is often characterized by: lack of taste, color and smell, delayed action, easy availability and difficulty to detect. The aim of the study was to analyze selected cases of political poisoning that took place in the years 1978-2020, to describe the mechanisms of action of the substances used and to evaluate the diagnosis and treatment. The analyzed cases of criminal poisoning concerned: Georgi Markov (ricin), Khalid Maszal (fentanyl), Wiktor Yushchenko (TCDD dioxin), Jasir Arafat (polonium ²¹⁰Po isotope), Alexander Litvinenko (polonium ²¹⁰Po isotope), Kim Jong-Nam (VX), Sergei Skripal (Novichok) and Alexei Navalny (Novichok). Contemporary poisons, to a greater extent than in the past, are based on the use of synthetic substances from the group of organophosphorus compounds and radioactive substances. The possibility of taking appropriate and effective treatment in such cases is the result of many factors, including the possibility of quick and competent rescue intervention, quick and reliable detection of the toxic substance and the possibility of using an antidote.

Nuclear and Radiological Emergencies: Biological Effects, Countermeasures and Biodosimetry

Atomic and radiological crises can be caused by accidents, military activities, terrorist assaults involving atomic installations, the explosion of nuclear devices, or the utilization of concealed radiation exposure devices. Direct damage is caused when radiation interacts directly with cellular components. Indirect effects are mainly caused by the generation of reactive oxygen species due to radiolysis of water molecules. Acute and persistent oxidative stress associates to radiation-induced biological damages. Biological impacts of atomic radiation exposure can be deterministic (in a period range a posteriori of the event and because of destructive tissue/organ harm) or stochastic (irregular, for example cell mutation related pathologies and heritable infections). Potential countermeasures according to a specific scenario require considering basic issues, e.g., the type of radiation, people directly affected and first responders, range of doses received and whether the exposure or contamination has affected the total body or is partial. This review focuses on available medical countermeasures (radioprotectors, radiomitigators, radionuclide scavengers), biodosimetry (biological and biophysical techniques that can be quantitatively correlated with the magnitude of the radiation dose received), and strategies to implement the response to an accidental radiation exposure. In the case of large-scale atomic or radiological events, the most ideal choice for triage, dose assessment and victim classification, is the utilization of global biodosimetry networks, in combination with the automation of strategies based on modular platforms.

Dose assessment for polonium-210 (Po-210) in New Zealand shellfish

Worldwide, Po-210 is an important contributor to human ionising radiation exposure through food. To characterise the ionising radiation dose for New Zealanders from Po-210 in shellfish, a dose assessment was undertaken. Deterministic and probabilistic dietary models were constructed by assigning shellfish consumption rates to Po-210 activity concentrations measured in shellfish. Modelling was undertaken for different shellfish consumer populations and geographical areas. Dietary modelling estimated an annual dose range from 4 μSv to 6070 μSv. The lowest dose was calculated for the overall shellfish consumer population residing in areas where baseline Po-210 activity concentrations were measured in shellfish. The highest dose was calculated for the high shellfish consumer population residing in areas where elevated activity concentrations were measured in shellfish. For the majority of the New Zealand population, the total estimated dose did not exceed the selected reference level of 1000 μSv, and Po-210 is therefore not a cause of concern. About 50% of high shellfish consumers residing in areas where shellfish had elevated Po-210 activity concentrations were exposed to ionising radiation resulting in an annual dose higher than 1000 μSv. Exposure assessment for different demographic groups identified that higher shellfish consumption rates in the population identifying as Māori lead to higher doses of ionising radiation for this group.

mRNA and small RNA gene expression changes in peripheral blood to detect internal Ra-223 exposure

PURPOSE

Excretion analysis is the established method for detection of incorporated alpha-emitting radionuclides, but it is laborious and time consuming. We sought a simplified method in which changes in gene expression might be measured in human peripheral blood to detect incorporated radionuclides. Such an approach could be used to quickly determine internal exposure in instances of a radiological dispersal device or a radiation accident.

MATERIALS AND METHODS

We evaluated whole blood samples from five patients with castration-resistant prostate cancer and multiple bone metastases (without visceral or nodal involvement), who underwent treatment with the alpha emitting isotope Radium-223 dichloride (Ra-223, Xofigo^®). Patients received about 4 MBq per cycle and, depending on survival and treatment tolerance, were followed for six months. We collected 24 blood samples approximately monthly corresponding to treatment cycle.

RESULTS

Firstly, we conducted whole genome screening of mRNAs (mRNA seq) and small RNAs (small RNA seq) using next generation sequencing in one patient at eight different time points during all six cycles of Ra-223-therapy. We identified 1900 mRNAs and 972 small RNAs (222 miRNAs) that were differentially up- or down-regulated during follow-up after the first treatment with Ra-223. Overall candidate RNA species inclusion criteria were a general (≥|2|-fold) change or with peaking profiles (≥|5|-fold) at specific points in time. Next we chose 72 candidate mRNAs and 101 small RNAs (comprising 29 miRNAs) for methodologic (n = 8 samples, one patient) and independent (n = 16 samples, four patients) validation by qRT-PCR. In total, 15 mRNAs (but no small RNAs) were validated by methodologic and independent testing. However, the deregulation occurred at different time points, showing a large inter-individual variability in response among patients.

CONCLUSIONS

This proof of concept provides support for the applicability of gene expression measurements to detect internalized alpha-emitting radionuclides, but further work is needed with a larger sample size. While our approach has merit for internal deposition monitoring, it was complicated by the severe clinical condition of the patients we studied.

Treatment of radiological contamination: a review

After nuclear accidents, people can be contaminated internally via ingestion, inhalation and via intact skin or wounds. The assessment of absorbed, committed doses after internal exposure is based on activity measurement byin vivoorin vitrobioassay. Estimation of dose following internal contamination is dependent on understanding the nature and form of the radionuclide. Direct counting methods that directly measureγ-rays coming from within the body or bioassay methods that measure the amount of radioactive materials in urine or feces are used to estimate the intake, which is required for calculating internal exposure doses. The interpretation of these data in terms of intake and the lifetime committed dose requires knowledge or making assumptions about a number of parameters (time, type of exposure, route of the exposure, physical, biological and chemical characteristics) and their biokinetics inside the body. Radioactive materials incorporated into the body emit radiation within the body. Accumulation in some specific organs may occur depending on the types of radioactive materials. Decorporation therapy is that acceleration of the natural rate of elimination of the contaminant will reduce the amount of radioactivity retained in the body. This article presents an overview of treatment of radiological contamination after internal contamination.

A high-throughput alpha particle irradiation system for monitoring DNA damage repair, genome instability and screening in human cell and yeast model systems

Ionizing radiation (IR) is environmentally prevalent and, depending on dose and linear energy transfer (LET), can elicit serious health effects by damaging DNA. Relative to low LET photon radiation (X-rays, gamma rays), higher LET particle radiation produces more disease causing, complex DNA damage that is substantially more challenging to resolve quickly or accurately. Despite the majority of human lifetime IR exposure involving long-term, repetitive, low doses of high LET alpha particles (e.g. radon gas inhalation), technological limitations to deliver alpha particles in the laboratory conveniently, repeatedly, over a prolonged period, in low doses and in an affordable, high-throughput manner have constrained DNA damage and repair research on this topic. To resolve this, we developed an inexpensive, high capacity, 96-well plate-compatible alpha particle irradiator capable of delivering adjustable, low mGy/s particle radiation doses in multiple model systems and on the benchtop of a standard laboratory. The system enables monitoring alpha particle effects on DNA damage repair and signalling, genome stability pathways, oxidative stress, cell cycle phase distribution, cell viability and clonogenic survival using numerous microscopy-based and physical techniques. Most importantly, this method is foundational for high-throughput genetic screening and small molecule testing in mammalian and yeast cells.

Disasters Resulting from Radiologic and Nuclear Events

Radiation accidents are rare, but can produce large numbers of casualties with predictable patterns of injury. Casualties may suffer from a wide range of radiation exposures. Triage based on presence or absence of conventional injuries and an accurate assessment of radiation dose based on event history, symptoms, and laboratory testing, is critical. Treatment of acute radiation syndrome is supportive: including fluids, antibiotics, blood products, colony-stimulating factors, and stem cell or bone marrow transplantation. Care of radiation-injured patients with conventional trauma or burns needs to be modified to account for adverse effects of radiation on wound healing and susceptibility to infections.

Collateral contamination concomitant to the polonium-210 poisoning of Mr Alexander Litvinenko

Mr Litvinenko died on 23 November 2006, having been poisoned with polonium-210 on 1 November, with evidence of a previous poisoning attempt during October 2006. Measurements of ²¹⁰Po in urine samples were made for a large number of people to determine whether they may have been contaminated. In the majority of cases, measured levels were attributable to the presence of ²¹⁰Po from normal dietary sources. For a small number of cases, elevated levels provided evidence of direct contamination associated with the poisonings. For one individual, while estimated doses were below thresholds for irreversible organ damage, a notably increased risk of cancer can be inferred. The use of the chelating agent, unithiol, to increase ²¹⁰Po excretion in this case was only moderately effective in reducing doses received.

Investigation of a new “N2S2O2” chelating agent with high Po(iv) affinity

A water-soluble complexing agent for 210-polonium decorporation was designed and synthesised with a high conditional stability constant.

(210)Po in drinking water, its potential health effects, and inadequacy of the gross alpha activity MCL

Polonium-210 ((210)Po) is a naturally-occurring, carcinogenic member of the (238)U decay series and the granddaughter of (210)Pb. It has a half life of 138.4days and is rarely found in drinking water at levels exceeding 5mBq/L because it strongly binds to aquifer sediment. When the current US Maximum Contaminant Level (MCL) covering (210)Po was promulgated in December 2000, very little was known about its occurrence and the processes responsible for mobilizing it. More is now known about the processes that mobilize (210)Po from sediments and a review of recent occurrence data show that it may not be as rare in the US as the US Environmental Protection Agency (USEPA) thought in 2000. Worldwide, only about 2200 analyses for (210)Po in drinking water were identified, with activities exceeding 500mBq/L being found only in Finland, India, Sweden, and the US. The median of 400 (210)Po analyses from the US is 4.75mBq/L and >10% of the samples exceed 500mBq/L. Current compliance-monitoring regulations in the US essentially guarantee that (210)Po contamination will not be detected except in very contaminated wells. Major problems with the US Gross Alpha Activity MCL include the volatility of (210)Po and extended holding times and sample-compositing methods that can allow the majority of (210)Po in a sample bottle to decay before analysis. In light of new information, the radionuclide rule should be changed and direct measurements of (210)Po should be made in all public-water supply wells to rule out its presence. Much of the important biological and toxicological research on (210)Po is more than four decades old and new laboratory research using modern tools is needed. Biological and epidemiological investigations of known contaminated areas are needed to assess the effect (210)Po exposure is having on animals and humans consuming the water.

Polonium-210 poisoning: a first-hand account

BACKGROUND

Polonium-210 ((210)Po) gained widespread notoriety after the poisoning and subsequent death of Mr Alexander Litvinenko in London, UK, in 2006. Exposure to (210)Po resulted initially in a clinical course that was indistinguishable from infection or exposure to chemical toxins, such as thallium.

METHODS

A 43-year-old man presented to his local hospital with acute abdominal pain, diarrhoea, and vomiting, and was admitted to the hospital because of dehydration and persistent gastrointestinal symptoms. He was initially diagnosed with gastroenteritis and treated with antibiotics. Clostridium difficile toxin was subsequently detected in his stools, which is when he first raised the possibility of being poisoned and revealed his background and former identity, having been admitted under a new identity with which he had been provided on being granted asylum in the UK. Within 6 days, the patient had developed thrombocytopenia and neutropenia, which was initially thought to be drug induced. By 2 weeks, in addition to bone marrow failure, he had evidence of alopecia and mucositis. Thallium poisoning was suspected and investigated but ultimately dismissed because blood levels of thallium, although raised, were lower than toxic concentrations. The patient continued to deteriorate and within 3 weeks had developed multiple organ failure requiring ventilation, haemofiltration, and cardiac support, associated with a drop in consciousness. On the 23rd day after he first became ill, he suffered a pulseless electrical activity cardiorespiratory arrest from which he could not be resuscitated and was pronounced dead.

FINDINGS

Urine analysis using gamma-ray spectroscopy on day 22 showed a characteristic 803 keV photon emission, raising the possibility of (210)Po poisoning. Results of confirmatory analysis that became available after the patient's death established the presence of (210)Po at concentrations about 10(9)-times higher than normal background levels. Post-mortem tissue analyses showed autolysis and retention of (210)Po at lethal doses in several organs. On the basis of the measured amounts and tissue distribution of (210)Po, it was estimated that the patient had ingested several 1000 million becquerels (a few GBq), probably as a soluble salt (eg, chloride), which delivered very high and fatal radiation doses over a period of a few days.

INTERPRETATION

Early symptoms of (210)Po poisoning are indistinguishable from those of a wide range of chemical toxins. Hence, the diagnosis can be delayed and even missed without a high degree of suspicion. Although body surface scanning with a standard Geiger counter was unable to detect the radiation emitted by (210)Po, an atypical clinical course prompted active consideration of poisoning with radioactive material, with the diagnosis ultimately being made with gamma-ray spectroscopy of a urine sample.

FUNDING

UK NHS, Public Health England, and the UK Department of Health.

The sources and fate of (210)Po in the urban air: A review

The origin of (210)Po activity and its fluctuations in the air are discussed in this paper. In the case of atmospheric aerosol samples, a comparison of the (210)Po/(210)Pb and (210)Bi/(210)Pb activity ratios makes it possible not only to determine aerosol residence times but also to appraise the contribution of the unsupported (210)Po coming from other sources than (222)Rn decay, such as human industrial activities, especially coal combustion. A simple mathematical method makes it possible to observe the seasonal fluctuations of the anthropogenic excess of (210)Po in the urban air. The average doses of (210)Po intake with food (including drinking water) and inhalation of urban aerosols are usually lower than those from (210)Po intake by cigarette smokers and negligible in comparison to total natural radiation exposure.

[The death of Yasser Arafat: molecular-genetic authentication of the remains as an indispensable condition for the evaluation of the medical hypotheses of the cause of his death]

The objective of the present study was the molecular-genetic authentication of the remains as an indispensable condition for the evaluation of the medical hypotheses of the cause of death in 2004 of Yasser Arafat, the former Palestinian leader and the first president of the Palestinian National Administration, the Nobel Peace Prize laureate. We carried out molecular-genetic investigations aimed at establishing the circumstances and cause of the death of Yasser Arafat including the analysis of the relevant medical documentation, the examination of the burial place at Ramallah, remains, and personal belongings stored in his Al Muqata'ah residence at Ramallah. The objective of the present molecular- genetic investigations was to confirm the authenticity of the fragments of Yasser Arafat's remains available for radio-toxicological, chemical toxicological, and other laboratory studies. The reference objects were the contact traces left on the personal belongings by their owner. The aggregate probabilistic estimate of the coincidence of genotype traits of autosomal DNA, Y-chromosomal DNA, and mtDNA was at least 99,(9)29 4% which gives evidence of the genetic identity of the objects of study. It is this value (99.999999 <...> 9999999(29) 4%) that characterizes the probability that the bone fragments provided for the laboratory studies are actually authentic remains of Yasser Arafat.

An assessment of the (210)Po ingestion dose due to the consumption of agricultural, marine, fresh water and forest foodstuffs in Gudalore (India)

The activity concentration of (210)Po in cereals, pulses, food materials of animal origin, vegetables and spices collected from Gudalore (India) has been estimated by radiochemical method. The activity concentration of (210)Po in cereals is found to vary from 124 to 604 mBq kg(-1). Raw rice registered the highest mean activity 504 ± 61 mBq kg(-1). In pulses (210)Po activity concentration varies from 42 to 320 mBq kg(-1) and the highest activity is found in black lentil with the average value of 172 ± 38 mBq kg(-1). Leafy vegetables registered the highest (210)Po activity concentration (662-7336 mBq kg(-1)) and are followed by tuber vegetables (390-1269 mBq kg(-1)) and then by other vegetables (75-595 mBq kg(-1)). The higher concentration of (210)Po observed in leafy vegetables may be attributed to the dry deposition of (210)Po and other daughter products of (222)Rn on large leaf surfaces from the air. Among animal products fish of marine origin registered the highest (210)Po activity concentration 36,850-48,964 mBq kg(-1). The mean (210)Po activity concentration in coffee has been estimated as 7500 mBq kg(-1). The activity concentration of (210)Po in leaf and bark of tree Cinnamom zeylanicum, a popular spice, is found to vary from 3500 to 11,100 mBq kg(-1) and 1600-3400 mBq kg(-1). The consumption of marine and fresh water fish contribute 60.7% (506.1 μSv y(-1)) to the total ingestion dose received. Cereals being consumed in a large scale, contribute 23.4% (194.9 μSv y(-1)) of the total ingestion dose received. The contribution from spices and leafy vegetables consumed is 5.8% (48.1 μSv y(-1)) and 6.5% (54.3 μSv y(-1)), respectively. The remaining 3.6% (30.0 μSv y(-1)) contribution to the total ingestion dose comes from other food materials and vegetables.

Occurrence of ²¹⁰Po and biological effects of low-level exposure: the need for research

BACKGROUND

Polonium-210 (²¹⁰Po) concentrations that exceed 1 Bq/L in drinking-water supplies have been reported from four widely separated U.S. states where exposure to it went unnoticed for decades. The radionuclide grandparents of ²¹⁰Po are common in sediments, and segments of the public may be chronically exposed to low levels of ²¹⁰Po in drinking water or in food products from animals raised in contaminated areas.

OBJECTIVES

We summarized information on the environmental behavior, biokinetics, and toxicology of ²¹⁰Po and identified the need for future research.

METHODS

Potential linkages between environmental exposure to ²¹⁰Po and human health effects were identified in a literature review.

DISCUSSION

²¹⁰Po accumulates in the ovaries where it kills primary oocytes at low doses. Because of its radiosensitivity and tendency to concentrate ²¹⁰Po, the ovary may be the critical organ in determining the lowest injurious dose for ²¹⁰Po. ²¹⁰Po also accumulates in the yolk sac of the embryo and in the fetal and placental tissues. Low-level exposure to ²¹⁰Po may have subtle, long-term biological effects because of its tropism towards reproductive and embryonic and fetal tissues where exposure to a single alpha particle may kill or damage critical cells. ²¹⁰Po is present in cigarettes and maternal smoking has several effects that appear consistent with the toxicology of ²¹⁰Po.

CONCLUSIONS

Much of the important biological and toxicological research on ²¹⁰Po is more than four decades old. New research is needed to evaluate environmental exposure to ²¹⁰Po and the biological effects of low-dose exposure to it so that public health officials can develop appropriate mitigation measures where necessary.

After the bomb drops: a new look at radiation-induced multiple organ dysfunction syndrome (MODS)

PURPOSE

There is increasing concern that, since the Cold War era, there has been little progress regarding the availability of medical countermeasures in the event of either a radiological or nuclear incident. Fortunately, since much is known about the acute consequences that are likely to be experienced by an exposed population, the probability of survival from the immediate hematological crises after total body irradiation (TBI) has improved in recent years. Therefore focus has begun to shift towards later down-stream effects, seen in such organs as the gastrointestinal tract (GI), skin, and lung. However, the mechanisms underlying therapy-related normal tissue late effects, resulting from localised irradiation, have remained somewhat elusive and even less is known about the development of the delayed syndrome seen in the context of whole body exposures, when it is likely that systemic perturbations may alter tissue microenvironments and homeostasis.

CONCLUSIONS

The sequence of organ failures observed after near-lethal TBI doses are similar in many ways to that of multiple organ dysfunction syndrome (MODS), leading to multiple organ failure (MOF). In this review, we compare the mechanistic pathways that underlie both MODS and delayed normal tissue effects since these may impact on strategies to identify radiation countermeasures.

Biokinetics of ²¹⁰Po in rats: excretion via urine and faeces and retention in tissues and organs

Daily excretions of ²¹⁰Po from rats via urine and faeces following i.v. administration of polonium citrate, from Day 2 to Day 5, were reported, together with retentions in tissues and organs on Day 5. Emphasis is given to the methods of measurement and data quality rather than to the discussion of the observations. The authors aim to contribute data for developing or refining the biokinetic model for ²¹⁰Po metabolism.

Increase of 210Po levels in human semen fluid after mussel ingestion

Polonium-210 ((210)Po) radioactive concentrations were determined in human semen fluid of vasectomized non-smoker volunteers. The (210)Po levels ranged from 0.10 to 0.39 mBq g(-1) (mean: 0.23 ± 0.08 mBq g(-1)). This value decreased to 0.10 ± 0.02 mBq g(-1) (range from 0.07 to 0.13 mBq g(-1)) after two weeks of a controlled diet, excluding fish and seafood. Then, volunteers ate during a single meal 200 g of the cooked mussel Perna perna L., and (210)Po levels were determined again, during ten days, in semen fluid samples collected every morning. Volunteers continued with the controlled diet and maintained sexual abstinence through the period of the experiment. A 300% increase of (210)Po level was observed the day following mussel consumption, with a later reduction, such that the level returned to near baseline by day 4.

Metabolism of 210Po in rats: volatile 210Po in excreta

Polonium-210 ((210)Po) is one of the most toxic radionuclides and was used as a poison in the Alexander Litvinenko case. In this study of the metabolism of (210)Po in rats, volatile (210)Po in excreta was measured, filling a knowledge gap of the previous studies. Five rats were intravenously administrated with 2 kBq and another five with 10 kBq of (210)Po (citrate form). They were housed in a glass Metabowl system for 4 d following the administration. Volatile (210)Po from the excreta was collected in a trapping system filled with liquid scintillation cocktail and was measured by liquid scintillation counting. Results showed that the daily excretion of volatile (210)Po by the rats is in a very small percentage (0.002-0.009 %) of the administered amounts. However, if the administered amount is large, the excretion of volatile (210)Po can be significant.