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Lee J, Jang WH, Shim S, Kim B, Jang WS, Myung JK, Park S, Kim KH. Characterization of early-stage cutaneous radiation injury by using optical coherence tomography angiography. BIOMEDICAL OPTICS EXPRESS 2020; 11:2652-2664. [PMID: 32499950 PMCID: PMC7249837 DOI: 10.1364/boe.387400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/12/2020] [Accepted: 04/13/2020] [Indexed: 05/09/2023]
Abstract
Cutaneous radiation injury (CRI) is a skin injury caused by exposure to high dose ionizing radiation (IR). Diagnosis and treatment of CRI is difficult due to its initial clinically latent period and the following inflammatory bursts. Early detection of CRI before clinical symptoms will be helpful for effective treatment, and various optical methods have been applied with limitations. Here we show that optical coherence tomography angiography (OCTA) could detect changes in the skin during the latent period in CRI mouse models non-invasively. CRI was induced on the mouse hindlimb with exposure to various IR doses and the injured skin regions were imaged longitudinally by OCTA until the onset of clinical symptoms. OCTA detected several changes in the skin including the skin thickening, the dilation of large blood vessels, and the irregularity in vessel boundaries. Some of OCTA findings were confirmed by histology. The study results showed that OCTA could be used for early CRI detection.
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Affiliation(s)
- Jungbin Lee
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
| | - Won Hyuk Jang
- Divison of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
| | - Sehwan Shim
- National Radiation Emergency Medical Centre, Korea Cancer Centre Hospital, Korea Institute of Radiological & Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, South Korea
| | - Bumju Kim
- Divison of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
| | - Won-Suk Jang
- Laboratory of Experimental Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological & Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, South Korea
| | - Jae Kyung Myung
- National Radiation Emergency Medical Centre, Korea Cancer Centre Hospital, Korea Institute of Radiological & Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, South Korea
- Laboratory of Experimental Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological & Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, South Korea
- Department of Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological & Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, South Korea
| | - Sunhoo Park
- National Radiation Emergency Medical Centre, Korea Cancer Centre Hospital, Korea Institute of Radiological & Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, South Korea
- Laboratory of Experimental Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological & Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, South Korea
- Department of Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological & Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, South Korea
| | - Ki Hean Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
- Divison of Integrative Biosciences & Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, South Korea
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McIntyre MK, Clifford JL, Maani CV, Burmeister DM. Progress of clinical practice on the management of burn-associated pain: Lessons from animal models. Burns 2016; 42:1161-72. [PMID: 26906668 DOI: 10.1016/j.burns.2016.01.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/05/2016] [Accepted: 01/21/2016] [Indexed: 02/08/2023]
Abstract
Opioid-based analgesics provide the mainstay for attenuating burn pain, but they have a myriad of side effects including respiratory depression, nausea, impaired gastrointestinal motility, sedation, dependence, physiologic tolerance, and opioid-induced hyperalgesia. To test and develop novel analgesics, validated burn-relevant animal models of pain are indispensable. Herein we review such animal models, which are mostly limited to rodent models of burn-induced, inflammatory, and neuropathic pain. The latter two are pain syndromes that provide insight into the pain caused by systemic pro-inflammatory cytokines and direct injury to nerves (e.g., after severe burn), respectively. To date, no single animal model optimally mimics the complex pathophysiology and pain that a human burn patient experiences. No currently available burn-pain model examines effects of pharmacological intervention on wound healing. As cornerstones of pain and wound healing, pro-inflammatory mediators may be utilized for insight into both processes. Moreover, common clinical concerns such as systemic inflammatory response syndrome and multiple organ dysfunction remain unaddressed. For development of analgesics, these aberrations can significantly alter the potential efficacy and/or adverse effects of a prescribed analgesic following burn trauma. We therefore suggest that a multi-model strategy would be the most clinically relevant when evaluating novel analgesics for use in burn patients.
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Affiliation(s)
- Matthew K McIntyre
- United States Army Institute of Surgical Research, 3650 Chambers Pass, BHT1:Bldg 3610, JBSA Fort Sam Houston, TX 78234-6315, United States.
| | - John L Clifford
- United States Army Institute of Surgical Research, 3650 Chambers Pass, BHT1:Bldg 3610, JBSA Fort Sam Houston, TX 78234-6315, United States.
| | - Christopher V Maani
- Brooke Army Medical Center, Department of Anesthesia and Operative Services, San Antonio Uniformed Services Health Education Consortium (SAUSHEC) Anesthesia Residency Program, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234-6315, United States.
| | - David M Burmeister
- United States Army Institute of Surgical Research, 3650 Chambers Pass, BHT1:Bldg 3610, JBSA Fort Sam Houston, TX 78234-6315, United States.
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Jang WH, Shim S, Wang T, Yoon Y, Jang WS, Myung JK, Park S, Kim KH. In vivo characterization of early-stage radiation skin injury in a mouse model by two-photon microscopy. Sci Rep 2016; 6:19216. [PMID: 26755422 PMCID: PMC4709756 DOI: 10.1038/srep19216] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/07/2015] [Indexed: 11/23/2022] Open
Abstract
Ionizing radiation (IR) injury is tissue damage caused by high energy electromagnetic waves such as X-ray and gamma ray. Diagnosis and treatment of IR injury are difficult due to its characteristics of clinically latent post-irradiation periods and the following successive and unpredictable inflammatory bursts. Skin is one of the many sensitive organs to IR and bears local injury upon exposure. Early-stage diagnosis of IR skin injury is essential in order to maximize treatment efficiency and to prevent the aggravation of IR injury. In this study, early-stage changes of the IR injured skin at the cellular level were characterized in an in vivo mouse model by two-photon microscopy (TPM). Various IR doses were applied to the mouse hind limbs and the injured skin regions were imaged daily for 6 days after IR irradiation. Changes in the morphology and distribution of the epidermal cells and damage of the sebaceous glands were observed before clinical symptoms. These results showed that TPM is sensitive to early-stage changes of IR skin injury and may be useful for its diagnosis.
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Affiliation(s)
- Won Hyuk Jang
- Divison of Integrative Biosciences &Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, Rep. of Korea
| | - Sehwan Shim
- National Radiation Emergency Medical Centre, Korea Cancer Centre Hospital, Korea Institute of Radiological &Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, Rep. of Korea
| | - Taejun Wang
- Divison of Integrative Biosciences &Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, Rep. of Korea
| | - Yeoreum Yoon
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, Rep. of Korea
| | - Won-Suk Jang
- Laboratory of Experimental Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological &Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, Rep. of Korea
| | - Jae Kyung Myung
- National Radiation Emergency Medical Centre, Korea Cancer Centre Hospital, Korea Institute of Radiological &Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, Rep. of Korea.,Laboratory of Experimental Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological &Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, Rep. of Korea.,Department of Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological &Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, Rep. of Korea
| | - Sunhoo Park
- National Radiation Emergency Medical Centre, Korea Cancer Centre Hospital, Korea Institute of Radiological &Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, Rep. of Korea.,Laboratory of Experimental Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological &Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, Rep. of Korea.,Department of Pathology, Korea Cancer Centre Hospital, Korea Institute of Radiological &Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 01812, Rep. of Korea
| | - Ki Hean Kim
- Divison of Integrative Biosciences &Biotechnology, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, Rep. of Korea.,Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, Rep. of Korea
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Lamkowski A, Forcheron F, Agay D, Ahmed EA, Drouet M, Meineke V, Scherthan H. DNA damage focus analysis in blood samples of minipigs reveals acute partial body irradiation. PLoS One 2014; 9:e87458. [PMID: 24498326 PMCID: PMC3911974 DOI: 10.1371/journal.pone.0087458] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 12/27/2013] [Indexed: 11/18/2022] Open
Abstract
Radiation accidents frequently involve acute high dose partial body irradiation leading to victims with radiation sickness and cutaneous radiation syndrome that implements radiation-induced cell death. Cells that are not lethally hit seek to repair ionizing radiation (IR) induced damage, albeit at the expense of an increased risk of mutation and tumor formation due to misrepair of IR-induced DNA double strand breaks (DSBs). The response to DNA damage includes phosphorylation of histone H2AX in the vicinity of DSBs, creating foci in the nucleus whose enumeration can serve as a radiation biodosimeter. Here, we investigated γH2AX and DNA repair foci in peripheral blood lymphocytes of Göttingen minipigs that experienced acute partial body irradiation (PBI) with 49 Gy (±6%) Co-60 γ-rays of the upper lumbar region. Blood samples taken 4, 24 and 168 hours post PBI were subjected to γ-H2AX, 53BP1 and MRE11 focus enumeration. Peripheral blood lymphocytes (PBL) of 49 Gy partial body irradiated minipigs were found to display 1–8 DNA damage foci/cell. These PBL values significantly deceed the high foci numbers observed in keratinocyte nuclei of the directly γ-irradiated minipig skin regions, indicating a limited resident time of PBL in the exposed tissue volume. Nonetheless, PBL samples obtained 4 h post IR in average contained 2.2% of cells displaying a pan-γH2AX signal, suggesting that these received a higher IR dose. Moreover, dispersion analysis indicated partial body irradiation for all 13 minipigs at 4 h post IR. While dose reconstruction using γH2AX DNA repair foci in lymphocytes after in vivo PBI represents a challenge, the DNA damage focus assay may serve as a rapid, first line indicator of radiation exposure. The occurrence of PBLs with pan-γH2AX staining and of cells with relatively high foci numbers that skew a Poisson distribution may be taken as indicator of acute high dose partial body irradiation, particularly when samples are available early after IR exposure.
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Affiliation(s)
- Andreas Lamkowski
- Institut für Radiobiologie der Bundeswehr in Verb. mit der Universität Ulm, München, Germany
| | - Fabien Forcheron
- Institut de Recherche Biomédicale des Armées (IRBA), Bretigny sur Orge, France
| | - Diane Agay
- Institut de Recherche Biomédicale des Armées (IRBA), Bretigny sur Orge, France
| | - Emad A. Ahmed
- Institut für Radiobiologie der Bundeswehr in Verb. mit der Universität Ulm, München, Germany
| | - Michel Drouet
- Institut de Recherche Biomédicale des Armées (IRBA), Bretigny sur Orge, France
| | - Viktor Meineke
- Institut für Radiobiologie der Bundeswehr in Verb. mit der Universität Ulm, München, Germany
| | - Harry Scherthan
- Institut für Radiobiologie der Bundeswehr in Verb. mit der Universität Ulm, München, Germany
- * E-mail:
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