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Little MP, Bazyka D, de Gonzalez AB, Brenner AV, Chumak VV, Cullings HM, Daniels RD, French B, Grant E, Hamada N, Hauptmann M, Kendall GM, Laurier D, Lee C, Lee WJ, Linet MS, Mabuchi K, Morton LM, Muirhead CR, Preston DL, Rajaraman P, Richardson DB, Sakata R, Samet JM, Simon SL, Sugiyama H, Wakeford R, Zablotska LB. A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure. Radiat Res 2024; 202:432-487. [PMID: 39021204 PMCID: PMC11316622 DOI: 10.1667/rade-24-00021.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024]
Abstract
In this article we review the history of key epidemiological studies of populations exposed to ionizing radiation. We highlight historical and recent findings regarding radiation-associated risks for incidence and mortality of cancer and non-cancer outcomes with emphasis on study design and methods of exposure assessment and dose estimation along with brief consideration of sources of bias for a few of the more important studies. We examine the findings from the epidemiological studies of the Japanese atomic bomb survivors, persons exposed to radiation for diagnostic or therapeutic purposes, those exposed to environmental sources including Chornobyl and other reactor accidents, and occupationally exposed cohorts. We also summarize results of pooled studies. These summaries are necessarily brief, but we provide references to more detailed information. We discuss possible future directions of study, to include assessment of susceptible populations, and possible new populations, data sources, study designs and methods of analysis.
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Affiliation(s)
- Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
- Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Oxford, OX3 0BP, UK
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | | | - Alina V. Brenner
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | - Harry M. Cullings
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eric Grant
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 1646 Abiko, Chiba 270-1194, Japan
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Gerald M. Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety, Fontenay aux Roses France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Martha S. Linet
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Lindsay M. Morton
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | | | | | - Preetha Rajaraman
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - David B. Richardson
- Environmental and Occupational Health, 653 East Peltason, University California, Irvine, Irvine, CA 92697-3957 USA
| | - Ritsu Sakata
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Hiromi Sugiyama
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16 Street, 2 floor, San Francisco, CA 94143, USA
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Carrothers E, Appleby M, Lai V, Kozbenko T, Alomar D, Smith BJ, Hamada N, Hinton P, Ainsbury EA, Hocking R, Yauk C, Wilkins RC, Chauhan V. AOP report: Development of an adverse outcome pathway for deposition of energy leading to cataracts. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2024. [PMID: 38644659 DOI: 10.1002/em.22594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/23/2024]
Abstract
Cataracts are one of the leading causes of blindness, with an estimated 95 million people affected worldwide. A hallmark of cataract development is lens opacification, typically associated not only with aging but also radiation exposure as encountered by interventional radiologists and astronauts during the long-term space mission. To better understand radiation-induced cataracts, the adverse outcome pathway (AOP) framework was used to structure and evaluate knowledge across biological levels of organization (e.g., macromolecular, cell, tissue, organ, organism and population). AOPs identify a sequence of key events (KEs) causally connected by key event relationships (KERs) beginning with a molecular initiating event to an adverse outcome (AO) of relevance to regulatory decision-making. To construct the cataract AO and retrieve evidence to support it, a scoping review methodology was used to filter, screen, and review studies based on the modified Bradford Hill criteria. Eight KEs were identified that were moderately supported by empirical evidence (e.g., dose-, time-, incidence-concordance) across the adjacent (directly linked) relationships using well-established endpoints. Over half of the evidence to justify the KER linkages was derived from the evidence stream of biological plausibility. Early KEs of oxidative stress and protein modifications had strong linkages to downstream KEs and could be the focus of countermeasure development. Several identified knowledge gaps and inconsistencies related to the quantitative understanding of KERs which could be the basis of future research, most notably directed to experiments in the range of low or moderate doses and dose-rates, relevant to radiation workers and other occupational exposures.
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Affiliation(s)
- Emma Carrothers
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Meghan Appleby
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Vita Lai
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Tatiana Kozbenko
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Dalya Alomar
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Benjamin J Smith
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Chiba, Japan
| | - Patricia Hinton
- Defense Research & Development Canada, Canadian Forces Environmental Medicine Establishment, Toronto, Ontario, Canada
| | - Elizabeth A Ainsbury
- Radiation, Chemical and Environmental Hazards Division, UK Health Security Agency, Birmingham, UK
- Environmental Research Group within the School of Public Health, Faculty of Medicine at Imperial College of Science, Technology and Medicine, London, UK
| | - Robyn Hocking
- Learning and Knowledge and Library Services, Health Canada, Ottawa, Ontario, Canada
| | - Carole Yauk
- Department of Biology, University of Ottawa, Ottawa, Ontario, Canada
| | - Ruth C Wilkins
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Vinita Chauhan
- Consumer and Clinical Radiation Protection Bureau, Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
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Kleiman NJ, Edmondson EF, Weil MM, Fallgren CM, King A, Schmidt C, Hall EJ. Radiation cataract in Heterogeneous Stock mice after γ-ray or HZE ion exposure. LIFE SCIENCES IN SPACE RESEARCH 2024; 40:97-105. [PMID: 38245354 PMCID: PMC10800003 DOI: 10.1016/j.lssr.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 01/22/2024]
Abstract
Health effects of space radiation are a serious concern for astronauts on long-duration missions. The lens of the eye is one of the most radiosensitive tissues in the body and, therefore, ocular health risks for astronauts is a significant concern. Studies in humans and animals indicate that ionizing radiation exposure to the eye produces characteristic lens changes, termed "radiation cataract," that can affect visual function. Animal models of radiation cataractogenesis have previously utilized inbred mouse or rat strains. These studies were essential for determining morphological changes and dose-response relationships between radiation exposure and cataract. However, the relevance of these studies to human radiosensitivity is limited by the narrow phenotypic range of genetically homogeneous animal models. To model radiation cataract in genetically diverse populations, longitudinal cataract phenotyping was nested within a lifetime carcinogenesis study in male and female heterogeneous stock (HS/Npt) mice exposed to 0.4 Gy HZE ions (n = 609) or 3.0 Gy γ-rays (n = 602) and in unirradiated controls (n = 603). Cataractous change was quantified in each eye for up to 2 years using Merriam-Focht grading criteria by dilated slit lamp examination. Virtual Optomotry™ measurement of visual acuity and contrast sensitivity was utilized to assess visual function in a subgroup of mice. Prevalence and severity of posterior lens opacifications were 2.6-fold higher in HZE ion and 2.3-fold higher in γ-ray irradiated mice compared to unirradiated controls. Male mice were at greater risk for spontaneous and radiation associated cataracts. Risk for cataractogenesis was associated with family structure, demonstrating that HS/Npt mice are well-suited to evaluate genetic determinants of ocular radiosensitivity. Last, mice were extensively evaluated for cataract and tumor formation, which revealed an overlap between individual susceptibility to both cancer and cataract.
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Affiliation(s)
- Norman J Kleiman
- Department of Environmental Health Sciences, Eye Radiation and Environmental Research Laboratory, Columbia University, Mailman School of Public Health, 722 West 168th St., 11th Floor, New York, NY, 10032, United States.
| | - Elijah F Edmondson
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, 80523, United States; Frederick National Laboratory for Cancer Research, Frederick, Maryland, 21702, United States
| | - Michael M Weil
- Department of Environment and Radiological Health Sciences, Colorado State University, Fort Collins, CO, 80523, United States
| | - Christina M Fallgren
- Department of Environment and Radiological Health Sciences, Colorado State University, Fort Collins, CO, 80523, United States
| | - Adam King
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, 80523, United States; MedVet Chicago, Chicago, IL, 60618, United States
| | - Catherine Schmidt
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, 80523, United States; Veterinary Eye Specialists, Thornwood, NY, 10594, , United States
| | - Eric J Hall
- Center for Radiological Research, Columbia University, College of Physicians and Surgeons, 630W. 168th St., New York, NY,10032, , United States
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Emami P, Gaudreau K, Little MP, Lee C, Moroz B, Boreham DR, Thome C. Assessment of Cataract Risk after Diagnostic Head CT Scan Radiation Exposure in Ontario, Canada. Radiat Res 2024; 201:1-6. [PMID: 38014578 PMCID: PMC11288167 DOI: 10.1667/rade-23-00179.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/03/2023] [Indexed: 11/29/2023]
Abstract
Ionizing radiation is one of the known risk factors for cataract development, however, there is still debate regarding the level of risk after low dose exposures. One of the largest sources of radiation exposure to the lens of the eye is diagnostic CT scans. The aim of this study was to examine whether ionizing radiation associated with head CT scans increases cataract risk in residents of Ontario, Canada. Data were collected from January 1, 1994 to December 31, 2015 (22 years) from anonymized Ontario Health Insurance Plan (OHIP) medical records for over 16 million subjects. A lens dose was estimated for each CT scan using the National Cancer Institute dosimetry system for CT (NCICT) program combined with Canada-specific CTDIvol data. Multivariate Cox proportional hazards analysis was performed with cataract extraction surgery as the primary outcome and lens dose as the main variable of interest, with inclusion of various medical and demographic covariates. Lag periods of 3, 5 and 7 years were incorporated. When lens dose was treated as a continuous variable, hazard ratios (per 100 mGy) ranged from 0.82 (0.80-0.84) to 1.10 (1.09-1.11) depending on the lag period. As a secondary analysis, when individuals were binned based on their total cumulative dose, no significant dose response pattern was observed in the low dose region. Overall, within the bounds of this study, the data do not support an increased risk of vision impairing cataracts after diagnostic head CT scan radiation exposure.
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Affiliation(s)
- Pirouz Emami
- Department of Physics & Astronomy, McMaster University, Hamilton, ON, Canada
| | | | - Mark P. Little
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | - Choonsik Lee
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | - Brian Moroz
- Computing and Software Solution for Science, LLC., Bethany Beach, DE, USA
| | - Douglas R. Boreham
- Medical Sciences Division, NOSM University, Sudbury, ON, Canada
- School of Natural Sciences, Laurentian University, Sudbury, ON, Canada
| | - Christopher Thome
- Medical Sciences Division, NOSM University, Sudbury, ON, Canada
- School of Natural Sciences, Laurentian University, Sudbury, ON, Canada
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Hamada N. Noncancer Effects of Ionizing Radiation Exposure on the Eye, the Circulatory System and beyond: Developments made since the 2011 ICRP Statement on Tissue Reactions. Radiat Res 2023; 200:188-216. [PMID: 37410098 DOI: 10.1667/rade-23-00030.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
For radiation protection purposes, noncancer effects with a threshold-type dose-response relationship have been classified as tissue reactions (formerly called nonstochastic or deterministic effects), and equivalent dose limits aim to prevent occurrence of such tissue reactions. Accumulating evidence demonstrates increased risks for several late occurring noncancer effects at doses and dose rates much lower than previously considered. In 2011, the International Commission on Radiological Protection (ICRP) issued a statement on tissue reactions to recommend a threshold of 0.5 Gy to the lens of the eye for cataracts and to the heart and brain for diseases of the circulatory system (DCS), independent of dose rate. Literature published thereafter continues to provide updated knowledge. Increased risks for cataracts below 0.5 Gy have been reported in several cohorts (e.g., including in those receiving protracted or chronic exposures). A dose threshold for cataracts is less evident with longer follow-up, with limited evidence available for risk of cataract removal surgery. There is emerging evidence for risk of normal-tension glaucoma and diabetic retinopathy, but the long-held tenet that the lens represents among the most radiosensitive tissues in the eye and in the body seems to remain unchanged. For DCS, increased risks have been reported in various cohorts, but the existence or otherwise of a dose threshold is unclear. The level of risk is less uncertain at lower dose and lower dose rate, with the possibility that risk per unit dose is greater at lower doses and dose rates. Target organs and tissues for DCS are also unknown, but may include heart, large blood vessels and kidneys. Identification of potential factors (e.g., sex, age, lifestyle factors, coexposures, comorbidities, genetics and epigenetics) that may modify radiation risk of cataracts and DCS would be important. Other noncancer effects on the radar include neurological effects (e.g., Parkinson's disease, Alzheimer's disease and dementia) of which elevated risk has increasingly been reported. These late occurring noncancer effects tend to deviate from the definition of tissue reactions, necessitating more scientific developments to reconsider the radiation effect classification system and risk management. This paper gives an overview of historical developments made in ICRP prior to the 2011 statement and an update on relevant developments made since the 2011 ICRP statement.
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Affiliation(s)
- Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Chiba, Japan
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Ali F, Richardson RB. Electron, Photon, and Neutron Dose Conversion Coefficients of Lens and Non-Lens Tissues Using a Multi-Tissue Eye Model to Assess Risk of Cataracts and Retinitis. Radiat Res 2023; 200:162-175. [PMID: 37410087 DOI: 10.1667/rade-23-00023.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/02/2023] [Indexed: 07/07/2023]
Abstract
Previous publications describe the estimation of the dose from ionizing radiation to the whole lens or parts of it but have not considered other eye tissues that are implicated in cataract development; this is especially critical for low-dose, low-ionizing-density exposures. A recent review of the biological mechanisms of radiation-induced cataracts showed that lenticular oxidative stress can be increased by inflammation and vascular damage to non-lens tissues in the eye. Also, the radiation oxygen effect indicates different radiosensitivities for the vascular retina and the severely hypoxic lens. Therefore, this study uses the Monte Carlo N-Particle simulations to quantify dose conversion coefficients for several eye tissues for incident antero-posterior exposure to electrons, photons, and neutrons (and the tertiary electron component of neutron exposure). A stylized, multi-tissue eye model was developed by modifying a model by Behrens etal. (2009) to include the retina, uvea, sclera, and lens epithelial cell populations. Electron exposures were simulated as a single eye, whereas photon and neutron exposures were simulated employing two eyes embedded in the ADAM-EVA phantom. For electrons and photons, dose conversion coefficients are highest for either anterior tissues for low-energy incident particles or posterior tissues for high-energy incident particles. Neutron dose conversion coefficients generally increase with increasing incident energy for all tissues. The ratio of the absorbed dose delivered to each tissue to the absorbed dose delivered to the whole lens demonstrated the considerable deviation of non-lens tissue doses from lens doses, depending on particle type and its energy. These simulations demonstrate that there are large variations in the dose to various ocular tissues depending on the incident radiation dose coefficients; this large variation will potentially impact cataract development.
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Affiliation(s)
- Fawaz Ali
- Canadian Nuclear Laboratories, Chalk River, Canada
| | - Richard B Richardson
- Canadian Nuclear Laboratories, Chalk River, Canada
- McGill University, Montreal, Canada
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Abstract
PURPOSE Cataract (opacification of the ocular lens) is a typical tissue reaction (deterministic effect) following ionizing radiation exposure, for which prevention dose limits have been recommended in the radiation protection system. Manifestations of radiation cataracts can vary among individuals, but such potential individual responses remain uncharacterized. Here we review relevant literature and discuss implications for radiation protection. This review assesses evidence for significant modification of radiation-induced cataractogenesis by age at exposure, sex and genetic factors based on current scientific literature. CONCLUSIONS In addition to obvious physical factors (e.g. dose, dose rate, radiation quality, irradiation volume), potential factors modifying individual responses for radiation cataracts include sex, age and genetics, with comorbidity and coexposures also having important roles. There are indications and preliminary data identifying such potential modifiers of radiation cataract incidence or risk, although no firm conclusions can yet be drawn. Further studies and a consensus on the evidence are needed to gain deeper insights into factors determining individual responses regarding radiation cataracts and the implications for radiation protection.
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Affiliation(s)
- Stephen G R Barnard
- UK Health Security Agency (UKHSA), Radiation, Chemical and Environmental Hazards Division (RCEHD), Didcot, UK
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan
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Candido KD, Malcolm T. Fluoroscopic Safety. Regen Med 2023. [DOI: 10.1007/978-3-030-75517-1_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Simon S, Kendall G, Bouffler S, Little M. The Evidence for Excess Risk of Cancer and Non-Cancer Disease at Low Doses and Dose Rates. Radiat Res 2022; 198:615-624. [PMID: 36136740 PMCID: PMC9797580 DOI: 10.1667/rade-22-00132.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/06/2022] [Indexed: 12/31/2022]
Abstract
The question of whether there are excess radiation-associated health risks at low dose is controversial. We present evidence of excess cancer risks in a number of (largely pediatrically or in utero exposed) groups exposed to low doses of radiation (<0.1 Gy). Moreover, the available data on biological mechanisms do not provide support for the idea of a low-dose threshold or hormesis for any of these endpoints. There are emerging data suggesting risks of cardiovascular disease and cataract at low doses, but this is less well established. This large body of evidence does not suggest and, indeed, is not statistically compatible with any very large threshold in dose (>10 mGy), or with possible beneficial effects from exposures. The presented data suggest that exposure to low-dose radiation causes excess cancer risks and quite possibly also excess risks of various non-cancer endpoints.
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Affiliation(s)
- S.L. Simon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (retired)
| | - G.M. Kendall
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom
| | - S.D. Bouffler
- Radiation Effects Department, UK Health Security Agency (UKHSA), Chilton, Didcot OX11 0RQ, United Kingdom
| | - M.P. Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-9778
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Cheng KL, Huang JY, Weng JH, Chiou JY, Lan CT, Tung KC. 18F-FDG PET/CT Did Not Increase the Risk of Cataract Occurrence in Oncology Patients: A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137651. [PMID: 35805310 PMCID: PMC9265417 DOI: 10.3390/ijerph19137651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/11/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the risk of cataract formation associated with radiation exposure from 18F-FDG PET/CT in oncology patients, using data from Taiwan’s National Health Insurance Research Database. The exposed group (Group E) consisted of oncology patients receiving 18F-FDG PET/CT within the first year of a cancer diagnosis. The comparison group (Group C) included subjects who had never been exposed to 18F-FDG PET/CT radiation and were propensity score-matched by date of enrolment, age, sex, cancer type, associated comorbidities, and CT utilization. Multiple Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) of cataract risk due to radiation exposure, while adjusting for potential confounding factors. A total of 703 patients and 1406 matched subjects were in Groups E and C, respectively. The incidence of cataract formation was not significantly higher among subjects in Group E (adjusted HR = 1.264; 95% confidence interval [CI] = 0.845–1.891). Our results revealed that 18F-FDG PET/CT was not a significant risk factor for developing cataracts in oncology patients.
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Affiliation(s)
- Kai-Lun Cheng
- Department of Veterinary Medicine, National Chung Hsing University, 250 Kuo Kuang Road, Taichung 40227, Taiwan;
- Department of Medical Imaging, Chung Shan Medical University Hospital, 110 Jianguo North Road, Taichung 40201, Taiwan
- School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan
| | - Jing-Yang Huang
- Center for Health Data Science, Chung Shan Medical University Hospital, 110 Jianguo North Road, Taichung 40201, Taiwan;
- Institute of Medicine, College of Medicine, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan
| | - Jui-Hung Weng
- Department of Nuclear Medicine, Chung Shan Medical University Hospital, 110 Jianguo North Road, Taichung 40201, Taiwan;
- School of Medicine, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan
| | - Jeng-Yuan Chiou
- School of Health Policy and Management, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan;
| | - Chyn-Tair Lan
- Department of Anatomy, Faculty of Medicine, Chung Shan Medical University, 110 Jianguo North Road, Taichung 40201, Taiwan;
| | - Kwong-Chung Tung
- Department of Veterinary Medicine, National Chung Hsing University, 250 Kuo Kuang Road, Taichung 40227, Taiwan;
- Correspondence:
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Kellermann F, Hödlmoser H, Leister I, Seidenbusch M, Treitl M, Wagner F, Militz M, Stuby F. [Radiation exposure of the eye lens in orthopedics and trauma surgery : A pilot study]. Unfallchirurg 2022; 126:399-404. [PMID: 35384465 DOI: 10.1007/s00113-022-01163-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND On 27 June 2017 the Act on new regulation of the law for the protection against the harmful effects of ionizing radiation was passed. One of the main innovations in daily surgical practice in the now legally stipulated provisions is the lowering of the eye lens dose to 20 mSv/year (§§ 78, 212 Radiation Protection Act, StrlSchG). MATERIAL AND METHODS To estimate the level of exposure of the eye lens to ionizing radiation that is to be expected in the course of surgical interventions, the dose that surgeons receive during surgery was determined. For this, the radiation exposure adjacent to the eye lens was measured using a forehead dosimeter while performing surgical interventions over a period of 8 weeks in 2 different operating rooms. RESULTS As a result, a mean estimated eye lens radiation dose Hp (3) of 190 µSv could be determined during the 2‑month study period. Thus, the estimated cumulative radiation dose in 1 year of approximately 1.2 mSv was significantly below the threshold of 20 mSv/year. CONCLUSION By complying with the common radiation protection measures in the context of operative interventions in orthopedics and trauma surgery, the legal limit value of 20 mSv/year is generally not expected to be exceeded.
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Affiliation(s)
- F Kellermann
- Septische und Rekonstruktive Chirurgie, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Deutschland.
- , Professor-Küntscher-Straße 8, 82418, Murnau am Staffelsee, Deutschland.
| | - H Hödlmoser
- Auswertungsstelle für Strahlendosimeter München-Neuperlach, Mirion Technologies, München-Neuperlach, Deutschland
| | - I Leister
- ParaMove, Berufsgenossenschaftliche Unfallklinik Murnau und Paracelsus Medizinische Privatuniversität Salzburg, Salzburg, Deutschland
- Zentrum für Rückenmarkverletzte mit Neurourologie, Berufsgenossenschaftliche Unfallklinik, Murnau, Deutschland
- Institut für Molekulare Regenerative Medizin, Paracelsus Medizinische Privatuniversität Salzburg, Salzburg, Deutschland
- Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medizinische Privatuniversität Salzburg, Salzburg, Deutschland
| | - M Seidenbusch
- Abteilung Radiologie, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Deutschland
| | - M Treitl
- Abteilung Radiologie, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Deutschland
| | - F Wagner
- Septische und Rekonstruktive Chirurgie, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Deutschland
| | - M Militz
- Septische und Rekonstruktive Chirurgie, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Deutschland
| | - F Stuby
- Abteilung Unfallchirurgie, Orthopädie und Allgemeinchirurgie, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Deutschland
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12
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Barnard S, Uwineza A, Kalligeraki A, McCarron R, Kruse F, Ainsbury EA, Quinlan RA. Lens Epithelial Cell Proliferation in Response to Ionizing Radiation. Radiat Res 2022; 197:92-99. [PMID: 33984857 DOI: 10.1667/rade-20-00294.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/20/2021] [Indexed: 11/03/2022]
Abstract
Lens epithelial cell proliferation and differentiation are naturally well regulated and controlled, a characteristic essential for lens structure, symmetry and function. The effect of ionizing radiation on lens epithelial cell proliferation has been demonstrated in previous studies at high acute doses, but the effect of dose and dose rate on proliferation has not yet been considered. In this work, mice received single acute doses of 0.5, 1 and 2 Gy of radiation, at dose rates of 0.063 and 0.3 Gy/min. Eye lenses were isolated postirradiation at 30 min up until 14 days and flat-mounted. Then, cell proliferation rates were determined using biomarker Ki67. As expected, radiation increased cell proliferation 2 and 24 h postirradiation transiently (undetectable 14 days postirradiation) and was dose dependent (changes were very significant at 2 Gy; P = 0.008). A dose-rate effect did not reach significance in this study (P = 0.054). However, dose rate and lens epithelial cell region showed significant interactions (P < 0.001). These observations further our mechanistic understanding of how the lens responds to radiation.
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Affiliation(s)
- S Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH13LE, United Kingdom
| | - A Uwineza
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH13LE, United Kingdom
| | - A Kalligeraki
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH13LE, United Kingdom
| | - R McCarron
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - F Kruse
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
- Department of Oncology, CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - E A Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - R A Quinlan
- Department of Biosciences, University of Durham, Mountjoy Science Site, Durham DH13LE, United Kingdom
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13
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Ainsbury EA, Barnard SGR. Sensitivity and latency of ionising radiation-induced cataract. Exp Eye Res 2021; 212:108772. [PMID: 34562436 DOI: 10.1016/j.exer.2021.108772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/26/2021] [Accepted: 09/20/2021] [Indexed: 01/29/2023]
Abstract
When managed with appropriate radiation protection procedures, ionising radiation is of great benefit to society. Opacification of the lens, and vision impairing cataract, have recently been recognised at potential effects of relatively low dose radiation exposure, on the order of 1 Gy or below. Within the last 10 years, understanding of the effects of low dose ionising radiation on the lens has increased, particularly in terms of DNA damage and responses, and how multiple radiation or other events in the lens might contribute to the overall risk of cataract. However, gaps remain, not least in the understanding of how radiation interacts with other risk factors such as aging, as well as the relative radiosensitivity of the lens compared to tissues of the body. This paper reviews the current literature in the field of low dose radiation cataract, with a particular focus on sensitivity and latency.
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Affiliation(s)
- Elizabeth A Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot Oxford, OX11 ORQ, UK.
| | - Stephen G R Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot Oxford, OX11 ORQ, UK.
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14
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Patel S, Vargo JA, Olson A, Mahajan A. Supportive care for toxicities in children undergoing radiation therapy. Pediatr Blood Cancer 2021; 68 Suppl 2:e28597. [PMID: 33818886 DOI: 10.1002/pbc.28597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/16/2020] [Accepted: 07/01/2020] [Indexed: 11/08/2022]
Abstract
Radiation therapy (RT) is an integral part of the management of many pediatric tumors; however, it is associated with both acute and permanent adverse events that can significantly impact a child's quality of life, lead to treatment delays, and potentially affect outcomes of cancer therapy. Prevention, early detection, and optimal management of these adverse effects will help reduce their impact on the patients' quality of life and overall well-being. Unfortunately, there has not been a coordinated effort to study the etiology, evaluate risk factors, and explore novel treatments for these conditions. Studies of supportive care for children undergoing RT are often small and uncontrolled. This review will focus on the impact of irradiation on the different organ systems and their current management. Further studies are required to improve our understanding of the contributing factors and explore novel treatment options for these adverse effects and to enable children and their families to better cope with some of the unavoidable toxicities following multimodality therapy.
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Affiliation(s)
- Samir Patel
- Divisions of Radiation Oncology and Pediatric Hematology, Oncology and Palliative Care, University of Alberta, Stollery Children's Hospital, Edmonton, Canada
| | - John Austin Vargo
- Department of Radiation Oncology, UPMC Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Adam Olson
- Department of Radiation Oncology, UPMC Children's Hospital of Pittsburg, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Anita Mahajan
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
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15
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Kunze S, Cecil A, Prehn C, Möller G, Ohlmann A, Wildner G, Thurau S, Unger K, Rößler U, Hölter SM, Tapio S, Wagner F, Beyerlein A, Theis F, Zitzelsberger H, Kulka U, Adamski J, Graw J, Dalke C. Posterior subcapsular cataracts are a late effect after acute exposure to 0.5 Gy ionizing radiation in mice. Int J Radiat Biol 2021; 97:529-540. [PMID: 33464160 DOI: 10.1080/09553002.2021.1876951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/28/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The long-term effect of low and moderate doses of ionizing radiation on the lens is still a matter of debate and needs to be evaluated in more detail. MATERIAL AND METHODS We conducted a detailed histological analysis of eyes from B6C3F1 mice cohorts after acute gamma irradiation (60Co source; 0.063 Gy/min) at young adult age of 10 weeks with doses of 0.063, 0.125, and 0.5 Gy. Sham irradiated (0 Gy) mice were used as controls. To test for genetic susceptibility heterozygous Ercc2 mutant mice were used and compared to wild-type mice of the same strain background. Mice of both sexes were included in all cohorts. Eyes were collected 4 h, 12, 18 and 24 months after irradiation. For a better understanding of the underlying mechanisms, metabolomics analyses were performed in lenses and plasma samples of the same mouse cohorts at 4 and 12 h as well as 12, 18 and 24 months after irradiation. For this purpose, a targeted analysis was chosen. RESULTS This analysis revealed histological changes particularly in the posterior part of the lens that rarely can be observed by using Scheimpflug imaging, as we reported previously. We detected a significant increase of posterior subcapsular cataracts (PSCs) 18 and 24 months after irradiation with 0.5 Gy (odds ratio 9.3; 95% confidence interval 2.1-41.3) independent of sex and genotype. Doses below 0.5 Gy (i.e. 0.063 and 0.125 Gy) did not significantly increase the frequency of PSCs at any time point. In lenses, we observed a clear effect of sex and aging but not of irradiation or genotype. While metabolomics analyses of plasma from the same mice showed only a sex effect. CONCLUSIONS This article demonstrates a significant radiation-induced increase in the incidence of PSCs, which could not be identified using Scheimpflug imaging as the only diagnostic tool.
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Affiliation(s)
- Sarah Kunze
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Neuherberg, Germany
| | - Alexander Cecil
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Cornelia Prehn
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Gabriele Möller
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Andreas Ohlmann
- Department of Ophthalmology, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Gerhild Wildner
- Department of Ophthalmology, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Stephan Thurau
- Department of Ophthalmology, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Kristian Unger
- Research Unit Radiation Cytogenetics, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Ute Rößler
- Department Radiation Protection and Health, Federal Office of Radiation Protection, Oberschleissheim, Germany
| | - Sabine M Hölter
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Neuherberg, Germany
| | - Soile Tapio
- Institute of Radiation Biology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
- School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian Wagner
- Institute of Radiation Medicine, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Fabian Theis
- Institute of Computational Biology, Neuherberg, Germany
| | - Horst Zitzelsberger
- Research Unit Radiation Cytogenetics, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Ulrike Kulka
- Department Radiation Protection and Health, Federal Office of Radiation Protection, Oberschleissheim, Germany
| | - Jerzy Adamski
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
- Lehrstuhl für Experimentelle Genetik, Technical University of Munich, Freising-Weihenstephan, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jochen Graw
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Neuherberg, Germany
| | - Claudia Dalke
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Neuherberg, Germany
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16
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Little MP, Azizova TV, Hamada N. Low- and moderate-dose non-cancer effects of ionizing radiation in directly exposed individuals, especially circulatory and ocular diseases: a review of the epidemiology. Int J Radiat Biol 2021; 97:782-803. [PMID: 33471563 PMCID: PMC10656152 DOI: 10.1080/09553002.2021.1876955] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/24/2020] [Accepted: 01/09/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE There are well-known correlations between high and moderate doses (>0.5 Gy) of ionizing radiation exposure and circulatory system damage, also between radiation and posterior subcapsular cataract. At lower dose correlations with circulatory disease are emerging in the Japanese atomic bomb survivors and in some occupationally exposed groups, and are still to some extent controversial. Heterogeneity in excess relative risks per unit dose in epidemiological studies at low (<0.1 Gy) and at low-moderate (>0.1 Gy, <0.5 Gy) doses may result from confounding and other types of bias, and effect modification by established risk factors. There is also accumulating evidence of excess cataract risks at lower dose and low dose rate in various cohorts. Other ocular endpoints, specifically glaucoma and macular degeneration have been little studied. In this paper, we review recent epidemiological findings, and also discuss some of the underlying radiobiology of these conditions. We briefly review some other types of mainly neurological nonmalignant disease in relation to radiation exposure. CONCLUSIONS We document statistically significant excess risk of the major types of circulatory disease, specifically ischemic heart disease and stroke, in moderate- or low-dose exposed groups, with some not altogether consistent evidence suggesting dose-response non-linearity, particularly for stroke. However, the patterns of risk reported are not straightforward. We also document evidence of excess risks at lower doses/dose-rates of posterior subcapsular and cortical cataract in the Chernobyl liquidators, US Radiologic Technologists and Russian Mayak nuclear workers, with fundamentally linear dose-response. Nuclear cataracts are less radiogenic. For other ocular endpoints, specifically glaucoma and macular degeneration there is very little evidence of effects at low doses; radiation-associated glaucoma has been documented only for doses >5 Gy, and so has the characteristics of a tissue reaction. There is some evidence of neurological detriment following low-moderate dose (∼0.1-0.2 Gy) radiation exposure in utero or in early childhood.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Tamara V Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorsk, Ozyorsk Chelyabinsk Region, Russia
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Komae, Tokyo, Japan
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17
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Ainsbury EA, Dalke C, Hamada N, Benadjaoud MA, Chumak V, Ginjaume M, Kok JL, Mancuso M, Sabatier L, Struelens L, Thariat J, Jourdain JR. Radiation-induced lens opacities: Epidemiological, clinical and experimental evidence, methodological issues, research gaps and strategy. ENVIRONMENT INTERNATIONAL 2021; 146:106213. [PMID: 33276315 DOI: 10.1016/j.envint.2020.106213] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/11/2020] [Accepted: 08/25/2020] [Indexed: 06/12/2023]
Abstract
In 2011, the International Commission on Radiological Protection (ICRP) recommended reducing the occupational equivalent dose limit for the lens of the eye from 150 mSv/year to 20 mSv/year, averaged over five years, with no single year exceeding 50 mSv. With this recommendation, several important assumptions were made, such as lack of dose rate effect, classification of cataracts as a tissue reaction with a dose threshold at 0.5 Gy, and progression of minor opacities into vision-impairing cataracts. However, although new dose thresholds and occupational dose limits have been set for radiation-induced cataract, ICRP clearly states that the recommendations are chiefly based on epidemiological evidence because there are a very small number of studies that provide explicit biological and mechanistic evidence at doses under 2 Gy. Since the release of the 2011 ICRP statement, the Multidisciplinary European Low Dose Initiative (MELODI) supported in April 2019 a scientific workshop that aimed to review epidemiological, clinical and biological evidence for radiation-induced cataracts. The purpose of this article is to present and discuss recent related epidemiological and clinical studies, ophthalmic examination techniques, biological and mechanistic knowledge, and to identify research gaps, towards the implementation of a research strategy for future studies on radiation-induced lens opacities. The authors recommend particularly to study the effect of ionizing radiation on the lens in the context of the wider, systemic effects, including in the retina, brain and other organs, and as such cataract is recommended to be studied as part of larger scale programs focused on multiple radiation health effects.
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Affiliation(s)
- Elizabeth A Ainsbury
- Public Health England (PHE) Centre for Radiation, Chemical and Environmental Hazards, Oxon, United Kingdom.
| | - Claudia Dalke
- Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Germany.
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan.
| | - Mohamed Amine Benadjaoud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP 17, 31 avenue de la division Leclerc, Fontenay-aux-Roses, France.
| | - Vadim Chumak
- National Research Centre for Radiation Medicine, Ukraine.
| | | | - Judith L Kok
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Mariateresa Mancuso
- Laboratory of Biomedical Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, (ENEA), Rome, Italy.
| | - Laure Sabatier
- Commissariat à l'Energie Atomique et aux Energies Alternatives, Saclay, France.
| | | | - Juliette Thariat
- Laboratoire de physique corpusculaire IN2P3/ENSICAEN -UMR6534 - Unicaen - Normandie University, France
| | - Jean-René Jourdain
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP 17, 31 avenue de la division Leclerc, Fontenay-aux-Roses, France.
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18
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Laiakis EC, Chauhan V, Little MP, Woloschak GE, Weil MM, Hamada N. Summary of the Second Bill Morgan Memorial Symposium: an update on low dose biology, epidemiology, its integration and implications for radiation protection. Int J Radiat Biol 2020; 97:861-865. [PMID: 33252285 PMCID: PMC10655691 DOI: 10.1080/09553002.2020.1855373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Evagelia C. Laiakis
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Vinita Chauhan
- Consumer and Clinical Radiation Protection Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Gayle E. Woloschak
- Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Michael M. Weil
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo 201-8511, Japan
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19
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Hamada N, Azizova TV, Little MP. An update on effects of ionizing radiation exposure on the eye. Br J Radiol 2020; 93:20190829. [PMID: 31670577 PMCID: PMC8519632 DOI: 10.1259/bjr.20190829] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/20/2019] [Accepted: 10/26/2019] [Indexed: 12/18/2022] Open
Abstract
The International Commission on Radiological Protection (ICRP) has considered for over 60 years that the lens of the eye is among the most radiosensitive tissues, and has recommended dose limits for the lens to prevent occurrence of vision impairing cataracts (VICs). Epidemiological evidence that doses much lower than previously thought produce cataracts led ICRP to recommend reducing dose threshold for VICs and reducing an occupational equivalent dose limit for the lens in 2011, when only a single threshold of 0.5 Gy was recommended. On the basis of epidemiological evidence, ICRP assumed progression of minor opacities into VICs and no dose rate effect. This contrasts with previously recommended separate thresholds for minor opacities and VICs, and for different exposure scenarios. Progression was assumed based on similar risks of cataracts and cataract surgery in Japanese atomic bomb survivors. The absence of dose rate effect derived from the observed similar thresholds for protracted exposures in Chernobyl cleanup workers and in atomic bomb survivors. Since 2011, there has been an increasing body of epidemiological evidence relating to cataracts and other ocular diseases (i.e. glaucoma and macular degeneration), particularly at low doses and low dose rates. This review paper gives an overview of the scientific basis of the 2011 ICRP recommendation, discusses the plausibility of these two assumptions in the light of emerging scientific evidence, and considers the radiosensitivity of the lens among ocular structures.
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Affiliation(s)
- Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo 201-8511, Japan
| | - Tamara V. Azizova
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, 456780, Ozersk, Russia
| | - Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, MSC 9778, Bethesda, MD 20892-9778, USA
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20
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Little MP, Patel A, Hamada N, Albert P. Analysis of Cataract in Relationship to Occupational Radiation Dose Accounting for Dosimetric Uncertainties in a Cohort of U.S. Radiologic Technologists. Radiat Res 2020; 194:153-161. [PMID: 32845990 PMCID: PMC10656143 DOI: 10.1667/rr15529.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 05/07/2020] [Indexed: 11/19/2023]
Abstract
Cataract is one of the major morbidities in the U.S. population and it has long been appreciated that high and acutely delivered radiation doses of 1 Gy or more can induce cataract. Some more recent studies, in particular those of the U.S. Radiologic Technologists, have suggested that cataract may be induced by much lower, chronically delivered doses of ionizing radiation. It is well recognized that dosimetric measurement error can substantially alter the shape of the radiation dose-response relationship and thus, the derived study risk estimates, and can also inflate the variance of the estimates. In the current study, we evaluate the impact of uncertainties in eye-lens absorbed doses on the estimated risk of cataract in the U.S. Radiologic Technologists' Monte Carlo Dosimetry System, using both absolute and relative risk models. Among 11,345 cases we show that the inflation in the standard error for the excess relative risk (ERR) is generally modest, at most approximately 20% of the unadjusted standard error, depending on the model used for the baseline risk. The largest adjustment results from use of relative risk models, so that the ERR/Gy and its 95% confidence intervals change from 1.085 (0.645, 1.525) to 1.085 (0.558, 1.612) after adjustment. However, the inflation in the standard error of the excess absolute risk (EAR) coefficient is generally minimal, at most approximately 0.04% of the standard error.
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Affiliation(s)
- Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MD 20892-9778, USA
| | - Ankur Patel
- Radiation Epidemiology Branch, National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MD 20892-9778, USA
- Biostatistics Branch, National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MD 20892-9778, USA
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo 201-8511, Japan
| | - Paul Albert
- Biostatistics Branch, National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MD 20892-9778, USA
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21
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Oh SA, Yea JW, Park JW, Park J. Use of a head-tilting baseplate during volumetric-modulated arc therapy (VMAT) to better protect organs at risk in hippocampal sparing whole brain radiotherapy (HS-WBRT). PLoS One 2020; 15:e0232430. [PMID: 32348379 PMCID: PMC7190113 DOI: 10.1371/journal.pone.0232430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/14/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Coplanar arcs are used with limited arc range to prevent direct beam entrance through the lens, which is challenging for satisfactory planning of hippocampal sparing in whole brain radiotherapy (HS-WBRT) with VMAT. We evaluated the dosimetric impact of applying a head-tilting technique during VMAT, which allows unrestricted use of the arc range. METHODS AND MATERIALS Twenty patients with multiple brain metastases who had received two computed tomography (CT)-simulation sessions between January 2016 and December 2018 were included. One session was delivered in a traditional supine position; the other was delivered with a tilting acrylic supine baseplate (MedTec, USA) to elevate the patients' head by 40°. For each patient, a VMAT without (sVMAT) and with head-tilting (htVMAT) plan was generated. Conformity index (CI), homogeneity index (HI), and organ at risk (OAR) dose were evaluated. The Wilcoxon-signed test was used to compare the effect between two plans. RESULTS The mean CI was 0.860±0.007 and 0.864±0.008 (p<0.05), and mean HI was 0.179±0.020 and 0.167±0.021 (p<0.05) for sVMAT and htVMAT, respectively. The mean dose to the hippocampus (9.91±0.30 Gy) was significantly lower in htVMAT than in sVMAT (10.36±0.29 Gy, P<0.05). htVMAT was associated with significantly reduced mean dose to the parotid gland, and right and left lens (4.77±1.97 Gy vs. 5.92±1.68 Gy, p<0.05; 3.29±0.44 Gy vs. 7.22±1.26 Gy, p<0.05; 3.33±0.45 Gy vs. 6.73±1.01 Gy, p<0.05, respectively). CONCLUSION This is the first study to demonstrate that the head-tilting technique might be useful for HS-WBRT planning with VMAT. This method could remove the limitations associated with the arc range, resulting in improved dose distribution and conformity, while sparing healthy organs, including the hippocampus, lens, and parotid gland.
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Affiliation(s)
- Se An Oh
- Department of Radiation Oncology, Yeungnam University Medical Center, Daegu, South Korea
| | - Ji Woon Yea
- Department of Radiation Oncology, Yeungnam University Medical Center, Daegu, South Korea
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jae Won Park
- Department of Radiation Oncology, Yeungnam University Medical Center, Daegu, South Korea
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jaehyeon Park
- Department of Radiation Oncology, Yeungnam University Medical Center, Daegu, South Korea
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, South Korea
- * E-mail:
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22
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Gaudreau K, Thome C, Weaver B, Boreham DR. Cataract Formation and Low-Dose Radiation Exposure from Head Computed Tomography (CT) Scans in Ontario, Canada, 1994–2015. Radiat Res 2020; 193:322-330. [DOI: 10.1667/rr15504.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Katherine Gaudreau
- Northern Ontario School of Medicine, Sudbury, Canada, P3E 2C6 and Thunder Bay, Canada, P7B 5E1
| | - Christopher Thome
- Northern Ontario School of Medicine, Sudbury, Canada, P3E 2C6 and Thunder Bay, Canada, P7B 5E1
| | - Bruce Weaver
- Northern Ontario School of Medicine, Sudbury, Canada, P3E 2C6 and Thunder Bay, Canada, P7B 5E1
| | - Douglas R. Boreham
- Northern Ontario School of Medicine, Sudbury, Canada, P3E 2C6 and Thunder Bay, Canada, P7B 5E1
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Doria S, Fedeli L, Redapi L, Piffer S, Rossi F, Falivene A, Busoni S, Belli G, Gori C, Taddeucci A. Addressing the efficiency of X-ray protective eyewear: Proposal for the introduction of a new comprehensive parameter, the Eye Protection Effectiveness (EPE). Phys Med 2020; 70:216-223. [DOI: 10.1016/j.ejmp.2020.01.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 11/26/2022] Open
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Little MP, Cahoon EK, Kitahara CM, Simon SL, Hamada N, Linet MS. Occupational radiation exposure and excess additive risk of cataract incidence in a cohort of US radiologic technologists. Occup Environ Med 2020; 77:1-8. [PMID: 31792080 PMCID: PMC10673645 DOI: 10.1136/oemed-2019-105902] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/18/2019] [Accepted: 10/28/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Previous analyses of cataract in radiation-exposed populations have assessed relative risk; radiogenic excess additive risk (EAR), arguably of more public health importance, has not been estimated. Previous analysis of a large prospective cohort of US radiologic technologists (USRT) quantified excess relative risk of cataract in relation to occupational radiation dose. We aim to assess EARs of cataract. METHODS We estimated EARs of cataract/cataract surgery in the USRT cohort using generalised additive models in relation to occupational radiation exposure, and assessed risk modification by a priori-selected cataract risk factors (diabetes, body mass index, smoking, race, sex, birth-year, ultraviolet B (UVB) radiation exposure). RESULTS There were 11 345 cataract diagnoses and 5440 of cataract surgery during 832 462 and 888 402 person-years of follow-up, respectively. Cumulative occupational radiation exposure was associated with self-reported cataract, but not with cataract surgery, with EAR/104 person-year Gy=94 (95% CI: 47 to 143, p<0.001) and EAR/104 person-year Gy=13 (95% CI: <0 to 57, p=0.551), respectively. There was marked (p<0.001) variation of EAR by age and by diabetes status, with risk higher among persons ≥75 years and diabetics. There were indications of elevated risk among those with higher UVB radiation (p=0.045), whites (p=0.056) and among those with higher levels of cigarette smoking (p=0.062). Elevated additive risk was observed for estimated occupational radiation eye-lens doses <100 mGy (p=0.004) with no dose-response curvature (p=0.903). CONCLUSIONS The elevated additive risks associated with low-dose radiation, if confirmed elsewhere, have important public health and clinical implications for radiation workers as well as regulatory measures.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Steven L Simon
- Epidemiology and Biostatistics Program, NCI, Bethesda, Maryland, USA
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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Sakashita T, Sato T, Hamada N. A biologically based mathematical model for spontaneous and ionizing radiation cataractogenesis. PLoS One 2019; 14:e0221579. [PMID: 31442279 PMCID: PMC6707595 DOI: 10.1371/journal.pone.0221579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/04/2019] [Indexed: 12/20/2022] Open
Abstract
Cataracts have long been known, but a biomathematical model is still unavailable for cataratogenesis. There has been a renewed interest in ionizing radiation cataracts because the recent international recommendation of the reduced lens dose limit stimulated the discussion toward its regulatory implementation in various countries. Nevertheless, a relationship between radiation (dose and dose rate) and response (e.g., incidence, onset and progression) remains incompletely understood, raising the need for a risk-predictive mathematical model. We here report for the first time an in silico model for cataractogenesis. First, a simplified cell proliferation model was developed for human lens growth based on stem and progenitor cell proliferation as well as epithelial-fiber cell differentiation. Then, a model for spontaneous cataractogenesis was developed to reproduce the human data on a relationship between age and cataract incidence. Finally, a model for radiation cataractogenesis was developed that can reproduce the human data on a relationship between dose and cataract onset at various ages, which was further applied to estimate cataract incidence following chronic lifetime exposure. The model can serve as the foundation for further development of the risk-predictive model for cataractogenesis along with additional considerations of various biological mechanisms and epidemiological datasets.
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Affiliation(s)
- Tetsuya Sakashita
- Department of Radiation-Applied Biology Research, Quantum Beam Science Research Directorate, National Institutes for Quantum and Radiological Science and Technology (QST), Watanuki, Takasaki, Gunma, Japan
| | - Tatsuhiko Sato
- Research Group for Radiation Transport Analysis, Nuclear Science and Engineering Center, Japan Atomic Energy Agency (JAEA), Shirakata, Tokai, Ibaraki, Japan
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Iwado-kita, Komae, Tokyo, Japan
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Barnard SGR, McCarron R, Moquet J, Quinlan R, Ainsbury E. Inverse dose-rate effect of ionising radiation on residual 53BP1 foci in the eye lens. Sci Rep 2019; 9:10418. [PMID: 31320710 PMCID: PMC6639373 DOI: 10.1038/s41598-019-46893-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 07/02/2019] [Indexed: 12/25/2022] Open
Abstract
The influence of dose rate on radiation cataractogenesis has yet to be extensively studied. One recent epidemiological investigation suggested that protracted radiation exposure increases radiation-induced cataract risk: cumulative doses of radiation mostly <100 mGy received by US radiologic technologists over 5 years were associated with an increased excess hazard ratio for cataract development. However, there are few mechanistic studies to support and explain such observations. Low-dose radiation-induced DNA damage in the epithelial cells of the eye lens (LECs) has been proposed as a possible contributor to cataract formation and thus visual impairment. Here, 53BP1 foci was used as a marker of DNA damage. Unexpectedly, the number of 53BP1 foci that persisted in the mouse lens samples after γ-radiation exposure increased with decreasing dose-rate at 4 and 24 h. The C57BL/6 mice were exposed to 0.5, 1 and 2 Gy ƴ-radiation at 0.063 and 0.3 Gy/min and also 0.5 Gy at 0.014 Gy/min. This contrasts the data we obtained for peripheral blood lymphocytes collected from the same animal groups, which showed the expected reduction of residual 53BP1 foci with reducing dose-rate. These findings highlight the likely importance of dose-rate in low-dose cataract formation and, furthermore, represent the first evidence that LECs process radiation damage differently to blood lymphocytes.
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Affiliation(s)
- Stephen G R Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, UK.
- Durham University, Department of Biosciences, Durham, UK.
| | - Roisin McCarron
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, UK
| | - Jayne Moquet
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, UK
| | - Roy Quinlan
- Durham University, Department of Biosciences, Durham, UK.
| | - Elizabeth Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, UK
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Azizova TV, Hamada N, Bragin EV, Bannikova MV, Grigoryeva ES. Risk of cataract removal surgery in Mayak PA workers occupationally exposed to ionizing radiation over prolonged periods. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:139-149. [PMID: 30879144 DOI: 10.1007/s00411-019-00787-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/07/2019] [Indexed: 06/09/2023]
Abstract
In this study, the risk of cataract removal surgery was assessed in a cohort of workers occupationally exposed to ionizing radiation over a prolonged period. The study cohort includes 22,377 workers of the Mayak Production Association (about 25% of whom are females) first employed at one of the main facilities in 1948-1982, who were followed up to the end of 2008. Dose estimates used in the study are provided by the Mayak Worker Dosimetry System 2008. The mean cumulative dose from external γ-rays [personal dose equivalent Hp(10)] is 0.54 ± 0.76 Sv for males and 0.44 ± 0.65 Sv for females. The mean cumulative doses from neutrons (personal dose equivalent Hp(10)n) were 0.034 ± 0.080 Sv for males and 0.033 ± 0.092 Sv for females. Relative risks and excess relative risks per unit dose were calculated based on maximum likelihood. Among 4,177 workers diagnosed with a verified diagnosis of senile cataract, 701 lens removal surgeries (16.7%) were performed by the end of the follow-up period. The risk of cataract removal surgery was shown to be significantly associated with non-radiation factors such as sex, attained age, smoking, an ocular comorbidity (e.g., glaucoma), and a somatic comorbidity (e.g., diabetes mellitus). There was no significant association of cataract removal surgery with external γ-dose regardless of inclusion of the neutron dose adjustment with either linear or non-linear models. It is concluded that cataract removal surgery rate may not be a highly sensitive and specific indicator that could serve as a surrogate for radiation-related cataracts.
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Affiliation(s)
- Tamara V Azizova
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, 456780, Russia.
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, 201-8511, Japan
| | - Evgeny V Bragin
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, 456780, Russia
| | - Maria V Bannikova
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, 456780, Russia
| | - Evgeniya S Grigoryeva
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, 456780, Russia
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Hamada N, Azizova TV, Little MP. Glaucomagenesis following ionizing radiation exposure. MUTATION RESEARCH. REVIEWS IN MUTATION RESEARCH 2019; 779:36-44. [PMID: 31097150 PMCID: PMC10654893 DOI: 10.1016/j.mrrev.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/02/2019] [Accepted: 01/07/2019] [Indexed: 12/31/2022]
Abstract
Glaucoma is a group of optic neuropathies causing optic nerve damage and visual field defects, and is one of the leading causes of blindness. Nearly a century has passed since the first report of glaucoma manifested following ionizing radiation therapy of cancers. Nevertheless, associations between glaucoma and radiation exposures, a dose response relationship, and the mechanistic underpinnings remain incompletely understood. Here we review the current knowledge on manifestations and mechanisms of radiogenic glaucoma. There is some evidence that neovascular glaucoma is manifest relatively quickly, within a few years after high-dose and high dose-rate radiotherapeutic exposure, but little evidence of excess risks of glaucoma after exposure to much lower doses or dose rates. As such, glaucoma appears to have some of the characteristics of a tissue reaction effect, with a threshold of at least 5 Gy but possibly much higher.
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Affiliation(s)
- Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, 201-8511, Japan.
| | - Tamara V Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, 456780, Russia.
| | - Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9778, Bethesda, MD, 20892-9778, USA.
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Kitamura H, Okubo T, Kodama K. EPIDEMIOLOGICAL STUDY OF HEALTH EFFECTS IN FUKUSHIMA NUCLEAR EMERGENCY WORKERS-STUDY DESIGN AND PROGRESS REPORT. RADIATION PROTECTION DOSIMETRY 2018; 182:40-48. [PMID: 30137628 DOI: 10.1093/rpd/ncy136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Between 14 March and 16 December 2011, the radiation dose limit for emergency work was tentatively raised from an effective dose of 100-250 mSv by the Japanese Government after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. The objective of this study is to clarify the long-term health effects of radiation on the emergency workers involved during that period, based on a detailed evaluation of the radiation exposures and long-term monitoring. The potential subjects of the study are the approximately 20 000 workers who were engaged in emergency operations at FDNPP during the period described above. During the first phase of this project, the first 5 years from 2014, we plan to set up a research scheme and establish a cohort. To date, the establishment of the scheme for general health examinations is nearly complete. As of 31 January 2017, 5419 emergency workers (27.4% of the subjects) have agreed to participate in the study. We will continue our efforts to recruit additional potential subjects during the first phase to maximize the size of the cohort.
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Affiliation(s)
- Hiroko Kitamura
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, Japan
| | - Toshiteru Okubo
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, Japan
| | - Kazunori Kodama
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, Japan
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30
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Little MP, Kitahara CM, Cahoon EK, Bernier MO, Velazquez-Kronen R, Doody MM, Borrego D, Miller JS, Alexander BH, Simon SL, Preston DL, Hamada N, Linet MS, Meyer C. Occupational radiation exposure and risk of cataract incidence in a cohort of US radiologic technologists. Eur J Epidemiol 2018; 33:1179-1191. [PMID: 30151727 PMCID: PMC10645574 DOI: 10.1007/s10654-018-0435-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 08/18/2018] [Indexed: 12/13/2022]
Abstract
It has long been known that relatively high-dose ionising radiation exposure (> 1 Gy) can induce cataract, but there has been no evidence that this occurs at low doses (< 100 mGy). To assess low-dose risk, participants from the US Radiologic Technologists Study, a large, prospective cohort, were followed from date of mailed questionnaire survey completed during 1994-1998 to the earliest of self-reported diagnosis of cataract/cataract surgery, cancer other than non-melanoma skin, or date of last survey (up to end 2014). Cox proportional hazards models with age as timescale were used, adjusted for a priori selected cataract risk factors (diabetes, body mass index, smoking history, race, sex, birth year, cumulative UVB radiant exposure). 12,336 out of 67,246 eligible technologists reported a history of diagnosis of cataract during 832,479 person years of follow-up, and 5509 from 67,709 eligible technologists reported undergoing cataract surgery with 888,420 person years of follow-up. The mean cumulative estimated 5-year lagged eye-lens absorbed dose from occupational radiation exposures was 55.7 mGy (interquartile range 23.6-69.0 mGy). Five-year lagged occupational radiation exposure was strongly associated with self-reported cataract, with an excess hazard ratio/mGy of 0.69 × 10-3 (95% CI 0.27 × 10-3 to 1.16 × 10-3, p < 0.001). Cataract risk remained statistically significant (p = 0.030) when analysis was restricted to < 100 mGy cumulative occupational radiation exposure to the eye lens. A non-significantly increased excess hazard ratio/mGy of 0.34 × 10-3 (95% CI - 0.19 × 10-3 to 0.97 × 10-3, p = 0.221) was observed for cataract surgery. Our results suggest that there is excess risk for cataract associated with radiation exposure from low-dose and low dose-rate occupational exposures.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA.
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Marie-Odile Bernier
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
- Laboratory of Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay aux Roses, France
| | - Raquel Velazquez-Kronen
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Michele M Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - David Borrego
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Jeremy S Miller
- Information Management Services, Silver Spring, MD, 20904, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, 55409, USA
| | - Steven L Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | | | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, 201-8511, Japan
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Craig Meyer
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, 55409, USA
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Cataract risk of neuro-interventional procedures: a nationwide population-based matched-cohort study. Clin Radiol 2018; 73:836.e17-836.e22. [PMID: 29945717 DOI: 10.1016/j.crad.2018.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 05/04/2018] [Indexed: 10/28/2022]
Abstract
AIM To demonstrate the risk of cataract associated with radiation exposure from neuro-interventional procedures. MATERIALS AND METHODS This was a nationwide population-based, matched-cohort study. The exposed group (group E) comprised patients diagnosed with an aneurysm, cerebrovascular system anomaly, or subarachnoid haemorrhage who underwent a neuro-interventional procedure, such as brain digital subtraction angiography or endovascular embolisation. The comparison group (group C) included subjects who were never exposed to radiation from neuro-interventional procedures and were propensity score-matched by the date of enrolment, age, sex, and associated comorbidities. Multiple Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) of cataract risk due to radiation exposure while adjusting for potential confounding factors. RESULTS There were 838 patients and 3,352 matched subjects in groups E and C, respectively. The incidence of cataracts was significantly greater among subjects in group E (adjusted HR [aHR] = 1.88; 95% confidence interval [CI] = 1.08-3.26), especially those aged >40 years (aHR = 2.14; 95% CI = 1.16-3.94). The number of computed tomography examinations was positively correlated, but not statistically significant, with an increased risk of cataract occurrence. CONCLUSIONS Neuro-interventional procedures might be significantly associated with an increased risk of cataract occurrence.
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Furukawa K, Misumi M. A semiparametric approach to evaluate the harm of low-dose exposures. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2018; 38:286-298. [PMID: 29303484 DOI: 10.1088/1361-6498/aaa57c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
While moderate to high levels of radiation exposure is known to cause adverse health effects, there is still controversy about the lowest dose that could be harmful. Given that epidemiological studies of practical sizes are unlikely to provide sufficient statistical power to detect a small risk in the low-dose range of concern, greater emphasis should be given to evaluating low-dose risk uncertainty. Using simulations under various dose-response relationships with a threshold, we show that a conventional approach based on simple parametric models (e.g. the linear model with or without a threshold) can be inefficient, biased and/or inaccurate in uncertainty evaluations at low doses. Alternatively, we consider a Bayesian semiparametric model of a connected piecewise-linear function allowing for autocorrelations between adjacent line sections. With no specific assumption, this can describe various plausible dose-response curves while appropriately handling the risk uncertainty. In particular, it can relatively accurately evaluate the dose range in which a threshold might exist, while retaining statistical power for a small risk increase after the threshold. As an illustration, we analyse cancer incidence data of Japanese atomic bomb survivors, a primary epidemiological source of quantitative risk estimates for health effects from radiation exposure.
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Affiliation(s)
- Kyoji Furukawa
- Department of Statistics, Radiation Effects Research Foundation, Japan
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Thome C, Chambers DB, Hooker AM, Thompson JW, Boreham DR. Deterministic Effects to the Lens of the Eye Following Ionizing Radiation Exposure: is There Evidence to Support a Reduction in Threshold Dose? HEALTH PHYSICS 2018; 114:328-343. [PMID: 29360710 DOI: 10.1097/hp.0000000000000810] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ionizing radiation exposure to the lens of the eye is a known cause of cataractogenesis. Historically, it was believed that the acute threshold dose for cataract formation was 5 Sv, and annual dose limits to the lens were set at 150 mSv. Recently, however, the International Commission on Radiological Protection has reduced their threshold dose estimate for deterministic effects to 0.5 Gy and is now recommending an occupational limit of 20 mSv per year on average. A number of organizations have questioned whether this new threshold and dose limit are justified based on the limited reliable data concerning radiation-induced cataracts. This review summarizes all of the published human epidemiological data on ionizing radiation exposure to the lens of the eye in order to evaluate the proposed threshold. Data from a variety of exposure cohorts are reviewed, including atomic bomb survivors, Chernobyl liquidators, medical workers, and radiotherapy patients. Overall, there is not conclusive evidence that the threshold dose for cataract formation should be reduced to 0.5 Gy. Many of the studies reviewed here are challenging to incorporate into an overall risk model due to inconsistencies with dosimetry, sample size, and scoring metrics. Additionally, risk levels in the studied cohorts may not relate to occupational scenarios due to differences in dose rate, radiation quality, age at exposure and latency period. New studies should be designed specifically focused on occupational exposures, with reliable dosimetry and grading methods for lens opacities, to determine an appropriate level for dose threshold and exposure limit.
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Kleiman NJ, Stewart FA, Hall EJ. Modifiers of radiation effects in the eye. LIFE SCIENCES IN SPACE RESEARCH 2017; 15:43-54. [PMID: 29198313 DOI: 10.1016/j.lssr.2017.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/05/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
World events, including the threat of radiological terrorism and the fear of nuclear accidents, have highlighted an urgent need to develop medical countermeasures to prevent or reduce radiation injury. Similarly, plans for manned spaceflight to a near-Earth asteroid or journey to Mars raise serious concerns about long-term effects of space radiation on human health and the availability of suitable therapeutic interventions. At the same time, the need to protect normal tissue from the deleterious effects of radiotherapy has driven considerable research into the design of effective radioprotectors. For more than 70 years, animal models of radiation cataract have been utilized to test the short and long-term efficacy of various radiation countermeasures. While some compounds, most notably the Walter Reed (WR) class of radioprotectors, have reported limited effectiveness when given before exposure to low-LET radiation, the human toxicity of these molecules at effective doses limits their usefulness. Furthermore, while there has been considerable testing of eye responses to X- and gamma irradiation, there is limited information about using such models to limit the injurious effects of heavy ions and neutrons on eye tissue. A new class of radioprotector molecules, including the sulfhydryl compound PrC-210, are reported to be effective at much lower doses and with far less side effects. Their ability to modify ocular radiation damage has not yet been examined. The ability to non-invasively measure sensitive, radiation-induced ocular changes over long periods of time makes eye models an attractive option to test the radioprotective and radiation mitigating abilities of new novel compounds.
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Affiliation(s)
- Norman J Kleiman
- Department of Environmental Health Sciences, Eye Radiation and Environmental Research Laboratory, Columbia University, Mailman School of Public Health, 722 West 168th St., 11th Floor, New York, NY 10032, USA.
| | - Fiona A Stewart
- Division of Biological Stress Response, Netherlands Cancer Institute, 1006 BE Amsterdam, The Netherlands
| | - Eric J Hall
- Center for Radiological Research, Columbia University, College of Physicians and Surgeons, 630 W. 168th St., New York, NY 10032, USA
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Yokoyama S, Hamada N, Hayashida T, Tsujimura N, Tatsuzaki H, Kurosawa T, Nabatame K, Ohguchi H, Ohno K, Yamauchi-Kawaura C, Iimoto T, Ichiji T, Hotta Y, Iwai S, Akahane K. Current situations and discussions in Japan in relation to the new occupational equivalent dose limit for the lens of the eye. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2017; 37:659-683. [PMID: 28516892 DOI: 10.1088/1361-6498/aa73e8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Since the International Commission on Radiological Protection recommended reducing the occupational equivalent dose limit for the lens of the eye in 2011, there have been extensive discussions in various countries. This paper reviews the current situation in radiation protection of the ocular lens and the discussions on the potential impact of the new lens dose limit in Japan. Topics include historical changes to the lens dose limit, the current situation with occupational lens exposures (e.g., in medical workers, nuclear workers, and Fukushima nuclear power plant workers) and measurements, and the current status of biological studies and epidemiological studies on radiation cataracts. Our focus is on the situation in Japan, but we believe such information sharing will be useful in many other countries.
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Affiliation(s)
- Sumi Yokoyama
- Faculty of Health Science, Fujita Health University; 1-98, Dengakugakubo, Kutsukakecho, Toyoake, Aichi 470-1192, Japan
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Mesa R, Tyagi M, Harocopos G, Vollman D, Bassnett S. Somatic Variants in the Human Lens Epithelium: A Preliminary Assessment. Invest Ophthalmol Vis Sci 2017; 57:4063-75. [PMID: 27537255 PMCID: PMC4986767 DOI: 10.1167/iovs.16-19726] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We hypothesize that somatic mutations accumulate in cells of the human lens and may contribute to the development of cortical or posterior sub-capsular cataracts. Here, we used a Next-generation sequencing (NGS) strategy to screen for low-allelic frequency variants in DNA extracted from human lens epithelial samples. Methods Next-Generation sequencing of 151 cancer-related genes (WUCaMP2 panel) was performed on DNA extracted from post-mortem or surgical specimens obtained from 24 individuals. Usually, pairwise comparisons were made between two or more ocular samples from the same individual, allowing putative somatic variants detected in lens samples to be differentiated from germline variants. Results Use of a targeted hybridization approach enabled high sequence coverage (>1000-fold) of the WUCaMP2 genes. In addition to high-frequency variants (corresponding to homozygous or heterozygous SNPs and Indels), somatic variants with allelic frequencies of 1-4% were detected in the lens epithelial samples. The presence of one such variant, a T > C point substitution at position 32907082 in BRCA2, was verified subsequently using droplet digital PCR. Conclusions Low-allelic fraction variants are present in the human lens epithelium, at frequencies consistent with the presence of millimeter-sized clones.
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Affiliation(s)
- Rosana Mesa
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Manoj Tyagi
- Genome Technology Access Center, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States
| | - George Harocopos
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States 3Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, United States
| | - David Vollman
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Steven Bassnett
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
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Xu F, Li X, Yan L, Yuan N, Fang Y, Cao Y, Xu L, Zhang X, Xu L, Ge C, An N, Jiang G, Xie J, Zhang H, Jiang J, Li X, Yao L, Zhang S, Zhou D, Wang J. Autophagy Promotes the Repair of Radiation-Induced DNA Damage in Bone Marrow Hematopoietic Cells via Enhanced STAT3 Signaling. Radiat Res 2017; 187:382-396. [PMID: 28327001 DOI: 10.1667/rr14640.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Autophagy protects hematopoietic cells from radiation damage in part by promoting DNA damage repair. However, the molecular mechanisms by which autophagy regulates DNA damage repair remain largely elusive. Here, we report that this radioprotective effect of autophagy depends on STAT3 signaling in murine bone marrow mononuclear cells (BM-MNCs). Specifically, we found that STAT3 activation and nuclear translocation in BM-MNCs were increased by activation of autophagy with an mTOR inhibitor and decreased by knockout of the autophagy gene Atg7. The autophagic regulation of STAT3 activation is likely mediated by induction of KAP1 degradation, because we showed that KAP1 directly interacted with STAT3 in the cytoplasm and knockdown of KAP1 increased the phosphorylation and nuclear translocation of STAT3. Subsequently, activated STAT3 transcriptionally upregulated the expression of BRCA1, which increased the ability of BM-MNCs to repair radiation-induced DNA damage. This novel finding that activation of autophagy can promote DNA damage repair in BM-MNCs via the ATG-KAP1-STAT3-BRCA1 pathway suggests that autophagy plays an important role in maintaining genomic integrity of BM-MNCs and its activation may confer protection of BM-MNCs against radiation-induced genotoxic stress.
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Affiliation(s)
- Fei Xu
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Xin Li
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Lili Yan
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Na Yuan
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Yixuan Fang
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Yan Cao
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Li Xu
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Xiaoying Zhang
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Lan Xu
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Chaorong Ge
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Ni An
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Gaoyue Jiang
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Jialing Xie
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Han Zhang
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Jiayi Jiang
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Xiaotian Li
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Lei Yao
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
| | - Suping Zhang
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China.,b Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas Medical Sciences, Little Rock, Arkansas 72205
| | - Daohong Zhou
- b Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas Medical Sciences, Little Rock, Arkansas 72205
| | - Jianrong Wang
- a Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Soochow University School of Medicine, Suzhou 215123, China
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Azizova TV, Bragin EV, Hamada N, Bannikova MV. Risk of Cataract Incidence in a Cohort of Mayak PA Workers following Chronic Occupational Radiation Exposure. PLoS One 2016; 11:e0164357. [PMID: 27723789 PMCID: PMC5056693 DOI: 10.1371/journal.pone.0164357] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/24/2016] [Indexed: 11/19/2022] Open
Abstract
This is the first study of cataract incidence in a cohort of Mayak Production Association workers first employed at one of the main facilities in 1948-1982 and followed up till the end of 2008 (22,377 workers). Principal advantages of the study are the large size of the cohort, long-term follow-up and sufficient statistical power, available results of annual eye examinations over the entire follow-up period and detailed information on non-radiation confounders. Individual measured doses from external γ-rays and neutrons used in the analyses were provided by the Mayak Worker Dosimetry System 2008 (MWDS-2008). Relative risk (RR) and excess relative risk (ERR) per unit dose (Gy) were calculated based on maximum likelihood using the AMFIT module of the EPICURE software. The RR of cataract incidence was found to be the highest in workers exposed at doses above 2.0 Gy. A significant linear association of cataract incidence with cumulative dose from external γ-rays was found with ERR/Gy equal to 0.28 (95% confidence intervals: 0.20, 0.37). The results obtained varied slightly with inclusion of additional adjustments for non-radiation factors (smoking index, hypertension, glaucoma and body mass index). Adjusting for the dose from neutrons gave a considerable increase in ERR/Gy for cataract incidence.
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Affiliation(s)
- Tamara V. Azizova
- Southern Urals Biophysics Institute, Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, Russia
| | - Evgeny V. Bragin
- Southern Urals Biophysics Institute, Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, Russia
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, Japan
| | - Maria V. Bannikova
- Southern Urals Biophysics Institute, Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, Russia
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Hamada N, Sato T. Cataractogenesis following high-LET radiation exposure. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 770:262-291. [DOI: 10.1016/j.mrrev.2016.08.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/04/2016] [Accepted: 08/17/2016] [Indexed: 12/24/2022]
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Shore RE. Radiation and cataract risk: Impact of recent epidemiologic studies on ICRP judgments. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 770:231-237. [DOI: 10.1016/j.mrrev.2016.06.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 02/04/2023]
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Ainsbury EA, Barnard S, Bright S, Dalke C, Jarrin M, Kunze S, Tanner R, Dynlacht JR, Quinlan RA, Graw J, Kadhim M, Hamada N. Ionizing radiation induced cataracts: Recent biological and mechanistic developments and perspectives for future research. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 770:238-261. [DOI: 10.1016/j.mrrev.2016.07.010] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 02/06/2023]
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JOURNAL CLUB: Scatter Radiation Dose From Digital Screening Mammography Measured in a Representative Patient Population. AJR Am J Roentgenol 2016; 206:359-64; quiz 365. [PMID: 26797364 DOI: 10.2214/ajr.15.14921] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to quantify the amount of scatter radiation received at the skin surface overlying the thyroid gland, salivary gland, lens of the eye, sternum, and uterus during a routine screening digital mammographic examination measured in a representative patient population. SUBJECTS AND METHODS The subjects were 207 women without symptoms with varied body mass indexes who underwent annual screening mammography while wearing six optically stimulated luminescence dosimeters placed at the bridge of the nose, right submandibular gland, right and left thyroid lobes, mid sternum, and 2 cm caudal to the umbilicus to assess scatter radiation dose to the skin. RESULTS The average scatter radiation doses at the skin surface during digital screening mammography in the representative population of women were as follows: overlying the right lobe of the thyroid, 0.24 mGy; left lobe of the thyroid, 0.25 mGy; salivary gland, 0.2 mGy; bridge of the nose, 0.025 mGy; sternum, 0.87 mGy; and umbilicus, 0.011 mGy. The scatter radiation doses at the umbilicus and the bridge of the nose were too low to measure with statistical confidence. Scatter radiation dose increased with increasing body mass index and increasing breast compression thickness. CONCLUSION Scatter radiation dose at the skin overlying organs of interest is a small fraction of the entrance skin dose to the breast. The low levels of scatter radiation measured do not support delaying clinically indicated mammography during early pregnancy.
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Chodick G, Sigurdson AJ, Kleinerman RA, Sklar CA, Leisenring W, Mertens AC, Stovall M, Smith SA, Weathers RE, Veiga LHS, Robison LL, Inskip PD. The Risk of Cataract among Survivors of Childhood and Adolescent Cancer: A Report from the Childhood Cancer Survivor Study. Radiat Res 2016; 185:366-74. [PMID: 27023263 PMCID: PMC4853230 DOI: 10.1667/rr14276.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
With therapeutic successes and improved survival after a cancer diagnosis in childhood, increasing numbers of cancer survivors are at risk of subsequent treatment-related morbidities, including cataracts. While it is well known that the lens of the eye is one of the most radiosensitive tissues in the human body, the risks associated with radiation doses less than 2 Gy are less understood, as are the long- and short-term cataract risks from exposure to ionizing radiation at a young age. In this study, we followed 13,902 five-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort an average of 21.4 years from the date of first cancer diagnosis. For patients receiving radiotherapy, lens dose (mean: 2.2 Gy; range: 0-66 Gy) was estimated based on radiotherapy records. We used unconditional multivariable logistic regression models to evaluate prevalence of self-reported cataract in relationship to cumulative radiation dose both at five years after the initial cancer diagnosis and at the end of follow-up. We modeled the radiation effect in terms of the excess odds ratio (EOR) per Gy. We also analyzed cataract incidence starting from five years after initial cancer diagnosis to the end of follow-up using Cox regression. A total of 483 (3.5%) cataract cases were identified, including 200 (1.4%) diagnosed during the first five years of follow-up. In a multivariable logistic regression model, cataract prevalence at the end of follow-up was positively associated with lens dose in a manner consistent with a linear dose-response relationship (EOR per Gy = 0.92; 95% CI: 0.65-1.20). The odds ratio for doses between 0.5 and 1.5 Gy was elevated significantly relative to doses <0.5 Gy (OR = 2.2; 95% CI: 1.3-3.7). The results from this study indicate a strong association between ocular exposure to ionizing radiation and long-term risk of pre-senile cataract. The risk of cataract increased with increasing exposure, beginning at lens doses as low as 0.5 Gy. Our findings are in agreement with a growing body of evidence of an elevated risk for lens opacities in populations exposed to doses of ionizing radiation below the previously suggested threshold level of 2 Gy.
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Affiliation(s)
- Gabriel Chodick
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alice J. Sigurdson
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Ruth A. Kleinerman
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Charles A. Sklar
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Wendy Leisenring
- Share Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ann C. Mertens
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Marilyn Stovall
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan A. Smith
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rita E. Weathers
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lene H. S. Veiga
- Institute of Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, Rio de Janeiro, Brazil
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Peter D. Inskip
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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Lin CM, Yeh PT, Doyle P, Tsan YT, Chen PC. Association Between 131I Treatment for Thyroid Cancer and Risk of Receiving Cataract Surgery: A Cohort Study from Taiwan. J Nucl Med 2016; 57:836-41. [DOI: 10.2967/jnumed.115.167197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/07/2016] [Indexed: 01/22/2023] Open
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45
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Rühm W, Fantuzzi E, Harrison R, Schuhmacher H, Vanhavere F, Alves J, Bottollier Depois JF, Fattibene P, Knežević Ž, Lopez MA, Mayer S, Miljanić S, Neumaier S, Olko P, Stadtmann H, Tanner R, Woda C. EURADOS strategic research agenda: vision for dosimetry of ionising radiation. RADIATION PROTECTION DOSIMETRY 2016; 168:223-34. [PMID: 25752758 PMCID: PMC4884873 DOI: 10.1093/rpd/ncv018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 05/04/2023]
Abstract
Since autumn 2012, the European Radiation Dosimetry Group (EURADOS) has been developing its Strategic Research Agenda (SRA), which is intended to contribute to the identification of future research needs in radiation dosimetry in Europe. The present article summarises-based on input from EURADOS Working Groups (WGs) and Voting Members-five visions in dosimetry and defines key issues in dosimetry research that are considered important for the next decades. The five visions include scientific developments required towards (a) updated fundamental dose concepts and quantities, (b) improved radiation risk estimates deduced from epidemiological cohorts, (c) efficient dose assessment for radiological emergencies, (d) integrated personalised dosimetry in medical applications and (e) improved radiation protection of workers and the public. The SRA of EURADOS will be used as a guideline for future activities of the EURADOS WGs. A detailed version of the SRA can be downloaded as a EURADOS report from the EURADOS website (www.eurados.org).
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Affiliation(s)
- W Rühm
- Helmholtz Center Munich, Institute of Radiation Protection, Neuherberg, Germany
| | - E Fantuzzi
- Radiation Protection Institute, ENEA, Bologna, Italy
| | | | - H Schuhmacher
- Physikalisch Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - F Vanhavere
- Belgian Nuclear Research Centre (SCK-CEN), Mol, Belgium
| | - J Alves
- Instituto Superior Técnico (IST), CTN, Lisboa, Portugal
| | - J F Bottollier Depois
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - P Fattibene
- Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Ž Knežević
- Ruđer Bošković Institute (RBI), Zagreb, Croatia
| | - M A Lopez
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid, Spain
| | - S Mayer
- Paul Scherer Institut (PSI), Villigen, Switzerland
| | - S Miljanić
- Ruđer Bošković Institute (RBI), Zagreb, Croatia
| | - S Neumaier
- Physikalisch Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - P Olko
- Instytut Fizyki Jądrowej (IFJ), Krakow, Poland
| | - H Stadtmann
- Seibersdorf Labor GmbH, Seibersdorf, Austria
| | - R Tanner
- Public Health England, Chilton, Didcot, UK
| | - C Woda
- Helmholtz Center Munich, Institute of Radiation Protection, Neuherberg, Germany
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Lehmann P, Boratyński Z, Mappes T, Mousseau TA, Møller AP. Fitness costs of increased cataract frequency and cumulative radiation dose in natural mammalian populations from Chernobyl. Sci Rep 2016; 6:19974. [PMID: 26814168 PMCID: PMC4728484 DOI: 10.1038/srep19974] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 12/21/2015] [Indexed: 11/09/2022] Open
Abstract
A cataract is a clouding of the lens that reduces light transmission to the retina, and it decreases the visual acuity of the bearer. The prevalence of cataracts in natural populations of mammals, and their potential ecological significance, is poorly known. Cataracts have been reported to arise from high levels of oxidative stress and a major cause of oxidative stress is ionizing radiation. We investigated whether elevated frequencies of cataracts are found in eyes of bank voles Myodes glareolus collected from natural populations in areas with varying levels of background radiation in Chernobyl. We found high frequencies of cataracts in voles collected from different areas in Chernobyl. The frequency of cataracts was positively correlated with age, and in females also with the accumulated radiation dose. Furthermore, the number of offspring in female voles was negatively correlated with cataract severity. The results suggest that cataracts primarily develop as a function of ionizing background radiation, most likely as a plastic response to high levels of oxidative stress. It is therefore possible that the elevated levels of background radiation in Chernobyl affect the ecology and fitness of local mammals both directly through, for instance, reduced fertility and indirectly, through increased cataractogenesis.
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Affiliation(s)
- Philipp Lehmann
- Centre of Excellence in Biological Interactions Research, Department of Biological and Environmental Science, P.O. Box 35, FI-40014 University of Jyväskylä, Finland.,Department of Zoology, SE-106 91 University of Stockholm, Sweden
| | - Zbyszek Boratyński
- CIBIO/InBIO, Research Center in Biodiversity and Genetic Resources, University of Porto, 4485-661 Vairão, Portugal
| | - Tapio Mappes
- Centre of Excellence in Biological Interactions Research, Department of Biological and Environmental Science, P.O. Box 35, FI-40014 University of Jyväskylä, Finland
| | - Timothy A Mousseau
- Department of Biological Sciences, University of South Carolina, Columbia, SC 29208, USA
| | - Anders P Møller
- Laboratoire d'Ecologie, Systématique et Evolution, CNRS UMR 8079, Université Paris-Sud, Bâtiment 362, F-91405 Orsay Cedex, France
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Hamada N, Fujimichi Y. Role of carcinogenesis related mechanisms in cataractogenesis and its implications for ionizing radiation cataractogenesis. Cancer Lett 2015; 368:262-74. [DOI: 10.1016/j.canlet.2015.02.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/09/2015] [Accepted: 02/10/2015] [Indexed: 12/20/2022]
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Nguyen TT, Yeom YS, Kim HS, Wang ZJ, Han MC, Kim CH, Lee JK, Zankl M, Petoussi-Henss N, Bolch WE, Lee C, Chung BS. Incorporation of detailed eye model into polygon-mesh versions of ICRP-110 reference phantoms. Phys Med Biol 2015; 60:8695-707. [DOI: 10.1088/0031-9155/60/22/8695] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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McKeown SR, Hatfield P, Prestwich RJD, Shaffer RE, Taylor RE. Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation. Br J Radiol 2015; 88:20150405. [PMID: 26462717 PMCID: PMC4984935 DOI: 10.1259/bjr.20150405] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/01/2015] [Accepted: 10/12/2015] [Indexed: 12/14/2022] Open
Abstract
Most radiotherapy (RT) involves the use of high doses (>50 Gy) to treat malignant disease. However, low to intermediate doses (approximately 3-50 Gy) can provide effective control of a number of benign conditions, ranging from inflammatory/proliferative disorders (e.g. Dupuytren's disease, heterotopic ossification, keloid scarring, pigmented villonodular synovitis) to benign tumours (e.g. glomus tumours or juvenile nasopharyngeal angiofibromas). Current use in UK RT departments is very variable. This review identifies those benign diseases for which RT provides good control of symptoms with, for the most part, minimal side effects. However, exposure to radiation has the potential to cause a radiation-induced cancer (RIC) many years after treatment. The evidence for the magnitude of this risk comes from many disparate sources and is constrained by the small number of long-term studies in relevant clinical cohorts. This review considers the types of evidence available, i.e. theoretical models, phantom studies, epidemiological studies, long-term follow-up of cancer patients and those treated for benign disease, although many of the latter data pertain to treatments that are no longer used. Informative studies are summarized and considered in relation to the potential for development of a RIC in a range of key tissues (skin, brain etc.). Overall, the evidence suggests that the risks of cancer following RT for benign disease for currently advised protocols are small, especially in older patients. However, the balance of risk vs benefit needs to be considered in younger adults and especially if RT is being considered in adolescents or children.
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Affiliation(s)
| | - Paul Hatfield
- Leeds Cancer Centre, St James's University Hospital, Leeds, UK
| | | | - Richard E Shaffer
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | - Roger E Taylor
- College of Medicine, Swansea University, South West Cancer Centre, Swansea, UK
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Lin W, Yuan N, Wang Z, Cao Y, Fang Y, Li X, Xu F, Song L, Wang J, Zhang H, Yan L, Xu L, Zhang X, Zhang S, Wang J. Autophagy confers DNA damage repair pathways to protect the hematopoietic system from nuclear radiation injury. Sci Rep 2015; 5:12362. [PMID: 26197097 PMCID: PMC4508834 DOI: 10.1038/srep12362] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/26/2015] [Indexed: 12/23/2022] Open
Abstract
Autophagy is essentially a metabolic process, but its in vivo role in nuclear radioprotection remains unexplored. We observed that ex vivo autophagy activation reversed the proliferation inhibition, apoptosis, and DNA damage in irradiated hematopoietic cells. In vivo autophagy activation improved bone marrow cellularity following nuclear radiation exposure. In contrast, defective autophagy in the hematopoietic conditional mouse model worsened the hematopoietic injury, reactive oxygen species (ROS) accumulation and DNA damage caused by nuclear radiation exposure. Strikingly, in vivo defective autophagy caused an absence or reduction in regulatory proteins critical to both homologous recombination (HR) and non-homologous end joining (NHEJ) DNA damage repair pathways, as well as a failure to induce these proteins in response to nuclear radiation. In contrast, in vivo autophagy activation increased most of these proteins in hematopoietic cells. DNA damage assays confirmed the role of in vivo autophagy in the resolution of double-stranded DNA breaks in total bone marrow cells as well as bone marrow stem and progenitor cells upon whole body irradiation. Hence, autophagy protects the hematopoietic system against nuclear radiation injury by conferring and intensifying the HR and NHEJ DNA damage repair pathways and by removing ROS and inhibiting apoptosis.
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Affiliation(s)
- Weiwei Lin
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Na Yuan
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Zhen Wang
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Yan Cao
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Yixuan Fang
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Xin Li
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Fei Xu
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Lin Song
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Jian Wang
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Han Zhang
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Lili Yan
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Li Xu
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Xiaoying Zhang
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Suping Zhang
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
| | - Jianrong Wang
- Hematology Center of Cyrus Tang Medical Institute, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Jiangsu Key Laboratory for Stem Cell Research, Soochow University School of Medicine, Suzhou 215123, China
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