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Sharma AK, Prasad A, Kalonia A, Shaw P, Kumar R, Shukla SK. Combined radiation burn injuries: A note. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:043502. [PMID: 36317279 DOI: 10.1088/1361-6498/ac9e61] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
Combined radiation injury occurs when radiation is accompanied by any other form of trauma. The past experiences of Hiroshima, Nagasaki, and Chernobyl have revealed that a large number of victims of such nuclear accidents or attacks suffer from combined radiation injuries. The possibility of a nuclear attack seems very far-fetched, but the destruction that would occur in such an event would be massive, with a huge lossof lives. Therefore, preparedness for the same should be done beforehand. The severity of combined radiation depends upon various factors, such as radiation dose, type, tissues affected, and traumas. The article focuses on combined radiation burn injury (CRBI) which may arise due to the combination of ionising radiation with thermal burns. CRBI can have varied effects on different organs like the hematopoietic, digestive, lymphatic, cardiovascular, and respiratory systems. Some of the most profound lethal effects are hematopoietic dysfunction, gastrointestinal leakage, bacterial translocation to other organ sites, pulmonary fibrosis, and pneumonitis. In this article, we have attempted to accumulate the knowledge of ongoing research on the functioning of different organ systems, which are affected due to CRBI and possible countermeasures to minimize the effects, thus improving survival.
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Affiliation(s)
- Ajay Kumar Sharma
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, New Delhi 110054, India
| | - Ayushi Prasad
- Sri Venkateswara College, University of Delhi, Benito Juarez Road, Dhaula Kuan, New Delhi 110021, India
| | - Aman Kalonia
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, New Delhi 110054, India
| | - Priyanka Shaw
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, New Delhi 110054, India
| | - Rishav Kumar
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, New Delhi 110054, India
| | - Sandeep Kumar Shukla
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, New Delhi 110054, India
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Eldeeb AE, Salah S, Amer MS, Elkasabgy NA. 3D nanocomposite alginate hydrogel loaded with pitavastatin nanovesicles as a functional wound dressing with controlled drug release; preparation, in-vitro and in-vivo evaluation. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Harrison KA, Romer E, Weyerbacher J, Ocana JA, Sahu RP, Murphy RC, Kelly LE, Smith TA, Rapp CM, Borchers C, Cool DR, Li G, Simman R, Travers JB. Enhanced Platelet-Activating Factor Synthesis Facilitates Acute and Delayed Effects of Ethanol-Intoxicated Thermal Burn Injury. J Invest Dermatol 2018; 138:2461-2469. [PMID: 29857067 DOI: 10.1016/j.jid.2018.04.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/06/2018] [Accepted: 04/20/2018] [Indexed: 02/07/2023]
Abstract
Thermal burn injuries in patients who are alcohol-intoxicated result in greater morbidity and mortality. Murine models combining ethanol and localized thermal burn injury reproduce the systemic toxicity seen in human subjects, which consists of both acute systemic cytokine production with multiple organ dysfunction, as well as a delayed systemic immunosuppression. However, the exact mechanisms for these acute and delayed effects are unclear. These studies sought to define the role of the lipid mediator platelet-activating factor in the acute and delayed effects of intoxicated burn injury. Combining ethanol and thermal burn injury resulted in increased enzymatic platelet-activating factor generation in a keratinocyte cell line in vitro, human skin explants ex vivo, as well as in murine skin in vivo. Further, the acute increase in inflammatory cytokines, such as IL-6, and the systemic immunosuppressive effects of intoxicated thermal burn injury were suppressed in mice lacking platelet-activating factor receptors. Together, these studies provide a potential mechanism and treatment strategies for the augmented toxicity and immunosuppressive effects of thermal burn injury in the setting of acute ethanol exposure, which involves the pleotropic lipid mediator platelet-activating factor.
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Affiliation(s)
- Kathleen A Harrison
- Department of Pharmacology, University of Colorado Health Sciences Center, Aurora, Colorado, USA
| | - Eric Romer
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Jonathan Weyerbacher
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jesus A Ocana
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ravi P Sahu
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Robert C Murphy
- Department of Pharmacology, University of Colorado Health Sciences Center, Aurora, Colorado, USA
| | - Lisa E Kelly
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Townsend A Smith
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Christine M Rapp
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Christina Borchers
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - David R Cool
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
| | - Gengxin Li
- Department of Mathematics and Statistics, Wright State University, Dayton, Ohio, USA
| | - Richard Simman
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA; Department of Dermatology, Wright State University, Dayton, Ohio, USA
| | - Jeffrey B Travers
- Department of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA; Department of Dermatology, Wright State University, Dayton, Ohio, USA; The Dayton VA Medical Center, Dayton, OH.
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Antonic V, Jackson IL, Ganga G, Shea-Donohue T, Vujaskovic Z. Development of A Novel Murine Model of Combined Radiation and Peripheral Tissue Trauma Injuries. Radiat Res 2017; 187:241-250. [PMID: 28118112 DOI: 10.1667/rr14557.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Detonation of a 10-kiloton nuclear bomb in an urban setting would result in >1 million casualties, the majority of which would present with combined injuries. Combined injuries, such as peripheral tissue trauma and radiation exposure, trigger inflammatory events that lead to multiple organ dysfunction (MOD) and death, with gastrointestinal (GI) and pulmonary involvement playing crucial roles. The objective of this study was to develop an animal model of combined injuries, peripheral tissue trauma (TBX animal model) combined with total body irradiation with 5% bone marrow shielding (TBI/BM5) to investigate if peripheral tissue trauma contributes to reduced survival. Male C57BL/6J mice were exposed to TBX10%, irradiation (TBI/BM5), or combined injuries (TBX10% + TBI/BM5). Experiments were conducted to evaluate mortality at day 7 after TBI/BM5. Serial euthanasia was performed at day 1, 3 and 6 or 7 after TBI/BM5 to evaluate the time course of pathophysiologic processes in combined injuries. Functional tests were performed to assess pulmonary function and GI motility. Postmortem samples of lungs and jejunum were collected to assess tissue damage. Results indicated higher lethality and shorter survival in the TBX10% +T BI/BM5 group than in the TBX10% or TBI/BM5 groups (day 1 vs. day 7 and 6, respectively). TBI/BM5 alone had no effects on the lungs but significantly impaired GI function at day 6. As expected, in the animals that received severe trauma (TBX10%), we observed impairment in lung function and delay in GI transit in the first 3 days, effects that decreased at later time points. Trauma combined with radiation (TBX10% + TBI/BM5) significantly augmented impairment of the lung and GI function in comparison to TBX10% and TBI/BM5 groups at 24 h. Histologic evaluation indicated that combined injuries caused greater tissue damage in the intestines in TBX10% + TBI/BM5 group when compared to other groups. We describe here the first combined tissue trauma/radiation injury model that will allow conduction of mechanistic studies to identify new therapeutic targets and serve as a platform for testing novel therapeutic interventions.
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Affiliation(s)
- Vlado Antonic
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Isabel L Jackson
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Gurung Ganga
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Terez Shea-Donohue
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Zeljko Vujaskovic
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
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Flood AB, Ali AN, Boyle HK, Du G, Satinsky VA, Swarts SG, Williams BB, Demidenko E, Schreiber W, Swartz HM. Evaluating the Special Needs of The Military for Radiation Biodosimetry for Tactical Warfare Against Deployed Troops: Comparing Military to Civilian Needs for Biodosimetry Methods. HEALTH PHYSICS 2016; 111:169-82. [PMID: 27356061 PMCID: PMC4930006 DOI: 10.1097/hp.0000000000000538] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of this paper is to delineate characteristics of biodosimetry most suitable for assessing individuals who have potentially been exposed to significant radiation from a nuclear device explosion when the primary population targeted by the explosion and needing rapid assessment for triage is civilians vs. deployed military personnel. The authors first carry out a systematic analysis of the requirements for biodosimetry to meet the military's needs to assess deployed troops in a warfare situation, which include accomplishing the military mission. Then the military's special capabilities to respond and carry out biodosimetry for deployed troops in warfare are compared and contrasted systematically, in contrast to those available to respond and conduct biodosimetry for civilians who have been targeted by terrorists, for example. Then the effectiveness of different biodosimetry methods to address military vs. civilian needs and capabilities in these scenarios was compared and, using five representative types of biodosimetry with sufficient published data to be useful for the simulations, the number of individuals are estimated who could be assessed by military vs. civilian responders within the timeframe needed for triage decisions. Analyses based on these scenarios indicate that, in comparison to responses for a civilian population, a wartime military response for deployed troops has both more complex requirements for and greater capabilities to use different types of biodosimetry to evaluate radiation exposure in a very short timeframe after the exposure occurs. Greater complexity for the deployed military is based on factors such as a greater likelihood of partial or whole body exposure, conditions that include exposure to neutrons, and a greater likelihood of combined injury. These simulations showed, for both the military and civilian response, that a very fast rate of initiating the processing (24,000 d) is needed to have at least some methods capable of completing the assessment of 50,000 people within a 2- or 6-d timeframe following exposure. This in turn suggests a very high capacity (i.e., laboratories, devices, supplies and expertise) would be necessary to achieve these rates. These simulations also demonstrated the practical importance of the military's superior capacity to minimize time to transport samples to offsite facilities and use the results to carry out triage quickly. Assuming sufficient resources and the fastest daily rate to initiate processing victims, the military scenario revealed that two biodosimetry methods could achieve the necessary throughput to triage 50,000 victims in 2 d (i.e., the timeframe needed for injured victims), and all five achieved the targeted throughput within 6 d. In contrast, simulations based on the civilian scenario revealed that no method could process 50,000 people in 2 d and only two could succeed within 6 d.
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Affiliation(s)
- Ann Barry Flood
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Arif N. Ali
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA
| | - Holly K. Boyle
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Gaixin Du
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | | | - Steven G. Swarts
- Department of Radiation Oncology, College of Medicine, University of Florida, Gainesville, FL
| | - Benjamin B. Williams
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
- Radiation Oncology Division, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Eugene Demidenko
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Wilson Schreiber
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Harold M. Swartz
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
- Radiation Oncology Division, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
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Ghrelin accelerates wound healing through GHS-R1a-mediated MAPK-NF-κB/GR signaling pathways in combined radiation and burn injury in rats. Sci Rep 2016; 6:27499. [PMID: 27271793 PMCID: PMC4895129 DOI: 10.1038/srep27499] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/19/2016] [Indexed: 11/08/2022] Open
Abstract
The therapeutic effect of ghrelin on wound healing was assessed using a rat model of combined radiation and burn injury (CRBI). Rat ghrelin, anti-rat tumor necrosis factor (TNF) α polyclonal antibody (PcAb), or selective antagonists of p38 mitogen-activated protein kinase (MAPK), c-Jun N-terminal kinase (JNK), and growth hormone secretagogue receptor (GHS-R) 1a (SB203580, SP600125, and [D-Lys3]-GHRP-6, respectively), were administered for seven consecutive days. Levels of various signaling molecules were assessed in isolated rat peritoneal macrophages. The results showed that serum ghrelin levels and levels of macrophage glucocorticoid receptor (GR) decreased, while phosphorylation of p38MAPK, JNK, and p65 nuclear factor (NF) κB increased. Ghrelin inhibited the serum induction of proinflammatory mediators, especially TNF-α, and promoted wound healing in a dose-dependent manner. Ghrelin treatment decreased phosphorylation of p38MAPK, JNK, and p65NF-κB, and increased GR levels in the presence of GHS-R1a. SB203580 or co-administration of SB203580 and SP600125 decreased TNF-α level, which may have contributed to the inactivation of p65NF-κB and increase in GR expression, as confirmed by western blotting. In conclusion, ghrelin enhances wound recovery in CRBI rats, possibly by decreasing the induction of TNF-α or other proinflammatory mediators that are involved in the regulation of GHS-R1a-mediated MAPK-NF-κB/GR signaling pathways.
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Gao F, Fish BL, Szabo A, Schock A, Narayanan J, Jacobs ER, Moulder JE, Lazarova Z, Medhora M. Enhanced survival from radiation pneumonitis by combined irradiation to the skin. Int J Radiat Biol 2014; 90:753-61. [PMID: 24827855 DOI: 10.3109/09553002.2014.922722] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To develop mitigators for combined irradiation to the lung and skin. METHODS Rats were treated with X-rays as follows: (1) 12.5 or 13 Gy whole thorax irradiation (WTI); (2) 30 Gy soft X-rays to 10% area of the skin only; (3) 12.5 or 13 Gy WTI + 30 Gy skin irradiation after 3 hours; (4) 12.5 Gy WTI + skin irradiation and treated with captopril (160 mg/m(2)/day) started after 7 days. Our end points were survival (primary) based on IACUC euthanization criteria and secondary measurements of breathing intervals and skin injury. Lung collagen at 210 days was measured in rats surviving 13 Gy WTI. RESULTS After 12.5 Gy WTI with or without skin irradiation, one rat (12.5 Gy WTI) was euthanized. Survival was less than 10% in rats receiving 13 Gy WTI, but was enhanced when combined with skin irradiation (p < 0.0001). Collagen content was increased at 210 days after 13 Gy WTI vs. 13 Gy WTI + 30 Gy skin irradiation (p < 0.05). Captopril improved radiation-dermatitis after 12.5 Gy WTI + 30 Gy skin irradiation (p = 0.008). CONCLUSIONS Radiation to the skin given 3 h after WTI mitigated morbidity during pneumonitis in rats. Captopril enhanced the rate of healing of radiation-dermatitis after combined irradiations to the thorax and skin.
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Affiliation(s)
- Feng Gao
- Department of Radiation Oncology
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