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Zablotska LB, Little MP, Hamada N. Revisiting an Inverse Dose-Fractionation Effect of Ionizing Radiation Exposure for Ischemic Heart Disease: Insights from Recent Studies. Radiat Res 2024; 202:80-86. [PMID: 38772552 PMCID: PMC11260496 DOI: 10.1667/rade-00230.1] [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: 11/07/2023] [Accepted: 04/26/2024] [Indexed: 05/23/2024]
Abstract
Over the last two decades, there has been emerging evidence suggesting that ionizing radiation exposures could be associated with elevated risks of cardiovascular disease (CVD), particularly ischemic heart disease (IHD). Excess CVD risks have been observed in a number of exposed groups, with generally similar risk estimates both at low and high radiation doses and dose rates. In 2014, we reported for the first time significantly higher risks of IHD mortality when radiation doses were delivered over a protracted period of time (an inverse dose-fractionation effect) in the Canadian Fluoroscopy Cohort Study. Here we review the current evidence on the dose-fractionation effect of radiation exposure, discuss potential implication for radiation protection policies and suggest further directions for research in this area.
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Affiliation(s)
- Lydia B Zablotska
- Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland; Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Oxford, United Kingdom
| | - 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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2
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Vieira GS, Martinez MC, Cardoso MRA. Cancer mortality in workers at risk of occupational exposure to ionizing radiation in a company in the nuclear sector headquarters in São Paulo. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240011. [PMID: 38511821 PMCID: PMC10946289 DOI: 10.1590/1980-549720240011] [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] [Received: 07/17/2023] [Revised: 11/13/2023] [Accepted: 12/06/2023] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE To compare cancer mortality among workers exposed to gamma and X radiation and the general population of the city of São Paulo, as well as that of the subgroup monitored with those not monitored for gamma and X radiation in a work unit with ionizing radiation based in the city of São Paulo. METHODS Between 2016 and 2021, a retrospective open cohort study was carried out with workers who were employed from 08/31/1956 to 12/31/2016 based on data collected at the company and in official institutions. Standardized mortality ratios (SMR) were calculated by sex, age and calendar period of cancers grouped according to type, risk factor and organ system in two analyses: in the external analysis, the mortality of the study population was compared with that of the general population of the city of São Paulo; In the internal analysis, the mortality of the monitored subgroup was compared with that of the subgroup not monitored for gamma and X radiation. RESULTS The external mortality analysis showed SMR=0.224 (95%CI 0.208-0.240) and the healthy worker effect, while the internal mortality analysis showed SMR=0.685 (95%CI 0.618-0.758). CONCLUSION This study showed lower cancer mortality among exposed workers when compared to mortality in the general population and the healthy worker effect. Among workers monitored for gamma and X radiation, cancer mortality was lower when compared to those not monitored.
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3
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Caramenti L, Gradowska PL, Moriña D, Byrnes G, Cardis E, Hauptmann M. Finite-Sample Bias of the Linear Excess Relative Risk in Cohort Studies of Computed Tomography-Related Radiation Exposure and Cancer. Radiat Res 2024; 201:206-214. [PMID: 38323646 DOI: 10.1667/rade-23-00187.1] [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: 09/23/2023] [Accepted: 01/22/2024] [Indexed: 02/08/2024]
Abstract
The linear excess relative risk (ERR) is the most commonly reported measure of association in radiation epidemiological studies, when individual dose estimates are available. While the asymptotic properties of the ERR estimator are well understood, there is evidence of small sample bias in case-control studies of treatment-related radiation exposure and second cancer risk. Cohort studies of cancer risk after exposure to low doses of radiation from diagnostic procedures, e.g., computed tomography (CT) examinations, typically have small numbers of cases and risks are small. Therefore, understanding the properties of the estimated ERR is essential for interpretation and analysis of such studies. We present results of a simulation study that evaluates the finite-sample bias of the ERR estimated by time-to-event analyses and its confidence interval using simulated data, resembling a retrospective cohort study of radiation-related leukemia risk after CT examinations in childhood and adolescence. Furthermore, we evaluate how the Firth-corrected estimator reduces the finite-sample bias of the classical estimator. We show that the ERR is overestimated by about 30% for a cohort of about 150,000 individuals, with 42 leukemia cases observed on average. The bias is reduced for higher baseline incidence rates and for higher values of the true ERR. As the number of cases increases, the ERR is approximately unbiased. The Firth correction reduces the bias for all cohort sizes to generally around or under 5%. Epidemiological studies showing an association between radiation exposure from pediatric CT and cancer risk, unless very large, may overestimate the magnitude of the relationship, while there is no evidence of an increased chance for false-positive results. Conducting large studies, perhaps by pooling individual studies to increase the number of cases, should be a priority. If this is not possible, Firth correction should be applied to reduce small-sample bias.
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Affiliation(s)
- L Caramenti
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane; Neuruppin, Germany
| | - P L Gradowska
- Erasmus MC Cancer Institute; Rotterdam, The Netherlands
| | - D Moriña
- Department of Econometrics, Statistics and Applied Economics, Riskcenter-IREA, Universitat de Barcelona (UB); Barcelona, Spain
| | - G Byrnes
- International Agency for Research in Cancer (IARC); Lyon, France
| | - E Cardis
- Institute for Global Health, ISGlobal; Barcelona, Spain
- Universitat Pompeu Fabra (UPF); Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Madrid, Spain
| | - M Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane; Neuruppin, Germany
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4
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Manenti G, Coppeta L, Kirev IV, Verno G, Garaci F, Magrini A, Floris R. Low-Dose Occupational Exposure to Ionizing Radiation and Cardiovascular Effects: A Narrative Review. Healthcare (Basel) 2024; 12:238. [PMID: 38255124 PMCID: PMC10815868 DOI: 10.3390/healthcare12020238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Historically, non-cancer diseases have not been considered a health risk following low-dose exposure to ionizing radiation. However, it is now well known that high-dose ionizing radiation causes cardiovascular disease, and emerging epidemiological evidence suggests an excess risk of non-cancer diseases even following exposure to lower doses of ionizing radiation than previously thought. In fact, the evidence is strongest for cardiovascular disease (CVD). The aim of this review was to report the most representative studies and data on the risk of CVD from low-dose radiation in people with occupational exposure. We reported the results of 27 articles selected from a database search of 1151 studies. The results show a complex evidence landscape on the relationship between radiation exposure and cardiovascular disease. In general, published papers show a positive association between ionizing radiation exposure and dermal microcirculation damage, ischemic heart disease, and cerebrovascular disease. Overall, they highlight the need for comprehensive and detailed research to clarify this relationship. Due to limited statistical power, the dose-risk relationship below 0.5 Gy is inconclusive, but if this relationship is found to have no threshold, it could have a significant impact on current estimates of health risks at low doses.
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Affiliation(s)
- Guglielmo Manenti
- Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.)
| | - Ivan Valentinov Kirev
- Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Greta Verno
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.)
| | - Francesco Garaci
- Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (L.C.); (G.V.)
| | - Roberto Floris
- Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, University of Rome Tor Vergata, 00133 Rome, Italy
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5
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Uruski P, Matuszewska J, Leśniewska A, Rychlewski D, Niklas A, Mikuła-Pietrasik J, Tykarski A, Książek K. An integrative review of nonobvious puzzles of cellular and molecular cardiooncology. Cell Mol Biol Lett 2023; 28:44. [PMID: 37221467 DOI: 10.1186/s11658-023-00451-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/17/2023] [Indexed: 05/25/2023] Open
Abstract
Oncologic patients are subjected to four major treatment types: surgery, radiotherapy, chemotherapy, and immunotherapy. All nonsurgical forms of cancer management are known to potentially violate the structural and functional integrity of the cardiovascular system. The prevalence and severity of cardiotoxicity and vascular abnormalities led to the emergence of a clinical subdiscipline, called cardiooncology. This relatively new, but rapidly expanding area of knowledge, primarily focuses on clinical observations linking the adverse effects of cancer therapy with deteriorated quality of life of cancer survivors and their increased morbidity and mortality. Cellular and molecular determinants of these relations are far less understood, mainly because of several unsolved paths and contradicting findings in the literature. In this article, we provide a comprehensive view of the cellular and molecular etiology of cardiooncology. We pay particular attention to various intracellular processes that arise in cardiomyocytes, vascular endothelial cells, and smooth muscle cells treated in experimentally-controlled conditions in vitro and in vivo with ionizing radiation and drugs representing diverse modes of anti-cancer activity.
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Affiliation(s)
- Paweł Uruski
- Department of Hypertensiology, Poznań University of Medical Sciences, Długa ½ Str., 61-848, Poznan, Poland
| | - Julia Matuszewska
- Department of Pathophysiology of Ageing and Civilization Diseases, Poznań University of Medical Sciences, Długa ½ Str., 61-848, Poznan, Poland
| | - Aleksandra Leśniewska
- Department of Pathophysiology of Ageing and Civilization Diseases, Poznań University of Medical Sciences, Długa ½ Str., 61-848, Poznan, Poland
| | - Daniel Rychlewski
- Department of Pathophysiology of Ageing and Civilization Diseases, Poznań University of Medical Sciences, Długa ½ Str., 61-848, Poznan, Poland
| | - Arkadiusz Niklas
- Department of Hypertensiology, Poznań University of Medical Sciences, Długa ½ Str., 61-848, Poznan, Poland
| | - Justyna Mikuła-Pietrasik
- Department of Pathophysiology of Ageing and Civilization Diseases, Poznań University of Medical Sciences, Długa ½ Str., 61-848, Poznan, Poland
| | - Andrzej Tykarski
- Department of Hypertensiology, Poznań University of Medical Sciences, Długa ½ Str., 61-848, Poznan, Poland
| | - Krzysztof Książek
- Department of Pathophysiology of Ageing and Civilization Diseases, Poznań University of Medical Sciences, Długa ½ Str., 61-848, Poznan, Poland.
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6
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ALMisned G, Rabaa E, Sen Baykal D, Ilik E, Kilic G, Zakaly HMH, Ene A, Tekin HO. Translocation of tungsten(vi) oxide/gadolinium(iii) fluoride in tellurite glasses towards improvement of gamma-ray attenuation features in high-density glass shields. OPEN CHEM 2023. [DOI: 10.1515/chem-2022-0289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Abstract
This study investigates the effect of substituting tungsten(vi) oxide/gadolinium(iii) fluoride in tellurite glasses whose densities varies from 5.0879 to 5.3246 g/cm3 on gamma-ray absorption properties. A range of fundamental absorption parameters, including attenuation coefficients, half-value layer thicknesses, effective atom and electron numbers, effective conductivity, exposure, and energy absorption buildup factors, were studied for five different glass samples with varying substitution ratios. The ratio of tungsten(vi) oxide to gadolinium(iii) fluoride varied between 0 and 20 mol%, as well as the TeO2 ratio in the composition was maintained between 90 and 80 mol%. The sample with the composition of 80–20 mol% TeO2/WO3, which attained the maximum density value with 20 mol% WO3 addition, showed the highest gamma-absorption capabilities based on the obtained findings in the range of 0.015–15 MeV. In consideration of the mechanical and physical properties of WO3 in tellurite glasses, it can be concluded that WO3 incorporation is a crucial monotonic process that may be utilized to further improve the properties of glass shields.
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Affiliation(s)
- Ghada ALMisned
- Department of Physics, College of Science, Princess Nourah Bint Abdulrahman University , P.O. Box 84428 , Riyadh 11671 , Saudi Arabia
| | - Elaf Rabaa
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah , Sharjah , 27272 , United Arab Emirates
| | - Duygu Sen Baykal
- Vocational School of Health Sciences, Istanbul Kent University , Istanbul 34433 , Turkey
| | - Erkan Ilik
- Department of Physics, Faculty of Science, Eskisehir Osmangazi University , Eskisehir , 26040 , Turkey
| | - Gokhan Kilic
- Department of Physics, Faculty of Science, Eskisehir Osmangazi University , Eskisehir , 26040 , Turkey
| | - Hesham M. H. Zakaly
- Institute of Physics and Technology, Ural Federal University , 620002 Ekaterinburg , Russia
- Physics Department, Faculty of Science, Al-Azhar University , Assiut 71524 , Egypt
| | - Antoaneta Ene
- INPOLDE Research Center, Department of Chemistry, Physics and Environment, Faculty of Sciences and Environment, Dunarea de Jos University of Galati , 47 Domneasca Street, 800008 Galati , Romania
| | - Huseyin Ozan Tekin
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah , Sharjah , 27272 , United Arab Emirates
- Computer Engineering Department, Faculty of Engineering and Natural Sciences, Istinye University , Istanbul 34396 , Turkey
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ALMisned G, Baykal DS, Kilic G, Ilik E, Rabaa E, Susoy G, Zakaly HM, Ene A, Tekin H. Comparative analysis on application conditions of indium (III) oxide-reinforced glasses in nuclear waste management and source transportation: A Monte Carlo simulation study. Heliyon 2023; 9:e14274. [PMID: 36950638 PMCID: PMC10025019 DOI: 10.1016/j.heliyon.2023.e14274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/09/2023] Open
Abstract
This study's primary objective is to provide the preliminary findings of novel research on the design of Indium (III) oxide-reinforced glass container that were thoroughly developed for the purpose of a nuclear material container for transportation and waste management applications. The shielding characteristics of an Indium (III) oxide-reinforced glass container with a certain elemental composition against the 60Co radioisotope was thoroughly evaluated. The energy deposition in the air surrounding the designed portable glass containers is measured using MCNPX general-purpose Monte Carlo code. Simulation studies were carried out using Lenovo-P620 workstation and the number of tracks was defined as 108 in each simulation phase. According to results, the indium oxide-doped C6 (TZI8) container exhibits superior protective properties compared to other conventional container materials such as 0.5Bitumen-0.5 Cement, Pb Glass composite, Steel-Magnetite concrete. In addition to its superiority in terms of nuclear safety, it is proposed that the source's simultaneous observation and monitoring, as well as the C6 (TZI8) glass structure's transparency, be underlined as significant advantages. High-density glasses, which may replace undesirable materials such as concrete and lead, provide several advantages in terms of production ease, non-toxic properties, and resource monitoring. In conclusion, the use of Indium (III) oxide-reinforced glass with its high transparency and outstanding protection properties may be a substantial choice in places where concrete is required to ensure the safety of nuclear materials.
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Affiliation(s)
- Ghada ALMisned
- Department of Physics, College of Science, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
| | - Duygu Sen Baykal
- Istanbul Kent University, Vocational School of Health Sciences, Medical Imaging Techniques, Istanbul, 34433, Turkiye
| | - G. Kilic
- Eskisehir Osmangazi University, Faculty of Science, Department of Physics, Eskisehir, 26040, Turkiye
| | - E. Ilik
- Eskisehir Osmangazi University, Faculty of Science, Department of Physics, Eskisehir, 26040, Turkiye
| | - Elaf Rabaa
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - G. Susoy
- Department of Physics, Faculty of Science, Istanbul University, 34134, Istanbul, Turkey
| | - Hesham M.H. Zakaly
- Institute of Physics and Technology, Ural Federal University, 620002, Ekaterinburg, Russia
- Physics Department, Faculty of Science, Al-Azhar University, Assiut, 71524, Egypt
| | - Antoaneta Ene
- INPOLDE Research Center, Department of Chemistry, Physics and Environment, Faculty of Sciences and Environment, Dunarea de Jos University of Galati, 47 Domneasca Street, 800008, Galati, Romania
- Corresponding author. INPOLDE Research Center, Department of Chemistry, Physics and Environment, Faculty of Sciences and Environment, Dunarea de Jos University of Galati, 47 Domneasca Street, 800008, Galati, Romania.
| | - H.O. Tekin
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
- Istinye University, Faculty of Engineering and Natural Sciences, Computer Engineering Department, Istanbul, 34396, Turkiye
- Corresponding author. Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.
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Koterov AN, Tukov AR, Ushenkova LN, Kalinina MV, Biryukov AP. Average Accumulated Radiation Doses for Global Nuclear Workers: Low Doses, Low Effects, and Comparison with Doses for Medical Radiologists. BIOL BULL+ 2022. [DOI: 10.1134/s106235902212007x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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9
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Lopes J, Baudin C, Leuraud K, Klokov D, Bernier MO. Ionizing radiation exposure during adulthood and risk of developing central nervous system tumors: systematic review and meta-analysis. Sci Rep 2022; 12:16209. [PMID: 36171442 PMCID: PMC9519546 DOI: 10.1038/s41598-022-20462-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/13/2022] [Indexed: 11/24/2022] Open
Abstract
Many studies on ionizing radiation (IR) exposure during childhood have shown deleterious effects on the central nervous system (CNS), however results regarding adult exposure are inconsistent, and no systematic reviews have been performed. The objectives are to synthesize the findings and draw evidence-based conclusions from epidemiological studies on the risk of benign and malignant brain and CNS tumors in humans exposed to low-to-moderate doses (< 0.5 Gy) of IR during adulthood/young adulthood. A systematic literature search of four electronic databases, supplemented by a hand search, was performed to retrieve relevant epidemiological studies published from 2000 to 2022. Pooled excess relative risk (ERRpooled) was estimated using a random effect model. Eighteen publications were included in the systematic review and twelve out of them were included in a meta-analysis. The following IR sources were considered: atomic bombs, occupational, and environmental exposures. No significant dose-risk association was found for brain/CNS tumors (ERRpooled at 100 mGy = − 0.01; 95% CI: − 0.05, 0.04). Our systematic review and meta-analysis did not show any association between exposure to low-to-moderate doses of IR and risk of CNS tumors. Further studies with histological information and precise dose assessment are needed.
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Affiliation(s)
- Julie Lopes
- Laboratory of Epidemiology (LEPID) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France.
| | - Clémence Baudin
- Laboratory of Epidemiology (LEPID) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France
| | - Klervi Leuraud
- Laboratory of Epidemiology (LEPID) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France
| | - Dmitry Klokov
- Laboratory of Radiobiology and Radiotoxicology (LRTOX) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France
| | - Marie-Odile Bernier
- Laboratory of Epidemiology (LEPID) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France
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10
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Risk of Developing Non-Cancerous Central Nervous System Diseases Due to Ionizing Radiation Exposure during Adulthood: Systematic Review and Meta-Analyses. Brain Sci 2022; 12:brainsci12080984. [PMID: 35892428 PMCID: PMC9331299 DOI: 10.3390/brainsci12080984] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 02/01/2023] Open
Abstract
Background: High-dose ionizing radiation (IR) (>0.5 Gy) is an established risk factor for cognitive impairments, but this cannot be concluded for low-to-moderate IR exposure (<0.5 Gy) in adulthood as study results are inconsistent. The objectives are to summarize relevant epidemiological studies of low-to-moderate IR exposure in adulthood and to assess the risk of non-cancerous CNS diseases. Methods: A systematic literature search of four electronic databases was performed to retrieve relevant epidemiological studies published from 2000 to 2022. Pooled standardized mortality ratios, relative risks, and excess relative risks (ERR) were estimated with a random effect model. Results: Forty-five publications were included in the systematic review, including thirty-three in the quantitative meta-analysis. The following sources of IR-exposure were considered: atomic bomb, occupational, environmental, and medical exposure. Increased dose-risk relationships were found for cerebrovascular diseases incidence and mortality (ERRpooled per 100 mGy = 0.04; 95% CI: 0.03−0.05; ERRpooled at 100 mGy = 0.01; 95% CI: −0.00−0.02, respectively) and for Parkinson’s disease (ERRpooled at 100 mGy = 0.11; 95% CI: 0.06−0.16); Conclusions: Our findings suggest that adult low-to-moderate IR exposure may have effects on non-cancerous CNS diseases. Further research addressing inherent variation issues is encouraged.
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11
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Tanno B, Novelli F, Leonardi S, Merla C, Babini G, Giardullo P, Kadhim M, Traynor D, Medipally DKR, Meade AD, Lyng FM, Tapio S, Marchetti L, Saran A, Pazzaglia S, Mancuso M. MiRNA-Mediated Fibrosis in the Out-of-Target Heart following Partial-Body Irradiation. Cancers (Basel) 2022; 14:cancers14143463. [PMID: 35884524 PMCID: PMC9323333 DOI: 10.3390/cancers14143463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
Recent reports have shown a link between radiation exposure and non-cancer diseases such as radiation-induced heart disease (RIHD). Radiation exposures are often inhomogeneous, and out-of-target effects have been studied in terms of cancer risk, but very few studies have been carried out for non-cancer diseases. Here, the role of miRNAs in the pathogenesis of RIHD was investigated. C57Bl/6J female mice were whole- (WBI) or partial-body-irradiated (PBI) with 2 Gy of X-rays or sham-irradiated (SI). In PBI exposure, the lower third of the mouse body was irradiated, while the upper two-thirds were shielded. From all groups, hearts were collected 15 days or 6 months post-irradiation. The MiRNome analysis at 15 days post-irradiation showed that miRNAs, belonging to the myomiR family, were highly differentially expressed in WBI and PBI mouse hearts compared with SI hearts. Raman spectral data collected 15 days and 6 months post-irradiation showed biochemical differences among SI, WBI and PBI mouse hearts. Fibrosis in WBI and PBI mouse hearts, indicated by the increased deposition of collagen and the overexpression of genes involved in myofibroblast activation, was found 6 months post-irradiation. Using an in vitro co-culture system, involving directly irradiated skeletal muscle and unirradiated ventricular cardiac human cells, we propose the role of miR-1/133a as mediators of the abscopal response, suggesting that miRNA-based strategies could be relevant for limiting tissue-dependent reactions in non-directly irradiated tissues.
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Affiliation(s)
- Barbara Tanno
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
- Correspondence: (B.T.); (M.M.)
| | - Flavia Novelli
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
| | - Simona Leonardi
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
| | - Caterina Merla
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
| | - Gabriele Babini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00168 Rome, Italy;
| | - Paola Giardullo
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
| | - Munira Kadhim
- Department of Biological and Medical Sciences, Oxford Brookes University (OBU), Oxford OX3 0BP, UK;
| | - Damien Traynor
- Radiation and Environmental Science Centre, Technological University Dublin, D02 HW71 Dublin, Ireland; (D.T.); (D.K.R.M.); (A.D.M.); (F.M.L.)
| | - Dinesh K. R. Medipally
- Radiation and Environmental Science Centre, Technological University Dublin, D02 HW71 Dublin, Ireland; (D.T.); (D.K.R.M.); (A.D.M.); (F.M.L.)
| | - Aidan D. Meade
- Radiation and Environmental Science Centre, Technological University Dublin, D02 HW71 Dublin, Ireland; (D.T.); (D.K.R.M.); (A.D.M.); (F.M.L.)
| | - Fiona M. Lyng
- Radiation and Environmental Science Centre, Technological University Dublin, D02 HW71 Dublin, Ireland; (D.T.); (D.K.R.M.); (A.D.M.); (F.M.L.)
| | - Soile Tapio
- Helmholtz Zentrum München, German Research Center for Environmental Health GmbH (HMGU), Institute of Radiation Biology, D-85764 Neuherberg, Germany;
| | - Luca Marchetti
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
- Department of Agricultural and Forestry Sciences, Università della Tuscia, 01100 Viterbo, Italy
| | - Anna Saran
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
- Department of Radiation Physics, Guglielmo Marconi University, 00193 Rome, Italy
| | - Simonetta Pazzaglia
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
| | - Mariateresa Mancuso
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy; (F.N.); (S.L.); (C.M.); (P.G.); (L.M.); (A.S.); (S.P.)
- Correspondence: (B.T.); (M.M.)
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12
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Park S, Lee DN, Jin YW, Cha ES, Jang WI, Park S, Seo S. Non-cancer disease prevalence and association with occupational radiation exposure among Korean radiation workers. Sci Rep 2021; 11:22415. [PMID: 34789809 PMCID: PMC8599676 DOI: 10.1038/s41598-021-01875-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/03/2021] [Indexed: 11/09/2022] Open
Abstract
Radiation-induced cancer risks have known stochastic effects; however, regarding non-cancer diseases, evidence of risk at low radiation doses remains unclear. We aimed to identify underlying characteristics concerning non-cancer disease prevalence and determine associations with radiation dose among Korean radiation workers. Using a nationwide baseline survey, 20,608 workers were enrolled. Data concerning participant demographics, occupational characteristics, lifestyle, and lifetime prevalence of non-cancer diseases were linked to a national dose registry. We compared non-cancer disease prevalences in the Korean general population with those in this cohort and undertook a dose-response analysis concerning the cumulative dose. Hyperlipidemia (10.6%), circulatory (9.6%), and respiratory (4.1%) system diseases, followed by thyroid diseases (3.5%), had the highest prevalences, with hyperlipidemia, thyroid diseases, and hepatitis prevalence being higher in the cohort than in the general population. Radiation doses were associated with elevated prevalences of most diseases; however, associations were attenuated and not significant after adjusting for confounders, except for musculoskeletal system diseases (prevalence odds ratio [POR]/10 mSv, 1.03; 95% confidence interval [CI] 1.00-1.07) and cataracts (POR/10 mSv, 1.04; 95% CI 1.00-1.07). Further studies are warranted to investigate the causality of those non-cancer diseases involving more varied confounders such as physical and psychosocial stresses and ultraviolet light.
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Affiliation(s)
- Soojin Park
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Dal Nim Lee
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Young Woo Jin
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Eun Shil Cha
- grid.222754.40000 0001 0840 2678Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Won-Il Jang
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea ,grid.415464.60000 0000 9489 1588Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Sunhoo Park
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea ,grid.415464.60000 0000 9489 1588Department of Pathology, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Songwon Seo
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812, South Korea.
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13
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Boice JD, Cohen SS, Mumma MT, Hagemeyer DA, Chen H, Golden AP, Yoder RC, Dauer LT. Mortality from Leukemia, Cancer and Heart Disease among U.S. Nuclear Power Plant Workers, 1957-2011. Int J Radiat Biol 2021; 98:657-678. [PMID: 34669562 DOI: 10.1080/09553002.2021.1967507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of the Million Person Study (MPS) of Low Dose Health Effects is to examine the level of radiation risk for chronic exposures received gradually over time and not acutely as was the case for the Japanese atomic bomb survivors. Nuclear power plant (NPP) workers comprise nearly 15 percent of the MPS. Leukemia, selected cancers, Parkinson's disease, ischemic heart disease (IHD) and other causes of death are evaluated. METHODS AND MATERIAL The U.S. Nuclear Regulatory Commission's Radiation Exposure Information and Reporting System (REIRS) and the Landauer, Inc. dosimetry databases identified 135,193 NPP workers first monitored 1957-1984. Annual personal dose equivalents [Hp(10)] were available for each worker. Radiation records from all places of employment were sought. Vital status was determined through 2011. Mean absorbed doses to red bone marrow (RBM), esophagus, lung, colon, brain and heart were estimated by adjusting the recorded Hp(10) for each worker by scaling factors, accounting for exposure geometry and energy of the incident gamma radiation. Standardized mortality ratios (SMR) were calculated. Radiation risks were estimated using Cox proportional hazards models. RESULTS Nearly 50% of workers were employed for more than 20 years. The mean duration of follow-up was 30.2 y. Overall, 29,076 total deaths occurred, 296 from leukemia other than chronic lymphocytic leukemia (CLL), 3,382 from lung cancer, 140 from Parkinson's disease and 5,410 from IHD. The mean dose to RBM was 37.9 mGy (maximum 1.0 Gy; percent >100 mGy was 9.2%), 43.2 mGy to lung, 43.7 mGy to colon, 33.2 mGy to brain, and 43.9 mGy to heart. The SMRs (95% CI) were 1.06 (0.94;1.19) for leukemia other than CLL, 1.10 (1.07;1.14) for lung cancer, 0.90 (0.76;1.06) for Parkinson's disease, and 0.80 (0.78; 0.82) for IHD. The excess relative risk (ERR) per 100 mGy for leukemia other than CLL was 0.15 (90% CI 0.001; 0.31). For all solid cancers the ERR per 100 mGy (95% CI) was 0.01 (-0.03; 0.05), for lung cancer -0.04 (-0.11; 0.02), for Parkinson's disease 0.24 (-0.02; 0.50), and for IHD -0.01 (-0.06; 0.04). CONCLUSION Prolonged exposure to radiation increased the risk of leukemia other than CLL among NPP workers. There was little evidence for a radiation-association for all solid cancers, lung cancer or ischemic heart disease. Increased precision will be forthcoming as the different cohorts within the MPS are combined, such as industrial radiographers and medical radiation workers who were assembled and evaluated in like manner.
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Affiliation(s)
- John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA.,Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | | | - Michael T Mumma
- International Epidemiology Institute, Rockville, MD, USA.,Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Heidi Chen
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Lawrence T Dauer
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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14
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Walsh L, Shore R, Azizova TV, Rühm W. On the choice of methodology for evaluating dose-rate effects on radiation-related cancer risks. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2021; 60:493-500. [PMID: 34170393 PMCID: PMC8310494 DOI: 10.1007/s00411-021-00920-y] [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: 05/13/2021] [Accepted: 06/17/2021] [Indexed: 05/06/2023]
Abstract
Recently, several compilations of individual radiation epidemiology study results have aimed to obtain direct evidence on the magnitudes of dose-rate effects on radiation-related cancer risks. These compilations have relied on meta-analyses of ratios of risks from low dose-rate studies and matched risks from the solid cancer Excess Relative Risk models fitted to the acutely exposed Japanese A-bomb cohort. The purpose here is to demonstrate how choices of methodology for evaluating dose-rate effects on radiation-related cancer risks may influence the results reported for dose-rate effects. The current analysis is intended to address methodological issues and does not imply that the authors recommend a particular value for the dose and dose-rate effectiveness factor. A set of 22 results from one recent published study has been adopted here as a test set of data for applying the many different methods described here, that nearly all produced highly consistent results. Some recently voiced concerns, involving the recalling of the well-known theoretical point-the ratio of two normal random variables has a theoretically unbounded variance-that could potentially cause issues, are shown to be unfounded when aimed at the published work cited and examined in detail here. In the calculation of dose-rate effects for radiation protection purposes, it is recommended that meta-estimators should retain the full epidemiological and dosimetric matching information between the risks from the individual low dose-rate studies and the acutely exposed A-bomb cohort and that a regression approach can be considered as a useful alternative to current approaches.
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Affiliation(s)
- Linda Walsh
- Department of Physics, Science Faculty, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland
| | - Roy Shore
- Department of Population Health, New York University Grossman School of Medicine, New York, USA
| | - Tamara V. Azizova
- Southern Urals Biophysics Institute, Ozyorskoe shosse 19, Ozyorsk, Chelyabinsk region 456780 Russia
| | - Werner Rühm
- Institute of Radiation Medicine, Helmholtz Zentrum München- German Research Center for Environmental Health, 85764 Neuherberg, Germany
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15
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Nagane M, Yasui H, Kuppusamy P, Yamashita T, Inanami O. DNA damage response in vascular endothelial senescence: Implication for radiation-induced cardiovascular diseases. JOURNAL OF RADIATION RESEARCH 2021; 62:564-573. [PMID: 33912932 PMCID: PMC8273807 DOI: 10.1093/jrr/rrab032] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/24/2021] [Indexed: 05/27/2023]
Abstract
A post-exposure cohort study in Hiroshima and Nagasaki reported that low-dose exposure to radiation heightened the risk of cardiovascular diseases (CVD), such as stroke and myocardial infarction, by 14-18% per Gy. Moreover, the risk of atherosclerosis in the coronary arteries reportedly increases with radiation therapy of the chest, including breast and lung cancer treatment. Cellular senescence of vascular endothelial cells (ECs) is believed to play an important role in radiation-induced CVDs. The molecular mechanism of age-related cellular senescence is believed to involve genomic instability and DNA damage response (DDR); the chronic inflammation associated with senescence causes cardiovascular damage. Therefore, vascular endothelial cell senescence is believed to induce the pathogenesis of CVDs after radiation exposure. The findings of several prior studies have revealed that ionizing radiation (IR) induces cellular senescence as well as cell death in ECs. We have previously reported that DDR activates endothelial nitric oxide (NO) synthase, and NO production promotes endothelial senescence. Endothelial NO synthase (eNOS) is a major isoform expressed in ECs that maintains cardiovascular homeostasis. Therefore, radiation-induced NO production, a component of the DDR in ECs, may be involved in CVDs after radiation exposure. In this article, we describe the pathology of radiation-induced CVD and the unique radio-response to radiation exposure in ECs.
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Affiliation(s)
- Masaki Nagane
- Laboratory of Biochemistry, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa 252-5201, Japan
| | - Hironobu Yasui
- Laboratory of Radiation Biology, Department of Applied Veterinary Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Periannan Kuppusamy
- Department of Radiology, The Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire 03756, US
| | - Tadashi Yamashita
- Laboratory of Biochemistry, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa 252-5201, Japan
| | - Osamu Inanami
- Laboratory of Radiation Biology, Department of Applied Veterinary Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
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16
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Karpov AB, Takhauov RM, Zerenkov AG, Semenova YV, Bogdanov IM, Kazantceva SB, Blinov AP, Kalinkin DE, Gorina GV, Litvinova OV, Ermolaev YD, Mironova EB, Plaksin MB, Takhauov AR, Zablotska LB. Descriptive characteristics of occupational exposures and medical follow-up in the cohort of workers of the Siberian Group of Chemical Enterprises in Seversk, Russia. Int J Radiat Biol 2021; 97:848-860. [PMID: 33979238 DOI: 10.1080/09553002.2021.1917787] [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: 10/06/2020] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To date, only a few studies have examined long-term health risks of exposures in the uranium processing industry and reported contradictory results, necessitating further research in this area. This is the first description of a cohort of ∼65,000 uranium processing workers (20.6% women) of the Siberian Group of Chemical Enterprises (SGCE) in Seversk, Russia, first employed during 1950-2010. METHODS SGCE is one of the largest and oldest uranium processing complexes in the world. SGCE workers at the Radiochemical, Plutonium, Sublimate and Enrichment plants were exposed to a combination of internal and external radiation, while workers at the Support Facility were primarily exposed to non-radiation factors. RESULTS Mean cumulative gamma-ray dose based on individual external dosimetry was 28.3 millisievert. About 4,000 workers have individual biophysical survey data that could be used for estimation of organ doses from uranium. SGCE workers were followed up for mortality and cancer incidence during 1950-2013 (vital status known for 80.8% of workers). The SGCE computerized database contains information on the results of regular medical examinations, and on smoking, alcohol and other individual characteristics. CONCLUSIONS The SGCE cohort is uniquely suited to examine long-term health risks of exposures to gamma-radiation and long-lived radionuclides in uranium processing workers.
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Affiliation(s)
- Andrey B Karpov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian State Medical University of the Ministry of Health of the Russian Federation, Tomsk, Russia
| | - Ravil M Takhauov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian State Medical University of the Ministry of Health of the Russian Federation, Tomsk, Russia
| | - Andrey G Zerenkov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Yulia V Semenova
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Igor M Bogdanov
- Center of Hygiene and Epidemiology №81 of the Federal Medical and Biological Agency, Seversk, Russia
| | - Svetlana B Kazantceva
- Center of Hygiene and Epidemiology №81 of the Federal Medical and Biological Agency, Seversk, Russia
| | - Aleksey P Blinov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Dmitriy E Kalinkin
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Galina V Gorina
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Olesya V Litvinova
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Yuriy D Ermolaev
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Elena B Mironova
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Mikhail B Plaksin
- Siberian Federal Research and Clinical Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Anas R Takhauov
- Seversk Biophysical Research Center of the Federal Medical and Biological Agency, Seversk, Russia
| | - Lydia B Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
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17
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Apostoaei AI, Thomas BA, Hoffman FO, Kocher DC, Thiessen KM, Borrego D, Lee C, Simon SL, Zablotska LB. Fluoroscopy X-Ray Organ-Specific Dosimetry System (FLUXOR) for Estimation of Organ Doses and Their Uncertainties in the Canadian Fluoroscopy Cohort Study. Radiat Res 2021; 195:385-396. [PMID: 33544842 PMCID: PMC8133309 DOI: 10.1667/rade-20-00212.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/13/2021] [Indexed: 11/03/2022]
Abstract
As part of ongoing efforts to assess lifespan disease mortality and incidence in 63,715 patients from the Canadian Fluoroscopy Cohort Study (CFCS) who were treated for tuberculosis between 1930 and 1969, we developed a new FLUoroscopy X-ray ORgan-specific dosimetry system (FLUXOR) to estimate radiation doses to various organs and tissues. Approximately 45% of patients received medical procedures accompanied by fluoroscopy, including artificial pneumothorax (air in pleural cavity to collapse of lungs), pneumoperitoneum (air in peritoneal cavity), aspiration of fluid from pleural cavity and gastrointestinal series. In addition, patients received chest radiographs for purposes of diagnosis and monitoring of disease status. FLUXOR utilizes age-, sex- and body size-dependent dose coefficients for fluoroscopy and radiography exams, estimated using radiation transport simulations in up-to-date computational hybrid anthropomorphic phantoms. The phantoms include an updated heart model, and were adjusted to match the estimated mean height and body mass of tuberculosis patients in Canada during the relevant time period. Patient-specific data (machine settings, exposure duration, patient orientation) used during individual fluoroscopy or radiography exams were not recorded. Doses to patients were based on parameter values inferred from interviews with 91 physicians practicing at the time, historical literature, and estimated number of procedures from patient records. FLUXOR uses probability distributions to represent the uncertainty in the unknown true, average value of each dosimetry parameter. Uncertainties were shared across all patients within specific subgroups of the cohort, defined by age at treatment, sex, type of procedure, time period of exams and region (Nova Scotia or other provinces). Monte Carlo techniques were used to propagate uncertainties, by sampling alternative average values for each parameter. Alternative average doses per exam were estimated for patients in each subgroup, with the total average dose per individual determined by the number of exams received. This process was repeated to produce alternative cohort vectors of average organ doses per patient. This article presents estimates of doses to lungs, female breast, active bone marrow and heart wall. Means and 95% confidence intervals (CI) of average organ doses across all 63,715 patients were 320 (160, 560) mGy to lungs, 250 (120, 450) mGy to female breast, 190 (100, 340) mGy to heart wall and 92 (47, 160) mGy to active bone marrow. Approximately 60% of all patients had average doses to the four studied organs of less than 10 mGy, 10% received between 10 and 100 mGy, 25% between 100 and 1,000 mGy, and 5% above 1,000 mGy. Pneumothorax was the medical procedure that accounted for the largest contribution to cohort average doses. The major contributors to uncertainty in estimated doses per procedure for the four organs of interest are the uncertainties in exposure duration, tube voltage, tube output, and patient orientation relative to the X-ray tube, with the uncertainty in exposure duration being most often the dominant source. Uncertainty in patient orientation was important for doses to female breast, and, to a lesser degree, for doses to heart wall. The uncertainty in number of exams was an important contributor to uncertainty for ∼30% of patients. The estimated organ doses and their uncertainties will be used for analyses of incidence and mortality of cancer and non-cancer diseases. The CFCS cohort is an important addition to existing radio-epidemiological cohorts, given the moderate-to-high doses received fractionated over several years, the type of irradiation (external irradiation only), radiation type (X rays only), a balanced combination of both genders and inclusion of people of all ages.
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Affiliation(s)
| | - Brian A. Thomas
- Oak Ridge Center for Risk Analysis, Inc., Oak Ridge, Tennessee 37830
| | - F. Owen Hoffman
- Oak Ridge Center for Risk Analysis, Inc., Oak Ridge, Tennessee 37830
| | - David C. Kocher
- Oak Ridge Center for Risk Analysis, Inc., Oak Ridge, Tennessee 37830
| | | | - David Borrego
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-9778
| | - Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-9778
| | - Steven L. Simon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-9778
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California 94143-1228
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18
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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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19
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Shahid S, Masood K, Khan AW. Prediction of impacts on liver enzymes from the exposure of low-dose medical radiations through artificial intelligence algorithms. Rev Assoc Med Bras (1992) 2021; 67:248-259. [PMID: 34406249 DOI: 10.1590/1806-9282.67.02.20200653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/16/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study aimed to develop artificial intelligence and machine learning-based models to predict alterations in liver enzymes from the exposure of low annual average effective doses in radiology and nuclear medicine personnel of Institute of Nuclear Medicine and Oncology Hospital. METHODS Ninety workers from the Radiology and Nuclear Medicine departments were included. A high-capacity thermoluminescent was used for annual average effective radiation dose measurements. The liver function tests were conducted for all subjects and controls. Three supervised learning models (multilayer precentron; logistic regression; and random forest) were applied and cross-validated to predict any alteration in liver enzymes. The t-test was applied to see if subjects and controls were significantly different in liver function tests. RESULTS The annual average effective doses were in the range of 0.07-1.15 mSv. Alanine transaminase was 50% high and aspartate transaminase was 20% high in radiation workers. There existed a significant difference (p=0.0008) in Alanine-aminotransferase between radiation-exposed and radiation-unexposed workers. Random forest model achieved 90-96.6% accuracies in Alanine-aminotransferase and Aspartate-aminotransferase predictions. The second best classifier model was the Multilayer perceptron (65.5-80% accuracies). CONCLUSION As there is a need of regular monitoring of hepatic function in radiation-exposed people, our artificial intelligence-based predicting model random forest is proved accurate in prediagnosing alterations in liver enzymes.
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Affiliation(s)
- Saman Shahid
- National University of Computer and Emerging Sciences, Foundation for the Advancement of Science and Technology, Department of Sciences & Humanities - Lahore, Pakistan
| | - Khalid Masood
- Institute of Nuclear Medicine and Oncology Lahore, Department of Medical Physics - Lahore, Pakistan
| | - Abdul Waheed Khan
- Institute of Nuclear Medicine and Oncology Lahore, Department of Medical Physics - Lahore, Pakistan
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20
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McEvoy-May JH, Jones DE, Stoa L, Dixon DL, Tai TC, Hooker AM, Boreham DR, Wilson JY. Unchanged cardiovascular and respiratory outcomes in healthy C57Bl/6 mice after in utero exposure to ionizing radiation. Int J Radiat Biol 2020; 97:131-138. [PMID: 33258723 DOI: 10.1080/09553002.2021.1855372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Advancements in medical technologies that utilize ionizing radiation have led to improved diagnosis and patient outcomes, however, the effect of ionizing radiation on the patient is still debated. In the case of pregnancy, the potential effects are not only to the mother but also to the fetus. The aim of this study was to determine if exposure from ionizing radiation during pregnancy alters the development of the cardiovascular and respiratory system of the offspring. MATERIALS AND METHODS Pregnant C57Bl/6 mice were whole-body irradiated at gestational day 15 with a 137Cs gamma radiation emitting source at 0 mGy (sham), 50 mGy, 300 mGy, or 1000 mGy. Post weaning weight and blood pressure measurements were taken weekly for both male and female pups until euthanasia at 16-17 weeks postnatal age. Immediately following, the trachea was cannulated, and the lungs and heart excised. The lung was then examined to assess respiratory physiological outcomes. RESULTS AND CONCLUSIONS In utero exposures to 1000 mGy caused significant growth reduction compared to sham irradiated, which remained persistent for both male and female pups. Growth restriction was not observed for lower exposures. There was no significant change in any cardiovascular or respiratory outcomes measured. Overall, intrauterine exposures to ionizing radiation does not appear to significantly alter the development of the cardiovascular and respiratory system in C57Bl/6 pups up to 17 weeks postnatal age.
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Affiliation(s)
- James H McEvoy-May
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.,Department of Biology, McMaster University, Hamilton, Ontario, Canada.,Centre for Radiation Research, Education and Innovation, University of Adelaide, Adelaide, South Australia, Australia
| | - Devon E Jones
- Department of Biology, McMaster University, Hamilton, Ontario, Canada
| | - Lisa Stoa
- Department of Biology, McMaster University, Hamilton, Ontario, Canada
| | - Dani-Louise Dixon
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.,Centre for Radiation Research, Education and Innovation, University of Adelaide, Adelaide, South Australia, Australia.,Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - T C Tai
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Antony M Hooker
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.,Centre for Radiation Research, Education and Innovation, University of Adelaide, Adelaide, South Australia, Australia
| | - Douglas R Boreham
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Joanna Y Wilson
- Department of Biology, McMaster University, Hamilton, Ontario, Canada
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21
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Rikhi R, Samra G, Arustamyan M, Patel J, Zhou L, Bungo B, Moudgil R. Radiation induced cardiovascular disease: An odyssey of bedside-bench-bedside approach. LIFE SCIENCES IN SPACE RESEARCH 2020; 27:49-55. [PMID: 34756229 DOI: 10.1016/j.lssr.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 06/13/2023]
Abstract
The journey to Mars will be an ambitious, yet arduous task as it will entail culmination of all the information we have gathered over many decades. While the mission is of utmost importance, preservation of astronaut's well-being is paramount also. To that end, mitigation of radiation risk especially afflicting cardiovascular disease (CVD) is of great interest and challenge. Current data from astronauts on low earth orbit and Apollo missions provides insight on the risk of CVD from radiation exposure. However, data is limited given the small cohort size of astronauts who embarked on just nine prolonged missions. Therefore, a cerebral approach to understanding and mitigating risks are essential. This paper discusses the need for a predictive preclinical model to help understand and mitigate the effects of radiation on astronauts. We will discuss strengths and limitations of preclinical models and the methods of validating and constructing a model to predict human clinical outcomes. Our bedside-bench-bedside approach focuses on adapting the preclinical model through common investigative tools used between humans and animals. The result will be an optimization of preclinical model to a point of being a surrogate clinical model capable of predicting CVD outcomes in astronauts exposed to radiation.
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Affiliation(s)
- Rishi Rikhi
- Section of Clinical Cardiology, Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Gursharan Samra
- Section of Clinical Cardiology, Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Michael Arustamyan
- Section of Clinical Cardiology, Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Jay Patel
- Section of Clinical Cardiology, Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Leon Zhou
- Section of Clinical Cardiology, Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Brandon Bungo
- Section of Clinical Cardiology, Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Rohit Moudgil
- Section of Clinical Cardiology, Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195, USA.
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22
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Study the relationship of endothelial damage / dysfunction due to occupational exposure to low dose ionizing radiation versus high dose exposure during radiotherapy. Cancer Treat Res Commun 2020; 25:100215. [PMID: 33091734 DOI: 10.1016/j.ctarc.2020.100215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/15/2020] [Accepted: 09/28/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Vascular injuries caused by irradiation include acute vasculitis with neutrophil invasion, endothelial cell (EC) swelling, capillary loss, and activation of coagulator mechanisms, along with local ischemia and fibrosis. The circulating endothelial cells (CECs), increase dramatically in diseases with vascular damage. AIM The aim of this study is to provide data on the endothelial dysfunction due to occupational exposure to low dose ionizing radiation versus high dose exposure during radiotherapy (RT). PATIENTS AND METHODS This study included 100 subjects divided into three main groups: Group I: High dose exposure group: 50 breast cancer patients treated with post-operative radiotherapy. Group II: Low dose exposure group: 25 hospital radiation workers. Group III: 25 healthy volunteers' age and sex matched as control group who had never worked in radiation-related jobs. TM levels measured by enzyme linked immunosorbent assay (ELISA). Circulating endothelial cells (CEC) enumerated in peripheral blood by flow cytometric analysis of their signature receptor CD146. RESULTS % CD146+ cells and plasma TM were significantly increased in radiation workers and after exposure to radiotherapy treatment in breast cancer patients. When comparing patients group with radiation workers group, we found significant elevation in plasma TM in radiation workers while insignificant difference was found in % CD146+ cells. CONCLUSION CECs and plasma TM both are increased in radiation workers and patients treated with radiotherapy. They may constitute valuable markers of endothelial injury. Workers exposed to low doses of ionizing radiation may develop significant endothelial dysfunction predisposes them to cardiovascular complications namely thrombosis, mostly due to oxidative stress among other causes.
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23
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The Risk of Cancer from CT Scans and Other Sources of Low-Dose Radiation: A Critical Appraisal of Methodologic Quality. Prehosp Disaster Med 2020; 35:3-16. [PMID: 32009606 DOI: 10.1017/s1049023x1900520x] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Concern exists that radiation exposure from computerized tomography (CT) will cause thousands of malignancies. Other experts share the same perspective regarding the risk from additional sources of low-dose ionizing radiation, such as the releases from Three Mile Island (1979; Pennsylvania USA) and Fukushima (2011; Okuma, Fukushima Prefecture, Japan) nuclear power plant disasters. If this premise is false, the fear of cancer leading patients and physicians to avoid CT scans and disaster responders to initiate forced evacuations is unfounded. STUDY OBJECTIVE This investigation provides a quantitative evaluation of the methodologic quality of studies to determine the evidentiary strength supporting or refuting a causal relationship between low-dose radiation and cancer. It will assess the number of higher quality studies that support or question the role of low-dose radiation in oncogenesis. METHODS This investigation is a systematic, methodologic review of articles published from 1975-2017 examining cancer risk from external low-dose x-ray and gamma radiation, defined as less than 200 millisievert (mSv). Following the PRISMA guidelines, the authors performed a search of the PubMed, Cochrane, Scopus, and Web of Science databases. Methodologies of selected articles were scored using the Newcastle Ottawa Scale (NOS) and a tool identifying 11 lower quality indicators. Manuscript methodologies were ranked as higher quality if they scored no lower than seven out of nine on the NOS and contained no more than two lower quality indicators. Investigators then characterized articles as supporting or not supporting a causal relationship between low-dose radiation and cancer. RESULTS Investigators identified 4,382 articles for initial review. A total of 62 articles met all inclusion/exclusion criteria and were evaluated in this study. Quantitative evaluation of the manuscripts' methodologic strengths found 25 studies met higher quality criteria while 37 studies met lower quality criteria. Of the 25 studies with higher quality methods, 21 out of 25 did not support cancer induction by low-dose radiation (P = .0003). CONCLUSIONS A clear preponderance of articles with higher quality methods found no increased risk of cancer from low-dose radiation. The evidence suggests that exposure to multiple CT scans and other sources of low-dose radiation with a cumulative dose up to 100 mSv (approximately 10 scans), and possibly as high as 200 mSv (approximately 20 scans), does not increase cancer risk.
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24
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A Cohort Study of Korean Radiation Workers: Baseline Characteristics of Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072328. [PMID: 32235620 PMCID: PMC7177891 DOI: 10.3390/ijerph17072328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 12/22/2022]
Abstract
The Korean Radiation Worker Study investigated the health effects of protracted low-dose radiation among nuclear-related occupations in the Nuclear Safety and Security Commission in Korea. From 2016–2017, 20,608 workers were enrolled (86.5% men and 30.7% nuclear power plant workers). The mean cumulative dose ± standard deviation between 1984 and 2017 (1st quarter) was 11.8 ± 28.8 (range 0–417) mSv. Doses below recording level (≤0.1 mSv) were reported in 7901 (38.3%) cases; 431 (2%) had cumulative doses ≥100 mSv. From 1999–2016, 212 cancers (189 men, 23 women) occurred; thyroid cancer predominated (39.2%, 72 men, 11 women). In men, the standardized incidence ratio (SIR) for all cancers was significantly decreased (SIR = 0.76, 95% CI 0.66–0.88); however, that for thyroid cancer was significantly increased (SIR = 1.94, 95% CI 1.54–2.44). Compared to the non-exposed group (≤0.1 mSv), the relative risk (RR) in the exposed group (>0.1 mSv) after adjusting for sex, attained age, smoking status, and duration of employment was 0.82 (95% CI 0.60–1.12) for all cancers and 0.83 (95% CI 0.49–1.83) for thyroid cancer. The preliminary findings from this baseline study with a shorter follow-up than the latency period for solid cancer cannot exclude possible associations between radiation doses and cancer risk.
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25
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Livingston K, Schlaak RA, Puckett LL, Bergom C. The Role of Mitochondrial Dysfunction in Radiation-Induced Heart Disease: From Bench to Bedside. Front Cardiovasc Med 2020; 7:20. [PMID: 32154269 PMCID: PMC7047199 DOI: 10.3389/fcvm.2020.00020] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/05/2020] [Indexed: 12/25/2022] Open
Abstract
Radiation is a key modality in the treatment of many cancers; however, it can also affect normal tissues adjacent to the tumor, leading to toxic effects. Radiation to the thoracic region, such as that received as part of treatment for breast and lung cancer, can result in incidental dose to the heart, leading to cardiac dysfunction, such as pericarditis, coronary artery disease, ischemic heart disease, conduction defects, and valvular dysfunction. The underlying mechanisms for these morbidities are currently being studied but are not entirely understood. There has been increasing focus on the role of radiation-induced mitochondrial dysfunction and the ensuing impact on various cardiac functions in both preclinical models and in humans. Cardiomyocyte mitochondria are critical to cardiac function, and mitochondria make up a substantial part of a cardiomyocyte's volume. Mitochondrial dysfunction can also alter other cell types in the heart. This review summarizes several factors related to radiation-induced mitochondrial dysfunction in cardiomyocytes and endothelial cells. These factors include mitochondrial DNA mutations, oxidative stress, alterations in various mitochondrial function-related transcription factors, and apoptosis. Through improved understanding of mitochondria-dependent mechanisms of radiation-induced heart dysfunction, potential therapeutic targets can be developed to assist in prevention and treatment of radiation-induced heart damage.
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Affiliation(s)
- Katie Livingston
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States.,Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Rachel A Schlaak
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Pharmacology & Toxicology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Lindsay L Puckett
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States.,Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Carmen Bergom
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States.,Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States.,Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
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26
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Shore RE, Beck HL, Boice JD, Caffrey EA, Davis S, Grogan HA, Mettler FA, Preston RJ, Till JE, Wakeford R, Walsh L, Dauer LT. Recent Epidemiologic Studies and the Linear No-Threshold Model For Radiation Protection-Considerations Regarding NCRP Commentary 27. HEALTH PHYSICS 2019; 116:235-246. [PMID: 30585971 DOI: 10.1097/hp.0000000000001015] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
National Council on Radiation Protection and Measurements Commentary 27 examines recent epidemiologic data primarily from low-dose or low dose-rate studies of low linear-energy-transfer radiation and cancer to assess whether they support the linear no-threshold model as used in radiation protection. The commentary provides a critical review of low-dose or low dose-rate studies, most published within the last 10 y, that are applicable to current occupational, environmental, and medical radiation exposures. The strengths and weaknesses of the epidemiologic methods, dosimetry assessments, and statistical modeling of 29 epidemiologic studies of total solid cancer, leukemia, breast cancer, and thyroid cancer, as well as heritable effects and a few nonmalignant conditions, were evaluated. An appraisal of the degree to which the low-dose or low dose-rate studies supported a linear no-threshold model for radiation protection or on the contrary, demonstrated sufficient evidence that the linear no-threshold model is inappropriate for the purposes of radiation protection was also included. The review found that many, though not all, studies of solid cancer supported the continued use of the linear no-threshold model in radiation protection. Evaluations of the principal studies of leukemia and low-dose or low dose-rate radiation exposure also lent support for the linear no-threshold model as used in protection. Ischemic heart disease, a major type of cardiovascular disease, was examined briefly, but the results of recent studies were considered too weak or inconsistent to allow firm conclusions regarding support of the linear no-threshold model. It is acknowledged that the possible risks from very low doses of low linear-energy-transfer radiation are small and uncertain and that it may never be possible to prove or disprove the validity of the linear no-threshold assumption by epidemiologic means. Nonetheless, the preponderance of recent epidemiologic data on solid cancer is supportive of the continued use of the linear no-threshold model for the purposes of radiation protection. This conclusion is in accord with judgments by other national and international scientific committees, based on somewhat older data. Currently, no alternative dose-response relationship appears more pragmatic or prudent for radiation protection purposes than the linear no-threshold model.
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Affiliation(s)
- Roy E Shore
- New York University School of Medicine, New York, NY, and Radiation Effects Research Foundation, Hiroshima, Japan (retired)
| | | | - John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, and Vanderbilt University, Nashville, TN
| | | | - Scott Davis
- Fred Hutchinson Cancer Research Center, Seattle, WA
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27
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Hagemeyer D, Nichols G, Mumma MT, Boice JD, Brock TA. 50 Years of the Radiation Exposure Information and Reporting System. Int J Radiat Biol 2018; 98:568-571. [DOI: 10.1080/09553002.2018.1540896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | - John D. Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA
- Division of Epidemiology Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
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28
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Cucinotta FA, Smirnova OA. Dependence of the human leukemia risk on the dose and dose rate of continuous irradiation: Modeling study. LIFE SCIENCES IN SPACE RESEARCH 2018; 19:17-23. [PMID: 30482277 DOI: 10.1016/j.lssr.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/24/2018] [Accepted: 08/14/2018] [Indexed: 06/09/2023]
Abstract
A biologically motivated dynamical model of the radiogenic leukemia risk assessment (Smirnova, 2015, 2017; Smirnova and Cucinotta, 2018) is applied to the study of the effects of dose rate N and dose D on the excess relative risk ERR for non-CLL leukemia among continuously irradiated humans. In the study, the dose rate N of continuous irradiation is varied from 3×10-6 to 0.576 Sv/day and the dose D is varied from zero to 2.2 Sv. In the considered range of doses D, the developed model reproduces the linear dependence of ERR on D for the low dose rates N. For higher N, the dependence of ERR on D remains linear for low doses D and becomes nonlinear for higher D, that agrees with empirical observations. In turn, for the considered values of D, the developed model reproduces the practical independence of the ratio ERR/D on N at low N, the inverse dependence of the ratio ERR/D on N at higher N, and the direct dependence of the ratio ERR/D on N at more high N, that also conforms to empirical observations. Additionally, the modeling values of ERR obtained for the scenarios of continuous irradiation corresponding to those for the nuclear industry workers, Chernobyl cleanup workers, and patients treated with radiotherapy, practically, coincide with the respective empirical data. All these modeling findings, along with those obtained in our previous works, demonstrate the predictive power of the developed model and its capability of estimating, on quantitative level, the excess relative risk for non-CLL leukemia among humans exposed to continuous irradiation in wide ranges of doses and dose rates.
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Affiliation(s)
- Francis A Cucinotta
- Department of Health Physics and Diagnostic Sciences, University of Nevada, Las Vegas, NV, USA.
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29
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Shore RE, Beck HL, Boice JD, Caffrey EA, Davis S, Grogan HA, Mettler FA, Preston RJ, Till JE, Wakeford R, Walsh L, Dauer LT. Implications of recent epidemiologic studies for the linear nonthreshold model and radiation protection. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2018; 38:1217-1233. [PMID: 30004025 DOI: 10.1088/1361-6498/aad348] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The recently published NCRP Commentary No. 27 evaluated the new information from epidemiologic studies as to their degree of support for applying the linear nonthreshold (LNT) model of carcinogenic effects for radiation protection purposes (NCRP 2018 Implications of Recent Epidemiologic Studies for the Linear Nonthreshold Model and Radiation Protection, Commentary No. 27 (Bethesda, MD: National Council on Radiation Protection and Measurements)). The aim was to determine whether recent epidemiologic studies of low-LET radiation, particularly those at low doses and/or low dose rates (LD/LDR), broadly support the LNT model of carcinogenic risk or, on the contrary, demonstrate sufficient evidence that the LNT model is inappropriate for the purposes of radiation protection. An updated review was needed because a considerable number of reports of radiation epidemiologic studies based on new or updated data have been published since other major reviews were conducted by national and international scientific committees. The Commentary provides a critical review of the LD/LDR studies that are most directly applicable to current occupational, environmental and medical radiation exposure circumstances. This Memorandum summarises several of the more important LD/LDR studies that incorporate radiation dose responses for solid cancer and leukemia that were reviewed in Commentary No. 27. In addition, an overview is provided of radiation studies of breast and thyroid cancers, and cancer after childhood exposures. Non-cancers are briefly touched upon such as ischemic heart disease, cataracts, and heritable genetic effects. To assess the applicability and utility of the LNT model for radiation protection, the Commentary evaluated 29 epidemiologic studies or groups of studies, primarily of total solid cancer, in terms of strengths and weaknesses in their epidemiologic methods, dosimetry approaches, and statistical modelling, and the degree to which they supported a LNT model for continued use in radiation protection. Recommendations for how to make epidemiologic radiation studies more informative are outlined. The NCRP Committee recognises that the risks from LD/LDR exposures are small and uncertain. The Committee judged that the available epidemiologic data were broadly supportive of the LNT model and that at this time no alternative dose-response relationship appears more pragmatic or prudent for radiation protection purposes.
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Affiliation(s)
- R E Shore
- New York University School of Medicine, New York, United States of America. Radiation Effects Research Foundation, Hiroshima, Japan
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30
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Affiliation(s)
- David G. Hoel
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
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31
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Seo S, Lee D, Seong KM, Park S, Kim SG, Won JU, Jin YW. Radiation-related occupational cancer and its recognition criteria in South Korea. Ann Occup Environ Med 2018; 30:9. [PMID: 29435340 PMCID: PMC5797363 DOI: 10.1186/s40557-018-0219-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 01/17/2018] [Indexed: 12/15/2022] Open
Abstract
Ionizing radiation is a well-known carcinogen, and is listed as one carcinogenic agent of occupational cancer. Given the increase in the number of workers exposed to radiation, as well as the increase in concern regarding occupational cancer, the number of radiation-related occupational cancer claims is expected to increase. Unlike exposure assessment of other carcinogenic agents in the workplace, such as asbestos and benzene, radiation exposure is usually assessed on an individual basis with personal dosimeters, which makes it feasible to assess whether a worker’s cancer occurrence is associated with their individual exposure. However, given the absence of a threshold dose for cancer initiation, it remains difficult to identify radiation exposure as the root cause of occupational cancer. Moreover, the association between cancer and radiation exposure in the workplace has not been clearly established due to a lack of scientific evidence. Therefore, criteria for the recognition of radiation-related occupational cancer should be carefully reviewed and updated with new scientific evidence and social consensus. The current criteria in Korea are valid in terms of eligible radiogenic cancer sites, adequate latent period, assessment of radiation exposure, and probability of causation. However, reducing uncertainty with respect to the determination of causation between exposure and cancer and developing more specific criteria that considers mixed exposure to radiation and other carcinogenic agents remains an important open question.
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Affiliation(s)
- Songwon Seo
- 1National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, 75, Nowon-ro, Nowon-gu, Seoul, 01812 Republic of Korea.,2Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dalnim Lee
- 1National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, 75, Nowon-ro, Nowon-gu, Seoul, 01812 Republic of Korea
| | - Ki Moon Seong
- 1National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, 75, Nowon-ro, Nowon-gu, Seoul, 01812 Republic of Korea
| | - Sunhoo Park
- 1National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, 75, Nowon-ro, Nowon-gu, Seoul, 01812 Republic of Korea
| | - Soo-Geun Kim
- 3Department of Occupational Medicine, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Jong-Uk Won
- 4The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
| | - Young Woo Jin
- 1National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, 75, Nowon-ro, Nowon-gu, Seoul, 01812 Republic of Korea
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32
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Ebrahimian TG, Beugnies L, Surette J, Priest N, Gueguen Y, Gloaguen C, Benderitter M, Jourdain JR, Tack K. Chronic Exposure to External Low-Dose Gamma Radiation Induces an Increase in Anti-inflammatory and Anti-oxidative Parameters Resulting in Atherosclerotic Plaque Size Reduction in ApoE -/- Mice. Radiat Res 2017; 189:187-196. [PMID: 29227739 DOI: 10.1667/rr14823.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Populations living in radiation-contaminated territories, such as Chernobyl and Fukushima, are chronically exposed to external gamma radiation and internal radionuclide contamination due to the large amount of 137Cs released in the environment. The effect of chronic low-dose exposure on the development of cardiovascular diseases remains unclear. Previously reported studies have shown that low-dose radiation exposure could lead to discrepancies according to dose rate. In this study, we examined the effect of very low-dose and dose-rate chronic external exposure on atherosclerosis development. ApoE-/- mice were chronically irradiated with a gamma source for 8 months at two different dose rates, 12 and 28 μGy/h, equivalent to dose rates measured in contaminated territories, with a cumulative dose of 67 and 157 mGy, respectively. We evaluated plaque size and phenotype, inflammatory profile and oxidative stress status. The results of this study showed a decrease in plaque sizes and an increase in collagen content in ApoE-/- mice exposed to 28 μGy/h for 8 months compared to nonexposed animals. The plaque phenotype was associated with an increase in anti-inflammatory and anti-oxidative gene expression. These results suggest that chronic low-dose gamma irradiation induces an upregulation of organism defenses leading to a decrease in inflammation and plaque size. To our knowledge, this is the first study to describe the possible effect of chronic external very low-dose ionizing radiation exposure for 8 months. This work could help to identify the potential existence of a dose threshold, below that which harmful effects are not exhibited and beneficial effects are potentially observed. Furthermore, these findings permit consideration of the importance of dose rate in radiation protection.
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Affiliation(s)
- T G Ebrahimian
- a Institut de Radioprotection et de Sureté Nucléaire (IRSN), PRP-HOM, SRBE, Fontenay-aux-Roses, France; and
| | - L Beugnies
- a Institut de Radioprotection et de Sureté Nucléaire (IRSN), PRP-HOM, SRBE, Fontenay-aux-Roses, France; and
| | - J Surette
- b Radiobiology and Health, Canadian Nuclear Laboratories, Chalk-River, Ontario K0J 1J0, Canada
| | - N Priest
- b Radiobiology and Health, Canadian Nuclear Laboratories, Chalk-River, Ontario K0J 1J0, Canada
| | - Y Gueguen
- a Institut de Radioprotection et de Sureté Nucléaire (IRSN), PRP-HOM, SRBE, Fontenay-aux-Roses, France; and
| | - C Gloaguen
- a Institut de Radioprotection et de Sureté Nucléaire (IRSN), PRP-HOM, SRBE, Fontenay-aux-Roses, France; and
| | - M Benderitter
- a Institut de Radioprotection et de Sureté Nucléaire (IRSN), PRP-HOM, SRBE, Fontenay-aux-Roses, France; and
| | - J R Jourdain
- a Institut de Radioprotection et de Sureté Nucléaire (IRSN), PRP-HOM, SRBE, Fontenay-aux-Roses, France; and
| | - K Tack
- a Institut de Radioprotection et de Sureté Nucléaire (IRSN), PRP-HOM, SRBE, Fontenay-aux-Roses, France; and
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33
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Shore R, Walsh L, Azizova T, Rühm W. Risk of solid cancer in low dose-rate radiation epidemiological studies and the dose-rate effectiveness factor. Int J Radiat Biol 2017; 93:1064-1078. [DOI: 10.1080/09553002.2017.1319090] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Roy Shore
- Environmental Medicine, New York University School of Medicine, New York, U.S.A
| | - Linda Walsh
- Department of Physics, University of Zurich, Zurich, Switzerland
| | - Tamara Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorsk, Russia
| | - Werner Rühm
- Department of Radiation Sciences, Institute of Radiation Protection, Helmholtz Centre Munich, Neuherberg, Germany
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34
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Occupational Radiation Exposure and Deaths From Malignant Intracranial Neoplasms of the Brain and CNS in U.S. Radiologic Technologists, 1983-2012. AJR Am J Roentgenol 2017; 208:1278-1284. [PMID: 28350475 DOI: 10.2214/ajr.16.16964] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Childhood exposure to acute, high-dose radiation has consistently been associated with risk of benign and malignant intracranial tumors of the brain and CNS, but data on risks of adulthood exposure to protracted, low-to-moderate doses of radiation are limited. In a large cohort of radiologic technologists, we quantified the association between protracted, low-to-moderate doses of radiation and malignant intracranial tumor mortality. MATERIALS AND METHODS The study population included 83,655 female and 26,642 male U.S. radiologic technologists who were certified for at least 2 years as of 1982. The cohort was followed from the completion date of the first or second survey (1983-1989 or 1994-1998) to the date of death, loss to follow-up, or December 31, 2012, whichever was earliest. Occupational brain doses through 1997 were based on work history, historical data, and, for most years after the mid 1970s, individual film badge measurements. Radiation-related excess relative risks (ERRs) and 95% CIs were estimated from Poisson regression models adjusted for attained age and sex. RESULTS Cumulative mean absorbed brain dose was 12 mGy (range, 0-290 mGy). During follow-up (median, 26.7 years), 193 technologists died of a malignant intracranial neoplasm. Based on models incorporating a 5-year lagged cumulative brain dose, cumulative brain dose was not associated with malignant intracranial tumor mortality (overall ERR per 100 mGy, 0.1; 95% CI, < -0.3 to 1.5). No effect modification was observed by sex or birth cohort. CONCLUSION In this nationwide cohort of radiologic technologists, cumulative occupational radiation exposure to the brain was not associated with malignant intracranial tumor mortality.
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Kamkar M, Wei L, Gaudet C, Bugden M, Petryk J, Duan Y, Wyatt HM, Wells RG, Marcel YL, Priest ND, Mitchel REJ, Ruddy TD. Evaluation of Apoptosis with 99mTc-rhAnnexin V-128 and Inflammation with 18F-FDG in a Low-Dose Irradiation Model of Atherosclerosis in Apolipoprotein E-Deficient Mice. J Nucl Med 2016; 57:1784-1791. [PMID: 27307347 DOI: 10.2967/jnumed.116.172346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/10/2016] [Indexed: 11/16/2022] Open
Abstract
Low-dose radiation in apolipoprotein E-deficient (ApoE-/-) mice has a protective effect with less subsequent atherosclerosis. Inflammation and apoptosis play major roles in the development of atherosclerosis. We evaluated the temporal pattern of the development of histologic atherosclerosis, inflammation with 18F-FDG, and apoptosis with 99mTc-rhAnnexin V-128 at 3 time points. METHODS ApoE-/- mice were fed a high-fat diet, exposed to low-dose 60Co γ-radiation of 25 mGy at 2 mo of age, and evaluated within 1 wk (2-mo group), 1 mo (3-mo group), and 2 mo (4-mo group) from the time of radiation. Mice were divided into 3 subgroups and each received 18F-FDG, 99mTc-rhAnnexin V-128, or no radiotracer for autoradiography. Mice underwent euthanasia and aortic root dissection. The extent of atherosclerosis was determined by en face and Oil red O imaging. Aortic arch inflammation (18F-FDG) and apoptosis (99mTc-rhAnnexin V-128) were determined with digital autoradiography. Aortic sinus sections were stained with Sudan IV for assessment of lesion area and stage, antiCD68 antibody for inflammation and anti-cleaved-caspase 3 antibody for apoptosis. RESULTS The extent of aortic atherosclerosis increased from 2 to 3 mo and from 3 to 4 mo. Inflammation (CD68) decreased and apoptosis (anti-cleaved-caspase 3 antibody) increased in aortic sinus slices measured as percentage of lesion by 4 mo. With increasing lesion stage, lesion inflammation decreased and lesion apoptosis increased. Aortic arch inflammation (18F-FDG uptake) did not differ over time and did not correlate with average lesion stage. However, aortic arch apoptosis (99mTc-rhAnnexin V-128) increased significantly by 4 mo and correlated with average lesion stage. There were no differences between the treatment subgroups (18F-FDG, 99mTc-rhAnnexin V-128, or no radiotracer). CONCLUSION The temporal pattern of development of inflammation and apoptosis differ during the development of atherosclerosis in ApoE-/- mice treated with low-dose radiation. Advanced lesions are characterized by increased apoptosis and either less or similar amounts of inflammation, shown on immunohistochemistry and autoradiography. Treatment with radiotracers had no significant effects on extent of atherosclerosis, inflammation, or apoptosis.
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Affiliation(s)
- Maryam Kamkar
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Chantal Gaudet
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Michelle Bugden
- Radiological Protection Research and Instrumentation Branch, Canadian Nuclear Laboratories, Chalk River, Canada
| | - Julia Petryk
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Yin Duan
- Nordion, Inc., Kanata, Canada; and
| | - Heather M Wyatt
- Radiological Protection Research and Instrumentation Branch, Canadian Nuclear Laboratories, Chalk River, Canada
| | - R Glenn Wells
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Yves L Marcel
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Nicholas D Priest
- Radiological Protection Research and Instrumentation Branch, Canadian Nuclear Laboratories, Chalk River, Canada
| | - Ronald E J Mitchel
- Radiological Protection Research and Instrumentation Branch, Canadian Nuclear Laboratories, Chalk River, Canada
| | - Terrence D Ruddy
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
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Seong KM, Seo S, Lee D, Kim MJ, Lee SS, Park S, Jin YW. Is the Linear No-Threshold Dose-Response Paradigm Still Necessary for the Assessment of Health Effects of Low Dose Radiation? J Korean Med Sci 2016; 31 Suppl 1:S10-23. [PMID: 26908982 PMCID: PMC4756336 DOI: 10.3346/jkms.2016.31.s1.s10] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/17/2015] [Indexed: 12/17/2022] Open
Abstract
Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation.
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Affiliation(s)
- Ki Moon Seong
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Songwon Seo
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Dalnim Lee
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Min-Jeong Kim
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Seung-Sook Lee
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Sunhoo Park
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Young Woo Jin
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
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Andreassi MG, Piccaluga E, Gargani L, Sabatino L, Borghini A, Faita F, Bruno RM, Padovani R, Guagliumi G, Picano E. Subclinical carotid atherosclerosis and early vascular aging from long-term low-dose ionizing radiation exposure: a genetic, telomere, and vascular ultrasound study in cardiac catheterization laboratory staff. JACC Cardiovasc Interv 2016; 8:616-27. [PMID: 25907089 DOI: 10.1016/j.jcin.2014.12.233] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 12/02/2014] [Accepted: 12/18/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study sought to assess the association between long-term radiation exposure in the catheterization laboratory (cath lab) and early signs of subclinical atherosclerosis. BACKGROUND There is growing evidence of an excess risk of cardiovascular disease at low-dose levels of ionizing radiation exposure. METHODS Left and right carotid intima-media thickness (CIMT) was measured in 223 cath lab personnel (141 male; age, 45 ± 8 years) and 222 unexposed subjects (113 male; age, 44±10 years). Leukocyte telomere length (LTL) was evaluated by quantitative reverse transcriptase polymerase chain reaction. The DNA repair gene XRCC3 Thr241Met polymorphism was also analyzed to explore the possible interaction with radiation exposure. The occupational radiological risk score (ORRS) was computed for each subject on the basis of the length of employment, individual caseload, and proximity to the radiation source. A complete lifetime effective dose (mSv) was recorded for 57 workers. RESULTS Left, right, and averaged CIMTs were significantly increased in high-exposure workers compared with both control subjects and low-exposure workers (all p values<0.04). On the left side, but not on the right, there was a significant correlation between CIMT and ORRS (p=0.001) as well as lifetime dose (p=0.006). LTL was significantly reduced in exposed workers compared with control subjects (p=0.008). There was a significant correlation between LTL and both ORRS (p=0.002) and lifetime dose (p=0.03). The XRCC3 Met241 allele presented a significant interaction with high exposure for right side (pinteraction=0.002), left side (pinteraction<0.0001), and averaged (pinteraction<0.0001) CIMTs. CONCLUSIONS Long-term radiation exposure in a cath lab may be associated with increased subclinical CIMT and telomere length shortening, suggesting evidence of accelerated vascular aging and early atherosclerosis.
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Affiliation(s)
| | | | - Luna Gargani
- CNR Institute of Clinical Physiology, Pisa, Italy
| | | | | | | | | | - Renato Padovani
- International Centre for Theoretical Physics, Trieste, Italy
| | - Giulio Guagliumi
- Ospedale Papa Giovanni XXIII, Cardiovascular Department, Bergamo, Italy; on behalf of the Healthy Cath Lab (HCL) Study Group of the Italian Society of Invasive Cardiology (GISE)
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Helm A, Lee R, Durante M, Ritter S. The Influence of C-Ions and X-rays on Human Umbilical Vein Endothelial Cells. Front Oncol 2016; 6:5. [PMID: 26835420 PMCID: PMC4718996 DOI: 10.3389/fonc.2016.00005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/04/2016] [Indexed: 12/21/2022] Open
Abstract
Damage to the endothelium of blood vessels, which may occur during radiotherapy, is discussed as a potential precursor to the development of cardiovascular disease. We thus chose human umbilical vein endothelial cells as a model system to examine the effect of low- and high-linear energy transfer (LET) radiation. Cells were exposed to 250 kV X-rays or carbon ions (C-ions) with the energies of either 9.8 MeV/u (LET = 170 keV/μm) or 91 MeV/u (LET = 28 keV/μm). Subculture of cells was performed regularly up to 46 days (~22 population doublings) post-irradiation. Immediately after exposure, cells were seeded for the colony forming assay. Additionally, at regular intervals, mitochondrial membrane potential (MMP) (JC-1 staining) and cellular senescence (senescence-associated β-galactosidase staining) were assessed. Cytogenetic damage was investigated by the micronucleus assay and the high-resolution multiplex fluorescence in situ hybridization (mFISH) technique. Analysis of radiation-induced damage shortly after exposure showed that C-ions are more effective than X-rays with respect to cell inactivation or the induction of cytogenetic damage (micronucleus assay) as observed in other cell systems. For 9.8 and 91 MeV/u C-ions, relative biological effectiveness values of 2.4 and 1.5 were obtained for cell inactivation. At the subsequent time points, the number of micronucleated cells decreased to the control level. Analysis of chromosomal damage by mFISH technique revealed aberrations frequently involving chromosome 13 irrespective of dose or radiation quality. Disruption of the MMP was seen only a few days after exposure to X-rays or C-ions. Cellular senescence was not altered by radiation at any time point investigated. Altogether, our data indicate that shortly after exposure C-ions were more effective in damaging endothelial cells than X-rays. However, late damage to endothelial cells was not found for the applied conditions and endpoints.
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Affiliation(s)
- Alexander Helm
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research , Darmstadt , Germany
| | - Ryonfa Lee
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research , Darmstadt , Germany
| | - Marco Durante
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research, Darmstadt, Germany; Department of Condensed Matter Physics, Technical University of Darmstadt, Darmstadt, Germany
| | - Sylvia Ritter
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research , Darmstadt , Germany
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Peterson LE, Kovyrshina T. Adjustment of lifetime risks of space radiation-induced cancer by the healthy worker effect and cancer misclassification. Heliyon 2015; 1:e00048. [PMID: 27441231 PMCID: PMC4945756 DOI: 10.1016/j.heliyon.2015.e00048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/13/2015] [Accepted: 11/10/2015] [Indexed: 01/12/2023] Open
Abstract
Background. The healthy worker effect (HWE) is a source of bias in occupational studies of mortality among workers caused by use of comparative disease rates based on public data, which include mortality of unhealthy members of the public who are screened out of the workplace. For the US astronaut corp, the HWE is assumed to be strong due to the rigorous medical selection and surveillance. This investigation focused on the effect of correcting for HWE on projected lifetime risk estimates for radiation-induced cancer mortality and incidence. Methods. We performed radiation-induced cancer risk assessment using Poisson regression of cancer mortality and incidence rates among Hiroshima and Nagasaki atomic bomb survivors. Regression coefficients were used for generating risk coefficients for the excess absolute, transfer, and excess relative models. Excess lifetime risks (ELR) for radiation exposure and baseline lifetime risks (BLR) were adjusted for the HWE using standardized mortality ratios (SMR) for aviators and nuclear workers who were occupationally exposed to ionizing radiation. We also adjusted lifetime risks by cancer mortality misclassification among atomic bomb survivors. Results. For all cancers combined (“Nonleukemia”), the effect of adjusting the all-cause hazard rate by the simulated quantiles of the all-cause SMR resulted in a mean difference (not percent difference) in ELR of 0.65% and mean difference of 4% for mortality BLR, and mean change of 6.2% in BLR for incidence. The effect of adjusting the excess (radiation-induced) cancer rate or baseline cancer hazard rate by simulated quantiles of cancer-specific SMRs resulted in a mean difference of −1.2% in the all-cancer mortality ELR and mean difference of −6.4% in the mortality BLR. Whereas for incidence, the effect of adjusting by cancer-specific SMRs resulted in a mean change of −14.4% for the all-cancer BLR. Only cancer mortality risks were adjusted by simulated quantiles for misclassification, and results indicate a mean change of 1.1% for all-cancer mortality ELR, while the mean change in the all-cancer PC was approximately 4% for males and 6% for females. Conclusions. The typical life table approach for projecting lifetime risk of radiation-induced cancer mortality and incidence for astronauts and radiation workers can be improved by adjusting for HWE while simulating the uncertainty of input rates, input excess risk coefficients, and bias correction factors during multiple Monte Carlo realizations of the life table.
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Affiliation(s)
- Leif E Peterson
- Center for Biostatistics, Houston Methodist Research Institute, 6565 Fannin Street, Suite MGJ6-031, Houston, TX 77030, United States
| | - Tatiana Kovyrshina
- Center for Biostatistics, Houston Methodist Research Institute, 6565 Fannin Street, Suite MGJ6-031, Houston, TX 77030, United States
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Barcellos-Hoff MH, Blakely EA, Burma S, Fornace AJ, Gerson S, Hlatky L, Kirsch DG, Luderer U, Shay J, Wang Y, Weil MM. Concepts and challenges in cancer risk prediction for the space radiation environment. LIFE SCIENCES IN SPACE RESEARCH 2015; 6:92-103. [PMID: 26256633 DOI: 10.1016/j.lssr.2015.07.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 06/04/2023]
Abstract
Cancer is an important long-term risk for astronauts exposed to protons and high-energy charged particles during travel and residence on asteroids, the moon, and other planets. NASA's Biomedical Critical Path Roadmap defines the carcinogenic risks of radiation exposure as one of four type I risks. A type I risk represents a demonstrated, serious problem with no countermeasure concepts, and may be a potential "show-stopper" for long duration spaceflight. Estimating the carcinogenic risks for humans who will be exposed to heavy ions during deep space exploration has very large uncertainties at present. There are no human data that address risk from extended exposure to complex radiation fields. The overarching goal in this area to improve risk modeling is to provide biological insight and mechanistic analysis of radiation quality effects on carcinogenesis. Understanding mechanisms will provide routes to modeling and predicting risk and designing countermeasures. This white paper reviews broad issues related to experimental models and concepts in space radiation carcinogenesis as well as the current state of the field to place into context recent findings and concepts derived from the NASA Space Radiation Program.
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Affiliation(s)
| | | | - Sandeep Burma
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | - Lynn Hlatky
- Center of Cancer Systems Biology, Tufts University, Boston, MA, USA
| | | | | | - Jerry Shay
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ya Wang
- Emory University, Atlanta, GA, USA
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Environmental carcinogens and mutational pathways in atherosclerosis. Int J Hyg Environ Health 2015; 218:293-312. [DOI: 10.1016/j.ijheh.2015.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 01/26/2015] [Accepted: 01/29/2015] [Indexed: 02/07/2023]
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Mathias D, Mitchel REJ, Barclay M, Wyatt H, Bugden M, Priest ND, Whitman SC, Scholz M, Hildebrandt G, Kamprad M, Glasow A. Low-dose irradiation affects expression of inflammatory markers in the heart of ApoE -/- mice. PLoS One 2015; 10:e0119661. [PMID: 25799423 PMCID: PMC4370602 DOI: 10.1371/journal.pone.0119661] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 01/21/2015] [Indexed: 01/17/2023] Open
Abstract
Epidemiological studies indicate long-term risks of ionizing radiation on the heart, even at moderate doses. In this study, we investigated the inflammatory, thrombotic and fibrotic late responses of the heart after low-dose irradiation (IR) with specific emphasize on the dose rate. Hypercholesterolemic ApoE-deficient mice were sacrificed 3 and 6 months after total body irradiation (TBI) with 0.025, 0.05, 0.1, 0.5 or 2 Gy at low (1 mGy/min) or high dose rate (150 mGy/min). The expression of inflammatory and thrombotic markers was quantified in frozen heart sections (CD31, E-selectin, thrombomodulin, ICAM-1, VCAM-1, collagen IV, Thy-1, and CD45) and in plasma samples (IL6, KC, MCP-1, TNFα, INFγ, IL-1β, TGFβ, INFγ, IL-10, sICAM-1, sE-selectin, sVCAM-1 and fibrinogen) by fluorescence analysis and ELISA. We found that even very low irradiation doses induced adaptive late responses, such as increases of capillary density and changes in collagen IV and Thy-1 levels indicating compensatory regulation. Slight decreases of ICAM-1 levels and reduction of Thy 1 expression at 0.025–0.5 Gy indicate anti-inflammatory effects, whereas at the highest dose (2 Gy) increased VCAM-1 levels on the endocardium may represent a switch to a pro-inflammatory response. Plasma samples partially confirmed this pattern, showing a decrease of proinflammatory markers (sVCAM, sICAM) at 0.025–2.0 Gy. In contrast, an enhancement of MCP-1, TNFα and fibrinogen at 0.05–2.0 Gy indicated a proinflammatory and prothrombotic systemic response. Multivariate analysis also revealed significant age-dependent increases (KC, MCP-1, fibrinogen) and decreases (sICAM, sVCAM, sE-selectin) of plasma markers. This paper represents local and systemic effects of low-dose irradiation, including also age- and dose rate-dependent responses in the ApoE-/- mouse model. These insights in the multiple inflammatory/thrombotic effects caused by low-dose irradiation might facilitate an individual evaluation and intervention of radiation related, long-term side effects but also give important implications for low dose anti-inflammatory radiotherapy.
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Affiliation(s)
- Daniel Mathias
- Department of Radiation Therapy, University of Leipzig, Leipzig, Germany
| | - Ronald E. J. Mitchel
- Radiological Protection Research and Instrumentation Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Mirela Barclay
- Departments of Pathology and Laboratory Medicine and Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Vascular Biology Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Heather Wyatt
- Radiological Protection Research and Instrumentation Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Michelle Bugden
- Radiological Protection Research and Instrumentation Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Nicholas D. Priest
- Radiological Protection Research and Instrumentation Branch, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Stewart C. Whitman
- Departments of Pathology and Laboratory Medicine and Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Vascular Biology Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Markus Scholz
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Germany
| | - Guido Hildebrandt
- Department of Radiotherapy and Radiation Oncology, University of Rostock, Rostock, Germany
| | - Manja Kamprad
- Institute of Clinical Immunology and Transfusion Medicine, University of Leipzig, Leipzig, Germany
| | - Annegret Glasow
- Department of Radiation Therapy, University of Leipzig, Leipzig, Germany
- * E-mail:
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McCunney RJ, Li J. Radiation risks in lung cancer screening programs: a comparison with nuclear industry workers and atomic bomb survivors. Chest 2014; 145:618-624. [PMID: 24590022 DOI: 10.1378/chest.13-1420] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 09/02/2013] [Indexed: 01/09/2023] Open
Abstract
The National Lung Cancer Screening Trial (NLST) demonstrated that screening with low-dose CT (LDCT) scan reduced lung cancer and overall mortality by 20% and 7%, respectively. The LDCT scanning involves an approximate 2-mSv dose, whereas full-chest CT scanning, the major diagnostic study used to follow up nodules, may involve a dose of 8 mSv. Radiation associated with CT scanning and other diagnostic studies to follow up nodules may present an independent risk of lung cancer. On the basis of the NLST, we estimated the incidence and prevalence of nodules detected in screening programs. We followed the Fleischner guidelines for follow-up of nodules to assess cumulative radiation exposure over 20- and 30-year periods. We then evaluated nuclear worker cohort studies and atomic bomb survivor studies to assess the risk of lung cancer from radiation associated with long-term lung cancer screening programs. The findings indicate that a 55-year-old lung screening participant may experience a cumulative radiation exposure of up to 280 mSv over a 20-year period and 420 mSv over 30 years. These exposures exceed those of nuclear workers and atomic bomb survivors. This assessment suggests that long-term (20-30 years) LDCT screening programs are associated with nontrivial cumulative radiation doses. Current lung cancer screening protocols, if conducted over 20- to 30-year periods, can independently increase the risk of lung cancer beyond cigarette smoking as a result of cumulative radiation exposure. Radiation exposures from LDCT screening and follow-up diagnostic procedures exceed lifetime radiation exposures among nuclear power workers and atomic bomb survivors.
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Boice JD, Cohen SS, Mumma MT, Ellis ED, Cragle DL, Eckerman KF, Wallace PW, Chadda B, Sonderman JS, Wiggs LD, Richter BS, Leggett RW. Mortality Among Mound Workers Exposed to Polonium-210 and Other Sources of Radiation, 1944–1979. Radiat Res 2014; 181:208-28. [DOI: 10.1667/rr13395.1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Azizova TV, Zhuntova GV, Haylock RGE, Moseeva MB, Grigoryeva ES, Hunter N, Bannikova MV, Belyaeva ZD, Bragin E. Chronic bronchitis in the cohort of Mayak workers first employed 1948-1958. Radiat Res 2013; 180:610-21. [PMID: 24219326 DOI: 10.1667/rr13228.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Incidence of chronic bronchitis has been studied in a cohort of 12,210 workers first employed at one of the main plants of the Mayak nuclear facility during 1948-1958 and followed up to 31 December 2005. Information on external gamma doses is available for virtually all of these workers; in contrast, plutonium body burden was measured only for 30% of workers. During the follow-up period in the study cohort 1,175 incident cases of chronic bronchitis were verified. The analyses of nonradiation factors revealed that the underlying risk of chronic bronchitis incidence increased with increasing attained age and was higher among smokers compared with never-smokers as would be expected. The most interesting finding in relationship to nonradiation factors was a sharp increase in the baseline chronic bronchitis risk before 1960. The cause of this is not clear but a number of factors may play a role. Based on the follow-up data after 1960, the analysis showed a statistically significant linear dose response relationship with cumulative external gamma-ray dose (ERR/Gy = 0.14, 95% CI 0.01, 0.32). Based on the same subset but with an additional restriction to members with cumulative internal lung dose below 1 Gy, a statistically significant linear dose response relationship with internal alpha-radiation lung dose from incorporated plutonium was found (ERR/Gy = 2.70, 95% CI 1.20, 4.87). In both cases, adjustment was made for nonradiation factors, including smoking and either internal or external dose as appropriate. At present there are no similar incidence studies with which to compare results. However, the most recent data from the atomic bomb survivor cohort (the Life Span Study) showed statistically significant excess mortality risk for respiratory diseases of 22% per Gy and this value is within the confidence bounds of the point estimate of the risk from this study in relation to external dose.
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Affiliation(s)
- T V Azizova
- a Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk Region, Russia; and
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Borghini A, Luca Gianicolo EA, Picano E, Andreassi MG. Ionizing radiation and atherosclerosis: Current knowledge and future challenges. Atherosclerosis 2013; 230:40-7. [DOI: 10.1016/j.atherosclerosis.2013.06.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/13/2013] [Accepted: 06/12/2013] [Indexed: 11/16/2022]
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Giardi MT, Touloupakis E, Bertolotto D, Mascetti G. Preventive or potential therapeutic value of nutraceuticals against ionizing radiation-induced oxidative stress in exposed subjects and frequent fliers. Int J Mol Sci 2013; 14:17168-92. [PMID: 23965979 PMCID: PMC3759958 DOI: 10.3390/ijms140817168] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 08/01/2013] [Accepted: 08/12/2013] [Indexed: 12/19/2022] Open
Abstract
Humans are constantly exposed to ionizing radiation deriving from outer space sources or activities related to medical care. Absorption of ionizing radiation doses over a prolonged period of time can result in oxidative damage and cellular dysfunction inducing several diseases, especially in ageing subjects. In this report, we analyze the effects of ionizing radiation, particularly at low doses, in relation to a variety of human pathologies, including cancer, and cardiovascular and retinal diseases. We discuss scientific data in support of protection strategies by safe antioxidant formulations that can provide preventive or potential therapeutic value in response to long-term diseases that may develop following exposure.
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Affiliation(s)
| | - Eleftherios Touloupakis
- Biosensor, Via Olmetti 44 Formello, Rome 00060, Italy; E-Mail:
- Department of Chemistry, University of Crete, P.O. Box 2208, Voutes-Heraklion 71003, Greece
| | - Delfina Bertolotto
- Agenzia Spaziale Italiana (ASI), Viale Liegi 26, Rome 00198, Italy; E-Mails: (D.B.); (G.M.)
| | - Gabriele Mascetti
- Agenzia Spaziale Italiana (ASI), Viale Liegi 26, Rome 00198, Italy; E-Mails: (D.B.); (G.M.)
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48
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Yentrapalli R, Azimzadeh O, Sriharshan A, Malinowsky K, Merl J, Wojcik A, Harms-Ringdahl M, Atkinson MJ, Becker KF, Haghdoost S, Tapio S. The PI3K/Akt/mTOR pathway is implicated in the premature senescence of primary human endothelial cells exposed to chronic radiation. PLoS One 2013; 8:e70024. [PMID: 23936371 PMCID: PMC3731291 DOI: 10.1371/journal.pone.0070024] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 06/20/2013] [Indexed: 11/18/2022] Open
Abstract
The etiology of radiation-induced cardiovascular disease (CVD) after chronic exposure to low doses of ionizing radiation is only marginally understood. We have previously shown that a chronic low-dose rate exposure (4.1 mGy/h) causes human umbilical vein endothelial cells (HUVECs) to prematurely senesce. We now show that a dose rate of 2.4 mGy/h is also able to trigger premature senescence in HUVECs, primarily indicated by a loss of growth potential and the appearance of the senescence-associated markers ß-galactosidase (SA-ß-gal) and p21. In contrast, a lower dose rate of 1.4 mGy/h was not sufficient to inhibit cellular growth or increase SA-ß-gal-staining despite an increased expression of p21. We used reverse phase protein arrays and triplex Isotope Coded Protein Labeling with LC-ESI-MS/MS to study the proteomic changes associated with chronic radiation-induced senescence. Both technologies identified inactivation of the PI3K/Akt/mTOR pathway accompanying premature senescence. In addition, expression of proteins involved in cytoskeletal structure and EIF2 signaling was reduced. Age-related diseases such as CVD have been previously associated with increased endothelial cell senescence. We postulate that a similar endothelial aging may contribute to the increased rate of CVD seen in populations chronically exposed to low-dose-rate radiation.
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Affiliation(s)
- Ramesh Yentrapalli
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Omid Azimzadeh
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
| | - Arundhathi Sriharshan
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
| | | | - Juliane Merl
- Research Unit Protein Science, Helmholtz Zentrum Muenchen, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Andrzej Wojcik
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Mats Harms-Ringdahl
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Michael J. Atkinson
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | | | - Siamak Haghdoost
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Soile Tapio
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
- * E-mail:
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49
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Kadhim M, Salomaa S, Wright E, Hildebrandt G, Belyakov OV, Prise KM, Little MP. Non-targeted effects of ionising radiation--implications for low dose risk. Mutat Res 2013; 752:84-98. [PMID: 23262375 PMCID: PMC4091999 DOI: 10.1016/j.mrrev.2012.12.001] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 12/03/2012] [Accepted: 12/04/2012] [Indexed: 12/17/2022]
Abstract
Non-DNA targeted effects of ionising radiation, which include genomic instability, and a variety of bystander effects including abscopal effects and bystander mediated adaptive response, have raised concerns about the magnitude of low-dose radiation risk. Genomic instability, bystander effects and adaptive responses are powered by fundamental, but not clearly understood systems that maintain tissue homeostasis. Despite excellent research in this field by various groups, there are still gaps in our understanding of the likely mechanisms associated with non-DNA targeted effects, particularly with respect to systemic (human health) consequences at low and intermediate doses of ionising radiation. Other outstanding questions include links between the different non-targeted responses and the variations in response observed between individuals and cell lines, possibly a function of genetic background. Furthermore, it is still not known what the initial target and early interactions in cells are that give rise to non-targeted responses in neighbouring or descendant cells. This paper provides a commentary on the current state of the field as a result of the non-targeted effects of ionising radiation (NOTE) Integrated Project funded by the European Union. Here we critically examine the evidence for non-targeted effects, discuss apparently contradictory results and consider implications for low-dose radiation health effects.
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Affiliation(s)
- Munira Kadhim
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK.
| | - Sisko Salomaa
- STUK - Radiation and Nuclear Safety Authority, P.O. Box 14, 00881 Helsinki, Finland
| | - Eric Wright
- School of Medicine, College of Medicine, Dentistry and Nursing, University of Dundee, Nethergate, Dundee, DD1 4HN, Scotland, UK
| | - Guido Hildebrandt
- Department of Radiotherapy and Radiation Oncology, University of Rostock, Südring 75, 18051 Rostock, Germany
| | - Oleg V Belyakov
- Hevesy Laboratory, Center for Nuclear Technologies, Technical University of Denmark, 4000 Roskilde, Denmark
| | | | - Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, 6120 Executive Boulevard, Rockville, MD 20852, USA
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50
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Yentrapalli R, Azimzadeh O, Barjaktarovic Z, Sarioglu H, Wojcik A, Harms-Ringdahl M, Atkinson MJ, Haghdoost S, Tapio S. Quantitative proteomic analysis reveals induction of premature senescence in human umbilical vein endothelial cells exposed to chronic low-dose rate gamma radiation. Proteomics 2013; 13:1096-107. [DOI: 10.1002/pmic.201200463] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 12/13/2012] [Accepted: 01/11/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Ramesh Yentrapalli
- Helmholtz Zentrum München; German Research Center for Environmental Health; Institute of Radiation Biology; Neuherberg Germany
- Centre for Radiation Protection Research; Department of Genetics; Microbiology and Toxicology; Stockholm University; Stockholm Sweden
| | - Omid Azimzadeh
- Helmholtz Zentrum München; German Research Center for Environmental Health; Institute of Radiation Biology; Neuherberg Germany
| | - Zarko Barjaktarovic
- Helmholtz Zentrum München; German Research Center for Environmental Health; Institute of Radiation Biology; Neuherberg Germany
| | - Hakan Sarioglu
- Helmholtz Zentrum München; German Research Center for Environmental Health; Department of Protein Science; Proteomics Core Facility; Neuherberg Germany
| | - Andrzej Wojcik
- Centre for Radiation Protection Research; Department of Genetics; Microbiology and Toxicology; Stockholm University; Stockholm Sweden
| | - Mats Harms-Ringdahl
- Centre for Radiation Protection Research; Department of Genetics; Microbiology and Toxicology; Stockholm University; Stockholm Sweden
| | - Michael J. Atkinson
- Helmholtz Zentrum München; German Research Center for Environmental Health; Institute of Radiation Biology; Neuherberg Germany
- Department of Radiation Oncology; Klinikum Rechts der Isar; Technische Universität München; Munich Germany
| | - Siamak Haghdoost
- Centre for Radiation Protection Research; Department of Genetics; Microbiology and Toxicology; Stockholm University; Stockholm Sweden
| | - Soile Tapio
- Helmholtz Zentrum München; German Research Center for Environmental Health; Institute of Radiation Biology; Neuherberg Germany
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