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Faria M, Ganz A, Galkin F, Zhavoronkov A, Snyder M. Psychogenic Aging: A Novel Prospect to Integrate Psychobiological Hallmarks of Aging. Transl Psychiatry 2024; 14:226. [PMID: 38816369 PMCID: PMC11139997 DOI: 10.1038/s41398-024-02919-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 12/20/2023] [Accepted: 05/08/2024] [Indexed: 06/01/2024] Open
Abstract
Psychological factors are amongst the most robust predictors of healthspan and longevity, yet are rarely incorporated into scientific and medical frameworks of aging. The prospect of characterizing and integrating the psychological influences of aging is therefore an unmet step for the advancement of geroscience. Psychogenic Aging research is an emerging branch of biogerontology that aims to address this gap by investigating the impact of psychological factors on human longevity. It is an interdisciplinary field that integrates complex psychological, neurological, and molecular relationships that can be best understood with precision medicine methodologies. This perspective argues that psychogenic aging should be considered an integral component of the Hallmarks of Aging framework, opening the doors for future biopsychosocial integration in longevity research. By providing a unique perspective on frequently overlooked aspects of organismal aging, psychogenic aging offers new insights and targets for anti-aging therapeutics on individual and societal levels that can significantly benefit the scientific and medical communities.
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Affiliation(s)
- Manuel Faria
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Ariel Ganz
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Alex Zhavoronkov
- Deep Longevity, Hong Kong, China
- Insilico Medicine, Hong Kong, China
- Buck Institute for Research on Aging, Novato, CA, USA
| | - Michael Snyder
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.
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Spadella MA, Silva EJR, Chies AB, Almeida LAD. Insights Into Antioxidant Strategies to Counteract Radiation-Induced Male Infertility. Antioxid Redox Signal 2024; 40:776-801. [PMID: 37917108 DOI: 10.1089/ars.2023.0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Significance: Radiotherapy, which employs ionizing radiation to destroy or prevent the multiplication of tumor cells, has been increasingly used in the treatment of neoplastic diseases, especially cancers. However, radiation collaterally leads to prolonged periods of sperm count suppression, presumably due to impaired spermatogenesis by depleting the germ cell pool, which has long-term side effects for male reproduction. Recent Advances: Studies of antioxidant compounds as a potential strategy for male fertility preservation have been performed mainly from animal models, aiming to prevent and restore the male germinal tissue and its function, particularly against the oxidative stress effects of radiation. Evidence in preclinical and clinical trials has shown that inhibitors of the renin-angiotensin system and other drugs, such as statins and metformin, are candidates for ameliorating radiation-induced damage to several tissues, including the testis and prostate. Critical Issues: Research for developing an ideal radioprotective agent is challenging due to toxicity in the normal tissue, tumor radioresistance, cellular response to radiation, costs, regulation, and timeline development. Moreover, male radioprotection experiments in humans, mainly clinical trials, are scarce and use few individuals. This scenario is reflected in the slow progress of innovation in the radioprotection field. Future Directions: Expanding human studies to provide clues on the efficacy and safety of radioprotective compounds in the human reproductive system is necessary. Drug repurposing, frequently used in clinical practice, can be a way to shorten the development pipeline for innovative approaches for radioprotection or radiomitigation of the repercussions of radiotherapy in the male reproductive system.
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Affiliation(s)
| | - Erick J R Silva
- Department of Biophysics and Pharmacology, Institute of Biosciences of Botucatu, São Paulo State University, Botucatu, São Paulo, Brazil
| | - Agnaldo Bruno Chies
- Laboratory of Pharmacology; Marília Medical School-Famema, Marília, São Paulo, Brazil
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Yamaga S, Aziz M, Murao A, Brenner M, Wang P. DAMPs and radiation injury. Front Immunol 2024; 15:1353990. [PMID: 38333215 PMCID: PMC10850293 DOI: 10.3389/fimmu.2024.1353990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/15/2024] [Indexed: 02/10/2024] Open
Abstract
The heightened risk of ionizing radiation exposure, stemming from radiation accidents and potential acts of terrorism, has spurred growing interests in devising effective countermeasures against radiation injury. High-dose ionizing radiation exposure triggers acute radiation syndrome (ARS), manifesting as hematopoietic, gastrointestinal, and neurovascular ARS. Hematopoietic ARS typically presents with neutropenia and thrombocytopenia, while gastrointestinal ARS results in intestinal mucosal injury, often culminating in lethal sepsis and gastrointestinal bleeding. This deleterious impact can be attributed to radiation-induced DNA damage and oxidative stress, leading to various forms of cell death, such as apoptosis, necrosis and ferroptosis. Damage-associated molecular patterns (DAMPs) are intrinsic molecules released by cells undergoing injury or in the process of dying, either through passive or active pathways. These molecules then interact with pattern recognition receptors, triggering inflammatory responses. Such a cascade of events ultimately results in further tissue and organ damage, contributing to the elevated mortality rate. Notably, infection and sepsis often develop in ARS cases, further increasing the release of DAMPs. Given that lethal sepsis stands as a major contributor to the mortality in ARS, DAMPs hold the potential to function as mediators, exacerbating radiation-induced organ injury and consequently worsening overall survival. This review describes the intricate mechanisms underlying radiation-induced release of DAMPs. Furthermore, it discusses the detrimental effects of DAMPs on the immune system and explores potential DAMP-targeting therapeutic strategies to alleviate radiation-induced injury.
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Affiliation(s)
- Satoshi Yamaga
- Center for Immunology and Inflammation, The Feinstein Institutes for Medical Research, Manhasset, NY, United States
| | - Monowar Aziz
- Center for Immunology and Inflammation, The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- Departments of Surgery and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States
| | - Atsushi Murao
- Center for Immunology and Inflammation, The Feinstein Institutes for Medical Research, Manhasset, NY, United States
| | - Max Brenner
- Center for Immunology and Inflammation, The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- Departments of Surgery and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States
| | - Ping Wang
- Center for Immunology and Inflammation, The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- Departments of Surgery and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States
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Makhijani K, Kumbhare LB, Nayak M, Kunwar A, Singh BG. Bis(1-methylimidazol-2-yl) diselenide and its evaluation as a chemical radio-protector: role of kinetic rate constants for ROS scavenging and glutathione peroxidase like activity. Free Radic Res 2024; 58:43-56. [PMID: 38165076 DOI: 10.1080/10715762.2023.2299341] [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: 08/22/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
Bis(1-methylimidazol-2-yl) diselenide (MeImSe), a derivative of selenoneine, has been examined for bimolecular rate constants for scavenging of various radiolytically and non-radiolytically generated reactive oxygen species (ROS). Further, its potential to show glutathione peroxidase (GPx)-like activity and to protect in vitro models of DNA and lipid against radiation induced strand breakage and lipid peroxidation, respectively were studied. The results confirmed that MeImSe scavenged all major short-lived (hydroxyl radical) and long-lived (peroxyl radical, carbonate radical, nitrogen dioxide radical, hypochlorite and hydrogen peroxide) oxidants involved in the radiation toxicity either directly or through GPx-like catalytic mechanism. The rate constants of MeImSe for these oxidants were found to be comparable to analogous sulfur and selenium-based compounds. The enzyme kinetics study established that MeImSe took part in the GPx cycle through the reductive pathway. Further, MeImSe inhibited the radiation induced DNA strand cleavage and lipid peroxidation with half maximal inhibitory concentration (IC50) of ∼ 60 μM and ∼100 μM, respectively. Interestingly, MeImSe treatment in the above concentration range (>100 μM) did not show any significant toxicity in normal human lung fibroblast (WI26) cells. The balance between efficacy and toxicity of MeImSe as a chemical radioprotector was attributed to the formation of less reactive intermediates during its oxidation/reduction reactions as evidenced from NMR studies.HighlightsMeImSe, a derivative of selenoneine protects DNA and lipid from radiation damageMeImSe scavenges all major short- and long-lived oxidants involved in radiation toxicityRate constants of MeImSe for ROS scavenging determined by pulse radiolysis techniqueFirst organoselenium compound reported to scavenge nitrogen dioxide radicalMeImSe exhibits GPx-like activity through reductive pathway.
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Affiliation(s)
- K Makhijani
- Radiation and Photochemistry Division, Bhabha Atomic Research Centre, Mumbai, India
| | - L B Kumbhare
- Chemistry Division, Bhabha Atomic Research Centre, Mumbai, India
| | - M Nayak
- Radiation and Photochemistry Division, Bhabha Atomic Research Centre, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - A Kunwar
- Radiation and Photochemistry Division, Bhabha Atomic Research Centre, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - B G Singh
- Radiation and Photochemistry Division, Bhabha Atomic Research Centre, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
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Selvan G T, Ashok AK, Rao S J A, Gollapalli P, R V, N SK, Chaudhury NK. Nrf2-regulated antioxidant response ameliorating ionizing radiation-induced damages explored through in vitro and molecular dynamics simulations. J Biomol Struct Dyn 2023; 41:8472-8484. [PMID: 36307909 DOI: 10.1080/07391102.2022.2137245] [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: 09/27/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
Abstract
This study aims to investigate the mechanism of natural antioxidant ferulic acid (FA) in reducing oxidative stress followed by its inhibitory effect on the Keap1-Nrf2 complex. FA was treated ex vivo with human blood for 30 min at 37 °C ± 1 °C and exposed to 1.5 Gy of γ- rays of 60Co (0.789 Gy/min) and allowed for repair for an hour at 37 °C ± 1 °C. FA's free radical scavenging capacity was measured using 2,7-dichlorofluorescein diacetate assay and cytogenetic assays. Further, a possible mechanism of protein-ligand interaction between FA and Keap1-Nrf2 pathway protein as a cellular drug target was studied using docking and molecular dynamics simulation. The 1.5 Gy of γ- rays exposed to pre-treated blood with FA showed a significant (p < 0.05) reduction in reactive oxygen species and DNA damage compared to the normal control blood group sample. The ligand-protein transient binding interaction in molecular dynamic simulation over a period of 100 ns was consistent and stable emphasizing complementary charge between the protein and ligand, speculating higher hydrophobic amino acid residues in the Keap1 active pocket. This might sway the Keap1 from interaction with Nrf2, and could lead to nuclear translocation of Nrf2 during radiation-induced oxidative stress. The present study emphasizes the radioprotective effect of FA against 1.5 Gy of γ- rays exposed to human blood and the application of in silico approaches helpful for the possible protective effect of FA.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Tamizh Selvan G
- Central Research Laboratory, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Avinash Karkada Ashok
- Department of Biotechnology, Siddaganga Institute of Technology, Tumakuru, Karnataka, India
| | - Aditya Rao S J
- Kimberelite Chemicals India Pvt. Ltd, KIADB III Phase, Bangalore, Karnataka, India
| | - Pavan Gollapalli
- Center for Bioinformatics and Biostatistics, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Vishakh R
- Central Research Laboratory, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Suchetha Kumari N
- Central Research Laboratory, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Nabo K Chaudhury
- Division of Radiation Biodosimetry, Institute of Nuclear Medicine and Allied Sciences-Defence Research and Development Organisation (DRDO), Delhi, India
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Boopathi E, Den RB, Thangavel C. Innate Immune System in the Context of Radiation Therapy for Cancer. Cancers (Basel) 2023; 15:3972. [PMID: 37568788 PMCID: PMC10417569 DOI: 10.3390/cancers15153972] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Radiation therapy (RT) remains an integral component of modern oncology care, with most cancer patients receiving radiation as a part of their treatment plan. The main goal of ionizing RT is to control the local tumor burden by inducing DNA damage and apoptosis within the tumor cells. The advancement in RT, including intensity-modulated RT (IMRT), stereotactic body RT (SBRT), image-guided RT, and proton therapy, have increased the efficacy of RT, equipping clinicians with techniques to ensure precise and safe administration of radiation doses to tumor cells. In this review, we present the technological advancement in various types of RT methods and highlight their clinical utility and associated limitations. This review provides insights into how RT modulates innate immune signaling and the key players involved in modulating innate immune responses, which have not been well documented earlier. Apoptosis of cancer cells following RT triggers immune systems that contribute to the eradication of tumors through innate and adoptive immunity. The innate immune system consists of various cell types, including macrophages, dendritic cells, and natural killer cells, which serve as key mediators of innate immunity in response to RT. This review will concentrate on the significance of the innate myeloid and lymphoid lineages in anti-tumorigenic processes triggered by RT. Furthermore, we will explore essential strategies to enhance RT efficacy. This review can serve as a platform for researchers to comprehend the clinical application and limitations of various RT methods and provides insights into how RT modulates innate immune signaling.
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Affiliation(s)
- Ettickan Boopathi
- Center for Translational Medicine, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Robert B. Den
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA;
| | - Chellappagounder Thangavel
- Center for Translational Medicine, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA;
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Pfau LC, Glasow A, Seidel C, Patties I. Imidazolyl Ethanamide Pentandioic Acid (IEPA) as Potential Radical Scavenger during Tumor Therapy in Human Hematopoietic Stem Cells. Molecules 2023; 28:molecules28052008. [PMID: 36903253 PMCID: PMC10004037 DOI: 10.3390/molecules28052008] [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: 12/31/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Radiochemotherapy-associated leuco- or thrombocytopenia is a common complication, e.g., in head and neck cancer (HNSCC) and glioblastoma (GBM) patients, often compromising treatments and outcomes. Currently, no sufficient prophylaxis for hematological toxicities is available. The antiviral compound imidazolyl ethanamide pentandioic acid (IEPA) has been shown to induce maturation and differentiation of hematopoietic stem and progenitor cells (HSPCs), resulting in reduced chemotherapy-associated cytopenia. In order for it to be a potential prophylaxis for radiochemotherapy-related hematologic toxicity in cancer patients, the tumor-protective effects of IEPA should be precluded. In this study, we investigated the combinatorial effects of IEPA with radio- and/or chemotherapy in human HNSCC and GBM tumor cell lines and HSPCs. Treatment with IEPA was followed by irradiation (IR) or chemotherapy (ChT; cisplatin, CIS; lomustine, CCNU; temozolomide, TMZ). Metabolic activity, apoptosis, proliferation, reactive oxygen species (ROS) induction, long-term survival, differentiation capacity, cytokine release, and DNA double-strand breaks (DSBs) were measured. In tumor cells, IEPA dose-dependently diminished IR-induced ROS induction but did not affect the IR-induced changes in metabolic activity, proliferation, apoptosis, or cytokine release. In addition, IEPA showed no protective effect on the long-term survival of tumor cells after radio- or chemotherapy. In HSPCs, IEPA alone slightly enhanced CFU-GEMM and CFU-GM colony counts (2/2 donors). The IR- or ChT-induced decline of early progenitors could not be reversed by IEPA. Our data indicate that IEPA is a potential candidate for the prevention of hematologic toxicity in cancer treatment without affecting therapeutic benefits.
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Zivkovic Radojevic M, Milosavljevic N, Miladinovic TB, Janković S, Folic M. Review of compounds that exhibit radioprotective and/or mitigatory effects after application of diagnostic or therapeutic ionizing radiation. Int J Radiat Biol 2023; 99:594-603. [PMID: 35930681 DOI: 10.1080/09553002.2022.2110308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE Exposure to ionizing radiation can be accidental or for medical purposes. Analyzes of the frequency of radiation damage in the general population, it has been determined that by far the most common are those that occur as a result of diagnostic or therapeutic procedures. Damage caused by radiation, either accidentally or for therapeutic purposes, can be reduced by the use of radioprotectors, mitigators or other therapeutic agents. A detailed research of the available literature shows that there is little systematized data of potentially radioprotective and/or mitigating effects of drugs from the personal therapy of patients during the application of therapeutic ionizing radiation. The aim of this paper is to present review of compounds, especially personal therapy drugs, that exhibit radioprotective and/or mitigating effects after the application of diagnostic or therapeutic ionizing radiation. CONCLUSIONS Given the widespread use of ionizing radiation for diagnostic and therapeutic purposes, there is a clear need to create a strategy and recommendations of relevant institutions for the use of radioprotectors and mitigators in everyday clinical practice, with individual evaluation of the patient's condition and selection of the compounds that will show the greatest benefit in terms of radioprotection.
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Affiliation(s)
| | - Neda Milosavljevic
- Centre for Radiation Oncology, University Clinical Centre Kragujevac, Kragujevac, Serbia
| | - Tatjana B Miladinovic
- Department of Science, Institute for Information Technologies, University of Kragujevac, Kragujevac, Serbia
| | - Slobodan Janković
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Clinical Pharmacology Department, University Clinical Centre Kragujevac, Kragujevac, Serbia
| | - Marko Folic
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Clinical Pharmacology Department, University Clinical Centre Kragujevac, Kragujevac, Serbia
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Development of an Optimal Model of Combined Radiation and Biological Lesions. Vet Med Int 2022; 2022:9433032. [PMID: 36118594 PMCID: PMC9477584 DOI: 10.1155/2022/9433032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/22/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Since the search for the effective medication in combined lesions includes the selection of an optimal experimental model for such injuries, there is actually a study aimed at developing an optimal model of combined radiation-biology (Pasteurella) lesions. The pathogen Pasteurella multocida (as one of the most frequent pathogenic agents involved in both isolated and combined radiation-biology lesions of agricultural animals) was used as a model of a biological agent to reproduce experimental biological research. We employed the “Chinchilla” rabbits of 2.5–3.0 kg body weight as a biological model for doing combined radiation Pasteurella lesion. When determining the optimal model of combined radiation-biology (Pasteurella) lesion, we consider that in the joint action of various pathological agents on the organism, there is a synergistic effect of explosion agents, previously specifying minimal doses of external γ-radiation and pasteurellosis pathogen that in the joint action of nonfatal doses would be lethal. The first stage of the experiments determined the minimal doses of gamma rays and pasteurellosis pathogen that in joint action causes combined radiation-biology pathology. We examined 66 rabbits divided into 11 groups of 6 animals each to determine minimal doses of infectious agent-pasteurellosis pathogen. The animals of the first 9 groups were given subcutaneously Pasteurella species at doses 1·109, 1·108, 1·107, 1·106, 1·105, 1·104, 1·103, 1·102, and 1·101 of microbial cells per animal of 0.3 ml suspension in volume; the 10th group of animals were given saline solution; the 11th served as a biological control group. In determining the minimal doses of gamma rays, we conducted experimental tests on 36 rabbits, which have been exposed to external γ-radiation in the “PUMA” system with a 137Cs radiation source of the exposure dose of 5.38 R/min at doses 2.0, 4.0, 6.0, 8.0, 10, and 12 Gy. To specify the optimal model of radiation-pasteurellosis lesion, we used the rabbits subjected to a combined radiation-biology effect using minimal doses of gamma rays and pasteurellosis agent, leading to a lethal effect during their complex action. The researches revealed that 50% of the death of rabbits infected with pasteurellosis occurs using Pasteurella at a dose of 3.7·104 microbial cells per kilogram (LD50 = 3.7∙104 m.c./kg), and 50% of radiation death in rabbits occurs when irradiated their gamma rays at a dose of 8.0 Gy (LD50 = 8.0 Gy). The combined effect of nonlethal doses of the studied agents in the indicated doses on rabbits led to the aggravation of the course of radiation and pasteurellosis infection, causing the death of animals from combined radiation-pasteurellosis pathology. The model combined radiation-pasteurellosis disease ran its course rapidly, and the animals died 3 to 6 days after the onset. The autopsy of the animals that died from acute radiation-pasteurellosis pathogen had found swelling of the subcutaneous tissue in the pharynx and intermaxillary space of the neck, hyperemia, lymphoid nodular hyperplasia, numerous hemorrhages on the serous and mucous membranes and in the tissues of the parenchymal organs, serous or serous-fibrinous exudate, and in the chest and abdominal regions, pulmonary edema. The research stated that gamma radiation of rabbits at a dose of 8.0 Gy conducted before exposure with Pasteurella at LD50 (3.7·104 m.c./kg) declined the course of the pasteurellosis process, facilitated its generalization, and fastened the death of animals. Combined radiation-pasteurellosis infection ran its course rapidly, and the animals died within 3 to 6 days after the onset of the disease. The autopsy showed the pathologicoanatomic factors of the acute pasteurellosis: swelling of the subcutaneous tissue, purulent-catarrhal bronchopneumonitis, and pulmonary edema.
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Ellahham S, Khalouf A, Elkhazendar M, Dababo N, Manla Y. An overview of radiation-induced heart disease. Radiat Oncol J 2022; 40:89-102. [PMID: 35796112 PMCID: PMC9262704 DOI: 10.3857/roj.2021.00766] [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: 08/10/2021] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/03/2022] Open
Abstract
Radiation therapy (RT) has dramatically improved cancer survival, leading to several inevitable complications. Unintentional irradiation of the heart can lead to radiation-induced heart disease (RIHD), including cardiomyopathy, pericarditis, coronary artery disease, valvular heart disease, and conduction system abnormalities. Furthermore, the development of RIHD is aggravated with the addition of chemotherapy. The screening, diagnosis, and follow-up for RIHD in patients who have undergone RT are described by the consensus guidelines from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE). There is compelling evidence that chest RT can increase the risk of heart disease. Although the prevalence and severity of RIHD are likely to be reduced with modern RT techniques, the incidence of RIHD is expected to rise in cancer survivors who have been treated with old RT regimens. However, there remains a gap between guidelines and clinical practice. Currently, therapeutic modalities followed in the treatment of RIHD are similar to the non-irradiated population. Preventive measures mainly reduce the radiation dose and radiation volume of the heart. There is no concrete evidence to endorse the preventive role of statins, angiotensin-converting enzyme inhibitors, and antioxidants. This review summarizes the current evidence of RIHD subtypes and risk factors and suggests screening regimens, diagnosis, treatment, and preventive approaches.
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Affiliation(s)
- Samer Ellahham
- Cleveland Clinic, Lyndhurst, OH, USA
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Amani Khalouf
- Emergency Medicine Institute, Cleveland Clinic Abu Dhabi, UAE
| | - Mohammed Elkhazendar
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
- Pathology & Laboratory Medicine Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Nour Dababo
- Pathology & Laboratory Medicine Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Yosef Manla
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
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