Actinide handling after wound entry with local or systemic decorporation therapy in the rat

DTPA Treatment of Wound Contamination in Rats with Americium: Evaluation of Urinary Profiles Using STATBIODIS Shows Importance of Prompt Administration

ABSTRACT

In the nuclear industry, wound contamination with americium is expected to increase with decommissioning and waste management. Treatment of workers with diethylenetriaminepentaacetic acid (DTPA) requires optimization to reduce internal contamination and radiation exposure. This work aimed at evaluating and comparing different DTPA protocol efficacies after wound contamination of rats with americium. Wound contamination was simulated in rats by depositing americium nitrate in an incision in the hind limb. Different routes, times, and frequencies of DTPA administration were evaluated. Individual daily urinary americium excretion and tissue retention were analyzed using the statistical tool STATBIODIS. Urinary profiles, urinary enhancement factors, and inhibition percentages of tissue retention were calculated. A single DTPA administration the day of contamination induced a rapid increase in americium urinary excretion that decreased exponentially over 7 d, indicating that the first DTPA administration should be delivered as early as possible. DTPA treatment limited americium uptake in systemic tissues irrespective of the protocol. Liver and skeleton burdens were markedly reduced, which would drive reduction of radiation dose. Local or intravenous injections were equally effective. Inherent difficulties in wound site activity measurements did not allow identification of a significant decorporating effect at the wound site. Repeated intravenous injections of DTPA also increased americium urinary excretion, which supports the use of multiple DTPA administrations shortly after wound contamination. Results from these statistical analyses will contribute to a better understanding of americium behavior in the presence or absence of DTPA and may aid optimization of treatment for workers.

Comparison of Local and Systemic DTPA Treatment Efficacy According to Actinide Physicochemical Properties Following Lung or Wound Contamination in the Rat

Purpose: In cases of occupational accidents in nuclear facilities or subsequent to terrorist activities, the most likely routes of internal contamination with alpha-particle emitting actinides, such as plutonium (Pu) and americium (Am), are by inhalation or following wounding. Following contamination, actinide transfer to the circulation and subsequent deposition in skeleton and liver depends primarily on the physicochemical nature of the compound. The treatment remit following internal contamination is to decrease actinide retention and in consequence potential health risks, both at the contamination site and in systemic retention organs as well as to promote elimination. The only approved drug for decorporation of Pu and Am is the metal chelator diethylenetriaminepentaacetic acid (DTPA). However, a limited efficacy of DTPA has been reported following contamination with insoluble actinides, irrespective of the contamination route. The objectives of this work are to evaluate the efficacy of prompt local and/or systemic DTPA treatment regimens following lung or wound contamination by actinides with differing solubility. The conclusions are drawn from retrospective analysis of experimental studies carried out over 10 years. Materials and Methods: Rat lungs or wounds were contaminated either with poorly soluble Mixed OXide (U, Pu O2) or more soluble forms of Pu (nitrate or citrate). DTPA treatment was administered promptly after contamination, locally to lungs by insufflation of a powder or inhalation of aerosolized solution or by injection directly into the wound site. Intravenous injections of DTPA were given either once or repeated in combination with the local treatment. Doses ranged from 1 to 30 µmol/kg. Animals were euthanized from day 7-21 and alpha activity levels were measured in urine, lungs, wound, bone and liver for determination of decorporation efficacy. Results: Different experiments confirmed that whatever the route of contamination, most of the activity is retained at the entry site after insoluble MOX contamination as compared with contamination with more soluble forms which results in very low activities reaching the systemic compartment and subsequent retention in bone and liver. Several DTPA treatment regimens were evaluated that had no significant effect on either lung or wound levels compared with untreated animals. In contrast, in all cases systemic retention (skeleton and liver) was reduced and urinary excretion were enhanced irrespective of the contamination route or DTPA treatment regimen. Conclusion: The present study demonstrates that despite limitation of retention in systemic organs, different DTPA protocols were ineffective in removing insoluble actinides deposited in lungs or wound site. For moderately soluble actinides, local or intravenous DTPA treatment reduced activity levels both at contamination and at systemic sites.

Forecasting the In Vivo Behavior of Radiocontaminants of Unknown Physicochemical Properties Using a Simple In Vitro Test

An understanding of the "bioavailability" of disseminated radiocontaminants is a necessary adjunct in order to tailor treatment and to calculate dose. A simple test has been designed to predict the bioavailability of different actinide forms likely to be found after dissemination of radioactive elements by dispersal devices or nuclear reactor incidents. Plutonium (Pu) or Americium (Am) nitrate or MOX (U,PuO2) are immobilized in culture wells using a static gel phase simulating biological compartments (lung, wound, etc.). Gels are incubated in a fluid phase representing physiological media (plasma, sweat, etc.). Transfer of radionuclide from static to fluid phase reflects contaminant bioavailability. After 48 h of incubation in physiological saline, Am transfer from static to fluid phase was greater than for Pu (70% vs. 15% of initial activity). Transfer of Pu or Am was markedly less from the oxide form of the two elements (1% Am and 0.05% Pu transferred). Medium representing intracellular lysosomal fluid (pH 4) increased transfer of Pu and Am, whereas culture medium including serum reduced actinide transfer. Actinide transfer was also reduced by elements of the extracellular matrix present in the static gel phase. Increasing DTPA concentrations (5 to 500 μM) to the fluid phase significantly enhanced transfer of Pu and Am. Although this agarose gel cannot fully represent in vivo complexity, this simple test can be used to investigate and predict the behavior in vivo of radiocontaminants to support medical treatments and medical forensic investigations.