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Lin RT, Boonhat H, Lin YY, Klebe S, Takahashi K. Health Effects of Occupational and Environmental Exposures to Nuclear Power Plants: A Meta-Analysis and Meta-Regression. Curr Environ Health Rep 2024; 11:329-339. [PMID: 38886298 PMCID: PMC11324671 DOI: 10.1007/s40572-024-00453-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE OF REVIEW Numerous epidemiological studies have shown increased health risks among workers and residents living near nuclear power plants exposed to radiation levels meeting regulatory dose limits. This study aimed to evaluate the association between radiation exposure and disease risks among these populations exposed to radiation levels meeting the current regulatory dose limits. RECENT FINDINGS We searched four databases (Cochrane Library, PubMed, ScienceDirect, and Web of Science) for studies published before August 2023, screened eligible studies (inclusion and exclusion criteria based on population, exposure, comparator, and outcome framework), and collected data on exposure indicators and disease risks. We applied random-effects models of meta-analysis to estimate the pooled effects and meta-regression to assess the dose-response relationship (radiation dose rate for workers and distance for residents). We identified 47 studies, 13 with worker and 34 with resident samples, covering 175 nuclear power plants from 17 countries, encompassing samples of 480,623 workers and 7,530,886 residents. Workers had a significantly lower risk for all-cancer and a significantly higher risk for mesothelioma. Residents had significantly higher risks for all-cancer, thyroid cancer, and leukemia. Notably, children under 5 years old showed the highest risk for all-cancer. Our meta-regression showed a significantly positive dose-response relationship between cumulative dose of radiation exposure and risk for circulatory disease among workers. Our findings demonstrated higher risks for mesothelioma for workers and all-cancer, thyroid cancer, and leukemia for residents exposed to low-dose radiation from nuclear power plants. Some included studies did not adjust for cancer risk confounders, which could overestimate the association between radiation exposure and cancer risk and increase the risk of bias.
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Affiliation(s)
- Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Address: No. 100, Sec. 1, Jing-Mao Rd., Beitun Dist., Taichung, 406040, Taiwan.
- Asbestos Diseases Research Institute, Sydney, NSW, 2139, Australia.
| | - Hathaichon Boonhat
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand
- Graduate Institute of Public Health, College of Public Health, China Medical University, Taichung, 406040, Taiwan
| | - Yu-Yu Lin
- Department of Public Health, College of Public Health, China Medical University, Taichung, 406040, Taiwan
| | - Sonja Klebe
- Flinders University, Adelaide, South Australia, 5001, Australia
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, NSW, 2139, Australia
- University of Occupational and Environmental Health, Kitakyushu, Japan
- JEOL Ltd, Tokyo, Japan
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Shan J, Liu Z, Yu J, Zhang Q, Shi H, Ma L. Comparative Cardiovascular Risks of Radical Prostatectomy and External Beam Radiation Therapy in Early-Stage Prostate Cancer: A Comprehensive Retrospective Analysis. Ann Surg Oncol 2024:10.1245/s10434-024-15982-7. [PMID: 39164605 DOI: 10.1245/s10434-024-15982-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/23/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND The risk of cardiac disease mortality has recently become a focal point of concern within the medical community for patients with prostate cancer (PCa). Given that radical prostatectomy (RP) and external beam radiation therapy (EBRT) are the main treatment modalities for localized PCa, their specific impact on cardiovascular-specific mortality (CSM) remains unclear. This study explored the specific effects of RP and EBRT on CSM risk to guide clinical treatment decisions. METHODS Data from patients aged 45-74 years, who were diagnosed with T1-2N0M0 stage PCa from the SEER database (2010-2015), were used. Multivariate statistical methods, including propensity score matching (PSM), competing risk regression, COX regression analysis, and Fine-Gray testing, were applied to assess the impact of RP and EBRT on CSM risk. RESULTS Among 146,082 T1-2 stage PCa patients, cardiac disease emerged as the primary cause of death, surpassing PCa itself. Multifactorial COX regression and competing risk regression analyses indicated that local treatments do not increase CSM risk. Further analysis revealed a significant increase in CSM risk for patients undergoing only EBRT compared with those undergoing only RP (hazard ratio [HR] = 2.71, 95% confidence interval [CI] 1.96-3.74, P < 0.001), with subsequent PSM adjustment, further confirming a significantly reduced risk in the RP treatment group (HR 0.23, 95% CI 0.13-0.40, P < 0.001). CONCLUSIONS T1-2 stage PCa patients face a significant risk of CSM, with RP offering a potential advantage over EBRT in reducing this risk. These findings encourage clinicians to comprehensively consider the potential impact on cardiac health when formulating treatment plans, providing crucial guidance for optimizing treatment strategies.
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Affiliation(s)
- Jiahao Shan
- The First Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Ziyang Liu
- The First Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Jin Yu
- The First Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Qiang Zhang
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Hongbin Shi
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Lianghong Ma
- Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, China.
- Institute of Medical Sciences, Ningxia Human Sperm Bank, General Hospital of Ningxia Medical University, Yinchuan, China.
- Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, China.
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Ferraro S, Dave A, Cereda C, Verduci E, Marcovina S, Zuccotti G. Space research to explore novel biochemical insights on Earth. Clin Chim Acta 2024; 558:119673. [PMID: 38621588 DOI: 10.1016/j.cca.2024.119673] [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: 02/19/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
Travel to space has overcome unprecedent technological challenges and this has resulted in transfer of these technological results on Earth to better our lives. Health technology, medical devices, and research advancements in human biology are the first beneficiaries of this transfer. The real breakthrough came with the International Space Station, which endorsed multidisciplinary international scientific collaborations and boosted the research on pathophysiological adaptation of astronauts to life on space. These studies evidenced that life in space appeared to have exposed the astronauts to an accelerated aging-related pathophysiological dysregulation across multiple systems. In this review we emphasize the interaction between several biomarkers and their alteration in concentrations/expression/function by space stress factors. These altered interactions, suggest that different biochemical and hormonal factors, and cell signals, contribute to a complex network of pathophysiological mechanisms, orchestrating the homeostatic dysregulation of various organs/metabolic pathways. The main effects of space travel on altering cell organelles biology, ultrastructure, and cross-talk, have been observed in cell aging as well as in the disruption of metabolic pathways, which are also the causal factor of rare inherited metabolic disorders, one of the major pediatric health issue. The pathophysiologic breakthrough from space research could allow the development of precision health both on Earth and Space by promoting the validation of improved biomarker-based risk scores and the exploration of new pathophysiologic hypotheses and therapeutic targets. Nonstandard abbreviations: International Space Station (ISS), Artificial Intelligence (AI), European Space Agency (ESA), National Aeronautics and Space Agency (NASA), Low Earth Orbit (LEO), high sensitive troponin (hs-cTn), high sensitive troponin I (hs-cTn I), high sensitive troponin T, Brain Natriuretic Peptide (BNP), N terminal Brain Natriuretic Peptide (NT-BNP), cardiovascular disease (CVD), parathyroid hormone (PTH), urinary hydroxyproline (uHP), urinary C- and N-terminal telopeptides (uCTX and uNTX), pyridinoline (PYD), deoxypyridinoline (DPD), half-time (HF), serum Bone Alkaline Phosphatase (sBSAP), serum Alkaline Phosphatase (sAP), Carboxy-terminal Propeptide of Type 1 Procollagen (P1CP), serum Osteocalcin (sOC)), advanced glycation end products (AGEs), glycated hemoglobin A1c (HbA1c), Insulin-like growth factor 1 (IGF1), Growth Hormone (GH), amino acid (AA), β-hydroxy-β methyl butyrate (HMB), maple syrup urine disease (MSUD), non-communicable diseases (NCDs).
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Affiliation(s)
- Simona Ferraro
- Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy.
| | - Anilkumar Dave
- Space Economy and Open Innovation, Darwix srl, Venice, Italy
| | - Cristina Cereda
- Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy; Center of Functional Genomics and Rare Diseases
| | - Elvira Verduci
- Department of Health Sciences, University of Milan, Milan, Italy; Metabolic Diseases Unit, Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy
| | | | - Gianvincenzo Zuccotti
- Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy; Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
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Mothersill C, Seymour C, Cocchetto A, Williams D. Factors Influencing Effects of Low-dose Radiation Exposure. HEALTH PHYSICS 2024; 126:296-308. [PMID: 38526248 DOI: 10.1097/hp.0000000000001816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
ABSTRACT It is now well accepted that the mechanisms induced by low-dose exposures to ionizing radiation (LDR) are different from those occurring after high-dose exposures. However, the downstream effects of these mechanisms are unclear as are the quantitative relationships between exposure, effect, harm, and risk. In this paper, we will discuss the mechanisms known to be important with an overall emphasis on how so-called "non-targeted effects" (NTE) communicate and coordinate responses to LDR. Targeted deposition of ionizing radiation energy in cells causing DNA damage is still regarded as the dominant trigger leading to all downstream events whether targeted or non-targeted. We regard this as an over-simplification dating back to formal target theory. It ignores that last 100 y of biological research into stress responses and signaling mechanisms in organisms exposed to toxic substances, including ionizing radiation. We will provide evidence for situations where energy deposition in cellular targets alone cannot be plausible as a mechanism for LDR effects. An example is where the energy deposition takes place in an organism not receiving the radiation dose. We will also discuss how effects after LDR depend more on dose rate and radiation quality rather than actual dose, which appears rather irrelevant. Finally, we will use recent evidence from studies of cataract and melanoma induction to suggest that after LDR, post-translational effects, such as protein misfolding or defects in energy metabolism or mitochondrial function, may dominate the etiology and progression of the disease. A focus on such novel pathways may open the way to successful prophylaxis and development of new biomarkers for better risk assessment after low dose exposures.
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Affiliation(s)
- Carmel Mothersill
- Department of Biology, McMaster University, 1280 Main St., Hamilton, ON, Canada L8S 4L8
| | - Colin Seymour
- Department of Biology, McMaster University, 1280 Main St., Hamilton, ON, Canada L8S 4L8
| | - Alan Cocchetto
- The National CFIDS Foundation, 285 Beach Ave., Hull, MA 02045
| | - David Williams
- Cambridge University, The Old Schools, Trinity Lane, Cambridge CB2 1TN, United Kingdom
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Li K, Chen W, Ma L, Yan L, Wang B. Approaches for reducing chemo/radiation-induced cardiotoxicity by nanoparticles. ENVIRONMENTAL RESEARCH 2024; 244:117264. [PMID: 37776941 DOI: 10.1016/j.envres.2023.117264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023]
Abstract
Nanoparticles are fascinating and encouraging carriers for cancer treatment due to their extraordinary properties and potential applications in targeted drug delivery, treatment, and diagnosis. Experimental studies including in vitro and in vivo examinations show that nanoparticles can cause a revolution in different aspects of cancer therapy. Normal tissue toxicity and early and late consequences are the major limitations of cancer therapy by radiotherapy and chemotherapy. However, the delivery of drugs into tumors or reducing the accumulation of drugs in normal tissues can permit a more satisfactory response of malignancies to therapy with more inferior side effects. Cardiac toxicity is one of the major problems for chemotherapy and radiotherapy. Therefore, several experimental studies have been performed to minimize the degenerative impacts of cancer treatment on the heart and also enhance the influences of radiotherapy and chemotherapy agents in cancers. This review article emphasizes the benefits of nanoparticle-based drug delivery techniques, including minimizing the exposure of the heart to anticancer drugs, enhancing the accumulation of drugs in cancers, and expanding the effectiveness of radiotherapy. The article also discusses the challenges and problems accompanied with nanoparticle-based drug delivery techniques such as toxicity, which need to be addressed through further research. Moreover, the article emphasizes the importance of developing safe and effective nanoparticle-based therapies that can be translated into clinical practice.
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Affiliation(s)
- Ketao Li
- Department of Cardiology, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, 310022, China
| | - Wan Chen
- Department of Cardiology, Jiulongpo First People's Hospital, Chongqing, 400051, China
| | - Liping Ma
- Department of Cardiology, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, 310022, China
| | - Laixing Yan
- Department of Cardiology, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, 310022, China
| | - Bing Wang
- Department of Cardiology, Zouping People's Hospital, Zouping, shandong, 256299, China.
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Russu E, Arbanasi EM, Chirila TV, Muresan AV. Therapeutic strategies based on non-ionizing radiation to prevent venous neointimal hyperplasia: the relevance for stenosed arteriovenous fistula, and the role of vascular compliance. Front Cardiovasc Med 2024; 11:1356671. [PMID: 38374996 PMCID: PMC10875031 DOI: 10.3389/fcvm.2024.1356671] [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: 12/18/2023] [Accepted: 01/23/2024] [Indexed: 02/21/2024] Open
Abstract
We have reviewed the development and current status of therapies based on exposure to non-ionizing radiation (with a photon energy less than 10 eV) aimed at suppressing the venous neointimal hyperplasia, and consequentially at avoiding stenosis in arteriovenous grafts. Due to the drawbacks associated with the medical use of ionizing radiation, prominently the radiation-induced cardiovascular disease, the availability of procedures using non-ionizing radiation is becoming a noteworthy objective for the current research. Further, the focus of the review was the use of such procedures for improving the vascular access function and assuring the clinical success of arteriovenous fistulae in hemodialysis patients. Following a brief discussion of the physical principles underlying radiotherapy, the current methods based on non-ionizing radiation, either in use or under development, were described in detail. There are currently five such techniques, including photodynamic therapy (PDT), far-infrared therapy, photochemical tissue passivation (PTP), Alucent vascular scaffolding, and adventitial photocrosslinking. The last three are contingent on the mechanical stiffening achievable by the exogenous photochemical crosslinking of tissular collagen, a process that leads to the decrease of venous compliance. As there are conflicting opinions on the role of compliance mismatch between arterial and venous conduits in a graft, this aspect was also considered in our review.
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Affiliation(s)
- Eliza Russu
- Clinic of Vascular Surgery, Mures County Emergency Hospital, Targu Mures, Romania
- Department of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Emil-Marian Arbanasi
- Clinic of Vascular Surgery, Mures County Emergency Hospital, Targu Mures, Romania
- Department of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
- Centre for Advanced Medical and Pharmaceutical Research (CCAMF), George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Traian V. Chirila
- Centre for Advanced Medical and Pharmaceutical Research (CCAMF), George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
- Queensland Eye Institute, Woolloongabba, QLD, Australia
- Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia
- Australian Institute of Bioengineering and Nanotechnology (AIBN), University of Queensland, St Lucia, QLD, Australia
| | - Adrian V. Muresan
- Clinic of Vascular Surgery, Mures County Emergency Hospital, Targu Mures, Romania
- Department of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
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Zhang H, Xie H, Li L. Association of radioactive iodine treatment in differentiated thyroid cancer and cardiovascular death: a large population-based study. J Endocrinol Invest 2024; 47:443-453. [PMID: 37543985 DOI: 10.1007/s40618-023-02159-4] [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: 04/14/2023] [Accepted: 07/14/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE The risk of cardiovascular diseases' death (CVD) in patients with differentiated thyroid cancer (DTC) treated with radioactive iodine (RAI) after surgery has not been adequately studied. METHODS Data of DTC patients who received RAI after surgery were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database (2004-2015). Standardized mortality rate (SMR) analysis was used to evaluate the CVD risk in patients with RAI vs general population. A 1:1 propensity score matching (PSM) was applied to balance inter-group bias, and Pearson's correlation coefficient was used to detect collinearity between variables. The Cox proportional hazard model and multivariate competing risk model were utilized to evaluate the impact of RAI on CVD. At last, we curved forest plots to compare differences in factors significantly associated with CVD or cancer-related deaths. RESULTS DTC patients with RAI treatment showed lower SMR for CVD than general population (RAI: SMR = 0.66, 95% CI 0.62-0.71, P < 0.05). After PSM, Cox proportional hazard regression demonstrated a decreased risk of CVD among patients with RAI compared to patients without (HR = 0.76, 95% CI 0.6-0.97, P = 0.029). However, in competing risk regression analysis, there was no significant difference (adjusted HR = 0.82, 95% CI 0.66-1.01, P = 0.11). The independent risk factors associated with CVD were different from those associated with cancer-related deaths. CONCLUSION The CVD risk between DTC patients treated with RAI and those who did not was no statistical difference. Noteworthy, they had decreased CVD risk compared with the general population.
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Affiliation(s)
- H Zhang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - H Xie
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China
| | - L Li
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China.
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Telischi J, Nisenbaum E, Nicolli E. Carotid endarterectomy for the management of carotid stenosis occurring concurrently with head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2023; 31:452-456. [PMID: 37916904 DOI: 10.1097/moo.0000000000000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
PURPOSE OF REVIEW Currently, most patients with concurrent head and neck cancer (HNC) and carotid stenosis (CS) are treated disjointedly for their oncologic and vascular lesions. The purpose of this review is to evaluate literature exploring a novel approach to these cases that poses several advantages, in which carotid endarterectomy (CEA) is performed simultaneously with surgical resection of HNC. RECENT FINDINGS Carotid stenosis is a common comorbidity of patients presenting with head and neck cancer as these pathologies have overlapping risk factors. Adjuvant oncologic therapy such as radiation therapy to the site of the lesion is known to increase development or progression of carotid stenosis. Performing simultaneous surgical management of CS and HNC decreases total procedures for the patient, provides a less challenging surgical field, and eliminates prioritization of treatment initiation for one pathology over the other. There has been limited reporting of simultaneous CEA with oncologic resection of HNC in the literature. However, of the 21 cases reviewed here, no perioperative strokes were reported with only one perioperative death from myocardial infarction. SUMMARY Available literature supports that simultaneous CEA with oncologic resection of HNC is safe and may offer several advantages, although larger studies are required.
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Affiliation(s)
- Julia Telischi
- Department of Otolaryngology, University of Miami Miller School of Medicine
| | - Eric Nisenbaum
- Department of Otolaryngology, University of Miami Miller School of Medicine
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Elizabeth Nicolli
- Department of Otolaryngology, University of Miami Miller School of Medicine
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA
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Vera-Chang MN, Danforth JM, Stuart M, Goodarzi AA, Brand M, Richardson RB. Profound DNA methylomic differences between single- and multi-fraction alpha irradiations of lung fibroblasts. Clin Epigenetics 2023; 15:174. [PMID: 37891670 PMCID: PMC10612361 DOI: 10.1186/s13148-023-01564-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/05/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Alpha (α)-radiation is a ubiquitous environmental agent with epigenotoxic effects. Human exposure to α-radiation at potentially harmful levels can occur repetitively over the long term via inhalation of naturally occurring radon gas that accumulates in enclosed spaces, or as a result of a single exposure from a nuclear accident. Alterations in epigenetic DNA methylation (DNAm) have been implicated in normal aging and cancer pathogenesis. Nevertheless, the effects of aberrations in the methylome of human lung cells following exposure to single or multiple α-irradiation events on these processes remain unexplored. RESULTS We performed genome-wide DNAm profiling of human embryonic lung fibroblasts from control and irradiated cells using americium-241 α-sources. Cells were α-irradiated in quadruplicates to seven doses using two exposure regimens, a single-fraction (SF) where the total dose was given at once, and a multi-fraction (MF) method, where the total dose was equally distributed over 14 consecutive days. Our results revealed that SF irradiations were prone to a decrease in DNAm levels, while MF irradiations mostly increased DNAm. The analysis also showed that the gene body (i.e., exons and introns) was the region most altered by both the SF hypomethylation and the MF hypermethylation. Additionally, the MF irradiations induced the highest number of differentially methylated regions in genes associated with DNAm biomarkers of aging, carcinogenesis, and cardiovascular disease. The DNAm profile of the oncogenes and tumor suppressor genes suggests that the fibroblasts manifested a defensive response to the MF α-irradiation. Key DNAm events of ionizing radiation exposure, including changes in methylation levels in mitochondria dysfunction-related genes, were mainly identified in the MF groups. However, these alterations were under-represented, indicating that the mitochondria undergo adaptive mechanisms, aside from DNAm, in response to radiation-induced oxidative stress. CONCLUSIONS We identified a contrasting methylomic profile in the lung fibroblasts α-irradiated to SF compared with MF exposures. These findings demonstrate that the methylome response of the lung cells to α-radiation is highly dependent on both the total dose and the exposure regimen. They also provide novel insights into potential biomarkers of α-radiation, which may contribute to the development of innovative approaches to detect, prevent, and treat α-particle-related diseases.
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Affiliation(s)
- Marilyn N Vera-Chang
- Radiobiology and Health Branch, Chalk River Laboratories, Canadian Nuclear Laboratories, Chalk River, ON, K0J 1J0, Canada
| | - John M Danforth
- Departments of Biochemistry and Molecular Biology and Oncology, Cumming School of Medicine, Robson DNA Science Centre, Charbonneau Cancer Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Marilyne Stuart
- Environment and Waste Technologies Branch, Chalk River Laboratories, Canadian Nuclear Laboratories, Chalk River, ON, K0J 1J0, Canada
| | - Aaron A Goodarzi
- Departments of Biochemistry and Molecular Biology and Oncology, Cumming School of Medicine, Robson DNA Science Centre, Charbonneau Cancer Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Marjorie Brand
- Ottawa Hospital Research Institute, Ottawa, ON, K1H 8L6, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, K1H 8L6, Canada
| | - Richard B Richardson
- Radiobiology and Health Branch, Chalk River Laboratories, Canadian Nuclear Laboratories, Chalk River, ON, K0J 1J0, Canada.
- McGill Medical Physics Unit, Cedars Cancer Centre-Glen Site, Montreal, QC, H4A 3J1, Canada.
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Sharma AB, Agrawal R. Reduction in Primary Operator Radiation Dose Exposure During Coronary Angioplasty Using Radiation Absorbing Drape. Cureus 2023; 15:e46619. [PMID: 37937037 PMCID: PMC10626564 DOI: 10.7759/cureus.46619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 11/09/2023] Open
Abstract
Background Percutaneous coronary intervention (PCI) involves the use of ionizing radiation and is a common procedure in a cardiac catheterization suite. The RADPAD® surgical drape (Worldwide Innovations & Technologies, Inc., Lenexa, KS) has been developed to reduce scatter radiation exposure to primary operators during routine PCI procedures. This study aims to assess the efficacy of RADPAD drapes in reducing radiation dose in the catheterization laboratory. Methods This was a single-center, prospective, observational study that aimed to compare the primary operator dose received with and without the use of a commercially available shield (RADPAD) during PCI. A total of 53 consecutive patients undergoing PCI were randomized in a 1:1 pattern to receive either the RADPAD (study group) or no RADPAD (control group). Standard shielding and personal protective equipment were used. Radiation exposure to the primary operator, total fluoroscopy time, number of cine acquisitions, and air kerma were recorded for each procedure. A one-way ANOVA calculator, including the Tukey honestly significant difference (HSD) test, was used to compare the mean values of radiation exposure. Scatterplot analysis and linear regression slopes of dose relative to air kerma were performed. All shields were reused once only. Results The study compared radiation exposure during PCI procedures between patients who received radiation attenuation devices (RADPAD) and those who did not. The RADPAD group had 30 patients, while the NO RADPAD group had 23 patients. There was a significant difference in the number of coronary angiography and single/multi-vessel PCI procedures between the two groups. There was no significant difference in procedural time or air kerma dose between the groups, but the RADPAD group had a significantly lower radiation dose (mean dose of 3.679 mrem) compared to the NO RADPAD group (mean dose of 8.12 mrem) (p < 0.00001). The primary operator dose per unit of air kerma was also significantly lower in the RADPAD group. Overall, the use of RADPAD resulted in a significant reduction in radiation exposure during PCI procedures. Conclusion The present study provides further evidence for the efficacy of using radiation-absorbing drapes (RADPAD) in reducing primary operator radiation dose exposure during coronary angioplasty. The equipment for radiation dose reduction of patients also reduces the radiation dose of medical staff. Therefore, the use of RADPAD is recommended as a safe and effective measure for reducing operator radiation dose exposure during coronary angioplasty.
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Aleman Oliva C, Aleman Espino E, Demory Beckler M, Kesselman MM. Radiation-Induced Peripheral Artery Disease in a 63-Year-Old Patient. Cureus 2023; 15:e47372. [PMID: 38022038 PMCID: PMC10657155 DOI: 10.7759/cureus.47372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Tobacco use, hypertension, diabetes, and hypercholesterolemia are known risk factors for peripheral artery disease (PAD). However, additional causes of PAD, such as radiation therapy, should be considered for the prevention and diagnosis of this disease. The patient described in this report had 36 radiation therapies directly to the pelvis and bladder area due to bladder cancer. The presence of severe PAD on this patient's right external iliac artery, the same area where he received radiation therapy, raises the question of whether radiation therapy contributed to the development of PAD. In addition, his history of anal intraepithelial neoplasia, obstructive uropathy, and chronic kidney disease further demonstrated that he possibly suffered extensive tissue damage due to radiation to the pelvis. This case report explores the current diagnosis guidelines and treatment options for patients with radiation-induced PAD. Through this case study, we aim to bring awareness to this lesser-known cause of PAD among medical providers and promote research for the prevention and treatment of this disease.
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Affiliation(s)
- Claudia Aleman Oliva
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Erik Aleman Espino
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Michelle Demory Beckler
- Microbiology and Immunology, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Marc M Kesselman
- Rheumatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
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12
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Wu S, Guan W, Zhao H, Li G, Zhou Y, Shi B, Zhang X. Assessment of short-term effects of thoracic radiotherapy on the cardiovascular parasympathetic and sympathetic nervous systems. Front Neurosci 2023; 17:1256067. [PMID: 37732299 PMCID: PMC10507252 DOI: 10.3389/fnins.2023.1256067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
Background Prior research suggests that cardiovascular autonomic dysfunction might be an early marker of cardiotoxicity induced by antitumor treatment and act as an early predictor of cardiovascular disease-related morbidity and mortality. The impact of thoracic radiotherapy on the parasympathetic and sympathetic nervous systems, however, remains unclear. Therefore, this study aimed to evaluate the short-term effects of thoracic radiotherapy on the autonomic nervous system, using deceleration capacity (DC), acceleration capacity (AC) of heart rate, and heart rate variability (HRV) as assessment tools. Methods A 5 min electrocardiogram was collected from 58 thoracic cancer patients before and after thoracic radiotherapy for DC, AC, and HRV analysis. HRV parameters employed included the standard deviation of the normal-normal interval (SDNN), root mean square of successive interval differences (RMSSD), low frequency power (LF), high frequency power (HF), total power (TP), and the LF to HF ratio. Some patients also received systemic therapies alongside radiotherapy; thus, patients were subdivided into a radiotherapy-only group (28 cases) and a combined radiotherapy and systemic therapies group (30 cases) for additional subgroup analysis. Results Thoracic radiotherapy resulted in a significant reduction in DC (8.5 [5.0, 14.2] vs. 5.3 [3.5, 9.4], p = 0.002) and HRV parameters SDNN (9.9 [7.03, 16.0] vs. 8.2 [6.0, 12.4], p = 0.003), RMSSD (9.9 [6.9, 17.5] vs. 7.7 [4.8, 14.3], p = 0.009), LF (29 [10, 135] vs. 24 [15, 50], p = 0.005), HF (35 [12, 101] vs. 16 [9, 46], p = 0.002), TP (74 [41, 273] vs. 50 [33, 118], p < 0.001), and a significant increase in AC (-8.2 [-14.8, -4.9] vs. -5.8 [-10.1, -3.3], p = 0.003) and mean heart rate (79.8 ± 12.6 vs. 83.9 ± 13.6, p = 0.010). Subgroup analysis indicated similar trends in mean heart rate, DC, AC, and HRV parameters (SDNN, RMSSD, LF, HF, TP) in both the radiotherapy group and the combined treatment group post-radiotherapy. No statistically significant difference was noted in the changes observed in DC, AC, and HRV between the two groups pre- and post-radiotherapy. Conclusion Thoracic radiotherapy may induce cardiovascular autonomic dysfunction by reducing parasympathetic activity and enhancing sympathetic activity. Importantly, the study found that the concurrent use of systemic therapies did not significantly amplify or contribute to the alterations in autonomic function in the short-term following thoracic radiotherapy. DC, AC and HRV are promising and feasible biomarkers for evaluating autonomic dysfunction caused by thoracic radiotherapy.
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Affiliation(s)
- Shuang Wu
- School of Medicine, Yangzhou University, Yangzhou, China
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
| | - Weizheng Guan
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Huan Zhao
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Guangqiao Li
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Yufu Zhou
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
| | - Bo Shi
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Xiaochun Zhang
- School of Medicine, Yangzhou University, Yangzhou, China
- Department of Oncology, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou, China
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13
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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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14
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Salman MA, Assal MM, Salman A, Elsherbiney M. Outcomes of Radioactive Iodine Versus Surgery for the Treatment of Graves’ Disease: a Systematic Review and Meta-analysis. Indian J Surg 2023. [DOI: 10.1007/s12262-023-03692-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Abstract
Graves’ disease (GD) is a systemic autoimmune disorder mainly affecting the thyroid gland. During GD management, the principal target is to control the hyperthyroid state. There have been three rather similarly effective modalities: medical therapy with antithyroid drugs (ATD), radioactive iodine (RAI), or surgical excision of the thyroid tissue (thyroidectomy). Defining the relative risks and benefits of each of the two potential definitive treatment options (RAI or thyroidectomy) is crucial for creating evidence-based therapy algorithms. This systematic review and meta-analysis aimed to compare the outcomes of these two treatment options. This is a systematic review and meta-analysis that analyzed the studies comparing RAI and thyroidectomy to treat GD. Studies were obtained by searching on Scopus, the Cochrane Central Register of Controlled Trials, and PubMed central database. The surgically treated group showed significantly lower failure rates, non-significantly lower cardiovascular morbidities, non-significantly higher complication rates, and significantly lower mortality rates. The RAI-related complications were mostly the development or worsening of Graves’ ophthalmopathy. This review and meta-analysis comparing surgery and radioactive iodine for the treatment of Grave’s disease from 16 well-conducted trials has shown that although surgery viz., total thyroidectomy was less frequently utilized for the treatment of Grave’s disease, it controlled the symptoms with greater success and without any worsening of Grave’s ophthalmopathy.
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15
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Atherogenic potential of microgravity hemodynamics in the carotid bifurcation: a numerical investigation. NPJ Microgravity 2022; 8:39. [PMID: 36085153 PMCID: PMC9463447 DOI: 10.1038/s41526-022-00223-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 08/22/2022] [Indexed: 11/08/2022] Open
Abstract
Long-duration spaceflight poses multiple hazards to human health, including physiological changes associated with microgravity. The hemodynamic adaptations occurring upon entry into weightlessness have been associated with retrograde stagnant flow conditions and thromboembolic events in the venous vasculature but the impact of microgravity on cerebral arterial hemodynamics and function remains poorly understood. The objective of this study was to quantify the effects of microgravity on hemodynamics and wall shear stress (WSS) characteristics in 16 carotid bifurcation geometries reconstructed from ultrasonography images using computational fluid dynamics modeling. Microgravity resulted in a significant 21% increase in flow stasis index, a 22-23% decrease in WSS magnitude and a 16-26% increase in relative residence time in all bifurcation branches, while preserving WSS unidirectionality. In two anatomies, however, microgravity not only promoted flow stasis but also subjected the convex region of the external carotid arterial wall to a moderate increase in WSS bidirectionality, which contrasted with the population average trend. This study suggests that long-term exposure to microgravity has the potential to subject the vasculature to atheroprone hemodynamics and this effect is modulated by subject-specific anatomical features. The exploration of the biological impact of those microgravity-induced WSS aberrations is needed to better define the risk posed by long spaceflights on cardiovascular health.
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16
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New Insights on the Toxicity on Heart and Vessels of Breast Cancer Therapies. Med Sci (Basel) 2022; 10:medsci10020027. [PMID: 35736347 PMCID: PMC9229896 DOI: 10.3390/medsci10020027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
Cardiovascular diseases are largely represented in patients with cancer and appear to be important side effects of cancer treatments, heavily affecting quality of life and leading to premature morbidity and death among cancer survivors. In particular, treatments for breast cancer have been shown to potentially play serious detrimental effects on cardiovascular health. This review aims to explore the available literature on breast cancer therapy-induced side effects on heart and vessels, illustrating the molecular mechanisms of cardiotoxicity known so far. Moreover, principles of cardiovascular risk assessment and management of cardiotoxicity in clinical practice will also be elucidated. Chemotherapy (anthracycline, taxanes, cyclophosphamide and 5-fluorouracil), hormonal therapy (estrogen receptor modulator and gonadotropin or luteinizing releasing hormone agonists) and targeted therapy (epidermal growth factor receptor 2 and Cyclin-dependent kinases 4 and 6 inhibitors) adverse events include arterial and pulmonary hypertension, supraventricular and ventricular arrhythmias, systolic and diastolic cardiac dysfunction and coronary artery diseases due to different and still not well-dissected molecular pathways. Therefore, cardiovascular prevention programs and treatment of cardiotoxicity appear to be crucial to improve morbidity and mortality of cancer survivors.
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17
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Huff JL, Plante I, Blattnig SR, Norman RB, Little MP, Khera A, Simonsen LC, Patel ZS. Cardiovascular Disease Risk Modeling for Astronauts: Making the Leap From Earth to Space. Front Cardiovasc Med 2022; 9:873597. [PMID: 35665268 PMCID: PMC9161032 DOI: 10.3389/fcvm.2022.873597] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/26/2022] [Indexed: 11/24/2022] Open
Abstract
NASA has recently completed several long-duration missions to the International Space Station and is solidifying plans to return to the Moon, with an eye toward Mars and beyond. As NASA pushes the boundaries of human space exploration, the hazards of spaceflight, including space radiation, levy an increasing burden on astronaut health and performance. The cardiovascular system may be especially vulnerable due to the combined impacts of space radiation exposure, lack of gravity, and other spaceflight hazards. On Earth, the risk for cardiovascular disease (CVD) following moderate to high radiation doses is well-established from clinical, environmental, and occupational exposures (largely from gamma- and x-rays). Less is known about CVD risks associated with high-energy charged ions found in space and increasingly used in radiotherapy applications on Earth, making this a critical area of investigation for occupational radiation protection. Assessing CVD risk is complicated by its multifactorial nature, where an individual's risk is strongly influenced by factors such as family history, blood pressure, and lipid profiles. These known risk factors provide the basis for development of a variety of clinical risk prediction models (CPMs) that inform the likelihood of medical outcomes over a defined period. These tools improve clinical decision-making, personalize care, and support primary prevention of CVD. They may also be useful for individualizing risk estimates for CVD following radiation exposure both in the clinic and in space. In this review, we summarize unique aspects of radiation risk assessment for astronauts, and we evaluate the most widely used CVD CPMs for their use in NASA radiation risk assessment applications. We describe a comprehensive dual-use risk assessment framework that supports both clinical care and operational management of space radiation health risks using quantitative metrics. This approach is a first step in using personalized medicine for radiation risk assessment to support safe and productive spaceflight and long-term quality of life for NASA astronauts.
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Affiliation(s)
- Janice L. Huff
- National Aeronautics and Space Administration, Langley Research Center, Hampton, VA, United States
- *Correspondence: Janice L. Huff
| | - Ianik Plante
- KBR, Houston, TX, United States
- National Aeronautics and Space Administration, Johnson Space Center, Houston, TX, United States
| | - Steve R. Blattnig
- National Aeronautics and Space Administration, Langley Research Center, Hampton, VA, United States
| | - Ryan B. Norman
- National Aeronautics and Space Administration, Langley Research Center, Hampton, VA, United States
| | - Mark P. Little
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services (DHHS), Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Amit Khera
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Lisa C. Simonsen
- National Aeronautics and Space Administration, NASA Headquarters, Washington, DC, United States
| | - Zarana S. Patel
- KBR, Houston, TX, United States
- National Aeronautics and Space Administration, Johnson Space Center, Houston, TX, United States
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18
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Martinez DSL, Noseworthy PA, Akbilgic O, Herrmann J, Ruddy KJ, Hamid A, Maddula R, Singh A, Davis R, Gunturkun F, Jefferies JL, Brown SA. Artificial intelligence opportunities in cardio-oncology: Overview with spotlight on electrocardiography. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 15:100129. [PMID: 35721662 PMCID: PMC9202996 DOI: 10.1016/j.ahjo.2022.100129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 01/21/2023]
Abstract
Cardiovascular disease is a leading cause of death among cancer survivors, second only to cancer recurrence or development of new tumors. Cardio-oncology has therefore emerged as a relatively new specialty focused on prevention and management of cardiovascular consequences of cancer therapies. Yet challenges remain regarding precision and accuracy with predicting individuals at highest risk for cardiotoxicity. Barriers such as access to care also limit screening and early diagnosis to improve prognosis. Thus, developing innovative approaches for prediction and early detection of cardiovascular illness in this population is critical. In this review, we provide an overview of the present state of machine learning applications in cardio-oncology. We begin by outlining some factors that should be considered while utilizing machine learning algorithms. We then examine research in which machine learning has been applied to improve prediction of cardiac dysfunction in cancer survivors. We also highlight the use of artificial intelligence (AI) in conjunction with electrocardiogram (ECG) to predict cardiac malfunction and also atrial fibrillation (AF), and we discuss the potential role of wearables. Additionally, the article summarizes future prospects and critical takeaways for the application of machine learning in cardio-oncology. This study is the first in a series on artificial intelligence in cardio-oncology, and complements our manuscript on echocardiography and other forms of imaging relevant to cancer survivors cared for in cardiology clinical practice.
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Affiliation(s)
- Daniel Sierra-Lara Martinez
- Coronary Care Unit, National Institute of Cardiology/Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
| | | | - Oguz Akbilgic
- Department of Health Informatics and Data Science, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
- Section of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Wake Forest, NC, USA
| | - Joerg Herrmann
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Ashima Singh
- Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Robert Davis
- Center for Biomedical Informatics, University of Tennessee Health Sciences Center, USA
| | - Fatma Gunturkun
- Center for Biomedical Informatics, University of Tennessee Health Sciences Center, USA
| | - John L. Jefferies
- Division of Cardiovascular Diseases, University of Tennessee Health Sciences Center, USA
- Department of Epidemiology, St. Jude Children's Research Hospital, USA
| | - Sherry-Ann Brown
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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19
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Sadeghinezhad S, Khodamoradi E, Diojan L, Taeb S, Najafi M. Radioprotective Mechanisms of Arbutin: A Systematic Review. Curr Drug Res Rev 2022; 14:132-138. [PMID: 35319405 DOI: 10.2174/2589977514666220321114415] [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: 09/21/2021] [Revised: 12/15/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE Efforts to produce radioprotective agents of high potential are appropriate strategies for overcoming possible IR toxicity in organisms. The present research aims to evaluate the signaling pathways and mechanisms through which arbutin exerts radioprotective effects on organisms. METHODS The databases of PubMed, Web of Sciences, Google Scholar, and Scopus were searched to find studies that reported radioprotective effects for arbutin. Besides, the data were searched within the time period from 2010 to 2020. RESULTS Five research articles met our criteria, which were included in the analysis based on their relevance to the topic. The present systematic review provides conclusions about various mechanisms and pathways through which arbutin induces radioprotection. CONCLUSIONS Based on the relevant studies, various mechanisms can be proposed for inducing radioprotective effects by arbutin, including inhibition of oxidative stress, apoptosis, and inflammation.
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Affiliation(s)
- Shima Sadeghinezhad
- Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Khodamoradi
- Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Loghman Diojan
- Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Taeb
- Department of Radiology, School of Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Masoud Najafi
- Medical Technology Research Center, Institute of Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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20
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OUP accepted manuscript. Br J Surg 2022; 109:381-389. [DOI: 10.1093/bjs/znab474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/30/2021] [Accepted: 12/19/2021] [Indexed: 11/12/2022]
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21
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Sallam M, Benotmane MA, Baatout S, Guns PJ, Aerts A. Radiation-induced cardiovascular disease: an overlooked role for DNA methylation? Epigenetics 2022; 17:59-80. [PMID: 33522387 PMCID: PMC8812767 DOI: 10.1080/15592294.2021.1873628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/27/2020] [Accepted: 01/04/2021] [Indexed: 11/25/2022] Open
Abstract
Radiotherapy in cancer treatment involves the use of ionizing radiation for cancer cell killing. Although radiotherapy has shown significant improvements on cancer recurrence and mortality, several radiation-induced adverse effects have been documented. Of these adverse effects, radiation-induced cardiovascular disease (CVD) is particularly prominent among patients receiving mediastinal radiotherapy, such as breast cancer and Hodgkin's lymphoma patients. A number of mechanisms of radiation-induced CVD pathogenesis have been proposed such as endothelial inflammatory activation, premature endothelial senescence, increased ROS and mitochondrial dysfunction. However, current research seems to point to a so-far unexamined and potentially novel involvement of epigenetics in radiation-induced CVD pathogenesis. Firstly, epigenetic mechanisms have been implicated in CVD pathophysiology. In addition, several studies have shown that ionizing radiation can cause epigenetic modifications, especially DNA methylation alterations. As a result, this review aims to provide a summary of the current literature linking DNA methylation to radiation-induced CVD and thereby explore DNA methylation as a possible contributor to radiation-induced CVD pathogenesis.
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Affiliation(s)
- Magy Sallam
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
- Laboratory of Physiopharmacology, University of Antwerp, Wilrijk, Belgium
| | - Mohammed Abderrafi Benotmane
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
| | - Sarah Baatout
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
- Department of Molecular Biotechnology, Ghent University, Ghent, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, University of Antwerp, Wilrijk, Belgium
| | - An Aerts
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
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22
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Sihver L, Mortazavi SMJ. Biological Protection in Deep Space Missions. J Biomed Phys Eng 2021; 11:663-674. [PMID: 34904063 PMCID: PMC8649166 DOI: 10.31661/jbpe.v0i0.1193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/20/2019] [Indexed: 01/15/2023]
Abstract
During deep space missions, astronauts are exposed to highly ionizing radiation, incl. neutrons, protons and heavy ions from galactic cosmic rays (GCR), solar wind (SW) and solar energetic particles
(SEP). This increase the risks for cancerogenisis, damages in central nervous system (CNS), cardiovascular diseases, etc. Large SEP events can even cause acute radiation syndrome (ARS).
Long term manned deep space missions will therefor require unique radiation protection strategies. Since it has been shown that physical shielding alone is not sufficient, this paper
propose pre-flight screening of the aspirants for evaluation of their level of adaptive responses. Methods for boosting their immune system, should also be further investigated,
and the possibility of using radiation effect modulators are discussed. In this paper, especially, the use of vitamin C as a promising non-toxic, cost-effective, easily available
radiation mitigator (which can be used hours after irradiation), is described. Although it has previously been shown that vitamin C can decrease radiation-induced chromosomal damage in rodents,
it must be further investigated before any conclusions about its radiation mitigating properties in humans can be concluded.
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Affiliation(s)
- Lembit Sihver
- PhD, Department of Radiation Physics, Atominstitut, Technische Universität Wien, Stadionallee 2, 1020 Vienna, Austria
- PhD, Department of Physics, Chalmers University of Technology, 412 96 Gothenburg, Sweden
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23
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Chen D, Kelly C, Haw TJ, Lombard JM, Nordman IIC, Croft AJ, Ngo DTM, Sverdlov AL. Heart Failure in Breast Cancer Survivors: Focus on Early Detection and Novel Biomarkers. Curr Heart Fail Rep 2021; 18:362-377. [PMID: 34731413 DOI: 10.1007/s11897-021-00535-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW Breast cancer survival rate has greatly improved in the last two decades due to the emergence of next-generation anti-cancer agents. However, cardiotoxicity remains a significant adverse effect arising from traditional and emerging chemotherapies as well as targeted therapies for breast cancer patients. In this review, we will discuss cardiotoxicities of both traditional and emerging therapies for breast cancer. We will discuss current practices to detect cardiotoxicity of these therapies with the focus on new and emerging biomarkers. We will then focus on 'omics approaches, especially the use of epigenetics to discover novel biomarkers and therapeutics to mitigate cardiotoxicity. RECENT FINDINGS Significant cardiotoxicities of conventional chemotherapies remain and new and unpredictable new forms of cardiac and/or vascular toxicity emerge with the surge in novel and targeted therapies. Yet, there is no clear guidance on detection of cardiotoxicity, except for significant left ventricular systolic dysfunction, and even then, there is no uniform definition of what constitutes cardiotoxicity. The gold standard for detection of cardiotoxicity involves a serial echocardiography in conjunction with blood-based biomarkers to detect early subclinical cardiac dysfunction. However, the ability of these tests to detect early disease remains limited and not all forms of toxicity are detectable with these modalities. There is an unprecedented need to discover novel biomarkers that are sensitive and specific for early detection of subclinical cardiotoxicity. In that space, novel echocardiographic techniques, such as strain, are becoming more common-place and new biomarkers, discovered by epigenetic approaches, seem to become promising alternatives or adjuncts to conventional non-specific cardiac biomarkers.
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Affiliation(s)
- Dongqing Chen
- Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle, NSW, Callaghan, Australia
| | - Conagh Kelly
- Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle, NSW, Callaghan, Australia
| | - Tatt Jhong Haw
- Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle, NSW, Callaghan, Australia.,Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle Calvary Mater Newcastle, NSW, Waratah, Australia
| | - Janine M Lombard
- Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle Calvary Mater Newcastle, NSW, Waratah, Australia
| | - Ina I C Nordman
- Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle Calvary Mater Newcastle, NSW, Waratah, Australia
| | - Amanda J Croft
- Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle Calvary Mater Newcastle, NSW, Waratah, Australia
| | - Doan T M Ngo
- Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle, NSW, Callaghan, Australia. .,School of Biomedical Science and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
| | - Aaron L Sverdlov
- Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle, NSW, Callaghan, Australia. .,Cardio-Oncology & Cardiometabolic Research Group, College of Health, Medicine and Wellbeing, Hunter Medical Research Institute & University of Newcastle Calvary Mater Newcastle, NSW, Waratah, Australia. .,Cardiovascular Department, John Hunter Hospital, Hunter New England Local Health District, NSW, New Lambton Heights, Australia. .,School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
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24
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Cehic DA, Sverdlov AL, Koczwara B, Emery J, Ngo DTM, Thornton-Benko E. The Importance of Primary Care in Cardio-Oncology. Curr Treat Options Oncol 2021; 22:107. [PMID: 34674055 DOI: 10.1007/s11864-021-00908-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 11/24/2022]
Abstract
OPINION STATEMENT There is significant interplay between cancer and cardiovascular disease involving shared risk factors, cross disease communication where cardiovascular events can influence cancer recurrence, and mortality rates and cardiotoxicity from cancer treatments with resultant increased cardiovascular mortality and morbidity in cancer patients. This is a major cause of death in many long-term cancer survivors. As a result, cardio-oncology, which involves the prevention, early detection, and optimal treatment of cardiovascular disease in patients treated for cancer, is expanding globally. However, there is still limited awareness of its importance and limited application of the lessons already learnt. Primary care physicians, and their clinical teams, especially nursing colleagues, have a foundation role in the management of all patients, and this paper outlines areas where they can lead in the cardio-oncology management of cancer patients. Although there is currently a lack of an adequate clinical framework or shared care plan, primary care physicians have a role to play in the various phases of cancer treatment: pre-therapy, during therapy, and survivorship.
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Affiliation(s)
- Daniel A Cehic
- GenesisCare Cardiology, GenesisCare, Building 1 & 11, The Mill, 41-43 Bourke Road, Alexandria, Sydney, NSW, 2015, Australia. .,Discipline of Medicine, School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia.
| | - Aaron L Sverdlov
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.,Hunter Cancer Research Alliance, Waratah, NSW, 2298, Australia.,Hunter New England Local Health District, Newcastle, NSW, 2305, Australia
| | - Bogda Koczwara
- Department of Medical Oncology, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia.,Flinders Health and Medical Research Institute, Flinders University, Flinders Drive, Bedford Park, SA, 5042, Australia
| | - Jon Emery
- Department of General Practice and Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Level 10, Victorian Comprehensive Cancer Centre, 305 Grattan St, Victoria, 3000, Australia
| | - Doan T M Ngo
- Hunter Cancer Research Alliance, Waratah, NSW, 2298, Australia.,Hunter New England Local Health District, Newcastle, NSW, 2305, Australia.,School of Biomedical Science and Pharmacy, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Elysia Thornton-Benko
- Bondi Road Doctors, 27 Bondi Road, Bondi Junction, Sydney, NSW, 2022, Australia.,Faculty of Medicine, Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, University of NSW, Randwick, NSW, Australia
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25
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Meerman M, Driessen R, van Engeland NCA, Bergsma I, Steenhuijsen JLG, Kozono D, Aikawa E, Hjortnaes J, Bouten CVC. Radiation Induces Valvular Interstitial Cell Calcific Response in an in vitro Model of Calcific Aortic Valve Disease. Front Cardiovasc Med 2021; 8:687885. [PMID: 34527708 PMCID: PMC8435633 DOI: 10.3389/fcvm.2021.687885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/13/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Mediastinal ionizing radiotherapy is associated with an increased risk of valvular disease, which demonstrates pathological hallmarks similar to calcific aortic valve disease (CAVD). Despite advances in radiotherapy techniques, the prevalence of comorbidities such as radiation-associated valvular disease is still increasing due to improved survival of patients receiving radiotherapy. However, the mechanisms of radiation-associated valvular disease are largely unknown. CAVD is considered to be an actively regulated disease process, mainly controlled by valvular interstitial cells (VICs). We hypothesize that radiation exposure catalyzes the calcific response of VICs and, therefore, contributes to the development of radiation-associated valvular disease. Methods and Results: To delineate the relationship between radiation and VIC behavior (morphology, calcification, and matrix turnover), two different in vitro models were established: (1) VICs were cultured two-dimensional (2D) on coverslips in control medium (CM) or osteogenic medium (OM) and irradiated with 0, 2, 4, 8, or 16 Gray (Gy); and (2) three-dimensional (3D) hydrogel system was designed, loaded with VICs and exposed to 0, 4, or 16 Gy of radiation. In both models, a dose-dependent decrease in cell viability and proliferation was observed in CM and OM. Radiation exposure caused myofibroblast-like morphological changes and differentiation of VICs, as characterized by decreased αSMA expression. Calcification, as defined by increased alkaline phosphatase activity, was mostly present in the 2D irradiated VICs exposed to 4 Gy, while after exposure to higher doses VICs acquired a unique giant fibroblast-like cell morphology. Finally, matrix turnover was significantly affected by radiation exposure in the 3D irradiated VICs, as shown by decreased collagen staining and increased MMP-2 and MMP-9 activity. Conclusions: The presented work demonstrates that radiation exposure enhances the calcific response in VICs, a hallmark of CAVD. In addition, high radiation exposure induces differentiation of VICs into a terminally differentiated giant-cell fibroblast. Further studies are essential to elucidate the underlying mechanisms of these radiation-induced valvular changes.
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Affiliation(s)
- Manon Meerman
- Department of Cardiothoracic Surgery, Heart and Lung Division, Leiden University Medical Center, Leiden, Netherlands
| | - Rob Driessen
- Department of Biomedical Engineering, Soft Tissue Engineering and Mechanobiology (STEM), Eindhoven University of Technology, Eindhoven, Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, Netherlands
| | - Nicole C A van Engeland
- Department of Biomedical Engineering, Soft Tissue Engineering and Mechanobiology (STEM), Eindhoven University of Technology, Eindhoven, Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, Netherlands.,Åbo Akademi University, Faculty of Science and Engineering, Molecular Biosciences, Turku, Finland
| | - Irith Bergsma
- Department of Biomedical Engineering, Soft Tissue Engineering and Mechanobiology (STEM), Eindhoven University of Technology, Eindhoven, Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, Netherlands
| | | | - David Kozono
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
| | - Elena Aikawa
- Center for Interdisciplinary Cardiovascular Sciences, Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Jesper Hjortnaes
- Department of Cardiothoracic Surgery, Heart and Lung Division, Leiden University Medical Center, Leiden, Netherlands
| | - Carlijn V C Bouten
- Department of Biomedical Engineering, Soft Tissue Engineering and Mechanobiology (STEM), Eindhoven University of Technology, Eindhoven, Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, Netherlands
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26
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Masannat YA, Lazaraviciute G, Garbett IK, Shivakumar N, Brownlee BV, Gagliardi T, Bromiley A, Heys SD, Sharma R. The relationship between cardiac dosimetry and tumour quadrant location in left sided whole breast and chest wall adjuvant radiotherapy. Breast Dis 2021; 41:67-74. [PMID: 34420936 DOI: 10.3233/bd-201025] [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: 11/15/2022]
Abstract
BACKGROUND Radiotherapy after breast surgery decreases locoregional recurrence and improves survival. This is not without risks from radiation exposure and could have implications in clinical practice. Our study investigates the correlation between tumour location and radiation dose to the heart. METHODS Left-sided breast cancer patients who had radiotherapy at Aberdeen Royal Infirmary in 2010 were identified. Tumour location was established from notes and imaging. Radiotherapy planning scans were reviewed, and cardiac doses calculated. The mean cardiac dose, maximum dose and volume of the heart in the field, along with V5-V40, were determined. RESULTS 40 patients had mastectomies and 118 breast conserving surgery. The median percentage of the heart in the field and the Interquartile Range was 0.59% (0.03-1.74) for all patients, with the highest for lower inner quadrant (LIQ) tumours 1.20% (0.29-2.40), followed by mastectomy 0.94% (0.02-1.82). The mean heart dose showed a higher median for mastectomies 1.59 Gy (1.00-1.94), followed by LIQ tumours 1.58 Gy (1.31-2.28), with an overall median of 1.42 Gy (1.13-1.95). The median percentage of the heart in the field, the mean cardiac dose and V5-V30 did not reach statistical significance, however, V40 and the maximum dose did. CONCLUSIONS The benefits of radiotherapy after breast cancer surgery are established, but with potential harm from cardiac exposure. Our cohort showed higher radiation exposure to the heart in patients with LIQ tumours and mastectomies but reached significance only for V40 and maximum dose. This highlights tumour location as a potentially important risk factor for cardiac exposure with breast radiotherapy.
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Affiliation(s)
- Yazan A Masannat
- Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK.,School of Medicine, Medical sciences and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, Scotland, UK
| | | | - Ian K Garbett
- Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK
| | - Natesh Shivakumar
- School of Medicine, Medical sciences and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, Scotland, UK
| | - Brittany V Brownlee
- School of Medicine, Medical sciences and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, Scotland, UK
| | - Tanja Gagliardi
- Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK
| | - Andrew Bromiley
- Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK
| | - Steven D Heys
- Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK.,School of Medicine, Medical sciences and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, Scotland, UK
| | - Ravi Sharma
- Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK
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27
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Tinganelli W, Luoni F, Durante M. What can space radiation protection learn from radiation oncology? LIFE SCIENCES IN SPACE RESEARCH 2021; 30:82-95. [PMID: 34281668 DOI: 10.1016/j.lssr.2021.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 06/13/2023]
Abstract
Protection from cosmic radiation of crews of long-term space missions is now becoming an urgent requirement to allow a safe colonization of the moon and Mars. Epidemiology provides little help to quantify the risk, because the astronaut group is small and as yet mostly involved in low-Earth orbit mission, whilst the usual cohorts used for radiation protection on Earth (e.g. atomic bomb survivors) were exposed to a radiation quality substantially different from the energetic charged particle field found in space. However, there are over 260,000 patients treated with accelerated protons or heavier ions for different types of cancer, and this cohort may be useful for quantifying the effects of space-like radiation in humans. Space radiation protection and particle therapy research also share the same tools and devices, such as accelerators and detectors, as well as several research topics, from nuclear fragmentation cross sections to the radiobiology of densely ionizing radiation. The transfer of the information from the cancer radiotherapy field to space is manifestly complicated, yet the two field should strengthen their relationship and exchange methods and data.
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Affiliation(s)
- Walter Tinganelli
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Darmstadt, Germany
| | - Francesca Luoni
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Darmstadt, Germany; Technische Universität Darmstadt, Institut für Physik Kondensierter Materie, Darmstadt, Germany
| | - Marco Durante
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Darmstadt, Germany; Technische Universität Darmstadt, Institut für Physik Kondensierter Materie, Darmstadt, Germany.
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28
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Durante M. Failla Memorial Lecture: The Many Facets of Heavy-Ion Science. Radiat Res 2021; 195:403-411. [PMID: 33979440 DOI: 10.1667/rade-21-00029.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/22/2021] [Indexed: 11/03/2022]
Abstract
Heavy ions are riveting in radiation biophysics, particularly in the areas of radiotherapy and space radiation protection. Accelerated charged particles can indeed penetrate deeply in the human body to sterilize tumors, exploiting the favorable depth-dose distribution of ions compared to conventional X rays. Conversely, the high biological effectiveness in inducing late effects presents a hazard for manned space exploration. Even after half a century of accelerator-based experiments, clinical applications and flight research, these two topics remain both fascinating and baffling. Heavy-ion therapy is very expensive, and despite the clinical success it remains controversial. Research on late radiation morbidity in spaceflight led to a reduction in uncertainty, but also pointed to new risks previously underestimated, such as possible damage to the central nervous system. Recently, heavy ions have also been used in other, unanticipated biomedical fields, such as treatment of heart arrhythmia or inactivation of viruses for vaccine development. Heavy-ion science nicely merges physics and biology and remains an extraordinary research field for the 21st century.
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Affiliation(s)
- Marco Durante
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; and Technische Universität Darmstadt, Institute of Condensed Matter Physics, 64289 Darmstadt, Germany
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29
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Maliszewska-Olejniczak K, Kaniowski D, Araszkiewicz M, Tymińska K, Korgul A. Molecular Mechanisms of Specific Cellular DNA Damage Response and Repair Induced by the Mixed Radiation Field During Boron Neutron Capture Therapy. Front Oncol 2021; 11:676575. [PMID: 34094980 PMCID: PMC8170402 DOI: 10.3389/fonc.2021.676575] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/28/2021] [Indexed: 01/04/2023] Open
Abstract
The impact of a mixed neutron-gamma beam on the activation of DNA damage response (DDR) proteins and non-coding RNAs (ncRNAs) is poorly understood. Ionizing radiation is characterized by its biological effectiveness and is related to linear energy transfer (LET). Neutron-gamma mixed beam used in boron neutron capture therapy (BNCT) can induce another type of DNA damage such as clustered DNA or multiple damaged sites, as indicated for high LET particles, such as alpha particles, carbon ions, and protons. We speculate that after exposure to a mixed radiation field, the repair capacity might reduce, leading to unrepaired complex DNA damage for a long period and may promote genome instability and cell death. This review will focus on the poorly studied impact of neutron-gamma mixed beams with an emphasis on DNA damage and molecular mechanisms of repair. In case of BNCT, it is not clear which repair pathway is involved, and recent experimental work will be presented. Further understanding of BNCT-induced DDR mechanisms may lead to improved therapeutic efficiency against different tumors.
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Affiliation(s)
| | - Damian Kaniowski
- Centre of Molecular and Macromolecular Studies, Polish Academy of Sciences, Lodz, Poland
| | - Martyna Araszkiewicz
- Faculty of Physics, University of Warsaw, Warsaw, Poland.,Nuclear Facilities Operations Department, National Centre for Nuclear Research, Otwock, Poland
| | - Katarzyna Tymińska
- Nuclear Facilities Operations Department, National Centre for Nuclear Research, Otwock, Poland
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30
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Walsh L, Hafner L, Straube U, Ulanowski A, Fogtman A, Durante M, Weerts G, Schneider U. A bespoke health risk assessment methodology for the radiation protection of astronauts. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2021; 60:213-231. [PMID: 33929575 PMCID: PMC8116305 DOI: 10.1007/s00411-021-00910-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/10/2021] [Indexed: 05/05/2023]
Abstract
An alternative approach that is particularly suitable for the radiation health risk assessment (HRA) of astronauts is presented. The quantity, Radiation Attributed Decrease of Survival (RADS), representing the cumulative decrease in the unknown survival curve at a certain attained age, due to the radiation exposure at an earlier age, forms the basis for this alternative approach. Results are provided for all solid cancer plus leukemia incidence RADS from estimated doses from theoretical radiation exposures accumulated during long-term missions to the Moon or Mars. For example, it is shown that a 1000-day Mars exploration mission with a hypothetical mission effective dose of 1.07 Sv at typical astronaut ages around 40 years old, will result in the probability of surviving free of all types of solid cancer and leukemia until retirement age (65 years) being reduced by 4.2% (95% CI 3.2; 5.3) for males and 5.8% (95% CI 4.8; 7.0) for females. RADS dose-responses are given, for the outcomes for incidence of all solid cancer, leukemia, lung and female breast cancer. Results showing how RADS varies with age at exposure, attained age and other factors are also presented. The advantages of this alternative approach, over currently applied methodologies for the long-term radiation protection of astronauts after mission exposures, are presented with example calculations applicable to European astronaut occupational HRA. Some tentative suggestions for new types of occupational risk limits for space missions are given while acknowledging that the setting of astronaut radiation-related risk limits will ultimately be decided by the Space Agencies. Suggestions are provided for further work which builds on and extends this new HRA approach, e.g., by eventually including non-cancer effects and detailed space dosimetry.
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Affiliation(s)
- Linda Walsh
- Department of Physics, Science Faculty, University of Zürich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Luana Hafner
- Department of Physics, ETH Zurich, Otto-Stern-Weg 1, 8092 Zurich, Switzerland
| | - Ulrich Straube
- Medical Operations and Space Medicine, HRE-OM, European Space Agency, ESA, European Astronaut Centre, EAC, Cologne, Germany
| | - Alexander Ulanowski
- Present Address: Environment Laboratories, International Atomic Energy Agency, 2444 Seibersdorf, Austria
- Institute of Radiation Medicine, Helmholtz Zentrum München- German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Anna Fogtman
- Medical Operations and Space Medicine, HRE-OM, European Space Agency, ESA, European Astronaut Centre, EAC, Cologne, Germany
| | - Marco Durante
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Technische Universität Darmstadt, Darmstadt, Germany
| | - Guillaume Weerts
- Medical Operations and Space Medicine, HRE-OM, European Space Agency, ESA, European Astronaut Centre, EAC, Cologne, Germany
| | - Uwe Schneider
- Department of Physics, Science Faculty, University of Zürich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
- Radiotherapy Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland
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31
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Rackova L, Mach M, Brnoliakova Z. An update in toxicology of ageing. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 84:103611. [PMID: 33581363 DOI: 10.1016/j.etap.2021.103611] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/17/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
The field of ageing research has been rapidly advancing in recent decades and it had provided insight into the complexity of ageing phenomenon. However, as the organism-environment interaction appears to significantly affect the organismal pace of ageing, the systematic approach for gerontogenic risk assessment of environmental factors has yet to be established. This puts demand on development of effective biomarker of ageing, as a relevant tool to quantify effects of gerontogenic exposures, contingent on multidisciplinary research approach. Here we review the current knowledge regarding the main endogenous gerontogenic pathways involved in acceleration of ageing through environmental exposures. These include inflammatory and oxidative stress-triggered processes, dysregulation of maintenance of cellular anabolism and catabolism and loss of protein homeostasis. The most effective biomarkers showing specificity and relevancy to ageing phenotypes are summarized, as well. The crucial part of this review was dedicated to the comprehensive overview of environmental gerontogens including various types of radiation, certain types of pesticides, heavy metals, drugs and addictive substances, unhealthy dietary patterns, and sedentary life as well as psychosocial stress. The reported effects in vitro and in vivo of both recognized and potential gerontogens are described with respect to the up-to-date knowledge in geroscience. Finally, hormetic and ageing decelerating effects of environmental factors are briefly discussed, as well.
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Affiliation(s)
- Lucia Rackova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia.
| | - Mojmir Mach
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia
| | - Zuzana Brnoliakova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia
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32
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Meerman M, Bracco Gartner TCL, Buikema JW, Wu SM, Siddiqi S, Bouten CVC, Grande-Allen KJ, Suyker WJL, Hjortnaes J. Myocardial Disease and Long-Distance Space Travel: Solving the Radiation Problem. Front Cardiovasc Med 2021; 8:631985. [PMID: 33644136 PMCID: PMC7906998 DOI: 10.3389/fcvm.2021.631985] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/11/2021] [Indexed: 12/12/2022] Open
Abstract
Radiation-induced cardiovascular disease is a well-known complication of radiation exposure. Over the last few years, planning for deep space missions has increased interest in the effects of space radiation on the cardiovascular system, as an increasing number of astronauts will be exposed to space radiation for longer periods of time. Research has shown that exposure to different types of particles found in space radiation can lead to the development of diverse cardiovascular disease via fibrotic myocardial remodeling, accelerated atherosclerosis and microvascular damage. Several underlying mechanisms for radiation-induced cardiovascular disease have been identified, but many aspects of the pathophysiology remain unclear. Existing pharmacological compounds have been evaluated to protect the cardiovascular system from space radiation-induced damage, but currently no radioprotective compounds have been approved. This review critically analyzes the effects of space radiation on the cardiovascular system, the underlying mechanisms and potential countermeasures to space radiation-induced cardiovascular disease.
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Affiliation(s)
- Manon Meerman
- Division Heart and Lung, Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Regenerative Medicine Center Utrecht, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tom C L Bracco Gartner
- Division Heart and Lung, Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Regenerative Medicine Center Utrecht, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jan Willem Buikema
- Regenerative Medicine Center Utrecht, University Medical Center Utrecht, Utrecht, Netherlands.,Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Sean M Wu
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Sailay Siddiqi
- Department of Cardiothoracic Surgery, Radboud University, Nijmegen, Netherlands
| | - Carlijn V C Bouten
- Department of Biomedical Engineering, Technical University Eindhoven, Eindhoven, Netherlands
| | | | - Willem J L Suyker
- Division Heart and Lung, Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jesper Hjortnaes
- Regenerative Medicine Center Utrecht, University Medical Center Utrecht, Utrecht, Netherlands.,Division Heart and Lung, Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands
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33
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Ali S, Ali O, Ahmed I, Nazir T. Trifascicular Block and Ventricular Standstill: A Late Complication of Mediastinal Radiotherapy in a Cancer Survivor. Cureus 2021; 13:e12806. [PMID: 33628674 PMCID: PMC7894380 DOI: 10.7759/cureus.12806] [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] [Accepted: 01/20/2021] [Indexed: 11/05/2022] Open
Abstract
Over the last half-century, radiation therapy has evolved to become one of the cornerstones of treatment for various types of cancers. It is estimated that more than 50% of patients with cancer are treated with radiotherapy. Patients with early stages of some cancers can even achieve a cure with radiotherapy alone. Radiation-induced heart disease is a well-recognized cause of mortality and morbidity in cancer survivors as a late complication of radiotherapy, often occurring more than a decade after radiotherapy. We describe a case of a middle-aged female who presented to the hospital with syncopal episodes. She was in remission from non-Hodgkin's lymphoma having received mediastinal radiotherapy 20 years, previously. Her initial workup such as laboratory investigations and 12 lead electrocardiogram were largely unremarkable. Cardiac monitoring over the course of the next few days was consistent with complete heart block with evidence of ventricular standstill. Her symptoms resolved following the implantation of a dual-chamber cardiac pacemaker. This case highlights the significance of clinical history taking and putting together all relevant facts to come to a differential diagnosis. In our case, this could have been easily overlooked as radiation therapy was given many years previously. We review and present an up-to-date albeit brief literature review on long-term cardiovascular complications of radiotherapy. Radiation-induced cardiac complications are an important cause of mortality and morbidity in cancer survivors. This article aims to raise awareness amongst clinicians of cardiac adverse effects occurring several years after the radiation therapy. This case also highlights the need for further research to better understand the pathophysiology of cardiovascular disease post-radiotherapy in order to develop effective prevention strategies and improve clinical outcomes.
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Affiliation(s)
- Sadaf Ali
- Internal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, GBR
| | - Omer Ali
- Internal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, GBR
| | - Irfan Ahmed
- Cardiology, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, GBR
| | - Tahir Nazir
- Internal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, GBR
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34
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Hmiel L, Nemeth A. An Interesting Case of a Cold Left Arm. Cureus 2020; 12:e11524. [PMID: 33354468 PMCID: PMC7746329 DOI: 10.7759/cureus.11524] [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] [Indexed: 12/03/2022] Open
Abstract
Inter-arm variability in blood pressure readings typically signifies arterial disease between the aortic arch and the subclavian artery. The differential diagnosis includes thoracic aortic dissection, atherosclerosis, thoracic outlet syndrome, and subclavian artery stenosis and thrombosis. In patients with prior coronary artery bypass grafting, including the internal mammary artery, several of those conditions can compromise coronary blood flow and lead to myocardial ischemia. Here we discuss a case of left subclavian artery thrombosis, which compromised left internal mammary artery blood flow and led to ischemic ventricular tachycardia.
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Affiliation(s)
- Laura Hmiel
- Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA.,Internal Medicine, Louis Stokes Cleveland VA Medical Center/Case Western Reserve University School of Medicine, Cleveland, USA
| | - Attila Nemeth
- Internal Medicine, Louis Stokes Cleveland VA Medical Center/Case Western Reserve University School of Medicine, Cleveland, USA
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Patel ZS, Brunstetter TJ, Tarver WJ, Whitmire AM, Zwart SR, Smith SM, Huff JL. Red risks for a journey to the red planet: The highest priority human health risks for a mission to Mars. NPJ Microgravity 2020; 6:33. [PMID: 33298950 PMCID: PMC7645687 DOI: 10.1038/s41526-020-00124-6] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/30/2020] [Indexed: 12/19/2022] Open
Abstract
NASA's plans for space exploration include a return to the Moon to stay-boots back on the lunar surface with an orbital outpost. This station will be a launch point for voyages to destinations further away in our solar system, including journeys to the red planet Mars. To ensure success of these missions, health and performance risks associated with the unique hazards of spaceflight must be adequately controlled. These hazards-space radiation, altered gravity fields, isolation and confinement, closed environments, and distance from Earth-are linked with over 30 human health risks as documented by NASA's Human Research Program. The programmatic goal is to develop the tools and technologies to adequately mitigate, control, or accept these risks. The risks ranked as "red" have the highest priority based on both the likelihood of occurrence and the severity of their impact on human health, performance in mission, and long-term quality of life. These include: (1) space radiation health effects of cancer, cardiovascular disease, and cognitive decrements (2) Spaceflight-Associated Neuro-ocular Syndrome (3) behavioral health and performance decrements, and (4) inadequate food and nutrition. Evaluation of the hazards and risks in terms of the space exposome-the total sum of spaceflight and lifetime exposures and how they relate to genetics and determine the whole-body outcome-will provide a comprehensive picture of risk profiles for individual astronauts. In this review, we provide a primer on these "red" risks for the research community. The aim is to inform the development of studies and projects with high potential for generating both new knowledge and technologies to assist with mitigating multisystem risks to crew health during exploratory missions.
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Affiliation(s)
- Zarana S Patel
- KBR, Houston, TX, USA.
- NASA Lyndon B. Johnson Space Center, Houston, TX, USA.
| | | | | | | | - Sara R Zwart
- NASA Lyndon B. Johnson Space Center, Houston, TX, USA
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Scott M Smith
- NASA Lyndon B. Johnson Space Center, Houston, TX, USA
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Prasad P, Branch M, Asemota D, Elsayed R, Addison D, Brown SA. Cardio-Oncology Preventive Care: Racial and Ethnic Disparities. CURRENT CARDIOVASCULAR RISK REPORTS 2020. [DOI: 10.1007/s12170-020-00650-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Nuszkiewicz J, Woźniak A, Szewczyk-Golec K. Ionizing Radiation as a Source of Oxidative Stress-The Protective Role of Melatonin and Vitamin D. Int J Mol Sci 2020; 21:E5804. [PMID: 32823530 PMCID: PMC7460937 DOI: 10.3390/ijms21165804] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/31/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023] Open
Abstract
Ionizing radiation (IR) has found widespread application in modern medicine, including medical imaging and radiotherapy. As a result, both patients and healthcare professionals are exposed to various IR doses. To minimize the negative side effects of radiation associated with oxidative imbalance, antioxidant therapy has been considered. In this review, studies on the effects of melatonin and vitamin D on radiation-induced oxidative stress are discussed. According to the research data, both substances meet the conditions for use as agents that protect humans against IR-induced tissue damage. Numerous studies have confirmed that melatonin, a hydro- and lipophilic hormone with strong antioxidant properties, can potentially be used as a radioprotectant in humans. Less is known about the radioprotective effects of vitamin D, but the results to date have been promising. Deficiencies in melatonin and vitamin D are common in modern societies and may contribute to the severity of adverse side effects of medical IR exposure. Hence, supporting supplementation with both substances seems to be of first importance. Interestingly, both melatonin and vitamin D have been found to selectively radiosensitise cancer cells, which makes them promising adjuvants in radiotherapy. More research is needed in this area, especially in humans.
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Affiliation(s)
- Jarosław Nuszkiewicz
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 24 Karłowicza St, 85-092 Bydgoszcz, Poland;
| | | | - Karolina Szewczyk-Golec
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 24 Karłowicza St, 85-092 Bydgoszcz, Poland;
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Ghanem H, Jaskani S, Alloush M, Hanbal I, Albader M, Safar H, Al-Ali J, Asfar S. Stiff to Dilate and Risky to Cut Through: Iliac Radiation Arteritis. VASCULAR AND ENDOVASCULAR REVIEW 2020. [DOI: 10.15420/ver.2019.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Radiation arteritis is not an uncommon clinical situation, given that almost 50% of patients with cancer receive radiotherapy in the course of treatment. Radiation effects are non-specific, and late radiation tissue injury presentation can be very variable. However, radiation arteritis has some unique clinical and radiological features, with consequent special therapeutic considerations. Iliac radiation arteritis may be accompanied by radiation-associated iliac vein disease and small vessel disease. Therefore, diagnostic and therapeutic plans should be directed toward all possible late radiation effects as relevant. Despite the complexity of the disease process and diagnostic challenges, treatment can be very straightforward if adequately planned. Otherwise, limb loss and/or life-threatening complications can rapidly ensue. This article highlights the natural history of radiation arteritis, with a particular emphasis on the iliac segment, and discusses the risk potentials of this condition, given that limb loss may be multifactorial, not merely because of the iliac arterial flow interruption. The main lines of management are also briefly discussed.
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Affiliation(s)
- Huthayfa Ghanem
- Department of Vascular Surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Sadia Jaskani
- Department of Surgery, Bedford Hospital NHS Trust, Bedford, UK
| | - Mohamed Alloush
- Vascular Surgery Unit, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Ibrahim Hanbal
- Vascular Surgery Unit, Al-Azhar Faculty of Medicine, Nasr City, Cairo, Egypt
| | - Marzouk Albader
- Vascular Surgery Unit, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Hussein Safar
- Vascular Surgery Unit, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Jassim Al-Ali
- Vascular Surgery Unit, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Sami Asfar
- Vascular Surgery Unit, Kuwait University Health Sciences Center, Jabriya, Kuwait
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Kluck GEG, Durham KK, Yoo JA, Trigatti BL. High Density Lipoprotein and Its Precursor Protein Apolipoprotein A1 as Potential Therapeutics to Prevent Anthracycline Associated Cardiotoxicity. Front Cardiovasc Med 2020; 7:65. [PMID: 32411725 PMCID: PMC7198830 DOI: 10.3389/fcvm.2020.00065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 04/06/2020] [Indexed: 01/01/2023] Open
Abstract
Cardiovascular disease and cancer are the leading causes of death in developed societies. Despite their effectiveness, many cancer therapies exhibit deleterious cardiovascular side effects such as cardiotoxicity and heart failure. The cardiotoxic effects of anthracyclines such as doxorubicin are the most well-characterized of cardiotoxic anti-cancer therapies. While other anti-neoplastic drugs also induce cardiotoxicity, often leading to heart failure, they are beyond the scope of this review. This review first summarizes the mechanisms of doxorubicin-induced cardiotoxicity. It then reviews emerging preclinical evidence that high density lipoprotein and its precursor protein apolipoprotein A1, which are known for their protective effects against ischemic cardiovascular disease, may also protect against doxorubicin-induced cardiotoxicity both directly and indirectly, when used therapeutically.
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Affiliation(s)
- George E. G. Kluck
- Department of Biochemistry and Biomedical Sciences, Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Kristina K. Durham
- Faculty of Health Sciences, Institute of Applied Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Jeong-Ah Yoo
- Department of Biochemistry and Biomedical Sciences, Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Bernardo L. Trigatti
- Department of Biochemistry and Biomedical Sciences, Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
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Huang S, Che J, Chu Q, Zhang P. The Role of NLRP3 Inflammasome in Radiation-Induced Cardiovascular Injury. Front Cell Dev Biol 2020; 8:140. [PMID: 32226786 PMCID: PMC7080656 DOI: 10.3389/fcell.2020.00140] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/19/2020] [Indexed: 12/24/2022] Open
Abstract
The increasing risk of long-term adverse effects from radiotherapy on the cardiovascular structure is receiving increasing attention. However, the mechanisms underlying this increased risk remain poorly understood. Recently, the nucleotide-binding domain and leucine-rich-repeat-containing family pyrin 3 (NLRP3) inflammasome was suggested to play a critical role in radiation-induced cardiovascular injury. However, the relationship between ionizing radiation and the NLRP3 inflammasome in acute and chronic inflammation is complex. We reviewed literature detailing pathological changes and molecular mechanisms associated with radiation-induced damage to the cardiovascular structure, with a specific focus on NLRP3 inflammasome-related cardiovascular diseases. We also summarized possible therapeutic strategies for the prevention of radiation-induced heart disease (RIHD).
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Affiliation(s)
- Shanshan Huang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Che
- College of Life Sciences, Wuhan University, Wuhan, China
| | - Qian Chu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Nematollahi HR, Hosseini R, Bijani A, Akhavan-Niaki H, Parsian H, Pouramir M, Saravi M, Bagherzadeh M, Mosapour A, Saleh-Moghaddam M, Rajabian M, Golpour M, Mostafazadeh A. Interleukin 10, lipid profile, vitamin D, selenium, metabolic syndrome, and serum antioxidant capacity in elderly people with and without cardiovascular disease: Amirkola health and ageing project cohort-based study. ARYA ATHEROSCLEROSIS 2020; 15:233-240. [PMID: 31949450 PMCID: PMC6954357 DOI: 10.22122/arya.v15i5.1623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The age-related autoinflammation-mediated atherosclerosis is associated with some immunological, nutritional, and metabolic parameters and redox status. Here, we evaluated the association of circulatory interleukin 10 (IL-10) levels with lipid profile, some nutrients, and total anti-oxidant capacity in elderly people who presented cardiovascular disease (CVD) with or without metabolic syndrome (MetS) and in healthy subjects. METHODS In this cross-sectional case-control study, 258 sera prepared from elderly people (144 healthy and 114 patient subjects) who participated in a community-based study, the Amirkola Health and Ageing Project (AHAP), were analyzed for IL-10, lipid profile, vitamin D, selenium (Se), antioxidant capacity, and MetS. RESULTS Compared to patients, the healthy subjects exhibited higher levels of circulatory IL-10 among individuals with detectable serum IL-10 (P = 0.036). However, this difference was not observed when total subjects from both groups were compared, since more than 90% of those people were IL-10-negative. Se, vitamin D, and antioxidant levels were similar in both groups. There was a negative association between IL-10 and body mass index (BMI) (P < 0.050) and an equivocal association with vitamin D levels, whereas the association between IL-10 and other indicated variables was not significant. Significant association was observed between MetS and CVD prevalence (P < 0.001). There was a positive correlation between Se and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) (P < 0.010) in healthy subjects and with TC in patients (P < 0.050). CONCLUSION A major proportion of elderly people were serum IL-10-negative, whereas independently to IL-10, MetS was most common in patients with CVD. Weight loss may have the potential to increase IL-10 levels in the elderly.
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Affiliation(s)
- Hamid Reza Nematollahi
- Department of Biochemistry, School of Sciences, Payame Noor University of Mashhad, Mashhad, Iran
| | - Reza Hosseini
- Professor, Social Determinants of Health Research Center AND Department of Community Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Assistant Professor, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Haleh Akhavan-Niaki
- Professor, Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hadi Parsian
- Professor, Department of Biochemistry, School of Sciences, Babol University of Medical Sciences, Babol, Iran
| | - Mahdi Pouramir
- Professor, Department of Biochemistry, School of Sciences, Babol University of Medical Sciences, Babol, Iran
| | - Mehrdad Saravi
- Associate Professor, Department of Cardiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mojgan Bagherzadeh
- Department of Immunology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Abbas Mosapour
- PhD Candidate, Department of Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Massud Saleh-Moghaddam
- Professor, Department of Biochemistry, School of Sciences, Payame Noor University of Mashhad, Mashhad, Iran
| | - Majid Rajabian
- Professor, Department of Biochemistry, School of Sciences, Payame Noor University of Mashhad, Mashhad, Iran
| | - Monireh Golpour
- PhD Candidate, Cellular and Molecular Biology Research Center AND Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amrollah Mostafazadeh
- Associate Professor, Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Brown SA. Preventive Cardio-Oncology: The Time Has Come. Front Cardiovasc Med 2020; 6:187. [PMID: 31998754 PMCID: PMC6965025 DOI: 10.3389/fcvm.2019.00187] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/10/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Sherry-Ann Brown
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
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Reynolds RJ, Bukhtiyarov IV, Tikhonova GI, Day SM, Ushakov IB, Gorchakova TYU. Contrapositive logic suggests space radiation not having a strong impact on mortality of US astronauts and Soviet and Russian cosmonauts. Sci Rep 2019; 9:8583. [PMID: 31273231 PMCID: PMC6609703 DOI: 10.1038/s41598-019-44858-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/24/2019] [Indexed: 12/31/2022] Open
Abstract
Space travelers are exposed to unique forms of ionizing radiation that pose potentially serious health hazards. Prior analyses have attempted to quantify excess mortality risk for astronauts exposed to space radiation, but low statistical power has frustrated inferences. If exposure to deep space radiation were causally linked to deaths due to two particular causes, e.g., cancer and cardiovascular disease, then those cause-specific deaths would not be statistically independent. In this case, a Kaplan-Meier survival curve for a specific cause that treats deaths due to competing causes as uninformative censored events would result in biased estimates of survival probabilities. Here we look for evidence of a deleterious effect of historical exposure to space radiation by assessing whether or not there is evidence for such bias in Kaplan-Meier estimates of survival probabilities for cardiovascular disease and cancer. Evidence of such bias may implicate space radiation as a common causal link to these two disease processes. An absence of such evidence would be evidence that no such common causal link to radiation exposure during space travel exists. We found that survival estimates from the Kaplan-Meier curves were largely congruent with those of competing risk methods, suggesting that if ionizing radiation is impacting the risk of death due to cancer and cardiovascular disease, the effect is not dramatic.
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Affiliation(s)
| | - Igor V Bukhtiyarov
- Federal State Budgetary Scientific Institution Izmerov Research Institute of Occupational Health, 31, Prospect Budennogo, Moscow, 105275, Russian Federation
| | - Galina I Tikhonova
- Federal State Budgetary Scientific Institution Izmerov Research Institute of Occupational Health, 31, Prospect Budennogo, Moscow, 105275, Russian Federation
| | - Steven M Day
- Mortality Research & Consulting, Inc., City of Industry, CA, USA
| | - Igor B Ushakov
- Russian State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, 46 Zhivopisnaya Street, 123182, Moscow, Russian Federation
| | - Tatyana Y U Gorchakova
- Federal State Budgetary Scientific Institution Izmerov Research Institute of Occupational Health, 31, Prospect Budennogo, Moscow, 105275, Russian Federation
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An oscillometric approach in assessing early vascular ageing biomarkers following long-term space flights. INTERNATIONAL JOURNAL CARDIOLOGY HYPERTENSION 2019; 2:100013. [PMID: 33447746 PMCID: PMC7803044 DOI: 10.1016/j.ijchy.2019.100013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/09/2019] [Accepted: 05/29/2019] [Indexed: 12/26/2022]
Abstract
Purpose The environmental conditions in space, particularly exposure to cosmic radiation, coupled with decreased mobility, altered glucose metabolism, and hemodynamic changes may promote cardiovascular disease Therefore, we assessed early vascular aging markers and hemodynamics using a novel oscillometric blood pressure device. Methodology In eight cosmonauts (46.5 ± 5.3 yrs, 77.6 ± 8.2 kg, 176 ± 6.2 cm, 7 men/1woman), we determined heart rate, peripheral blood pressure, central blood pressure, and pulse wave velocity in the supine position using an oscillometric brachial device coupled with transfer function analysis. We obtained measurements at baseline (65–90 days before flight) and four days (R+4) and eight days (R+8) after return from six months mission onboard the International Space Station. Results Compared to baseline, heart rate increased significantly on R+4 (58.6 ± 6.4 vs. 70.3 ± 5.2 bpm) but did not differ on R+8. Central systolic blood pressure increased from 112.5 ± 13.5 on baseline to 125.6 ± 18.5 on R+4 and 121.6 ± 9.5 mmHg, albeit showing no statistical significance compared to baseline (p = 0.243/0.295). Peripheral diastolic and systolic as well as central diastolic blood pressure measurements followed this trend. Pulse wave velocity increased non-significantly from baseline (6.7 ± 0.8 m/s) to R+4 (7.2 ± 0.8 m/s, p = 0.499) and stayed elevated on R+8 (7.1 ± 0.5 m/s, p = 0.614). Conclusion The important finding of our study is that six months in a near-earth orbit do not lead to clinically significant changes in early vascular ageing biomarkers. However, these findings cannot be extrapolated to the conditions encountered in deep space. Non-invasive testing of vascular biomarkers may have utility in detecting vascular risks during space travel at an early stage.
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Cardiovascular Complications Associated with Mediastinal Radiation. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2019; 21:31. [DOI: 10.1007/s11936-019-0737-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Caron J, Nohria A. Cardiac Toxicity from Breast Cancer Treatment: Can We Avoid This? Curr Oncol Rep 2018; 20:61. [DOI: 10.1007/s11912-018-0710-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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