Medical Countermeasures for Radiation Exposure and Related Injuries

Abstract

World events over the past decade have highlighted the threat of nuclear terrorism as well as an urgent need to develop radiation countermeasures for acute radiation exposures and subsequent bodily injuries. An increased probability of radiological or nuclear incidents due to detonation of nuclear weapons by terrorists, sabotage of nuclear facilities, dispersal and exposure to radioactive materials, and accidents provides the basis for such enhanced radiation exposure risks for civilian populations. Although the search for suitable radiation countermeasures for radiation-associated injuries was initiated more than half a century ago, no safe and effective radiation countermeasure for the most severe of these injuries, namely acute radiation syndrome (ARS), has been approved by the United States Food and Drug Administration (FDA). The dearth of FDA-approved radiation countermeasures has prompted intensified research for a new generation of radiation countermeasures. In this communication, the authors have listed and reviewed the status of radiation countermeasures that are currently available for use, or those that might be used for exceptional nuclear/radiological contingencies, plus a limited few medicines that show early promise but still remain experimental in nature and unauthorized for human use by the FDA.

Astaxanthin attenuates total body irradiation-induced hematopoietic system injury in mice via inhibition of oxidative stress and apoptosis

“…It has been well established that TBI causes radiolysis of intracellular water molecules, leading to increased production of ROS [36]. As shown in our study, ATX markedly mitigated ROS production detected by DCFDA and MitoSOX, but not DHE, suggesting that ATX can scavenge ROS produced from mitochondria, but that it has no scavenging effect on superoxide anion free radicals.…”

Addressing the Symptoms or Fixing the Problem? Developing Countermeasures against Normal Tissue Radiation Injury

“…The validation of circulating biomarkers that could indicate damage in specific organs, such as club cell secretory protein (54) and citrulline (69, 174) for the lung and gut, respectively, may provide invaluable assistance to emergency medical personnel when determining therapy under uncertain conditions. In contrast, determining tissues and organs at risk will be a relatively easier task in the radiation oncology clinic, given the highly defined and circumscribed nature of the modern radiation treatment volume.…”

“…More commonly, however, this approach is used as treatment for therapy-induced cytopenias, particularly those induced by the older chemotherapeutic agents. Indeed, as a result of their success with respect to the treatment of chemotherapy-induced neutropenia, granulocyte colony-stimulating factor (G-CSF/filgrastim) and PEGylated G-CSF (pegfilgrastim) have been added to the strategic national stockpile as countermeasures to myelosuppression for use in the aftermath of a large-scale radiation event (69) and recently received FDA approval for treatment of hematopoietic syndrome (70, 71). …”

Medical countermeasures for unwanted CBRN exposures: part II radiological and nuclear threats with review of recent countermeasure patents

“…We have limited this article to include agents identified (patents) as potential radiation countermeasures since 2014 (Table 1). There are recent, extensive reviews of this subject that list earlier patents [13,14,17,22]. …”