Medical management of radiation injuries: current approaches

Abstract

The current approach to medical management of irradiated patients begins with early diagnosis of radiation injury. Medical assessment of radiation dose is based on event history, symptomatology and laboratory results, with emphasis on time to emesis and lymphocyte depletion kinetics. Dose assessment provides a basis for early use of haematopoietic growth factors that can shorten the period of neutropaenia for patients with acute radiation syndrome. Assessments of haematopoietic, gastrointestinal and cutaneous syndromes have improved in recent years, but treatment options remain limited. Selected examples of current developments are presented.

Mechanism of radioprotection by δ-tocotrienol: pharmacokinetics, pharmacodynamics and modulation of signalling pathways

“…The haematopoietic tissue is a rapidly proliferating, self-renewing organ, which is highly vulnerable to radiation injury, making it a major dose-limiting organ for triage following radiological accidents [15], and the status of bone marrow determines the course of treatment with radiation and/ or chemotherapy [16,17]. Therefore, a major research goal in radiation biology and oncology has been the identification of protectants that can ameliorate radiation-induced ARS.…”

Automated micronucleus (MN) scoring for population triage in case of large scale radiation events

“…However, some of these symptoms are subjective parameters and can be the consequence of intense anxiety. Also, they vary from person to person, which can result in false positive and false negative identifications (Berger et al 2006, Roy et al 2007). In an accidental exposure, physical dosimetry based on a physical reconstruction of the event or based on external dosimeters carried by personnel at risk are possible, but will be progressively less useful when the number of potentially irradiated people increases.…”

Medical Response to Radiological Accidents in Latin America and International Assistance

“…From 1945 to 2005, there were 565 significant nuclear or radiological emergencies reported worldwide, in which 3,000 individuals were exposed and 169 fatalities occurred (2,3). From 2000 to 2010, 130 individuals were exposed and 14 fatalities occurred in North America, South America, Africa, Asia and Europe.…”

“…Accordingly, preliminary results from a collaborative preclinical study indicate that injection of hMSC-derived exosomes results in a similarly beneficial effect as MSC injection in a radiological skin injury mouse model. 2 On the basis of clinical observations during patient follow-up, a new strategy for optimizing treatment will consist of targeting the injured tissue by using tissuespecific stem cells (e.g., muscle and bone).…”