Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre, Mumbai, India.
Int J Radiat Biol. 2010 Aug;86(8):613-35. doi: 10.3109/09553001003746059.
With increasing utilisation of nuclear technologies in power production, medical and industrial applications, and in a scenario of nuclear terrorism/war, there is an enhanced likelihood of accidental radiation exposure to occupational workers, patients and public. The consequent health effects of the radiation exposure are resultant of interaction of radiation with biological systems and subsequent radiation injury. The present review discusses the knowledge gained in radiation biology that can be exploited for better treatment and management of radiation accident victims.
In comparison with planned radiation exposure during diagnosis/therapy, the management of accidental radiation exposure is quite complicated due to uncertainties in dose, duration, organs involved and radionuclides internalised, and hence, require multi-faceted approaches. However, the options available for dosimetry, decorporation of radionuclides and therapeutic protocols of patients are limited, which provides substantial scope in these areas of research. Moreover, there is a need to fill the gaps in knowledge of radiation action in different dose ranges and post-irradiation windows, which would help in improving therapeutic approaches. Cytogenetic approaches are 'gold standard' for biodosimetry but with limited applications in mass casualty scenario. State-of-the-art technological advancement and high throughput in metabolomics, proteomics and genomics could be employed successfully in developing better biodosimetry for triage in accidental radiation exposure. Furthermore, identification of targets at organs/organelles level of internalised radionuclides would be helpful to develop effective decorporation strategies. Despite substantial research investigating several agents, which could modify radiation effects, only a few could reach up to practical application due to poor bioavailability or toxicity.
Deeper insight into the mechanisms of radiation injury under accidental radiation conditions would be helpful in achieving better biodosimetry, decorporation strategies and improvement in prevention/post-irradiation management of radiation accident patients.
随着核能在发电、医疗和工业应用中的应用不断增加，以及在核恐怖主义/战争的情况下，职业工人、患者和公众意外辐射暴露的可能性增加。辐射暴露的相应健康影响是辐射与生物系统相互作用和随后的辐射损伤的结果。本综述讨论了在辐射生物学方面获得的知识，这些知识可用于更好地治疗和管理辐射事故受害者。
与诊断/治疗期间计划的辐射暴露相比，由于剂量、持续时间、涉及的器官和内吸放射性核素的不确定性，意外辐射暴露的管理相当复杂，因此需要多方面的方法。然而，可供剂量测定、放射性核素去除和患者治疗方案选择的选项有限，这为这些研究领域提供了很大的空间。此外，需要填补不同剂量范围和辐射后时间窗内辐射作用知识的空白，这将有助于改进治疗方法。细胞遗传学方法是生物剂量测定的“金标准”，但在大规模伤亡情况下的应用有限。代谢组学、蛋白质组学和基因组学的最先进技术进步和高通量可以成功地用于开发更好的生物剂量测定方法，以便在意外辐射暴露时进行分类。此外，确定内吸放射性核素在器官/细胞器水平的靶标将有助于制定有效的去除策略。尽管有大量研究调查了几种可以改变辐射效应的试剂，但由于生物利用度或毒性差，只有少数试剂能够实际应用。
更深入地了解意外辐射条件下的辐射损伤机制，将有助于更好地进行生物剂量测定、去除策略，并改善辐射事故患者的预防/辐射后管理。
