Epistem Ltd, Manchester, UK.
Health Phys. 2012 Oct;103(4):400-10. doi: 10.1097/hp.0b013e31826530e2.
The acute effects of irradiation on the gastrointestinal (GI) system are well documented, but the longer-term effects are less well known. Increased incidence of adenocarcinoma has been noted, but apart from descriptions of fibrosis, the development of other pathologies specific to survivors of acute radiation is poorly understood. Samples were taken from C57BL/6 mice irradiated with partial-body irradiation where the thorax, head, and forelimbs were shielded (i.e., sparing 40% of the bone marrow). Tissue from age-matched controls was also collected. There were clear pathological changes in the intestine associated with DEARE (Delayed Effects of Acute Radiation Exposure) at doses greater than 12 Gy, with a dose-related increase in observed pathologies. Mice maintained on the synthetic antibiotic ciprofloxacin during the acute phase (days 4 to 20), however, had a lower or delayed incidence of symptoms. After 20 d, mice developed structures similar to early adenomas. Abnormally high levels of apoptotic and mitotic cells were present in some crypts, along with the early adenomas, suggesting tissue regeneration and areas of deregulated cell turnover. Over time, there was inhibited crypt cell proliferation in animals with advanced symptoms, a blunting of the crypts and villi, and an enlargement of villus girth, with an increasingly acellular and fibrotic extracellular matrix (a characteristic that has been demonstrated previously in aging mice). Together these changes may lead to a reduced functional surface area and less motile intestine. These observations are similar to those seen in geriatric animals, suggesting a premature aging of the GI tract.
辐射对胃肠道(GI)系统的急性影响已有充分记录,但长期影响知之甚少。已经注意到腺癌的发病率增加,但除了纤维化的描述外,对于急性辐射幸存者特有的其他病理学的发展还了解甚少。从接受半身照射的 C57BL/6 小鼠中采集样本,其中胸部、头部和前肢被屏蔽(即,骨髓保留 40%)。还收集了来自年龄匹配对照的组织。在大于 12 Gy 的剂量下,与 DEARE(急性辐射暴露的延迟效应)相关的肠道出现明显的病理变化,观察到的病变呈剂量相关性增加。然而,在急性阶段(第 4 天至第 20 天)用合成抗生素环丙沙星维持的小鼠,症状的发生率较低或延迟。20 天后,小鼠形成类似于早期腺瘤的结构。在一些隐窝中,除了早期腺瘤外,还存在凋亡和有丝分裂细胞的异常高水平,表明组织再生和细胞更替失调区域。随着时间的推移,在有晚期症状的动物中,隐窝细胞增殖受到抑制,隐窝和绒毛变钝,绒毛周长增大,细胞外基质无细胞和纤维化程度增加(这一特征以前在老年小鼠中得到证实)。这些变化共同导致功能表面积减少和肠蠕动减少。这些观察结果与老年动物中观察到的情况相似,表明胃肠道过早衰老。