Rios Carmen I, Cassatt David R, Dicarlo Andrea L, Macchiarini Francesca, Ramakrishnan Narayani, Norman Mai-Kim, Maidment Bert W
Radiation Nuclear Countermeasures Program, Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
Drug Dev Res. 2014 Feb;75(1):23-8. doi: 10.1002/ddr.21163. Epub 2013 Dec 26.
The possibility of a public health radiological or nuclear emergency in the United States remains a concern. Media attention focused on lost radioactive sources and international nuclear threats, as well as the potential for accidents in nuclear power facilities (e.g., Windscale, Three Mile Island, Chernobyl, and Fukushima) highlight the need to address this critical national security issue. To date, no drugs have been licensed to mitigate/treat the acute and long-term radiation injuries that would result in the event of large-scale, radiation, or nuclear public health emergency. However, recent evaluation of several candidate radiation medical countermeasures (MCMs) has provided initial proof-of-concept of efficacy. The goal of the Radiation Nuclear Countermeasures Program (RNCP) of the National Institute of Allergy and Infectious Diseases (National Institutes of Health) is to help ensure the government stockpiling of safe and efficacious MCMs to treat radiation injuries, including, but not limited to, hematopoietic, gastrointestinal, pulmonary, cutaneous, renal, cardiovascular, and central nervous systems. In addition to supporting research in these areas, the RNCP continues to fund research and development of decorporation agents targeting internal radionuclide contamination, and biodosimetry platforms (e.g., biomarkers and devices) to assess the levels of an individual's radiation exposure, capabilities that would be critical in a mass casualty scenario. New areas of research within the program include a focus on special populations, especially pediatric and geriatric civilians, as well as combination studies, in which drugs are tested within the context of expected medical care management (e.g., antibiotics and growth factors). Moving forward, challenges facing the RNCP, as well as the entire radiation research field, include further advancement and qualification of animal models, dose conversion from animal models to humans, biomarker identification, and formulation development. This paper provides a review of recent work and collaborations supported by the RNCP.
美国发生公共卫生放射或核紧急情况的可能性仍然令人担忧。媒体关注的焦点是丢失的放射源和国际核威胁，以及核电设施发生事故的可能性（如温斯凯尔、三里岛、切尔诺贝利和福岛事故），这凸显了应对这一关键国家安全问题的必要性。迄今为止，尚无药物被批准用于减轻/治疗在大规模辐射或核公共卫生紧急情况下可能导致的急性和长期辐射损伤。然而，最近对几种候选辐射医学对策（MCMs）的评估提供了疗效的初步概念验证。美国国立卫生研究院国家过敏和传染病研究所的辐射核对策计划（RNCP）的目标是帮助确保政府储备安全有效的MCMs，以治疗辐射损伤，包括但不限于造血、胃肠道、肺部、皮肤、肾脏、心血管和中枢神经系统损伤。除了支持这些领域的研究外，RNCP还继续资助针对体内放射性核素污染的促排剂以及用于评估个人辐射暴露水平的生物剂量测定平台（如生物标志物和设备）的研发，这些能力在大规模伤亡情况下至关重要。该计划内的新研究领域包括关注特殊人群，特别是儿童和老年平民，以及联合研究，即在预期的医疗护理管理背景下对药物进行测试（如抗生素和生长因子）。展望未来，RNCP以及整个辐射研究领域面临的挑战包括动物模型的进一步改进和鉴定、从动物模型到人类的剂量转换、生物标志物识别和制剂开发。本文综述了RNCP支持的近期工作和合作。
