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[辐射对策搜索与研究的实际问题]

[Actual problems of searching and studying radiation countermeasures].

作者信息

Rozhdestvenskiĭ L M

出版信息

Radiats Biol Radioecol. 2013 Sep-Oct;53(5):513-20.

Abstract

The state of radiation counterdrug elaboration has been analyzed. The main criterion of estimation is how various possible radiation incidents are provided with radiation countermeasures. The latter are differentiated in 3 principal groups: radioprotectors, radiomodificators (these are able to have a positive effect when administered preliminary, before the exposure, or provide a delayed nonspecific protection after the exposure--urgent therapy) and hemopoietic growth factors demanding course administration. It should be underlined that the list ofofficinal radiation countermeasures is rather short. The most dynamic now are investigations aimed at developing a home preparation of recombinant human interleukine-1beta named betaleukine, and the preparation CBLB502, a modified microbe polypeptide elaborated in the USA. Also elaborated is a scheme of emergency exposure treatment. It includes urgent administration of the cytokine combination (betaleukine and thrombopoietin) with subsequent supportive therapy and a hemopoietic growth factors course. In the case of medical radiation- and chemotherapy the preparations betaleukine and thiol compound amifostine are used rather seldom. Official countermeasures for protection against low dose rate prolonged exposure are still absent. The problem of an indicator/marker of the radioresistance induced by a radioprotector or radiomodificator still remains unsolved. Reliable indicators/markers are needed to provide the 2nd stage of clinical trials of radioprotectors/modificators.

摘要

对辐射抗药研发状况进行了分析。评估的主要标准是各种可能的辐射事件是否有相应的辐射应对措施。后者分为3个主要类别:辐射防护剂、辐射修饰剂(这些在暴露前预先给药时能够产生积极效果,或者在暴露后提供延迟的非特异性保护——紧急治疗)以及需要进行疗程给药的造血生长因子。应当强调的是,官方认可的辐射应对措施清单相当短。目前最具活力的是旨在研发重组人白细胞介素-1β的国产制剂倍他白细胞介素以及美国研发的改良微生物多肽制剂CBLB502的研究。还制定了紧急暴露治疗方案。它包括紧急给予细胞因子组合(倍他白细胞介素和血小板生成素)并随后进行支持性治疗以及一个造血生长因子疗程。在医疗辐射和化疗的情况下很少使用倍他白细胞介素和硫醇化合物氨磷汀制剂。针对低剂量率长期暴露的官方防护措施仍然缺失。辐射防护剂或辐射修饰剂诱导的抗辐射性指标/标志物问题仍然未得到解决。需要可靠的指标/标志物来开展辐射防护剂/修饰剂的第二阶段临床试验。

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