Singh Vijay K, Seed Thomas M
a Division of Radioprotection, Department of Pharmacology and Molecular Therapeutics , F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences , Bethesda , MD , USA.
b Armed Forces Radiobiology Research Institute , Uniformed Services University of the Health Sciences , Bethesda , MD , USA.
Int J Radiat Biol. 2017 Sep;93(9):851-869. doi: 10.1080/09553002.2017.1332438. Epub 2017 Jun 26.
The increasing global risk of nuclear and radiological accidents or attacks has driven renewed research interest in developing medical countermeasures to potentially injurious exposures to acute irradiation. Clinical symptoms and signs of a developing acute radiation injury, i.e. the acute radiation syndrome, are grouped into three sub-syndromes named after the dominant organ system affected, namely the hematopoietic, gastrointestinal, and neurovascular systems. The availability of safe and effective countermeasures against the above threats currently represents a significant unmet medical need. This is the first article within a three-part series covering the nature of the radiation sub-syndromes, various animal models for radiation countermeasure development, and the agents currently approved by the United States Food and Drug Administration for countering the medical consequences of several of these prominent radiation exposure-associated syndromes.
From the U.S. and global perspectives, biomedical research concerning medical countermeasure development is quite robust, largely due to increased government funding following the 9/11 incidence and subsequent rise of terrorist-associated threats. A wide spectrum of radiation countermeasures for specific types of radiation injuries is currently under investigation. However, only a few radiation countermeasures have been fully approved by regulatory agencies for human use during radiological/nuclear contingencies. Additional research effort, with additional funding, clearly will be needed in order to fill this significant, unmet medical health problem.
全球核与放射事故或袭击风险不断增加,这促使人们重新对开发针对急性辐射潜在伤害性暴露的医学应对措施展开研究。急性辐射损伤(即急性放射病)发展过程中的临床症状和体征分为三个子综合征,分别以受影响最显著的器官系统命名,即造血系统、胃肠道系统和神经血管系统。目前,针对上述威胁,安全有效的应对措施仍存在重大的医学需求未得到满足。本文是一个系列文章的第一篇,该系列共三篇,内容涵盖辐射子综合征的性质、用于开发辐射应对措施的各种动物模型,以及美国食品药品监督管理局目前批准用于对抗几种与辐射暴露相关的突出综合征的医学后果的药物。
从美国和全球的角度来看,有关医学应对措施开发的生物医学研究相当活跃,这主要归功于“9·11”事件后政府资金投入的增加以及随后与恐怖主义相关威胁的增多。目前正在对针对特定类型辐射损伤的一系列辐射应对措施进行研究。然而,在放射/核突发事件期间,只有少数辐射应对措施已获得监管机构的全面批准可用于人类。显然,需要更多的研究努力和资金投入,以解决这一重大的、未得到满足的医疗卫生问题。