Slezak Jan, Kura Branislav, Babal Pavel, Barancik Miroslav, Ferko Miroslav, Frimmel Karel, Kalocayova Barbora, Kukreja Rakesh C, Lazou Antigone, Mezesova Lucia, Okruhlicova Ludmila, Ravingerova Tanya, Singal Pawan K, Szeiffova Bacova Barbara, Viczenczova Csilla, Vrbjar Norbert, Tribulova Narcis
a Institute for Heart Research, Slovak Academy of Sciences, 840 05 Bratislava, Slovakia.
b Institute of Pathology, Medical Faculty of Comenius University, Bratislava, Slovakia.
Can J Physiol Pharmacol. 2017 Oct;95(10):1190-1203. doi: 10.1139/cjpp-2017-0121. Epub 2017 Jul 27.
Irradiation of normal tissues leads to acute increase in reactive oxygen/nitrogen species that serve as intra- and inter-cellular signaling to alter cell and tissue function. In the case of chest irradiation, it can affect the heart, blood vessels, and lungs, with consequent tissue remodelation and adverse side effects and symptoms. This complex process is orchestrated by a large number of interacting molecular signals, including cytokines, chemokines, and growth factors. Inflammation, endothelial cell dysfunction, thrombogenesis, organ dysfunction, and ultimate failing of the heart occur as a pathological entity - "radiation-induced heart disease" (RIHD) that is major source of morbidity and mortality. The purpose of this review is to bring insights into the basic mechanisms of RIHD that may lead to the identification of targets for intervention in the radiotherapy side effect. Studies of authors also provide knowledge about how to select targeted drugs or biological molecules to modify the progression of radiation damage in the heart. New prospective studies are needed to validate that assessed factors and changes are useful as early markers of cardiac damage.
正常组织受到辐射会导致活性氧/氮物质急性增加，这些物质作为细胞内和细胞间信号，改变细胞和组织功能。在胸部放疗的情况下，它会影响心脏、血管和肺部，从而导致组织重塑以及不良副作用和症状。这一复杂过程由大量相互作用的分子信号协调，包括细胞因子、趋化因子和生长因子。炎症、内皮细胞功能障碍、血栓形成、器官功能障碍以及最终的心脏衰竭作为一种病理实体——“放射性心脏病”（RIHD）出现，这是发病和死亡的主要原因。本综述的目的是深入了解RIHD的基本机制，这可能有助于确定放疗副作用的干预靶点。作者的研究还提供了有关如何选择靶向药物或生物分子来改变心脏辐射损伤进程的知识。需要新的前瞻性研究来验证所评估的因素和变化是否可作为心脏损伤的早期标志物。
