Obrador Elena, Salvador-Palmer Rosario, Villaescusa Juan I, Gallego Eduardo, Pellicer Blanca, Estrela José M, Montoro Alegría
Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain.
Service of Radiological Protection, Clinical Area of Medical Image, La Fe University Hospital, 46026 Valencia, Spain.
Antioxidants (Basel). 2022 May 31;11(6):1098. doi: 10.3390/antiox11061098.
Atomic and radiological crises can be caused by accidents, military activities, terrorist assaults involving atomic installations, the explosion of nuclear devices, or the utilization of concealed radiation exposure devices. Direct damage is caused when radiation interacts directly with cellular components. Indirect effects are mainly caused by the generation of reactive oxygen species due to radiolysis of water molecules. Acute and persistent oxidative stress associates to radiation-induced biological damages. Biological impacts of atomic radiation exposure can be deterministic (in a period range a posteriori of the event and because of destructive tissue/organ harm) or stochastic (irregular, for example cell mutation related pathologies and heritable infections). Potential countermeasures according to a specific scenario require considering basic issues, e.g., the type of radiation, people directly affected and first responders, range of doses received and whether the exposure or contamination has affected the total body or is partial. This review focuses on available medical countermeasures (radioprotectors, radiomitigators, radionuclide scavengers), biodosimetry (biological and biophysical techniques that can be quantitatively correlated with the magnitude of the radiation dose received), and strategies to implement the response to an accidental radiation exposure. In the case of large-scale atomic or radiological events, the most ideal choice for triage, dose assessment and victim classification, is the utilization of global biodosimetry networks, in combination with the automation of strategies based on modular platforms.
原子和放射危机可能由事故、军事活动、涉及原子设施的恐怖袭击、核装置爆炸或使用隐蔽辐射暴露装置引起。当辐射直接与细胞成分相互作用时会造成直接损害。间接影响主要是由于水分子的辐射分解产生活性氧物种所致。急性和持续性氧化应激与辐射诱导的生物损伤相关。原子辐射暴露的生物影响可以是确定性的（在事件发生后的一段时间范围内，由于组织/器官的破坏性损伤）或随机性的（不规则的，例如与细胞突变相关的病理和遗传性感染）。根据具体情况的潜在应对措施需要考虑一些基本问题，例如辐射类型、直接受影响的人员和第一响应者、接受的剂量范围以及暴露或污染是影响全身还是局部。本综述重点关注可用的医学应对措施（辐射防护剂、辐射缓解剂、放射性核素清除剂）、生物剂量测定（可与所接受辐射剂量大小进行定量关联的生物和生物物理技术）以及对意外辐射暴露实施应对的策略。在大规模原子或放射事件的情况下，进行分诊、剂量评估和受害者分类的最理想选择是利用全球生物剂量测定网络，并结合基于模块化平台的策略自动化。
