Radiobiology and Health, Canadian Nuclear Laboratories, Chalk River, Canada.
Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, Canada.
Int J Radiat Biol. 2024;100(3):317-334. doi: 10.1080/09553002.2023.2277372. Epub 2023 Nov 15.
The growing concern over potential unintended nuclear accidents or malicious activities involving nuclear/radiological devices cannot be overstated. Exposure to whole-body doses of radiation can result in acute radiation syndrome (ARS), colloquially known as "radiation sickness," which can severely damage various organ systems. Long-term health consequences, such as cancer and cardiovascular disease, can develop many years post-exposure. Identifying effective medical countermeasures and devising a strategic medical plan represents an urgent, unmet need. Various clinical studies have investigated the therapeutic use of umbilical cord blood (UCB) for a range of illnesses, including ARS. The objective of this review is to thoroughly discuss ARS and its sub-syndromes, and to highlight recent findings regarding the use of UCB for radiation injury. UCB, a rich source of stem cells, boasts numerous advantages over other stem cell sources, like bone marrow, owing to its ease of collection and relatively low risk of severe graft-versus-host disease. Preclinical studies suggest that treatment with UCB, and often UCB-derived mesenchymal stromal cells (MSCs), results in improved survival, accelerated hematopoietic recovery, reduced gastrointestinal tract damage, and mitigation of radiation-induced pneumonitis and pulmonary fibrosis. Interestingly, recent evidence suggests that UCB-derived exosomes and their microRNAs (miRNAs) might assist in treating radiation-induced damage, largely by inhibiting fibrotic pathways.
UCB holds substantial potential as a radiation countermeasure, and future research should focus on establishing treatment parameters for ARS victims.
对涉及核/放射性装置的潜在意外核事故或恶意活动的日益关注，怎么强调都不为过。全身接受辐射剂量可导致急性辐射综合征（ARS），俗称“辐射病”，可严重损害各种器官系统。暴露后多年可能会出现长期健康后果，如癌症和心血管疾病。确定有效的医疗对策并制定战略医疗计划是当务之急，尚未得到满足的需求。各种临床研究已经调查了脐带血（UCB）在一系列疾病中的治疗用途，包括 ARS。本综述的目的是全面讨论 ARS 及其亚综合征，并强调最近关于使用 UCB 治疗辐射损伤的发现。UCB 是一种富含干细胞的资源，由于其易于采集和相对较低的严重移植物抗宿主病风险，与骨髓等其他干细胞来源相比具有许多优势。临床前研究表明，使用 UCB 治疗，通常使用 UCB 衍生的间充质基质细胞（MSCs），可提高存活率、加速造血恢复、减少胃肠道损伤，并减轻辐射引起的肺炎和肺纤维化。有趣的是，最近的证据表明，UCB 衍生的外泌体及其 microRNAs（miRNAs）可能有助于治疗辐射引起的损伤，主要是通过抑制纤维化途径。
UCB 作为一种辐射对策具有巨大潜力，未来的研究应集中于为 ARS 患者建立治疗参数。
