Department of Radiology & Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Mil Med. 2024 Aug 19;189(Suppl 3):598-607. doi: 10.1093/milmed/usae198.
Military members and first responders may, at moment's notice, be asked to assist in incidents that may result in radiation exposure such as Operation Tomadachi in which the U.S. Navy provided significant relief for the Fukushima Daiichi Nuclear Reactor accident in Japan after an earthquake and tsunami in 2011. We are also currently facing potential threats from nuclear power plants in the Ukraine should a power disruption to a nuclear plant interfere with cooling or other safety measures. Exposure to high doses of radiation results in acute radiation syndrome (ARS) characterized by symptoms arising from hematopoietic, gastrointestinal, and neurovascular injuries. Although there are mitigators FDA approved to treat ARS, there are currently no FDA-approved prophylactic medical interventions to help protect persons who may need to respond to radiation emergencies. There is strong evidence that manganese (Mn) has radiation protective efficacy as a promising prophylactic countermeasure.
All animal procedures were approved by the Institutional Animal Care and Use Committee. Male and female B6D2F1J mice, 10 to 11 weeks old, were used for neurotoxicity studies and temporal effects of Mn. Four groups were evaluated: (1) vehicle injection, (2) dose of 4.5 mg/kg for 3 days, (3) dose of 13.5 mg/kg, and (4) sham. Irradiated mice were exposed to 9.5 Gy whole body Co60 γ-radiation. MRI was performed with a high dose of manganese chloride (MnCl2) (150 mg/kg) to assess the distribution of the MnCl2.
The mice have promising survival curves (highest survival-13.5 mg/kg dose over 3 days of MnCl2 at 80% [87% female, 73% male] P = 0.0004). The complete blood count (CBC) results demonstrated a typical hematopoietic response in all of the irradiated groups, followed by mildly accelerated recovery by day 28 in the treated groups. No difference between groups was measured by Rota Rod, DigiGait, and Y-maze. Histologic evaluation of the bone marrow sections in the group given 13.5 mg/kg dose over 3 days had the best return to cellularity at 80%. MRI showed a systemic distribution of MnCl2.
The preliminary data suggest that a dose of 13.5 mg/kg of MnCl2 given over 3 days prior to exposure of radiation may have a protective benefit while not exhibiting the neurobehavioral problems. A countermeasure that can prophylactically protect emergency personnel entering an area contaminated with high levels of radiation is needed, especially in light that nuclear accidents are a continued global threat. There is a need for a protective agent with easy long-term storage, easy to transport, easy to administer, and low cost. Histologic evaluation supports the promising effect of MnCl2 in protecting tissue, especially the bone marrow using the dose given over 3 days (4.5 mg/kg per day) of MnCl2.
Initial experiments show that MnCl2 is a promising safe and effective prophylactic countermeasure against ARS. MRI data support the systemic distribution of MnCl2 which is needed in order to protect multiple tissues in the body. The pathology data in bone marrow and the brain support faster recovery from radiation exposure in the treated animals and decreased organ damage.
军人和急救人员可能会在接到通知的情况下,协助处理可能导致辐射暴露的事件,例如 2011 年日本福岛第一核电站事故期间,美国海军在地震和海啸后为日本提供了大量援助。目前,我们也面临着乌克兰核电站的潜在威胁,如果核电站的电力中断干扰了冷却或其他安全措施,可能会导致辐射。接触高剂量辐射会导致急性辐射综合征(ARS),其特征是造血、胃肠道和神经血管损伤引起的症状。虽然有经美国食品和药物管理局批准的缓解剂可用于治疗 ARS,但目前尚无经美国食品和药物管理局批准的预防性医疗干预措施来帮助保护可能需要应对辐射紧急情况的人员。有强有力的证据表明,锰(Mn)具有辐射防护功效,是一种有前途的预防措施。
所有动物程序均获得机构动物护理和使用委员会的批准。10 至 11 周龄的 B6D2F1J 雄性和雌性小鼠用于神经毒性研究和 Mn 的时间效应。评估了四组:(1)载体注射,(2)3 天内 4.5mg/kg 剂量,(3)13.5mg/kg 剂量,和(4)假手术。辐照小鼠接受 9.5Gy 全身 Co60 γ 射线照射。用高剂量氯化锰(MnCl2)(150mg/kg)进行 MRI 以评估 MnCl2 的分布。
小鼠有良好的生存曲线(最高生存率-3 天内给予 13.5mg/kg 剂量的 MnCl2 为 80%[雌性 87%,雄性 73%]P=0.0004)。所有辐照组的全血细胞计数(CBC)结果均显示出典型的造血反应,随后在治疗组中,在第 28 天恢复加速。在旋转棒、Digigait 和 Y 迷宫上未测量到组间差异。在接受 13.5mg/kg 剂量 3 天的组的骨髓切片组织学评估中,细胞数量恢复最好,达到 80%。MRI 显示 MnCl2 的全身分布。
初步数据表明,在暴露于辐射之前 3 天内给予 13.5mg/kg 的 MnCl2 剂量可能具有保护作用,而不会出现神经行为问题。需要一种能够预防进入高水平辐射污染区域的应急人员的对策,特别是考虑到核事故是持续存在的全球威胁。需要一种具有易于长期储存、易于运输、易于管理和低成本的防护剂。组织学评估支持 MnCl2 以保护组织,尤其是骨髓的有希望的作用,使用 3 天(4.5mg/kg/天)给予 MnCl2 的剂量。
初步实验表明,MnCl2 是一种有前途的安全有效的急性辐射综合征预防措施。MRI 数据支持 MnCl2 的全身分布,这是保护体内多种组织所必需的。骨髓和大脑的病理学数据支持治疗动物更快地从辐射暴露中恢复,并减少器官损伤。