Kumar Rishav, Sharma Ajay Kumar, Kalonia Aman, Shaw Priyanka, Yashvarddhan M H, Vibhuti Arpana, Shukla Sandeep Kumar
Radiation Combined Injuries Research Department, Institute of Nuclear Medicine and Allied Sciences, Defence Research Development Organization, Timarpur, Delhi, India.
Department of Biotechnology, SRM University, Sonepat, India.
Int Rev Immunol. 2025;44(1):31-43. doi: 10.1080/08830185.2024.2402023. Epub 2024 Sep 11.
The occurrence of incidents involving radiation-combined burn injuries (RCBI) poses a significant risk to public health. Understanding the immunological and physiological responses associated with such injuries is crucial for developing care triage to counter the mortality that occurs due to the synergistic effects of radiation and burn injuries. The core focus of this narrative review lies in unraveling the immune response against RCBI. Langerhans cells, mast cells, keratinocytes, and fibroblasts, which induce innate immunity, have been explored for their response to radiation, burns, and combined injuries. In the case of adaptive immune response, exploring behavioral changes in T regulatory (Treg) cells, T helper cells (Th1, Th2, and Th17), and immunoglobulin results in delayed healing compared to burn and radiation injury. The review also includes the function of complement system components such as neutrophils, acute phase proteins (CRP, C3, and C5), and cytokines for their role in RCBI. Combined insults resulting in a reduction in the cell population of immune cells display variation in response based on radiation doses, burn injury types, and their intrinsic radiosensitivity. The lack of approved countermeasures against RCBI poses a significant challenge. Drug repurposing might help to balance immune cell alteration, resulting in fast recovery and decreasing mortality, which gives it clinical significance for its implication on the site of such incidence. However, the exact immune response in RCBI remains insufficiently explored in pre-clinical and clinical stages, which might be due to the non-availability of models, standard animal models, or human subjects, warranting further research.
涉及辐射合并烧伤损伤（RCBI）的事件发生对公众健康构成重大风险。了解与此类损伤相关的免疫和生理反应对于制定护理分诊措施以应对因辐射和烧伤损伤的协同作用而导致的死亡率至关重要。本叙述性综述的核心重点在于阐明针对RCBI的免疫反应。已对诱导先天免疫的朗格汉斯细胞、肥大细胞、角质形成细胞和成纤维细胞对辐射、烧伤及合并损伤的反应进行了研究。在适应性免疫反应方面，研究发现与烧伤和辐射损伤相比，T调节（Treg）细胞、辅助性T细胞（Th1、Th2和Th17）以及免疫球蛋白的行为变化会导致愈合延迟。该综述还包括补体系统成分的功能，如中性粒细胞、急性期蛋白（CRP、C3和C5）以及细胞因子在RCBI中的作用。基于辐射剂量、烧伤损伤类型及其内在放射敏感性，合并损伤导致免疫细胞群体减少时，其反应存在差异。缺乏针对RCBI的批准对策构成了重大挑战。药物重新利用可能有助于平衡免疫细胞改变，从而实现快速恢复并降低死亡率，这使其在此类事件发生部位具有临床意义。然而，在临床前和临床阶段，RCBI的确切免疫反应仍未得到充分探索，这可能是由于缺乏模型、标准动物模型或人类受试者，因此需要进一步研究。
