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Acute Radiation Disease. How many Acute Radiation Syndromes are associated with disease? Part 1.
DMITRI POPOV. PHD, RADIOBIOLOGY. MD (RUSSIA)ADVANCED MEDICAL TECHNOLOGY AND SYSTEMS INC. [email protected]
Acute Radiation Disease.
Added: 2015-11-14 T 21:26:30 UTC DOI: 10.13140/RG.2.1.4444.1046
Acute Radiation Disease.
Disease to be Disease ? Or Not to be Disease? That is the question?
Discussion.
Acute Radiation Disease.
A syndrome is a set of medical signs and symptoms that are correlated with each other and, often, with a specific disease. The word derives from the Greek σύνδρομον, meaning "concurrence".
In some instances a syndrome is so closely correlated with a pathogenesis or etiology that the words syndrome, disease, and disorder end up being used interchangeably for them.
This is especially true of genetically caused syndromes. For example, Down syndrome, Wolf–Hirschhorn syndrome, and
Andersen syndrome are disorders with known pathogeneses, so each is more than just a set of signs and symptoms, despite the syndrome nomenclature. In other instances, a syndrome is not specific to only one disease.
For example, toxic shock syndrome can be caused by various toxins; premotor syndrome can be caused by various brain lesions;
https://en.wikipedia.org/wiki/Syndrome
Acute Radiation Disease.
Acute Radiation Cerebrovascular Syndrome. Acute Radiation Cardiovascular Syndrome. Acute Radiation Hematopoietic Syndrome. Acute Radiation Gastrointestinal Syndrome. Is it All? May be not. May be we forgot something ? What about an Acute Radiation Immune System Reactions
Syndrome?
Acute Cerebrovascular Radiation Syndrome.
The cerebrovascular syndrome is less well defined than other syndromes, and its stages are compressed. Individuals presenting with fever, hypotension, and major impairment of cognitive function will most likely have had a supralethal exposure . These symptoms may be observed in those receiving more than 20 to 30 Gy of radiation . The prodromal phase is characterized by disorientation, confusion, and prostration and may be accompanied by loss of balance and seizures. The physical examination may show papilledema, ataxia, and reduced or absent deep tendon and corneal reflexes. During the latent period, apparent improvement occurs for a few hours and is followed by severe manifest illness. Within 5 to 6 hours, watery diarrhea, respiratory distress, hyperpyrexia, and cardiovascular shock can occur. This rapid decline mimics the clinical course of acute sepsis and septic shock, both of which must be considered. The ensuing circulatory complications of hypotension, cerebral edema, increased intracranial pressure, and cerebral anoxia can bring death within 2 days.
Medical Management of the Acute Radiation Syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group
Jamie K. Waselenko,
Acute Cardiovascular Radiation Syndrome.
Review Article Radiation-Induced Heart Disease: A Clinical Update Syed Wamique Yusuf, Shehzad Sami, and Iyad N. Daher Department of Cardiology, University of Texas MD Anderson Cancer Center, Unit 1451, Houston, TX 77030, USA Correspondence should be addressed to Syed Wamique Yusuf, [email protected] Received 14 October 2010; Accepted 15 December 2010 Academic Editor: Jean-Bernard Durand.
A number of acute effects, including endothelial damage, lipid and inflammatory cell infiltration, and lysosomal activation, have been described . Primary basic mechanism behind radiation induced vascular damage appear to be endothelial dysfunction.
R. Virmani, A. Farb, A. J. Carter, and R. M. Jones, “Pathology of radiation-induced coronary artery disease in human and pig,” Cardiovascular Radiation Medicine, vol. 1, no. 1, pp. 98– 101, 1999
Acute Radiation Cardiovascular Disease.
F. C. Brosius, B. F. Waller, and W. C. Roberts, “Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 rads to the heart,” American Journal of Medicine, vol. 70, no. 3, pp. 519–530, 1981.
S. L. Hancock, M. A. Tucker, and R. T. Hoppe, “Factors affecting late mortality from heart disease after treatment of Hodgkin’s disease,” Journal of the American Medical Association, vol. 270, no. 16, pp. 1949–1955, 1993.
F. C. Brosius, B. F. Waller, and W. C. Roberts, “Radiation heart disease. Analysis of 16 young (aged 15 to 33 years) necropsy patients who received over 3,500 rads to the heart,” American Journal of Medicine, vol. 70, no. 3, pp. 519–530, 1981.
Acute Radiation Cardiovascular/ Cerebrovascular Syndromes.
N. L. Weintraub, W. K. Jones, and D. Manka, “Understanding radiation-induced vascular disease,” Journal of the American College of Cardiology, vol. 55, no. 12, pp. 1237–1239, 2010
T. Hayashi, Y. Kusunoki, M. Hakoda et al., “Radiation dosedependent increases in inflammatory response markers in Abomb survivors,” International Journal of Radiation Biology, vol. 79, no. 2, pp. 129–136, 2003.
M. P. Little, A. Gola, and I. Tzoulaki, “A model of cardiovascular disease giving a plausible mechanism for the effect of fractionated low-dose ionizing radiation exposure,” PLoS Computational Biology, vol. 5, no. 10, Article ID e1000539, 2009.
Acute Cardiovascular Radiation Disease. Morphology and Metabolic pathology.
J. P. Veinot and W. D. Edwards, “Pathology of radiation induced heart disease: a surgical and autopsy study of 27 cases,” Human Pathology, vol. 27, no. 8, pp. 766–773, 1996.
http://www.intechopen.com/books/current-topics-in-ionizing-radiation-research/radiation-toxins-molecular-mechanisms-of-toxicity-and-radiomimetic-properties-
O. A. Hatoum, M. F. Otterson, D. Kopelman et al., “Radiation induces endothelial dysfunction in murine intestinal arterioles via enhanced production of reactive oxygen species,” Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 26, no. 2, pp. 287–294, 2006.
Acute Radiation Cardiovascular Syndrome.
M. Boerma, C. Zurcher, I. Esveldt, C. I. Schutte-Bart, and J. Wondergem, “Histopathology of ventricles, coronary arteries and mast cell accumulation in transverse and longitudinal sections of the rat heart after irradiation,” Oncology Reports, vol. 12, no. 2, pp. 213–219, 2004.
M. M. Dunn, E. A. Drab, and D. B. Rubin, “Effects of irradiation on endothelial cell-polymorphonuclear leukocyte interactions,” Journal of Applied Physiology, vol. 60, no. 6, pp. 1932–1937, 1986.
J. R. Stewart and L. F. Fajardo, “Radiation-induced heart disease: an update,” Progress in Cardiovascular Diseases, vol. 27, no. 3, pp. 173–194, 1984.
Acute Radiation Cardiovascular Syndrome.
K. A. Tolba and E. N. Deliargyris, “Cardiotoxicity of cancer therapy,” Cancer Investigation, vol. 17, no. 6, pp. 408–422, 1999.
http://www.slideshare.net/dlpopov/acuteradiation-disease-acute-radiation-vasculitis
M. J. Adams, P. H. Hardenbergh, L. S. Constine, and S. E. Lipshultz, “Radiation-associated cardiovascular disease,” Critical Reviews in Oncology/Hematology, vol. 45, no. 1, pp. 55–75, 2003.
U. Nellessen, M. Zingel, H. Hecker, J. Bahnsen, and D. Borschke, “Effects of radiation therapy on myocardial cell integrity and pump function: which role for cardiac biomarkers?” Chemotherapy, vol. 56, no. 2, pp. 147–152, 2010
Acute Gastro Intestinal Radiation Syndrome.
Y. Shimizu, D. A. Pierce, D. L. Preston, and K. Mabuchi, “Studies of the mortality of atomic bomb survivors. Report 12, part II. Non cancer mortality: 1950–1990,” Radiation Research, vol. 152, no. 4, pp. 374–389, 1999.
http://www.intechopen.com/books/current-topics-in-ionizing-radiation-research/radiation-toxins-molecular-mechanisms-of-toxicity-and-radiomimetic-properties-
O. A. Hatoum, M. F. Otterson, D. Kopelman et al., “Radiation induces endothelial dysfunction in murine intestinal arterioles via enhanced production of reactive oxygen species,” Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 26, no. 2, pp. 287–294, 2006.
Acute Radiation Gastrointestinal Syndrome.
http://www.biomodels.com/animal-models/radiation-countermeasures/gastrointestinai-acute-radiation-syndrome-gi-ars/
SAMT DEEL 68 28 SEPTEMBER 1985. Radiation bowel and other vasculitides.. N. H. GILlNSKY
Gilinsky NH, Bums DG, Barbezat GO, Levin W, Myers HS, Marks IN. The natural history of radiation-induced proctosigmoiditis: an analysis of 88 patients. Q] Med 1983; 52: 40-53.
Acute Radiation Gastrointestinal Syndrome.
The most commonly encountered example of gastro-intestinal vasculitis is radiation bowel disease. The typical patient is a woman who has received pelvic irradiation for a gynaecological tumour some 9 months previously and who presents with fresh rectal bleeding with or without some degree of lower abdominal discomfort. Sigmoidoscopy invariably reveals mucosal oedema, erythema, much friability and possible ulceration, often limited to the recrum. A careful inspection may demonstrate characteristic telangiectatic vessels, pathognomonic of previous irradiation. A barium srudy may show ulceration, perhaps indistinguishable from inflammarory bowel disease, but the upper limit of abnormality rarely extends proximal to the junction of sigmoid and descending colon. SAMT DEEL 68 28 SEPTEMBER 1985. Radiation bowel and other vasculitides.. N. H. GILlNSKY
Acute Hematopoietic Radiation Syndrome.
http://www.remm.nlm.gov/andrewslymphocytes.htm Lymphocyte Depletion http://www.remm.nlm.gov/radeffectblood.htm http://www.remm.nlm.gov/rad_bloodcounts.htm Blood Count
Free Radicals.
Ionizing radiation may interact directly with intracellular targets or may interact with other molecules (such as H2 O) to produce free radicals that, in turn, reach a target (such as DNA and the plasma membrane). The Hematologist and Radiation Casualties Nicholas Dainiak, Jamie K. Waselenko, James O. Armitage, Thomas J. MacVittie, and Ann M. Farese
Abheri Das Sarma et. al. / International Journal of Pharma Sciences and Research (IJPSR) Vol.1(3), 2010, 185-192 Free Radicals and Their Role in Different Clinical Conditions: An Overview 2 Abheri Das Sarma, 1 Anisur Rahaman Mallick and 1 A. K. Ghosh* 1 Department of Pharmacology, Gupta College of Technological Sciences Asansol, Burdwan, West Bengal, Pin - 713301, India 2 Department of Pharmaceutics, Gupta College of Technological Sciences Asansol, Burdwan, West Bengal, Pin - 713301, India
Free Radicals.
“Free Radicals are molecules with an unpaired electron and are important intermediates in natural processes involving cytotoxicity, control of vascular tone, and neurotransmission”.
“Generally, harmful effects of reactive oxygen species on the cell are most often like damage of DNA, oxidations of polydesaturated fatty acids in lipids, oxidations of amino acids in proteins, oxidatively inactivate specific enzymes by oxidation of co-factors. ”
Free Radicals.
So, major source of free radicals is a radiolysis of water. However, most important source of free radicals is reactive oxygen
species in phagocytic leukocytes. “Phagocytic leukocytes consume oxygen and generate reactive oxygen
species in response to appropriate stimuli.” “Phagocytic leukocytes, when appropriately stimulated, consume oxygen
and produce superoxide (O2 -) in a process often referred to as the respiratory burst”.
Histochem Cell Biol. 2008 Aug; 130(2): 281–297. Published online 2008 Jul 3. doi: 10.1007/s00418-008-0461-4 Reactive oxygen species in phagocytic leukocytes John M. Robinson
Free Radicals.
Phagocytic leukocytes, when appropriately stimulated, consume oxygen and produce superoxide (O2 -) in a process often referred to as the respiratory burst.
Radiation appropriately stimulated leukocytes and produce large amount of superoxide.
The respiratory burst is mediated by the NADPH-oxidase complex, a multicomponent system that is rapidly assembled following activation of neutrophils. As we have discussed previously, the neutrophil NADPH oxidase produces O2
− and hydrogen peroxide (H2O2) following activation (Robinson et al. 2004).
Acute Immune System Reactions Syndrome.
Scientists at the Stanford University School of Medicine found that "Ionizing radiation can functionally alter the immune system and break self-tolerance"(a technical term for when radiation breaks down the normal ability to fight off disease). The study is published in the Journal of Immunology. The researchers irradiated the thymus and the peripheral lymphoid organs/tissues in mice to induce the autoimmune response. Total lymphoid irradiation on mice caused various organ-specific autoimmune diseases, such as gastritis, thyroiditis, and orchitis, depending on the radiation dosages, the extent of lymphoid irradiation, and the genetic background of the mouse strains. They concluded, "these results indicate that high dose, fractionated ionizing radiation on the lymphoid organs/tissues can cause autoimmune disease by affecting the T cell immune system."
Acute Immune System Reaction Syndrome.
Continued in Part 2.
