Journal ArticleDOI
ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs – Threshold Doses for Tissue Reactions in a Radiation Protection Context
F A Stewart,A V Akleyev,Martin Hauer-Jensen,Jolyon H Hendry,N J Kleiman,Thomas J. MacVittie,B M Aleman,Angela B. Edgar,K Mabuchi,C R Muirhead,Roy E. Shore,William Wallace +11 more
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Estimates of ‘practical’ threshold doses for tissue injury defined at the level of 1% incidence are provided and it appears that the rate of dose delivery does not modify the low incidence for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease.Abstract:
This report provides a review of early and late effects of radiation in normal tissues and organs with respect to radiation protection. It was instigated following a recommendation in Publication 103 (ICRP, 2007), and it provides updated estimates of 'practical' threshold doses for tissue injury defined at the level of 1% incidence. Estimates are given for morbidity and mortality endpoints in all organ systems following acute, fractionated, or chronic exposure. The organ systems comprise the haematopoietic, immune, reproductive, circulatory, respiratory, musculoskeletal, endocrine, and nervous systems; the digestive and urinary tracts; the skin; and the eye. Particular attention is paid to circulatory disease and cataracts because of recent evidence of higher incidences of injury than expected after lower doses; hence, threshold doses appear to be lower than previously considered. This is largely because of the increasing incidences with increasing times after exposure. In the context of protection, it is the threshold doses for very long follow-up times that are the most relevant for workers and the public; for example, the atomic bomb survivors with 40-50years of follow-up. Radiotherapy data generally apply for shorter follow-up times because of competing causes of death in cancer patients, and hence the risks of radiation-induced circulatory disease at those earlier times are lower. A variety of biological response modifiers have been used to help reduce late reactions in many tissues. These include antioxidants, radical scavengers, inhibitors of apoptosis, anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, growth factors, and cytokines. In many cases, these give dose modification factors of 1.1-1.2, and in a few cases 1.5-2, indicating the potential for increasing threshold doses in known exposure cases. In contrast, there are agents that enhance radiation responses, notably other cytotoxic agents such as antimetabolites, alkylating agents, anti-angiogenic drugs, and antibiotics, as well as genetic and comorbidity factors. Most tissues show a sparing effect of dose fractionation, so that total doses for a given endpoint are higher if the dose is fractionated rather than when given as a single dose. However, for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease, it appears that the rate of dose delivery does not modify the low incidence. This implies that the injury in these cases and at these low dose levels is caused by single-hit irreparable-type events. For these two tissues, a threshold dose of 0.5Gy is proposed herein for practical purposes, irrespective of the rate of dose delivery, and future studies may elucidate this judgement further.read more
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A multicenter study of radiation doses to the eye lenses of medical staff performing non-vascular imaging and interventional radiology procedures in Japan.
Kosuke Matsubara,Yasutaka Takei,Hiroshige Mori,Ikuo Kobayashi,Kimiya Noto,Takayuki Igarashi,Shoichi Suzuki,Keiichi Akahane +7 more
TL;DR: Physicians should wear radioprotective glasses and use additional radiop rotective devices to reduce the amount of eye lens doses they receive, according to the revised occupational equivalent dose limit for the eye lens.
Journal ArticleDOI
Ionizing radiation response of primary normal human lens epithelial cells.
TL;DR: Results partially explain mechanisms of previous observations, such that unrepaired or incompletely repaired DNA damage causes a growth delay in a subset of HLEC1 cells without changing viability through induction of premature senescence, thereby leading to clonogenic inactivation, but that growth is stimulated in another subset via as yet unidentified mechanisms, warranting further studies.
Journal ArticleDOI
Risk of radiation-induced lens opacities among surgeons and interventional medical staff.
Luca Coppeta,Antonio Pietroiusti,Anna Neri,Agostino Spataro,Elisabetta De Angelis,Stefano Perrone,Andrea Magrini +6 more
TL;DR: Protection of the crystalline lens against exposure to ionizing radiation by means of goggles is recommended and examination of the lens via slit lamp examination is recommended for all operators involved in interventional procedures with the current levels of radiation exposure.
Journal ArticleDOI
Rheumatological diseases and cancer: the hidden variable of radiation exposure
TL;DR: The hypothesis that, in rheumatological patients, the use of medical radiation may pose an additional risk for cancer development, possibly potentiated by the concurrent use of antirheumatic drugs is drawn to.
Journal ArticleDOI
One-carbon metabolism and ionizing radiation: a multifaceted interaction.
Isabelle R. Miousse,Julia Tobacyk,Stepan Melnyk,S. Jill James,Amrita K. Cheema,Marjan Boerma,Martin Hauer-Jensen,Igor Koturbash +7 more
TL;DR: This conceptual review proposes the IR-induced changes to one-carbon metabolism as prerequisites to alterations in the cellular epigenome as well as the potential for the manipulation of the one- carbon metabolism in clinical applications for the purpose of normal tissue protection and for increasing the radiosensitivity of cancerous cells.
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