Challenges in the Design of Russian Radiation Protection Means in the Crisis Period: The Search for Key Directions of Development

Abstract

This review discusses the development of radiation countermeasure agents (RCA) in its historical progression with the description of the key radiobiological concepts and drug classifications at various stages. The rationale for classifying antiradiation drugs into two main groups, the radioprotectors/oxidomodulators and radiomodifiers/cytomodulators, which act at the two stages of radiation damage development, namely, the radiochemical and cell death stages, respectively, is provided. One way to overcome the currently observed crisis in RCA development may prove to be bringing the known efficient RCA to approvement as medical preparations by using pharmacological approaches such as combining the preparations belonging to the two groups indicated and using preparations that are able to mitigate side effects. Out of the two possible scenarios of radiation disease in humans (exposure to cosmic radiation with a dense ionizing component and delayed radiation effects) most relevant in terms of RCA search, the latter has been considered with description of the results of experiments using a model of prolonged exposure of mice to gamma-irradiation with a small dose rate. Suggestions for possible prospective directions in the field of radiobiology are provided. The conclusion has been made that there are still a lot of unresolved issues concerning the sufficiency of medicines to ensure radiation safety under various scenarios of radiation incidents.