Abstract

Studies have shown an increased risk for a variety of cancers, specifically brain cancer, in healthcare workers occupationally exposed to ionizing radiation. Although the mechanisms mediating these phenomena are not fully understood, ionizing radiation-mediated elevated levels of reactive oxygen species (ROS), oxidative DNA damage, and immune modulation are likely involved. A group of 20 radiation exposed workers and 40 sex- and age-matched non-exposed control subjects were recruited for the study. We measured superoxide (O2•−) levels in whole blood of healthcare workers and all other measurements of cytokines, oxidative DNA damage, extracellular superoxide dismutase (EcSOD) activity and reduced/oxidized glutathione ratio (GSH/GSSG) in plasma. Levels of O2•− were significantly higher in radiation exposed workers compared to control. Similarly, a significant increase in the levels of interleukin (IL)-6, IL-1α and macrophage inflammatory protein (MIP)-1α in radiation exposed workers compared to control was observed, while there was no significance difference in the other 27 screened cytokines. A significant positive correlation was found between MIP-1α and O2•− levels with no correlation in either IL-6 or IL-1α. Further, a dose-dependent relationship with significant O2•− production and immune alterations in radiation exposed workers was demonstrated. There was no statistical difference between the groups in terms of oxidative DNA damage, GSH/GSSG levels, or EcSOD activity. Although the biologic significance of cytokines alterations in radiation exposed workers is unclear, further studies are needed for determining the underlying mechanism of their elevation.

Highlights

  • Ionizing radiation is used commonly in medical diagnostics, and the advancement of diagnostic imaging and interventional radiology has raised concern about the potential risk these advancements may pose to healthcare workers utilizing these technologies

  • The average annual dose levels of radiation exposed workers, 2.03 mSv, are below the limits set by the International Commission of Radiation Protection (ICRP) [1]

  • We demonstrate that levels of IL-6, macrophage inflammatory protein (MIP)-1α, and IL-1α are remarkably present study, we investigated the effect of occupational radiation exposure on immune response increased in radiation exposed workers compared to the control subjects

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Summary

Introduction

Ionizing radiation is used commonly in medical diagnostics, and the advancement of diagnostic imaging and interventional radiology has raised concern about the potential risk these advancements may pose to healthcare workers utilizing these technologies. Antioxidants 2019, 8, 12 the currently accepted limits (i.e., less than 50 millisieverts (mSV)) set by the International Commission of Radiation Protection (ICRP) [1], several epidemiological studies of radiation exposed workers have indicated an increased risk for a variety of cancers, more than two-fold for brain cancer [2]. The mechanisms mediating these phenomena are complex and likely involve elevated levels of reactive oxygen species (ROS), oxidative DNA damage, and immunosuppression triggered by ionizing radiation [3,4,5,6]. It must not go unnoticed that there are other factors contributing to radiation-induced carcinogenesis such as non targeted effects, inflammation, as well as constant activation of the immune system as reviewed in [12]

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