Abstract

Ionizing radiation interacts with the immune system in many ways with a multiplicity that mirrors the complexity of the immune system itself: namely the need to maintain a delicate balance between different compartments, cells and soluble factors that work collectively to protect, maintain, and restore tissue function in the face of severe challenges including radiation damage. The cytotoxic effects of high dose radiation are less relevant after low dose exposure, where subtle quantitative and functional effects predominate that may go unnoticed until late after exposure or after a second challenge reveals or exacerbates the effects. For example, low doses may permanently alter immune fitness and therefore accelerate immune senescence and pave the way for a wide spectrum of possible pathophysiological events, including early-onset of age-related degenerative disorders and cancer. By contrast, the so called low dose radiation therapy displays beneficial, anti-inflammatory and pain relieving properties in chronic inflammatory and degenerative diseases. In this review, epidemiological, clinical and experimental data regarding the effects of low-dose radiation on the homeostasis and functional integrity of immune cells will be discussed, as will be the role of immune-mediated mechanisms in the systemic manifestation of localized exposures such as inflammatory reactions. The central conclusion is that ionizing radiation fundamentally and durably reshapes the immune system. Further, the importance of discovery of immunological pathways for modifying radiation resilience amongst other research directions in this field is implied.

Highlights

  • The immune system is the body’s main defence mechanism able to distinguish between self and non-self as well as sensing danger

  • The level of IL-4 increased in individuals who lived in area with high levels of natural radiation, which could lead to T helper 2 (Th2) pattern of immune response Low dose exposure induced long term changes of the innate immune system; immune system seems to react to discontinuous characteristics shared with non (DNA) damage driving innate immune cell activation in an effort to eliminate T-cell receptor (TCR)-mutated lymphocytes other than by apoptosis

  • There is a wealth of scientific evidence based on epidemiological data from various cohorts exposed to different radiation doses, dose rates and radiation qualities as well as clinical studies and experimental in vitro and in vivo data, all collectively supporting the notion that low dose ionizing radiation (IR) affects the immune system in multiple ways

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Summary

Introduction

The immune system is the body’s main defence mechanism able to distinguish between self and non-self as well as sensing danger. A comprehensive review of available data on IR effects on the immune system was published in the UNSCEAR 2006 report (Radiation, 2008) including both high and low dose effects and highlighted complex functional changes within the immune system in response to radiation. This was the first report released by an international organisation investigating radiation health effects which abandoned the “classical” paradigm that IR is purely im­ mune suppressive. Among the best studied cohorts today are A-bomb survivors and clean-up workers (liq­ uidators) of the Chernobyl nuclear power plant accident, subjected to single dose acute exposure

A-bomb survivors and Chernobyl clean-up workers cohorts
Remarks & Conclusions
Environmental or occupational radiation exposures
Studies on radiation-exposed children
Systemic and abscopal effects of local radiotherapy
Initiation of anti-inflammatory vs pro-inflammatory processes by IR
Conclusions
Findings
Recommendations for future research
Full Text
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