Abstract
Radioprotectors are compounds that protect against radiation injury when given prior to radiation exposure. Mitigators can protect against radiation injury when given after exposure but before symptoms appear. Radioprotectors and mitigators can potentially improve the outcomes of radiotherapy for cancer treatment by allowing higher doses of radiation and/or reduced damage to normal tissues. Such compounds can also potentially counteract the effects of accidental exposure to radiation or deliberate exposure (e.g., nuclear reactor meltdown, dirty bomb, or nuclear bomb explosion); hence they are called radiation countermeasures. Here, we will review the general principles of radiation injury and protection and describe selected examples of radioprotectors/mitigators ranging from small-molecules to proteins to cell-based treatments. We will emphasize agents that are in more advanced stages of development.
Highlights
Medical countermeasures (MCM) is a term utilized by the Departments of Defense and Health and Human Services that refers to agents used to prevent or treat radiation injury
If cells protected by NF-κB signaling have not fully repaired their DNA damage, this can result in cells with genomic instability, which can result in the accumulation of mutations and, eventually, carcinogenesis, a late effect that usually occurs at a minimum of 3–5 years after radiation exposure [60, 61]
As protection was observed in radiation dose–response assays, these findings suggest that the observed radioprotection of tetracycline is not due directly to its properties as an anti-microbial agent. p53 Up-regulated modulator of apoptosis (PUMA) is a Bcl2 homology 3 (BH3)-only Bcl-2 family member that has been implicated in radiation-induced apoptosis
Summary
Reviewed by: Chandan Guha, Albert Einstein College of Medicine, USA Michael Wayne Epperly, University of Pittsburgh Cancer Institute, USA. Radioprotectors are compounds that protect against radiation injury when given prior to radiation exposure. Mitigators can protect against radiation injury when given after exposure but before symptoms appear. Radioprotectors and mitigators can potentially improve the outcomes of radiotherapy for cancer treatment by allowing higher doses of radiation and/or reduced damage to normal tissues. Such compounds can potentially counteract the effects of accidental exposure to radiation or deliberate exposure (e.g., nuclear reactor meltdown, dirty bomb, or nuclear bomb explosion); they are called radiation countermeasures. We will review the general principles of radiation injury and protection and describe selected examples of radioprotectors/mitigators ranging from small-molecules to proteins to cell-based treatments.
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