Abstract
A radiological or nuclear attack could involve such a large number of subjects as to overwhelm the emergency facilities in charge. Resources should therefore be focused on those subjects needing immediate medical attention and care. In such a scenario, for the triage management by first responders, it is necessary to count on efficient biological dosimetry tools capable of early detection of the absorbed dose. At present the validated assays for measuring the absorbed dose are dicentric chromosomes and micronuclei counts, which require more than 2–3 days to obtain results. To overcome this limitation the NATO SPS Programme funded an Italian–Egyptian collaborative project aimed at validating a fast, accurate and feasible tool for assessing the absorbed dose early after radiation exposure. Biomarkers as complete blood cell counts, DNA breaks and radio-inducible proteins were investigated on blood samples collected before and 3 h after the first fraction of radiotherapy in patients treated in specific target areas with doses/fraction of about: 2, 3.5 or > 5 Gy and compared with the reference micronuclei count. Based on univariate and multivariate multiple linear regression correlation, our results identify five early biomarkers potentially useful for detecting the extent of the absorbed dose 3 h after the exposure.
Highlights
A radiological or nuclear attack could involve such a large number of subjects as to overwhelm the emergency facilities in charge
The correlation between Gy and DNA breaks we found after 3 h is likely lower than what we would have found within 1 h, but even so, it is correlated with the absorbed dose and can be used as a feasible early biomarker
The main result of our study is, in the both Institutions involved, the correlation of several early biomarkers with the absorbed dose according to the RT treatment plans
Summary
A radiological or nuclear attack could involve such a large number of subjects as to overwhelm the emergency facilities in charge. Resources should be focused on those subjects needing immediate medical attention and care In such a scenario, for the triage management by first responders, it is necessary to count on efficient biological dosimetry tools capable of early detection of the absorbed dose. HemoDose 6, the AFRRI (Armed Forces Radiobiology Research Institute) Biodosimetry Assessment Tool (BAT)[7,8] and the First-responders Radiological Assessment Triage (WinFRAT) 9, are softwares developed for estimating the individuals’ absorbed doses in case of accidental exposure to radiations All are based both on multi-type blood cell counts and prodromic clinical symptomatology, to be integrated with cytogenetic counts[7,8]. The HemoDose dosimetry tool, was recently validated with the dicentric count by Abend and collaborators 20, confirming that is applicable only starting from 24 h after the IR exposure
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