It has long been known that time is an important parameter in radiobiological effects, especially the intervals between radiation exposures in fractionated radiotherapy. But time is also an important experimental variable, which can be used to distinguish between possible contributions of differing pathways in radiation effects. A recent review of mechanisms underlying oxygen-dependent radiosensitivity by Liu, Lin and Yun (1) prompted this author to remind readers of seminal contributions utilizing time as a variable. Although these contributions were groundbreaking in the 1960s (2), it is important that they remain absolutely central to our thoughts in this area of research even today. If we define the ‘‘oxygen effect’’ as the almost universal, major increase in radiosensitivity (around a factor of two to three reduction in dose required for the same effect) that results from the presence of oxygen (compared to anoxia) in cells of widely-varying absolute radiosensitivity exposed to low-linear energy transfer radiation, then a testable hypothesis is that the effect largely reflects the concentration of oxygen present in cells at the instant of irradiation. As discussed below, this hypothesis is supported by experimental data obtained several decades ago. This is important because, as discussed in the recent review (1), there are numerous oxygen-dependent biological changes that can influence radiosensitivity. However, time is a key variable by which the relative importance of these changes to oxygen-dependent radiosensitivity can be identified. Well over 50 years ago, Howard-Flanders and Moore showed cells physically transported from a nitrogen atmosphere to oxygen around 20 ms after irradiation showed no radiosensitizing effect from the added oxygen (3). Using a liquid-phase rapid-mix flow technique, Adams and Michael et al. shortened the time interval between irradiation of anoxic cells and subsequently adding oxygenated buffer to ;5 ms but still found very little radiosensitizing effect; conversely, adding oxygen to previously anoxic cells for just a few milliseconds before irradiation gave good radiosensitization (2, 4). Much better time resolution was achieved by Michael and colleagues, who managed to change the cellular environment in bacteria from anoxic to oxic in times of about 0.1 ms using a ‘‘gas explosion’’ technique (5). [Ultimately, the time required for oxygen to diffuse to the target site is resolution limiting; and by using an alternative approach in which oxygen was first depleted by a radiation pulse, followed by a second pulse with an interval allowing for oxygen replenishment by diffusion, the same timescale of around 0.1 ms for some oxygen-dependent effect was detected and deduced (6, 7).] By varying the interval between (sub-microsecond) irradiation pulses and admission of oxygen, the lifetimes of oxygen-dependent damage and the effects of chemical modifiers could be properly resolved for the first time in mammalian cells (8). Crucially, these lifetimes could be compared using end points in addition to clonogenic survival, such as DNA strand break measurements. For example, it was shown that the timescales of action of chemicals influencing clonogenic survival and the yield of DNA double-strand breaks were similar (9). Other alternative fast mixing methods were developed and applied (10). Briefly, the key conclusion from these time-resolved studies is that the oxygen effect in radiobiology must arise to a very large extent from events that are completed in a few milliseconds, and by far the dominant factor is the concentration of oxygen in cells at the instant of irradiation. Because of this timescale, reactions involving short-lived free radicals are likely to be the major contributors to the oxygen effect, and chemists have presented plausible mechanistic schemes by which reactions involving oxygen lead to DNA strand breaks, differing in nature and extent from those found in anoxia. In fact, our understanding of these pathways is far advanced beyond that which might be surmised from the description of ‘‘oxygen fixation’’ and formation of ‘‘peroxides that cannot be structurally restored’’ in the review which prompted this letter (1). Oxygen is thought not to ‘‘fix’’ damage directly, but to modify the chemical pathways to DNA strand breaks, and peroxides are incidental by-products of these pathways 1 Address for correspondence: 20 Highover Park, Amersham, Buck inghamsh i r e HP7 0BN, Un i t ed Kingdom; ema i l : peterwardman@btinternet.com.
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