当前位置: X-MOL 学术Health Phys. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Scientific and Logistical Considerations When Screening for Radiation Risks by Using Biodosimetry Based on Biological Effects of Radiation Rather than Dose: The Need for Prior Measurements of Homogeneity and Distribution of Dose.
Health Physics ( IF 2.2 ) Pub Date : 2020-3-17 , DOI: 10.1097/hp.0000000000001244
Harold M Swartz , Ann Barry Flood 1 , Vijay K Singh , Steven G Swarts 2
Affiliation  

An effective medical response to a large-scale radiation event requires prompt and effective initial triage so that appropriate care can be provided to individuals with significant risk for severe acute radiation injury. Arguably, it would be advantageous to use injury rather than radiation dose for the initial assessment; i.e., use bioassays of biological damage. Such assays would be based on changes in intrinsic biological response elements; e.g., up- or down-regulation of genes, proteins, metabolites, blood cell counts, chromosomal aberrations, micronuclei, micro-RNA, cytokines, or transcriptomes. Using a framework to evaluate the feasibility of biodosimetry for triaging up to a million people in less than a week following a major radiation event, Part 1 analyzes the logistical feasibility and clinical needs for ensuring that biomarkers of organ-specific injury could be effectively used in this context. We conclude that the decision to use biomarkers of organ-specific injury would greatly benefit by first having independent knowledge of whether the person's exposure was heterogeneous and, if so, what was the dose distribution (to determine which organs were exposed to high doses). In Part 2, we describe how these two essential needs for prior information (heterogeneity and dose distribution) could be obtained by using in vivo nail dosimetry. This novel physical biodosimetry method can also meet the needs for initial triage, providing non-invasive, point-of-care measurements made by non-experts with immediate dose estimates for four separate anatomical sites. Additionally, it uniquely provides immediate information as to whether the exposure was homogeneous and, if not, it can estimate the dose distribution. We conclude that combining the capability of methods such as in vivo EPR nail dosimetry with bioassays to predict organ-specific damage would allow effective use of medical resources to save lives.

中文翻译:

使用基于辐射的生物效应而非剂量的生物剂量学筛查辐射风险时的科学和后勤考虑:需要事先测量均匀性和剂量分布。

对大规模辐射事件的有效医疗反应需要迅速和有效的初步分类,以便可以为具有严重急性辐射损伤风险的个体提供适当的护理。可以说,在初始评估中使用伤害而不是辐射剂量是有利的;即,使用生物损伤的生物测定。这种分析将基于内在生物反应元素的变化;例如,基因、蛋白质、代谢物、血细胞计数、染色体畸变、微核、微RNA、细胞因子或转录组的上调或下调。使用一个框架来评估生物剂量测定法在重大辐射事件后不到一周内对多达 100 万人进行分类的可行性,第 1 部分分析了确保器官特异性损伤的生物标志物可以在这种情况下有效使用的后勤可行性和临床需求。我们得出结论,使用器官特异性损伤的生物标志物的决定将极大地受益,因为首先要独立了解该人的暴露是否是异质的,如果是,那么剂量分布是什么(以确定哪些器官暴露于高剂量)。在第 2 部分中,我们描述了如何通过使用体内指甲剂量测定来获得对先验信息(异质性和剂量分布)的这两个基本需求。这种新颖的物理生物剂量测定方法还可以满足初始分诊的需求,提供由非专家进行的非侵入性、即时测量,以及对四个独立解剖部位的即时剂量估计。此外,它独特地提供了关于暴露是否均匀的即时信息,如果不是,它可以估计剂量分布。我们得出结论,将体内 EPR 指甲剂量测定法等方法与生物测定相结合来预测器官特异性损伤,将允许有效利用医疗资源来挽救生命。
更新日期:2020-12-17
down
wechat
bug