Radiation Research ( IF 3.4 ) Pub Date : 2021-05-12 , DOI: 10.1667/rade-20-00147.1 Nikolai V Gorbunov 1 , Juliann G Kiang 2, 3, 4
Exposure to ionizing radiation, mechanical trauma, toxic chemicals or infections, or combinations thereof (i.e., combined injury) can induce organic injury to brain tissues, the structural disarrangement of interactive networks of neurovascular and glial cells, as well as on arrays of the paracrine and systemic destruction. This leads to subsequent decline in cognitive capacity and decompensation of mental health. There is an ongoing need for improvement in mitigating and treating radiation- or combined injury-induced brain injury. Cranial irradiation per se can cause a multifactorial encephalopathy that occurs in a radiation dose- and time-dependent manner due to differences in radiosensitivity among the various constituents of brain parenchyma and vasculature. Of particular concern are the radiosensitivity and inflammation susceptibility of: 1. the neurogenic and oligodendrogenic niches in the subependymal and hippocampal domains; and 2. the microvascular endothelium. Thus, cranial or total-body irradiation can cause a plethora of biochemical and cellular disorders in brain tissues, including: 1. decline in neurogenesis and oligodendrogenesis; 2. impairment of the blood-brain barrier; and 3. ablation of vascular capillary. These changes, along with cerebrovascular inflammation, underlie different stages of encephalopathy, from the early protracted stage to the late delayed stage. It is evident that ionizing radiation combined with other traumatic insults such as penetrating wound, burn, blast, systemic infection and chemotherapy, among others, can exacerbate the radiation sequelae (and vice versa) with increasing severity of neurogenic and microvascular patterns of radiation brain damage.
中文翻译:
电离辐射后的脑损伤和神经血管疾病的模式。放射治疗和放射联合损伤的并发症
暴露于电离辐射、机械创伤、有毒化学物质或感染,或它们的组合(即联合损伤)可引起脑组织的器质性损伤、神经血管和神经胶质细胞相互作用网络的结构紊乱,以及旁分泌阵列和系统性破坏。这导致随后的认知能力下降和心理健康失代偿。对减轻和治疗放射损伤或联合损伤引起的脑损伤的改进存在持续的需要。颅脑照射本身由于脑实质和脉管系统的各种成分之间的放射敏感性不同,可导致多因素脑病,这种脑病以辐射剂量和时间依赖性方式发生。尤其值得关注的是以下物质的放射敏感性和炎症敏感性: 1. 室管膜下和海马结构域中的神经源性和少突胶质细胞壁龛;2.微血管内皮。因此,颅脑或全身照射可导致脑组织中过多的生化和细胞紊乱,包括: 1. 神经发生和少突胶质细胞发生减退;2.血脑屏障受损;3.毛细血管消融术。这些变化以及脑血管炎症是脑病不同阶段的基础,从早期的长期阶段到晚期的晚期阶段。