Biomarkers of ionising radiation relevant to carcinogenesis : Dose, dose rate and LET dependency of the responses

A better understanding of the relationship between ionising radiation (IR) dose, dose rate and radiation quality, and the risk of stochastic effects would improve risk extrapolation from atomic bomb survivors’ data. Owing to insufficient statistical power of epidemiological studies to detect excess incidence of cancer following low doses of IR delivered at low dose rates (LDLDR), as typically encountered in most common human exposure scenarios, radiobiological experiments are fundamental to describe the biological effectiveness of LDLDR and to define the underlying molecular mechanisms. DNA damage and downstream effects are major contributors to radiation carcinogenesis, and as such, these processes have been investigated in the context of plausible mechanisms of radiation-induced health effects in the studies compiled in this thesis, using different cell models and appropriate radiation sources.  In Paper I, we characterized the energy, activity and dose rate of new low activity gamma and alpha sources of IR, expected to promote small-scale radiation protection research, and used to demonstrate that LDLDR led to an increased micronucleus frequency, a marker of DNA damage, in human osteosarcoma cells as compared to control cells.  In Paper II, we used blood from patients undergoing radiological imaging procedures, i.e. PET-CT and scintigraphy, to investigate whether candidate IR biomarkers, i.e. ROS, γH2AX, and expression of a panel of radiation-responsive genes, are altered following in vivo low dose exposure as compared to control samples obtained before the diagnostic procedure. We showed that radiological imaging generally induced weak γH2AX, ROS, and gene expression fold changes at the selected timepoints, although few donors presented stronger responses. The observed mild increase in DNA damage was, nevertheless, coherent with a subsequent DNA damage response. This study also indicated that owing to the heterogeneity of the response across individuals, the discrimination of exposed samples might be complicated in the absence of a control for low dose exposures.  The current risk assessment approach for mixed beam exposures, as encountered in space and other exposure scenarios, assumes additivity of effects of each radiation quality component, but some reports, which show synergistic effects instead, are in conflict with this assumption and indicate a potential underestimation of the corresponding cancer risk. In Paper III, we investigated the consistency of the interaction between low and high LET IR in two healthy donors who presented the largest inter- and intra-donor variability following mixed beam exposure in a previous study.  Based on nine biological replicates, this study confirmed that combined alpha particles and photon radiation led to a higher cytogenetic damage and gene expression responses than those expected based on simple additivity of effects, but that the interaction was prone to seasonal intra-donor and inter-donor variation for both endpoints. This study additionally showed that IR exposure modified alternative transcription of FDXR and MDM2 in a radiation quality-dependent manner, albeit alternative transcription did not coincide with the mode of interaction between the different radiation qualities. In light of these results, we suggest that the possible interaction between low and high LET IR should be considered in calculating uncertainty of risk for mixed exposures.  In Paper IV, we investigated the early- and long-term biological effects of LDLDR gamma radiation as compared to the same doses delivered acutely in human AHH-1 lymphoblasts, using relevant endpoints related to carcinogenesis, i.e. cell viability, clonogenic survival, chromosomal aberrations, cell growth and global gene expression. The results presented in this study are coherent with a potential detrimental effect of 100 mGy, delivered either chronically or acutely, with a clear dose rate effect for chromosomal aberrations and gene expression, which may modulate cancer risk by dose rate-dependent mechanisms.

Biomarkers of ionising radiation relevant to carcinogenesis : Dose, dose rate and LET dependency of the responses

A better understanding of the relationship between ionising radiation (IR) dose, dose rate and radiation quality, and the risk of stochastic effects would improve risk extrapolation from atomic bomb survivors’ data. Owing to insufficient statistical power of epidemiological studies to detect excess incidence of cancer following low doses of IR delivered at low dose rates (LDLDR), as typically encountered in most common human exposure scenarios, radiobiological experiments are fundamental to describe the biological effectiveness of LDLDR and to define the underlying molecular mechanisms. DNA damage and downstream effects are major contributors to radiation carcinogenesis, and as such, these processes have been investigated in the context of plausible mechanisms of radiation-induced health effects in the studies compiled in this thesis, using different cell models and appropriate radiation sources.  In Paper I, we characterized the energy, activity and dose rate of new low activity gamma and alpha sources of IR, expected to promote small-scale radiation protection research, and used to demonstrate that LDLDR led to an increased micronucleus frequency, a marker of DNA damage, in human osteosarcoma cells as compared to control cells.  In Paper II, we used blood from patients undergoing radiological imaging procedures, i.e. PET-CT and scintigraphy, to investigate whether candidate IR biomarkers, i.e. ROS, γH2AX, and expression of a panel of radiation-responsive genes, are altered following in vivo low dose exposure as compared to control samples obtained before the diagnostic procedure. We showed that radiological imaging generally induced weak γH2AX, ROS, and gene expression fold changes at the selected timepoints, although few donors presented stronger responses. The observed mild increase in DNA damage was, nevertheless, coherent with a subsequent DNA damage response. This study also indicated that owing to the heterogeneity of the response across individuals, the discrimination of exposed samples might be complicated in the absence of a control for low dose exposures.  The current risk assessment approach for mixed beam exposures, as encountered in space and other exposure scenarios, assumes additivity of effects of each radiation quality component, but some reports, which show synergistic effects instead, are in conflict with this assumption and indicate a potential underestimation of the corresponding cancer risk. In Paper III, we investigated the consistency of the interaction between low and high LET IR in two healthy donors who presented the largest inter- and intra-donor variability following mixed beam exposure in a previous study.  Based on nine biological replicates, this study confirmed that combined alpha particles and photon radiation led to a higher cytogenetic damage and gene expression responses than those expected based on simple additivity of effects, but that the interaction was prone to seasonal intra-donor and inter-donor variation for both endpoints. This study additionally showed that IR exposure modified alternative transcription of FDXR and MDM2 in a radiation quality-dependent manner, albeit alternative transcription did not coincide with the mode of interaction between the different radiation qualities. In light of these results, we suggest that the possible interaction between low and high LET IR should be considered in calculating uncertainty of risk for mixed exposures.  In Paper IV, we investigated the early- and long-term biological effects of LDLDR gamma radiation as compared to the same doses delivered acutely in human AHH-1 lymphoblasts, using relevant endpoints related to carcinogenesis, i.e. cell viability, clonogenic survival, chromosomal aberrations, cell growth and global gene expression. The results presented in this study are coherent with a potential detrimental effect of 100 mGy, delivered either chronically or acutely, with a clear dose rate effect for chromosomal aberrations and gene expression, which may modulate cancer risk by dose rate-dependent mechanisms.

Impact of fractionated cisplatin and radiation treatment on cell growth and accumulation of DNA damage in two normal cell types differing in origin

Abstract Evidence on the impact of chemotherapy on radiotherapy-induced second malignant neoplasms is controversial. We estimated how cisplatin modulates the in vitro response of two normal cell types to fractionated radiation. AHH-1 lymphoblasts and VH10 fibroblasts were irradiated at 1 Gy/fraction 5 and 3 times per week during 12 and 19 days, respectively, and simultaneously treated with 0.1, 0.2, 0.4, 0.8, 1.7 and 3.3 µM of cisplatin twice a week. Cell growth during treatment was monitored. Cell growth/cell death and endpoints related to accumulation of DNA damage and, thus, carcinogenesis, were studied up to 21 days post treatment in cells exposed to radiation and the lowest cisplatin doses. Radiation alone significantly reduced cell growth. The impact of cisplatin alone below 3.3 µM was minimal. Except the lowest dose of cisplatin in VH10 cells, cisplatin reduced the inhibitory effect of radiation on cell growth. Delayed cell death was highest in the combination groups while the accumulation of DNA damage did not reveal a clear pattern. In conclusion, fractionated, concomitant exposure to radiation and cisplatin reduces the inhibitory effect of radiation on cell proliferation of normal cells and does not potentiate delayed effects resulting from accumulation of DNA damage

Cell Type-Specific Patterns in the Accumulation of DNA Damage Following Multifractional Radiation Exposure

Predicting the risk of second malignant neoplasms is complicated by uncertainties regarding the shape of the dose–response relationship at high doses. Limited understanding of the competitive relationship between cell killing and the accumulation of DNA lesions at high doses, as well as the effects of other modulatory factors unique to radiation exposure during radiotherapy, such as dose heterogeneity across normal tissue and dose fractionation, contribute to these uncertainties. The aim of this study was to analyze the impact of fractionated irradiations on two cell systems, focusing on the endpoints relevant for cancer induction. To simulate the heterogeneous dose distribution across normal tissue during radiotherapy, exponentially growing VH10 fibroblasts and AHH-1 lymphoblasts were irradiated with 9 and 12 fractions (VH10) and 10 fractions (AHH-1) at 0.25, 0.5, 1, or 2 Gy per fraction. The effects on cell growth, cell survival, radiosensitivity and the accumulation of residual DNA damage lesions were analyzed as functions of dose per fraction and the total absorbed dose. Residual γH2AX foci and other DNA damage markers (micronuclei, nuclear buds, and giant nuclei) were accumulated at high doses in both cell types, but in a cell type-dependent manner. The competitive relationship between cell killing and the accumulation of carcinogenic DNA damage following multifractional radiation exposure is cell type-specific

Image_1_Short- and long-term effects of radiation exposure at low dose and low dose rate in normal human VH10 fibroblasts.pdf

IntroductionExperimental studies complement epidemiological data on the biological effects of low doses and dose rates of ionizing radiation and help in determining the dose and dose rate effectiveness factor.MethodsHuman VH10 skin fibroblasts exposed to 25, 50, and 100 mGy of 137Cs gamma radiation at 1.6, 8, 12 mGy/h, and at a high dose rate of 23.4 Gy/h, were analyzed for radiation-induced short- and long-term effects. Two sample cohorts, i.e., discovery (n = 30) and validation (n = 12), were subjected to RNA sequencing. The pool of the results from those six experiments with shared conditions (1.6 mGy/h; 24 h), together with an earlier time point (0 h), constituted a third cohort (n = 12).ResultsThe 100 mGy-exposed cells at all abovementioned dose rates, harvested at 0/24 h and 21 days after exposure, showed no strong gene expression changes. DMXL2, involved in the regulation of the NOTCH signaling pathway, presented a consistent upregulation among both the discovery and validation cohorts, and was validated by qPCR. Gene set enrichment analysis revealed that the NOTCH pathway was upregulated in the pooled cohort (p = 0.76, normalized enrichment score (NES) = 0.86). Apart from upregulated apical junction and downregulated DNA repair, few pathways were consistently changed across exposed cohorts. Concurringly, cell viability assays, performed 1, 3, and 6 days post irradiation, and colony forming assay, seeded just after exposure, did not reveal any statistically significant early effects on cell growth or survival patterns. Tendencies of increased viability (day 6) and reduced colony size (day 21) were observed at 12 mGy/h and 23.4 Gy/min. Furthermore, no long-term changes were observed in cell growth curves generated up to 70 days after exposure.DiscussionIn conclusion, low doses of gamma radiation given at low dose rates had no strong cytotoxic effects on radioresistant VH10 cells.</p

Gene expression for biodosimetry and effect prediction purposes: promises, pitfalls and future directions - key session ConRad 2021.

PURPOSE: In a nuclear or radiological event, an early diagnostic or prognostic tool is needed to distinguish unexposed from low- and highly exposed individuals with the latter requiring early and intensive medical care. Radiation-induced gene expression (GE) changes observed within hours and days after irradiation have shown potential to serve as biomarkers for either dose reconstruction (retrospective dosimetry) or the prediction of consecutively occurring acute or chronic health effects. The advantage of GE markers lies in their capability for early (1-3 days after irradiation), high-throughput, and point-of-care (POC) diagnosis required for the prediction of the acute radiation syndrome (ARS). CONCLUSIONS: As a key session of the ConRad conference in 2021, experts from different institutions were invited to provide state-of-the-art information on a range of topics including