Opinion article: the METREPOL criteria – are they still relevant?

2021 ◽  
Author(s):  
Laurence Lebaron-Jacobs ◽  
Eduardo Daniel Herrera Reyes
Keyword(s):  
Medical Management ◽  
Acute Radiation ◽  
Acute Radiation Syndrome ◽  
Radiation Accidents ◽  
Strategic Approach ◽  
Organ Systems ◽  
Radiation Induced ◽  
Critical Organ ◽  
Opinion Article ◽  
Broad Overview

Abstract The Medical management of radiation accidents manual on the acute radiation syndrome (METREPOL) proposed a successful strategic approach to diagnosing and treating acute radiation syndrome: the response category concept. Based on clinical and laboratory parameters, this approach aimed to assess damage to critical organ systems as a function of time, categorising different therapeutical approaches. After 20 years of its publication, the following paper attempts to provide a broad overview of this important document and tries to respond if proposed criteria are still relevant for the medical management of radiation-induced injuries. In addition, a critical analysis of its limitations and perspectives is proposed.

EUROPEAN CONSENSUS ON THE MEDICAL MANAGEMENT OF ACUTE RADIATION SYNDROME AND ANALYSIS OF THE RADIATION ACCIDENTS IN BELGIUM AND SENEGAL

2010 ◽  
Vol 98 (6) ◽  
pp. 825-832 ◽  
Author(s):  
Patrick Gourmelon ◽  
Marc Benderitter ◽  
Jean Marc Bertho ◽  
Christelle Huet ◽  
Norbert Claude Gorin ◽  
...  
Keyword(s):  
Medical Management ◽  
Acute Radiation ◽  
Acute Radiation Syndrome ◽  
Radiation Accidents ◽  
European Consensus

Investigating the Role of Inflammasome Caspases 1 and 11 in the Acute Radiation Syndrome

2021 ◽  
Author(s):  
Andrea R. Daniel ◽  
Lixia Luo ◽  
Chang-Lung Lee ◽  
David G. Kirsch
Keyword(s):  
Cell Death ◽  
Drug Targets ◽  
Acute Radiation ◽  
Rational Approach ◽  
High Dose ◽  
Acute Radiation Syndrome ◽  
Alternative Pathways ◽  
Caspase 1 ◽  
Organ Systems ◽  
Sensitive Organ

Exposure to high dose radiation causes life-threatening acute and delayed effects. Defining the mechanisms of lethal radiation-induced acute toxicity of gastrointestinal and hematopoietic tissues are critical steps to identify drug targets to mitigate and protect against the acute radiation syndrome (ARS). For example, one rational approach would be to design pharmaceuticals that block cell death pathways to preserve tissue integrity in radiation-sensitive organ systems including the gastrointestinal tract and hematopoietic compartment. A previous study reported that the inflammasome pathway, which mediates inflammatory cell death through pyroptosis, promotes ARS. However, we show that mice lacking the inflammatory executioner caspases, caspase-1 and caspase-11, are not protected from ARS when compared directly to littermates expressing caspase-1 and caspase-11. These results suggest that alternative pathways will need to be targeted by drugs that successfully mitigate and protect against the ARS.

scholarly journals Cholinergic and cytoprotective signaling cascades mediate the mitigative effect of erythropoietin on acute radiation syndrome

2018 ◽  
Vol 96 (5) ◽  
pp. 442-458
Author(s):  
Shereen Mohamed Galal ◽  
Mohamed Khairy Abdel-Rafei ◽  
Hesham Farouk Hasan
Keyword(s):  
White Blood Cells ◽  
Acute Radiation ◽  
Janus Kinase ◽  
Sublethal Dose ◽  
Related Factor ◽  
Acute Radiation Syndrome ◽  
Signal Transducers ◽  
Human Erythropoietin ◽  
Radiation Induced ◽  
Total Body

The present investigation aimed to evaluate the radiomitigative efficacy of the recombinant human erythropoietin (EPO) against acute radiation syndrome (ARS) in a rat model. Rats were irradiated with a single sublethal dose of γ-radiation (7 Gy; total body irradiation; TBI) on the 1st day of experimental course, then received EPO (5000 IU/kg; i.p.) 24 h after irradiation, and rats were observed for 30 days of survival analysis. Administration of EPO improved 30-day survival, alleviated TBI-induced myelosuppression and pancytopenia, by augmenting lymphocytes and other white blood cells in the peripheral blood of rats, while bone marrow and spleen cellularity were restored. EPO post-exposure treatment alleviated hepatotoxicity biomarkers and restored splenic function. EPO abrogated radiation-induced oxidative stress through the upregulation of the cholinergic anti-inflammatory nicotinic acetylcholine receptor (α-7-nAChR) and the pro-survival Janus kinase-2 and signal transducers and activators of transcription JAK-2/STAT-3 signaling mediated via enhancing nuclear factor erythroid-2 related factor-2 (Nrf-2) cytoprotective machinery in liver and spleen of irradiated rats. Moreover, EPO treatment prevented hepatic and splenic apoptosis. The present study establishes the implication of α-7-nAChR–JAK-2/STAT-3–Nrf-2 signaling cascade in the radiomitigative potential of EPO against ARS.

Investigating the Multifaceted Nature of Radiation-Induced Coagulopathies in a Göttingen Minipig Model of Hematopoietic Acute Radiation Syndrome

2021 ◽  
Vol 196 (2) ◽  
Author(s):  
Bernadette Hritzo ◽  
Betre Legesse ◽  
Jerrold M. Ward ◽  
Amandeep Kaur ◽  
Saeed Y. Aghdam ◽  
...  
Keyword(s):  
Acute Radiation ◽  
Acute Radiation Syndrome ◽  
Göttingen Minipig ◽  
Radiation Induced

Opinion article: the acute radiation syndrome – need for updated medical guidelines

2022 ◽  
Author(s):  
Leif Stenke ◽  
Christel Hedman ◽  
Marita Lagergren Lindberg ◽  
Karin Lindberg ◽  
Jack Valentin
Keyword(s):  
Low Frequency ◽  
Recent Decade ◽  
Organ Damage ◽  
Conclusive Evidence ◽  
Acute Radiation ◽  
Acute Radiation Syndrome ◽  
Global Consensus ◽  
Organ Systems ◽  
Dose Dependent Fashion ◽  
Medical Guidelines

Abstract The major immediate and severe medical consequences in man following exposure to high doses of ionizing radiation can be summarized within the concept of the acute radiation syndrome (ARS). In a dose-dependent fashion, a multitude of organ systems can be affected by such irradiation, presenting considerable medical challenges to treating physicians. Accidents or malevolent events leading to ARS can provoke devastating effects, but they occur at a low frequency and in a highly varying manner and magnitude. Thus, it is difficult to make precise medical predictions and planning, or to draw conclusive evidence from occurred events. Therefore, knowledge from on-going continuous developments within related medical areas needs to be acknowledged and incorporated into the ARS setting, enabling the creation of evidence-based guidelines. In 2011 the WHO published a first global consensus on the medical management of ARS among patients subjected to nontherapeutic radiation. During the recent decade the understanding of and capability to counteract organ damage related to radiation and other agents have improved considerably. Furthermore, legal and logistic hurdles in the process of formally approving appropriate medical countermeasures have been reduced. We believe the time is now ripe for developing an update of internationally consented medical guidelines on ARS.

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