Authors: Greenberger, Joel S.; Epperly, Michael W.

Source: Current Respiratory Medicine Reviews, Volume 3, Number 1, February 2007 , pp. 29-37(9)

Publisher: Bentham Science Publishers

Abstract:

There is increasing evidence that lung irradiation damage is mediated by oxidative stress responses of pulmonary vascular and parenchymal cells. The acute irradiation response involves strand breaks in nuclear DNA, then stress activated protein kinase (SAP-Kinase) transport to mitochondria where lipid peroxidation changes lead to cytochrome-c release and apoptosis. However, secondary cytokine elevations lead to a second wave of apoptosis both directly and indirectly mediated through inflammatory cell infiltrates. A recovery phase and latent period follows wherein little structural or physiological evidence of lung damage is detectable in animal models or in humans. The late effects of irradiation pulmonary fibrosis initiate by unknown triggering events thought to involve not only resident pulmonary endothelial cells, but also recruited bone marrow origin macrophages and progenitors of myofibroblasts, which contribute to the lesion of organizing alveolitis in the mouse model or pulmonary irradiation fibrosis in humans. Oxidative stress markers are elevated during formation of the late lesion in a pattern, which is reminiscent of the acute lesion. The amelioration of both the acute and late pulmonary pathophysiologic changes by administration of antioxidant therapies suggests that similar molecular mechanisms may be involved. This article reviews several bodies of evidence concerning the cause and possible therapeutic strategies, which may be of value in treating ionizing irradiation, induced lung damage.

Keywords: Ionizing irradiation; radiation fibrosis; radiation pneumonitis; manganese superoxide dismutase

Document Type: Research article

DOI: http://dx.doi.org/10.2174/157339807779941767

Affiliations: 1: Department of Radiation Oncology, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.

Publication date: 2007-02-01

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• Current Respiratory Medicine Reviews publishes frontier reviews on all the latest advances on respiratory diseases and its related areas e.g. pharmacology, pathogenesis, clinical care, and therapy. The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in respiratory medicine.

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