ABSTRACT
Objective To evaluate the protective effect of ACEI drugs on radiation pneumonitis,and to compare ACEI with ARB,statin, steroid, and NSAID on the treatment of radiation induced lung injury through the network Meta-analysis. Methods A computer-based online search of PubMed, EMbase, Cochrane Library, as well as CNKI, CBM, VIP, Wanfang database was conduce. The NOS score was used to evaluate the quality of studies,and the results were analyzed by stata14. 0 software. Results ACEI drugs showed desired effect on the treatment of radiation pneumonia,which can effectively reduce the incidence of radiation-induced lung injury,but can not prolong the survival time of the patients.The protective effects of statins and non-steroid anti-inflammatory drugs are second only to those of ACEI.Meta-analysis results were proved to be stable and credible by the sensitive-analysis.The therapeutic effect of ACEI on radiation induced lung injury is not affected by sex and age of patients. Conclusion ACEI drugs have an optimum protective effect on radiation induced lung injury.
ABSTRACT
ObjectiveTo evaluate the effect on lung injury of gefitinib or/and radiation.Methods Totally 160 mice were divided into five groups:control (C) ;gefitinib (G) ;radiation (R) ;gefitinib followed by irradiation ( G + R) ;and R + G.12 Gy irradiation was delivered.Geiitinib fed by 200 mg/kg once daily for 3 weeks.Mice were sacrificed on 1,2,4 or 6 months after radiation.Macrophage count of lung lavage fluid and hydroxyproline assessed,lung fibrosis scored.and plasma TGF-β1 concentration assayed.One-way ANOVA was used to test the significance. Results The lung lavage macrophage cell number were significantly higher in group R,R + G and G + R than group C ( q =2.95 - 8.61,all P ＜ 0.05 ) on 4 and 6months,yet no significant difference between the three groups ( q =0.37 -3.49,all P ＜ 0.05 ) ; The macrophage was significantly lower in month 1,4 and 6 in group G than R,R + G and G + R ( q =3.37- 6.25,all P ＜ 0.05 ).The hydroxyproline content and the fibrosis score of G,R,R + G and G + R were significantly higher than C ( q =3.14 - 4.76,all P ＜ 0.05 ),but no significant difference between the four groups ( q =0.70 - 4.19,all P ＞ 0.05 ).The TGF-β1 concentration of R,G + R,R + G at all time points and TGF-β1 concentration of G at 1 st and 2nd months were significantly higher than C ( q =3.76 -8.09,all P ＜ 0.05).ConclusionsGefitinib could cause lung fibrosis in vivo in BalB/C mouse.The combination of gefitinib and radiation did not significantly exacerbate lung injury caused byeither alone.The mechanism of lung fibrosis caused by gefitinib might be different from that by radiation which needs further research.