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Radiation therapy is one of the main treatment methods for patients with thoracic malignant tumors, which can effectively improve the survival rate of the patients. However, radiation therapy can also cause damage to normal tissues while treating tumors, leading to radiation-induced lung injury such as radiation pneumonia and pulmonary fibrosis. Radiation-induced lung injury is a complex pathophysiological process involving many factors, and its prevention and treatment is one of the difficult problems in the field of radiation medicine. Therefore, the search for sensitive predictors of radiation-induced lung injury can guide clinical radiotherapy and reduce the incidence of radiation-induced lung injury. With the in-depth study of intestinal flora, it can drive immune cells or metabolites to reach lung tissue through the circulatory system to play a role, and participate in the occurrence, development and treatment of lung diseases. At present, there are few studies on intestinal flora and radiation-induced lung injury. Therefore, this paper will comprehensively elaborate the interaction between intestinal flora and radiation-induced lung injury, so as to provide a new direction and strategy for studying the protective effect of intestinal flora on radiation-induced lung injury. .
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Humans , Lung Injury/prevention & control , Gastrointestinal Microbiome , Lung Neoplasms/radiotherapy , Lung/pathology , Radiation Injuries/metabolism , Thoracic NeoplasmsABSTRACT
Radiation induced lung injury (RILI) is a common complication after radiation therapy of breast tumors and bone marrow transplantation pretreatment, and it is a critical limiting factor of radiotherapy doses in patients. Once RILI progresses to the radiation-induced pulmonary fibrosis stage, it seriously reduces the patient’s quality of life, while causing the patient’s respiratory failure and eventually leading to death. Ionizing radiation (IR) can induce cell injuries, including apoptosis, epithelial-mesenchymal transition, senescence, pyroptosis and ferroptosis, and these injuries can play an important role in the occurrence and development of radioactive lung injury. Starting from discussion of the occurrence of different forms of injury in different cells after IR stimulation, this review summarizes the pathogenesis of RILI and its clinical prevention and treatment.
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Radiation-induced lung injury （RILI）， one of the common complications caused by radiotherapy， encompasses two phases： an early phase known as radiation pneumonitis （RP） and a late phase called radiation fibrosis （RF）， threatening the life and life quality of patients， with poor prognosis. Accumulating evidence has shown that the occurrence of RILI is related to a variety of cytokines and signaling pathways. This paper summarized the research on the effects of Chinese medicine on RILI from the perspective of cytokines and signaling pathways. Cytokines include transforming growth factor-β1 （TGF-β1）， interleukins （ILs）， tumor necrosis factor-α （TNF-α）， platelet-derived growth factor （PDGF）， vascular endothelial growth factor （VEGF）， and high mobility group box-1 （HMGB1）. Related signaling pathways are phosphatidylinositol-3-kinase/protein kinase B（PI3K/Akt） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， Wnt/β-catenin signaling pathway， Notch1/Jagged1 signaling pathway， and nuclear factor-E2-related factor2/antioxidant response element （Nrf2/ARE） signaling pathway. Cytokines may interfere with RILI progression by initiating various downstream signaling pathways， such as TGF-β1/Smads signaling pathway， TGF-β1/VEGF signaling pathway， TNF-α/nuclear factor-κB （NF-κB） signaling pathway， and HMGB1/Toll-like receptor 4 （TLR4） signaling pathway. In recent years， many scholars have attempted to delay RILI progression by down-regulating the expression of cytokines， antagonizing the effect of cytokines or regulating signaling pathways. It has been verified that many Chinese medicines， Chinese medicine monomers， and compound Chinese medicine prescriptions can inhibit the release of some cytokines or regulate some signaling pathways to reduce the incidence/severity of RILI， with satisfactory therapeutic effects， which have attracted the interest of scholars.
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Objective:To investigate the protective effect and mechanism of ophiopogonin D on lung injury induced by radiation in mice.Methods:A total of 60 female C57BL/6 mice were randomly divided into 4 groups: control group, irradiation group, irradiation+ ophiopogonin D group and irradiation+ dexamethasone group, with 15 mice in each group. The mice were irradiated with a single dose of 6 MV X-rays of 15 Gy. Three days before irradiation, the mice in irradiation+ ophiopogonin D group were intraperitoneally injected with 10 mg/kg ophiopogonin D solution. The mice in irradiation+ dexamethasone group were intraperitoneally injected with 10 mg/kg dexamethasone solution. The mice in control group and irradiation group were intraperitoneally injected with normal saline once a day until 1 week after irradiation. Tissue samples were collected at 3 d, 1 week, and 6 weeks post-irradiation. Hematoxylin-eosin (HE) staining and Masson′s trichrome staining were used to observe the pathological changes of lung tissue. The expressions of 8-hydroxy-deoxyguanosine (8-OHdG), p53, p53 up-regulated apoptosis factor (PUMA), cysteine aspartate proteolytic enzyme-3 (caspase-3), Collagen Ⅰ and Collagen Ⅲ were observed by immunohistochemistry. Western blot was used to verify the expressions of apoptosis related proteins including p53, PUMA and caspase-3.Results:HE staining of lung tissue showed that ophiopogonin D could reduce hemorrhage, exudation, edema and inflammatory infiltration in lung tissue 1 week post irradiation. Moreover, ophiopogonin D reduced the expression of 8-OHdG ( t=8.39, P < 0.05), the oxidative stress, and the expressions of p53, PUMA, caspase-3 apoptosis-related proteins ( t=12.60, 5.92, 7.00, P < 0.05), and inhibited the apoptosis of alveolar epithelial cells and alleviated other damage in the irradiated lung tissue 1 week post-irradiation. Ophiopogonin D also reduced collagen deposition in lung tissue 6 weeks after irradiation, and reduced the expression of transforming growth factor (TGF-β1) ( t=9.32, 8.97, 6.83, P < 0.05) and interleukin-6 ( t=8.22, 7.80, 8.28, P < 0.05) in the blood of mice at 3 d, 1 week, and 6 weeks after irradiation. At 6 weeks after exposure, ophiopogonin D reduced the production of Collagen Ⅰ and Collagen Ⅲ in the lung interstitium ( t=6.41, 7.50, P < 0.05), and alleviated the pulmonary fibrosis in the late stage of radiation. Conclusions:Ophiopogonin D has protective effects on lung injury caused by radiation, including the alleviation of early radiation pneumonia and late pulmonary fibrosis, by reducing oxidative stress, the expression of inflammation-related factors, apoptosis of lung tissue, and collagen production.
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Objective:To study the protective anti-radiation effect of inhibiting CD47 expression in the lung tissues of mice and to explore the associated mechanism.Methods:Female C57BL/6 mice ( n = 60) were randomly divided into four groups: normal, blank, negative and positive. The blank group received only whole-lung irradiation; The negative group received whole-lung irradiation and tracheal infusion of adeno-associated virus containing nonsense sequence shRNA; The positive group received whole lung irradiation and tracheal drip containing adeno-associated virus containing shRNA expression of CD47. Fresh blood samples were collected at 24 h, 4 weeks, and 12 weeks post-irradiation, respectively. The expression level of CD47 mRNA was determined by RT-PCR. Determination of hydroxyproline content by alkaline hydrolysis. The LC3 expression level was measured by immunohistochemical staining. Serum transforming growth factor-β 1 (TGF-β 1) and tumor necrosis factor-α (TNF-α) levels were assessed by ELISA. Results:RT-PCR showed that the relative expression level of CD47 mRNA in the lung tissues in the positive group was significantly lower compared to those in the negative group, the normal group, the blank group (24-hour, P were <0.001,<0.001,<0.001, respectively. 4-weeks, P were <0.001,0.003,0.001, respectively. 12-weeks, P were 0.009, 0.002, 0.005, respectively). There were no significant differences in CD47 mRNA expression in the three groups except the positive group (all P>0.05), and there was no significant difference in CD47 mRNA expression with time in each group (all P>0.05).The serum TGF-β1 content was higher in the 24 h, 4-week, and 12-week blank groups ( P were <0.001, 0.003 and 0.003, respectively) and negative groups( P were 0.001, 0.021 and 0.034, respectively) after irradiation than that in the mice in the normal group. At the same time, the serum TNF-α of positive group after irradiation (24 hours, 4 weeks, 12 weeks, P were 0.022, <0.001, <0.001, respectively) were significantly higher than those of the normal group. The content of hydroxyproline in the blank group was significantly higher than that in the normal group (4 weeks, 12 weeks, P were 0.002, <0.001, respectively). Immunohistochemical indications: 24 h after irradiation was higher than the expression of LC3 in mouse lung tissue at 4 weeks and 12 weeks (all P < 0.001). The difference between the negative group and the blank group was not obvious ( P>0.05). Conclusions:Inhibition of CD47 expression can reduce the degree of radiation-induced pneumonia and pulmonary fibrosis probably via enhanced autophagy. CD47 may represent a novel target for the protection of radiation-induced lung injury.
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Objective:To explore the dynamic phenotype of type Ⅱ alveolar epithelial cells(AEC Ⅱ)in radiation-induced lung fibrosisand its role in the formation of fibrosis.Methods:Totally 90 C57BL/6J female mice were divided into 2 groups: irradiation group (50, thoracic irradiation with a single dose of 20 Gy X-rays), control group (40, sham irradiation). At 24 h, 4 and 12 weeks after irradiation, 5 mice were euthanized and the lungs were collected for pathological observation. The other lungtissues were collected for the isolation of primary AEC Ⅱ cells with microbeadssorting.The mRNA expressions of proSP-C, HOPX, vimentin, β-catenin and TGF-β1 in AEC II cells were detected by RT-PCR.Results:Acute pneumonitis was observed in the lungs at 24 h after irradiation and alleviated in accompany with partial alveolar septal thickening and a small amount of collagen deposition at 4 weeks after irradiation. The collagen deposition became more pronounced at 12 weeks after irradiation, together with collapsed and fused alveolar cavities, alveolar septal hyperplasia, and pulmonary fibrosis formation.The mRNAexpression levels of proSP-C and HOPX in primary AEC Ⅱ cells increased at 24 hours after irradiation and then approached to a peak value at 4 weeks after irradiation ( F=8.441, 3.586, P=0.036). The mRNA expression levels of vimentin, a biomarker of EMT, was increased significantly at 4 weeks and continued up to 12 weeks after irradiation( F=8.358, P=0.001). The mRNA expression levels of profibrotic factors β-catenin and TGF-β1 were both significant increased at 12 weeks after irradiation( F=4.62, 3.279, P=0.044). Conclusions:The phenotypeof AECⅡ cells could not only be transformed from proSP-C+ to HOPX+ /proSP-C+ , HOPX+ /proSP-C+ /vimentin+ , and vimentin+ /proSP-C, but also differentiated into mesenchymal cells with highly expressed profibrotic factors, thereby inducing EMT process, which either played a role in the repair of radiation-induced lung injury or triggered radiation-induced fibrosis.
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Objective:To study the effect of crizotinib on acute radiation-induced lung injury in mice and its possible mechanism.Methods:A total of 72 mice were randomly divided into 4 groups by the random number table method: healthy control group (NC group, n=12), crizotinib-only group (CRZ group, n=12), radiotherapy-only group (RT group, n=24), and radiotherapy pluscrizotinib group (RT+ CRZ group, n=24). The whole lungs were exposed to a single dose of 12 Gy X-rays. Lung tissue and bronchoalveolar lavage fluid (BALF) were obtained at 1, 2, 4, and 8 weeks after radiotherapy. The total number of nucleated cells was counted under a light microscope, and the total protein content of BALF was detected by bicinchoninic acid (BCA) protein assay. The pathological changes of lung tissue were observed by HE staining and MASSON staining. The expressions of TGF-β1 and ICAM-1 mRNA in lung tissue were detected by real-time quantitative polymerase chain reaction (qPCR), the locations and expressions of MPO and ICAM-1 proteins were observed by immunohistochemical staining, and the expressions of TGF-β1, Smad3, p-Smad3 and ICAM-1 proteins in lung tissue were detected by Western blot. Results:At different time points after irradiation, the pathological manifestations such as inflammation and exudation of lung tissue in the RT+ CRZ group were significantly increased, and the total number of cells and protein content in BALF was higher than that of the other three groups, compared with RT group, the difference was statistically significant at 4 week ( t=-5.031, -2.814, P<0.05). Compared with RT group, the expressions of ICAM-1 and TGF-β1 mRNA in lung tissue of the RT+ CRZ group were significantly increased, while the expression of TGF-β1 increased significantly at 1, 4 and 8 weeks after irradiation ( t=-2.687, -7.032, -5.221, P<0.05), and the expression of ICAM-1 increased significantly at 2 and 4 weeks after irradiation ( t=-4.819, -6.057, P<0.05). The expressions of these two gradually increased from 1 to 4 weeks and peaked in 4 weeks, then decreased at 8 weeks. At the same time, the trend of the expression of MPO mRNA was consistent with ICAM-1 and TGF-β1. At 4 week, there was no difference in the expression of Smad3 protein in these four groups ( P>0.05). The expressions of TGF-β1, p-Smad3, ICAM-1 and p-Smad3/Smad3 proteins of the RT+ CRZ group were all higher than those of the other three groups ( F=14.74, 10.03, 35.29, 22.94, P<0.05). Conclusions:Crizotinib combined with radiotherapy can aggravate acute radiation-induced lung injury, which may due to the increase of ICAM-1 expression by up-regulating the TGF-β1 signaling pathway.
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@#<b>Objective</b> To investigate the role of complement in radiation-induced lung injury in mice after chest irradiation with <sup>60</sup>Co γ-rays at a single dose of 20 Gy. <b>Methods</b> C57BL/6 mice underwent chest irradiation with <sup>60</sup>Co γ-rays at a single dose of 20 Gy, followed by observation for the inflammatory reaction of the lung tissue in the early stage (within 15 d) and pulmonary fibrosis in the later stage (30 and 180 d). Enzyme-linked immunosorbent assay was used to measure the levels of C2, C3a, C4, and C5b-9 in the lung tissues at 1, 3, 7, 15, 30, and 180 d after irradiation. The expression of complement mRNA in BEAS-2B cells after irradiation was determined using RT-PCR. <b>Results</b> Radiation-induced lung injury in micepresented as inflammatory response in the early stage and fibrosis in the late stage. Complement C2, C4, and C5b-9 complexes were increased in the early period (3 or 7 d) after irradiation (<i>P</i> < 0.05), which might be associated with the inflammatory response induced by irradiation. During 3 to 180 d, complement C3a was significantly higher in the irradiated mice than in the control mice, suggesting a close relationship between C3a and radiation-induced lung injury. The irradiated cells showed increased mRNA expression of C2 and C3, with no changes in the mRNA levels of C4 and C5. <b>Conclusion</b> Different complement proteins have varying responses to radiation-induced lung injury, among which C3a is closely related to radiation-induced lung injury, suggesting that regulating C3a and its receptors may be a new way to prevent and treat radiation-induced lung injury.
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Objective To investigate the changes in the expression of cold-inducible RNA-binding protein (CIRBP) in a radiation-induced lung injury model. Methods Thirty male C57BL/6 mice were randomly divided by body weight into control group (no intervention) and model group (single chest X-ray irradiation with a dose of 20 Gy to build a radiation-induced lung injury model). The mice were dissected five weeks after irradiation. Hematoxylin-eosin staining and Masson staining were used to observe the pathological changes of the lung tissue and the deposition of collagen fibers. Immunohistochemistry was used to measure the expression of the inflammatory factors interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the lung tissue. qRT-PCR was used to measure the expression of CIRBP mRNA in the lung tissue. The expression of CIRBP protein in the lung tissue was determined by the immunofluorescence assay and Western blot. Results Compared with the control group, the model group showed significant pulmonary vascular congestion, significant inflammatory cell infiltration, significant thickening of some alveolar septa, significantly increased IL-6 expression [(129.41 ± 5.58) vs (187.22 ± 34.77), t = 3.179, P < 0.05], significantly increased TNF-α expression [(137.52 ± 23.53) vs (187.02 ± 19.16), t = 5.069, P < 0.05], significantly increased CIRBP mRNA expression [(1 ± 0.08) vs (1.97 ± 0.39), t = 3.45, P < 0.05], and significantly increased CIRBP protein expression [(9.32 ± 1.26) vs (14.76 ± 1.61), t = 3.751, P < 0.05], by the immunofluorescence assay; [(1.13 ± 0.17) vs (1.49 ± 0.14), t = 2.819, P < 0.05], by Western blot). Conclusion The expression of CIRBP is significantly increased in the radiation-induced lung injury model, which may be an important pro-inflammatory factor in radiation-induced lung injury.
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Radiation-induced lung injury is a common complication of thoracic malignant tumor radiotherapy and severe nuclear accident injury. Currently, there is no effective treatment on this injury. Mesenchymal stem cells (MSCs) are a group of cells with multi-directional differentiation potential and they can protect lung tissue from radiation damage by homing to the injured site and differentiating to the damaged tissues, secreting cytokines and immune regulation. Further, the genetically modifying mesenchymal stem cells have not only the main characteristics of MSCs, but also can efficiently and stably express or knock down a certain of target genes, thereby enhancing or reducing the sensitivity of mesenchymal stem cells to various physiological stimulus and enhancing its therapeutic effect in radiation-induced lung injury, providing new ideas and new strategies for clinical treatment. This paper reviewed the relevant research progress in recent years.
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OBJECTIVES@#To analyze the differentially expressed genes (DEGs) with radiation-induced rat lung injury, and to reveal the protective mechanism for mild hypothermia in the radiation-induced lung injury in rats at the transcriptome level.@*METHODS@#A total of 10 male SD rats aged 6-8 weeks were randomly divided into 2 groups to establish a rat model of radiation-induced lung injury, and one group was treated with mild hypothermia. RNA was extracted from left lung tissue of each group, and sequenced by BGISEQ-500 platform. Significance analysis of DEGs was carried out by edgeR software. Gene ontology (GO) function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were used to analyze the gene function. Then 5 key DEGs were verified by real-time reverse transcription PCR (real-time RT-PCR).@*RESULTS@#There were 2 790 DEGs (false discovery rate<0.001, |log@*CONCLUSIONS@#The DEGs and pathways related to mild hypothermia protection against radiation-induced lung injury in rats are obtained, which provides an experimental basis for the protection of mild hypothermia against radiation-induced lung injury.
Subject(s)
Animals , Male , Rats , Gene Expression Profiling , Hypothermia , Lung Injury , RNA-Seq , Rats, Sprague-Dawley , TranscriptomeABSTRACT
Radiation-induced lung injury (RILI), including acute radiation pneumonitis and chronic radiation-induced pulmonary fibrosis (RIPF), is a side effect of radiotherapy for lung cancer and esophageal cancer. Pulmonary macrophages, as a kind of natural immune cells maintaining lung homeostasis, play a key role in the whole pathological process of RILI. In the early stage of RILI, classically activated M1 macrophages secrete proinflammatory cytokines to induce inflammation and produce massive reactive oxygen species (ROS) through ROS-induced cascade to further impair lung tissue. In the later stage of RILI, alternatively activated M2 macrophages secrete profibrotic cytokines to promote the development of RIPF. The roles of macrophage in the pathogenesis of RILI and the related potential clinical applications are summarized in this review.
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Humans , Lung/radiation effects , Lung Injury/physiopathology , Macrophages/metabolism , Radiation Injuries , Radiation Pneumonitis/etiology , Radiotherapy/adverse effectsABSTRACT
Objective@#To evaluate the incidence and risk factors of symptomatic radiation-induced lung toxicity (SRILT) in non-small cell lung cancer (NSCLC) patients treated with modern radiotherapy after surgery.@*Methods@#Clinical data of consecutive NSCLC patients treated with postoperative three-dimensional conformal or intensity-modulated radiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences between November 2002 and December 2011 were retrospectively analyzed. According to the Common Terminology Criteria for Adverse Events (CTCAE, version 3.0), SRILT was defined as ≥grade 2 radiation-induced lung toxicity. Potential clinical risk factors and dosimetric parameters for SRILT were evaluated using logistic regression model.@*Results@#Among 227 enrolled patients, 190 cases underwent lobectomy and 37 patients received pneumonectomy. Twenty-three patients (10.1%) developed SRILT after lobectomy. Seventeen patients experienced grade 2 SRILT, 5 cases of grade 3 SRILT and 1 case of grade 4 SRILT. Univariate analysis showed that postoperative concurrent chemoradiotherapy, relatively large PTV, mean lung dose and V20- V40 were significantly correlated with the incidence of SRILT (P=0.015, 0.048 and<0.001). Multivariate analysis demonstrated that postoperative concurrent chemoradiotherapy and V20 were significantly associated with the incidence of SRILT (P=0.017 and P=0.009).@*Conclusions@#The incidence of SRILT is relatively low in NSCLC patients after postoperative radiotherapy. Concurrent chemoradiotherapy and V20 are risk factors of SRILT.
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Objective To evaluate the incidence and risk factors of symptomatic radiation-induced lung toxicity (SRILT) in non-small cell lung cancer (NSCLC) patients treated with modern radiotherapy after surgery.Methods Clinical data of consecutive NSCLC patients treated with postoperative three-dimensional conformal or intensity-modulated radiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences between November 2002 and December 2011 were retrospectively analyzed.According to the Common Terminology Criteria for Adverse Events (CTCAE,version 3.0),SRILT was defined as ≥ grade 2 radiationinduced lung toxicity.Potential clinical risk factors and dosimetric parameters for SRILT were evaluated using logistic regression model.Results Among 227 enrolled patients,190 cases underwent lobectomy and 37 patients received pneumonectomy.Twenty-three patients (10.1％) developed SRILT after lobectomy.Seventeen patients experienced grade 2 SRILT,5 cases of grade 3 SRILT and 1 case of grade 4 SRILT.Univariate analysis showed that postoperative concurrent chemoradiotherapy,relatively large PTV,mean lung dose and V20-V40 were significantly correlated with the incidence of SRILT (P=0.015,0.048 and＜0.001).Multivariate analysis demonstrated that postoperative concurrent chemoradiotherapy and V20 were significantly associated with the incidence of SRILT (P =0.017 and P =0.009).Conclusions The incidence of SRILT is relatively low in NSCLC patients after postoperative radiotherapy.Concurrent chemoradiotherapy and V20 are risk factors of SRILT.
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Radiotherapy is an important treatment for lung cancer. However,the radiation-induced lung injury(RILI)affects some patients and also affects the efficacy of treatment. Therefore,it is very important to identify high-risk patients who may have RI-LI and take action intervention or monitoring. Although the individual difference is often explained by clinical and dosimetric,genetic factors also influence the occurrence of RILI. Currently,there are reports on the relationship between single nucleotide polymorphism (SNP)and RILI. The SNP of these specific genes may become an important predictor of RILI,and thus reduce the incidence of radia-tion-induced lung injury.
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Objective To investigate the effects of G-CSF-mobilized autologous stem cells in the prevention of radiation pulmonary injury.Methods Mice were divided into control group,irradiation group and treatment group.Mouse model of pulmonary fibrosis was established by exposing chest to a single dose of 14 Gy.Animals in the treatment group received recombinant human G-CSF (250 μg/kg daily for 5 d) before the irradiation in order to mobilize autologous stem cells in vivo.The general condition and mortality were documented after radiation injury.The pathological study with histological scoring,Masson staining and Sirius red staining with polarized light analysis were used to identify lung injury and the potential benefit of stem cell mobilization.Results Local chest irradiation of a single dose of 14 Gy was a suitable dose to create radiation-induced pulmonary fibrosis in mice.The death rate was 37.5％,which mainly happened around 11 weeks after injury.In contrast,all of the animals in G-CSF treated group survived.The ratio of lung to body mass was significantly increased in both irradiation group and treatment group (F =23.20,P＜0.05) around 3 months after the injury,with a higher ratio in irradiation group than that in treatment group (P＜0.05).Histological scoring for alveolar inflammation at 3 months after injury revealed statistically significant difference in irradiation group and treatment group compared with control group (F=11.93,P＜ 0.05).At this time point,the pathological observation showed lung tissue degeneration and necrosis with alveolitis and interstitial inflammation,as well as fibroblasts proliferation and focal collagen deposition in alveolar septa.At 4 month after the injury,the inflammation ininterstitial tissue was receded,but fibrosis and collagen deposition were significantly increased.In addition,at 3 and 4 months afterinjury,the pulmonary fibrosis was aggravated in irradiation group (F=28.73,16.85,P＜0.05),and significantly alleviated in the treatment group (P＜0.05).The similar results were confirmed in collagen content analysis (IOD) by Sirius red staining and image analysis (F =17.70,17.79,P＜ 0.05).Conclusions Autologous mobilization of stem cells could prevent the death of radiation-injured animals possibly by alleviating early lung injury and interstitial inflammation as well as the late pulmonary fibrosis,suggesting a therapeutic potential of autologous stem cell mobilization in radiation pulmonary fibrosis.
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Objective To investigate the radioprotective function and its mechanism of miR-223 in acute radiation-induced lung injury in mice.Methods Forty female C57BL/6 J mice were randomly divided into healthy control group,irradiation group,irradiation plus miR-223 group and irradiation plus NC group.Radiation groups were exposed with a single dose of 15 Gy of 6 MV X-rays delivered by a linear accelerator.The mice in drug group were administered by tail vein injection with miR-223 agomir or agomirNC every other day from 1 d before irradiation to 14 d after irradiation.The lung tissue samples of mice were taken at 14 d post-irradiation.The pathological changes were observed by HE staining.The localization and expressions of IL-1β and IL-18 were observed by immunohistochemistry (IHC).Real-time PCR was used to detect miR-223,but NLRP3 mRNA expression in lung tissue.Western blot was used to detect the protein expressions of NLRP3 and Caspase-1,and ELISA assay was used to detect the expressions of IL-1β and IL-18 in lung homogenate.Results Radiation decreased the expression of miR-223,but increased the expression of NLRP3 in lung tissue.Administration of miR-223 agomir inhibited the expression of NLRP3 and attenuated lung inflammation.HE and IHC staining showed that miR-223 reduced the acute inflammatory response and the expressions of IL-1β and IL-18 in lung tissue compared with irradiation group (t=10.16,6.00,P＜0.05).The expressions of NLRP3 and Caspase-1 protein in lung tissue of irradiated plus miR-223 group was lower than that in the irradiation alone group (t =12.47,4.95,P＜ 0.05).ELISA assay also showed a decrease of inflammatory factors IL-1β and IL-18 in lung tissue homogenate of the irradiation plus miR-223 group (t =8.22,8.47,P＜0.05).Conclusions MiR-223 effectively reduces the secretion of radiation-induced inflammatory factors IL-1β and IL-18 by inhibiting the expression of NLRP3 in lung tissue of mice,and thus has protective effect on radiation-induced lung injury.
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Radiation induced lung injury (RILI) is a serious complication in patients received thoracic radiotherapy. The main clinical symptom of RILI includes short of breath, low fever and cough, seriously affect the survival of patients. How to better prevent and treat RILI is an urgent problem. Target theory, cytokine theory, free radical theory, and vascular endothelial cell damage theory are the main mechanisms of RILI. Among them, reactive oxygen species (ROS) produced during radiotherapy can induce tissue damage throughout the course of RILI, and have a direct effect on both radiation pneumonitis and radiation-induced lung fibrosis. Anti-oxygen therapy including thiol compounds, antioxidant enzymes, and plant antioxidants have been applied in the prevention and treatment of RILI. This article reviews the research and application of antioxidant therapy in RILI. .
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Radiation-induced lung injury (RILI) is a common complication after radiotherapy for thoracic tumors.It is one of the most urgent problems to explore the optimal animal model and evaluate the effect for basic research and drug intervention along with the extensive studies of radiation pneumonia.By reviewing the literatures published in recent 10 years,the selection of irradiation site,determination of irradiation dosage,irradiation method and effect evaluation were statistically compared among different RILI animal models,aiming to explore a stable method of establishing the animal model with RILI and identify a definite effect mechanism.It provides a reliable approach for basic research and drug development to prevent and mitigate the incidence and development of RILI.
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Objective To externally validate the accuracy of combined use of neutrophil-lymphocyte ratio (NLR),V20,and Dmean in predicting the incidence of grade Ⅲ or higher radiation-induced lung injury (RILI) in lung cancer patients.Methods A total of 166 lung cancer patients,who participated in the model establishment were selected into the internal validation group,and 85 lung cancer patients who received intensity-modulated radiotherapy in our department between June 2016 and June 2018 were assigned into the external validation group.The incidence rate of grade 3 or higher RILI was statistically compared between the internal and external validation groups.Multivariate logistic analysis was performed for NLR,V20 and Dmean The discrimination degree of the predictive model was evaluated by using ROC curve in combination with NLR,V20 and Dmean The calibration degree of the predictive model was assessed by Hosmer-Lemeshow test.Results The incidence rate of grade 3 or higher RILI in the internal and external validation groups was 23.8％ and 22.9％.Multivariate logistic analysis demonstrated that NLR,V20 and Dmean significantly differed in the internal validation group (P=0.032,0.006 and 0.005).However,only V20 significantly differed in the external validation group (P=0.038).The discrimination and calibration degree of RILI was almost consistent between the internal and external validation groups (both P＞0.05).The area under the curve (AUC) predicted by NLR,V20,Dmean and the combination of three indexes were 0.611,0.646,0.682 and 0.775 in the internal validation group,and 0.544,0.702,0.658 and 0.754 in the external validation group,respectively.The calibration degree in the internal validation group was P=2.797and 0.834,P=2.452 and 0.653 in the external validation group.Conclusion Combined application of NLR,V20 and Dmean can accurately predict the incidence of grade Ⅲ or higher RILI in lung can cancer patients,which has been validated by external dataset.