Radiotherapy and immune response: the systemic effects of a local treatment

Technological developments have allowed improvements in radiotherapy delivery, with higher precision and better sparing of normal tissue. For many years, it has been well known that ionizing radiation has not only local action but also systemic effects by triggering many molecular signaling pathways. There is still a lack of knowledge of this issue. This review focuses on the current literature about the effects of ionizing radiation on the immune system, either suppressing or stimulating the host reactions against the tumor, and the factors that interact with these responses, such as the radiation dose and dose / fraction effects in the tumor microenvironment and vasculature. In addition, some implications of these effects in cancer treatment, mainly in combined strategies, are addressed from the perspective of their interactions with the more advanced technology currently available, such as heavy ion therapy and nanotechnology.

Enhancement of radiation induced cell death in chicken B lymphocytes by withaferin A.

Withaferin A (WA), a plant withanolide, has shown significant radiosensitizing effect in vitro and in vivo. Inhibition of DNA repair has been suggested as a mechanism of radiosensitization by WA. To test this, the effect of withaferin A on survival of DT40 chicken B-lymphocyte cell line and its repair deficient single gene mutants Rad54-/-, Ku70-/- and double mutant Ku70-/- /Rad54-/- after irradiation was studied. Exponentially growing cells were treated for 1 hr with 5 microM WA and then exposed to different doses of X-rays. Cell survival was studied by clonogenic assay. WA significantly reduced survival of DT40, Ku70-/- and Ku70-/- /Rad54-/-, but not Rad54-/- cells, suggesting that WA enhances radiosensitivity by interfering with homologous repair, the major pathway of DSB repair in these cells. Inhibition of DNA repair is further indicated in a significant decrease in surviving fraction of DT40 cells by post-irradiation incubation with WA. This could have relevance to cancer radiotherapy.

Effect of ionizing radiation on rat parotid gland

A common side effect of radiotherapy used in the treatment of oral cancer is the occurrence of structural and physiological alterations of the salivary glands due to exposure to ionizing radiation, as demonstrated by conditions such as decreased salivary flow. The present study evaluated ultrastructural alterations in the parotid glands of rats receiving a fractionated dose (1,500-cGy) of radiation emitted by a Cesium-137 source and rats that were not subjected to ionizing radiation. After sacrifice, the parotid glands were removed and examined by transmission electron microscopy. Damage such as cytoplasmic vacuolization, dilatation of the endoplasmic reticulum and destruction of mitochondria, as well as damage to the cellular membrane of acinar cells, were observed. These findings lead to the conclusion that ionizing radiation promotes alterations in the glandular parenchyma, and that these alterations are directly related to the dose level of absorbed radiation. Certain phenomena that appear in the cytoplasm and nuclear material indicate that ionizing radiation causes acinar cell death (apoptosis).

Um efeito colateral comum da radioterapia usada no tratamento de câncer na cavidade oral é a ocorrência de alterações estruturais e fisiológicas sobre as glândulas salivares por exposição à radiação ionizante, como demonstrada em situações com decréscimo do fluxo salivar. O presente estudo teve por objetivo avaliar as alterações ultra-estruturais de glândulas parótidas de ratos que receberam uma dose fracionada (1500 - cGy) de radiação emitida por uma fonte de Césio 137 e ratos que não receberam a radiação ionizante. Após o sacrifício, as glândulas parótidas foram removidas e examinadas por microscopia eletrônica de transmissão. Lesões das organelas citoplasmáticas, como dilatação do retículo endoplasmático, destruição das mitocôndrias e formação das vacuolizações citoplasmáticas, além de lesão da membrana celular das células acinares foram observadas. Portanto, a radiação ionizante promove alterações no parênquima glandular, o que está diretamente relacionado com a dose de radiação absorvida. Determinados fenômenos que surgem no citoplasma e material nuclear são indicadores de que a radiação ionizante leva a célula acinar a morte programada (apoptose).