Critical volume model analysis of lung complication data from different strains of mice.

The critical volume (CV) normal tissue complication probability (NTCP) model was used to fit experimental data on radiation pneumonitis in mice to test the model and determine the values of the model parameters characterizing the lung structure: relative critical volume and cell radiosensitivity. The entire lungs of mice from ten different strains were irradiated acutely and homogeneously to different doses. The experimental animals from the different strains expressed different radiation sensitivities, forming ten well-defined dose-response curves. The most widely accepted biological NTCP model (the individual CV NTCP) readily applicable to cases of acute uniform irradiation was used to fit all the individual dose-response curves simultaneously. To account for the apparent difference in the response of the different strains, it was assumed that the strains differed in their (cell) radiosensitivity. The maximum likelihood method of fitting was used. The obtained fit was statistically highly acceptable. The best-fit value of the relative critical volume, mu, was 78%, which is extremely close to the histologically observed value of around 72%. The values of radiosensitivity, alpha, ranged between 0.26 and 0.37 Gy(-1) for the different strains. The best-fit numbers of functional subunits (FSU) constituting the lung, N, and the number of cells in an FSU, N(o), were implausibly low: N = 9 and N(o) = 23, respectively. The best-fit value of N(o)N was a very small number that was unlikely to correspond to the total number of cells comprising the lung, suggesting that a different interpretation of N and N(o) was required. The individual CV model provided a simultaneous description of the individual responses of different mouse strains through assumed interindividual variability in alpha only. A new interpretation is given to the entities corresponding to N(o) and N. N(o)N is interpreted as the number of certain elementary structures. These structures are considered to be equivalent to the classical functional subunit, which is much larger than a cell and plays a fundamental role in determining the radiation response of the organ. N is identified as the number of the few large subdivisions of the lungs, M = microN is the number that have to be damaged for the lung to fail. N(o) is interpreted as the mean number of elementary structures (FSU) per large subdivision. This imposes a picture of damage to large, contiguous subdivisions containing many FSU, which is consistent with the histological appearance of the lungs of mice in respiratory distress. This picture is in marked contrast to the random distribution of small areas of damage expected for the small size of an FSU. This random distribution is characteristic of earlier stages of the development of radiation pneumonitis, suggesting that some additional process spreads injury from damaged FSU to adjacent, undamaged FSU during the terminal phase.

Immunohistochemical localization of transforming growth factor beta and tumor necrosis factor alpha in the lungs of fibrosis-prone and "non-fibrosing" mice during the latent period and early phase after irradiation.

To evaluate the possibility that TGF-beta and TNF-alpha are involved in fibrosis induced in mouse lung by irradiation, the proportion of cells immunoreactive for each was compared in two strains of mice. C3HeB/FeJ mice develop only classical pneumonitis during the early phase, whereas C57L/J mice develop small, tightly packed areas of inflammation which undergo fibrosis during the latent period, and exhibit progressive fibrosis of large regions of intense inflammation during the early phase. Very few cells were immunoreactive for an antibody to the latency-associated peptide (LAP) of TGF-beta during the latent period in C3HeB/FeJ mice, and no cells were positive during the early phase. In contrast, between 0.7 and 10% of cells were positive in C57L/J mice in lesions without fibrosis and in lesions in the early stages of fibrosis. Fibroblasts positive for LAP were seen only in lesions containing fibrosis. A similar pattern of immunoreactivity was seen in C57L/J mice using an antibody which recognizes active TGF-beta, with the exception that positive fibroblasts were observed within areas of inflammation without fibrosis. Thus the association of active TGF-beta with fibroblasts might be a characteristic of the initiation of fibrosis in this model. TNF-alpha was detected in macrophages in all classes of lesions, and minor differences between the strains did not appear to be biologically meaningful.

A comparison of the ultrastructure of perfusion-deficient and functional lung parenchyma in CBA mice during the late phase after irradiation.

The ultrastructure of lung parenchyma of CBA/J mice 1 year after 14 Gy X irradiation was studied by transmission electron microscopy (TEM) and compared with the ultrastructure of age-matched control mice. The irradiated mice had received an injection of colloidal carbon just prior to death to identify patent capillaries. Regions containing carbon were compared by TEM with apparently nonperfused areas lacking carbon. The interalveolar interstitial tissue and the capillary endothelium were not different ultrastructurally in perfused and nonperfused regions. There were no appreciable differences between irradiated and unirradiated lung, except for small, infrequent focal areas with a slight increase in the number of collagen fibers. The ultrastructural examination did not reveal any lesion which might have been missed in the preliminary light microscope studies, which confirms that the lack of perfusion in CBA/J mice which have an appreciable respiratory functional deficit in the late phase is not due to the loss of patent capillaries or to fibrosis of the alveolar wall. It was concluded that the lesion must be at the "pre-capillary" level, probably damage to or loss of small blood vessels.

Evidence for two patterns of inheritance of sensitivity to induction of lung fibrosis in mice by radiation, one of which involves two genes.

We showed previously that autosomal recessive determinants control the development of pulmonary fibrosis in mice during the early and late phases after irradiation. The extent of fibrosis was inversely correlated with the intrinsic lung activity of both plasminogen activator (PLA) and angiotensin-converting enzyme (ACE). To test these observations further, two groups of mice were given a dose of 15 Gy to the thorax: offspring of a backcross between C57L/J ("fibrosing mice") and the F1 of CBA/J ("non-fibrosing in the early phase") x C57L/J, and additional F1 individuals of CBA/J x C57L/J. Mice were euthanized upon developing a substantial respiratory deficiency (50% reduction in carbon monoxide uptake) during the early phase (14-25 weeks postirradiation). Seventeen mice from the backcross were heavily fibrosed, 38 were classed as intermediate, and 15 contained no fibrosis. No evidence of sex linkage was seen. These data strongly support our earlier conclusions and suggest that two autosomal genes which function additively determine the extent of the principal type of fibrosis in these strains. As no indication of a bimodal distribution of lung PLA or ACE activity was obtained, it is unlikely that one of the genes controls the level of either enzyme. The F1 mice unexpectedly showed small amounts of an unusual type of fibrosis which was not associated with hyaline material or fibrin deposits, in contrast to all previous reports of fibrosis during the early phase in mice. Similar, fibrin-free fibrosis was found during the early phase in mast cell-deficient WBB6F1/J mice (and their normal siblings). In the F1 mice this unusual fibrosis appears to be regulated independently by two additional genes, one of which is sex-linked.

Development of fibrosis after lung irradiation in relation to inflammation and lung function in a mouse strain prone to fibrosis.

The development of lung fibrosis after single-dose thoracic irradiation was studied histologically in C57L/J male mice. Lung function was monitored using uptake of carbon monoxide. During the latent period (prior to 15 weeks postirradiation) mice were chosen at random, while during the early phase (15-22 weeks) mice were sacrificed when they developed a functional deficit of at least 50%. Excess mice with a deficit of 50% in the early phase were followed into the late phase and sacrificed at 31 or 40 weeks. Two scoring methods were used to quantify lung damage. Fibrotic lesions and foci of inflammation were counted for the latent period, and the proportion of nonfunctional acini was determined for the early and late phases. After a dose 1 Gy less than the LD50/180, small regions of mild inflammatory infiltration appeared at 6 weeks, and small, focal fibrotic lesions containing numerous macrophages appeared at 8 weeks postirradiation. The number of fibrotic lesions increased steadily during the latent period in a manner that is consistent with conversion of inflammatory lesions to foci of fibrosis. Mice sacrificed upon developing a 50% functional deficit during the early phase had approximately equal proportions of lung affected by fibrosis and inflammation. Those mice which developed a similar respiratory deficit in the early phase and were followed into the late phase usually showed little change in lung function. However, when sacrificed at 31 weeks they had twice as much fibrosis and very little inflammation, suggesting that the inflammatory lesions had become fibrosed. The average number of macrophages per unit area of fibrosis declined during the latent period and changed little during the early and late phases. Lymphocytes and mast cells were also quantified in fibrosed regions.

Assessment of radiation-induced lung injury in mice using carbon monoxide uptake: correlation with histologically visible damage.

Carbon monoxide uptake is a sensitive measure of lung injury, but its application to mice using the rebreathing technique has produced a nonlinear dependence of carbon monoxide uptake on mouse weight, in contrast to the linear relationship obtained in larger rodents using the single-breath technique. Improvements were made to the equipment and the procedures used in the rebreathing technique which resulted in linear relationships between uptake and weight in three mouse strains, CBA/J, C57BL/6J, and C57L/J. Sequential measurements were made on mice during the early and intermediate phases after irradiation of the thorax which demonstrated the development of injury in individual mice with considerable sensitivity. Estimates of the proportion of lung which was considered to be nonfunctional based on its histological appearance were obtained using alveolar ducts as sampling markers in 64 C57L/J mice between 10 and 31 weeks after irradiation. The deficit in carbon monoxide uptake was determined on the day of sacrifice for each mouse, and the results showed good correspondence to the histological estimate of the extent of damage. The correspondence between breathing rate elevation and the histological assay was not as good.

The genetic basis of strain-dependent differences in the early phase of radiation injury in mouse lung.

Substantial differences between mouse strains have been reported in the lesions present in the lung during the early phase of radiation injury. Some strains show only classical pneumonitis, while other strains develop substantial fibrosis and hyaline membranes which contribute appreciably to respiratory insufficiency, in addition to pneumonitis. Other strains are intermediate between these extremes. These differences correlate with intrinsic differences in activities of lung plasminogen activator and angiotensin converting enzyme. The genetic basis of these differences was assessed by examining histologically the early reaction in lungs of seven murine hybrids available commercially after whole-thorax irradiation. Crosses between fibrosing and nonfibrosing parents were uniformly nonfibrosing, and crosses between fibrosing and intermediate parents were uniformly intermediate. No evidence of sex linkage was seen. Thus the phenotype in which fibrosis is found is controlled by autosomal recessive determinants. Strains prone to radiation-induced pulmonary fibrosis and hyaline membranes exhibited intrinsically lower activities of lung plasminogen activator and angiotensin converting enzyme than either the nonfibrosing strains or the nonfibrosing hybrid crosses. The median time of death of the hybrids was genetically determined primarily by the longest-lived parent regardless of the types of lesions expressed.

Radiation-induced pulmonary endothelial dysfunction and hydroxyproline accumulation in four strains of mice.

C57BL mice exposed to 14 Gy of whole-thorax irradiation develop significant histologic lung fibrosis within 52 weeks, whereas CBA and C3H mice do not exhibit substantial fibrosis during this time. The purpose of the present study was to determine whether this strain-dependent difference in radiation histopathology is associated with genetic differences in pulmonary endothelial metabolic activity or in endothelial radioresponsiveness. C57BL/6J, C57BL/10J, CBA/J, and C3H/HeJ mice were sacrificed 12 weeks after exposure to 0 or 14 Gy of 300-kV X rays to the whole thorax. Lung angiotensin converting enzyme (ACE) activity and plasminogen activator (PLA) activity were measured as indices of pulmonary endothelial function; and lung hydroxyproline (HP) content served as an index of pulmonary fibrosis. Lung ACE and PLA activities in sham-irradiated C57BL/6J and CB57BL/10J mice were only half as high as those in sham-irradiated CBA/J and C3H/HeJ mice. Exposure to 14 Gy of X rays produced a slight but nonsignificant reduction in lung ACE and PLA activity in the C57BL strains, and a significant reduction in the CBA/J and C3H/HeJ mice. Even after 14 Gy, however, lung ACE and PLA activities in CBA/J and C3H/HeJ mice were higher than those in sham-irradiated C57BL/6J and C57BL/10J mice. Lung HP content in all four strains increased significantly after irradiation, but this increase was accompanied by an increase in lung wet weight. As a result, HP concentration (per milligram wet weight) remained constant or increased slightly in both C57BL strains and actually decreased in the CBA/J and C3H/HeJ mice. These data demonstrate significant genetic differences in both intrinsic pulmonary endothelial enzyme activity and endothelial radioresponsiveness among the four strains of mice. Specifically, strains prone to radiation-induced pulmonary fibrosis (C57BL/6J, C57BL/10J) exhibit only half as much lung ACE and PLA activity as do strains resistant to fibrosis (CBA and C3H).

A quantitative histological study of strain-dependent differences in the effects of irradiation on mouse lung during the early phase.

Strain differences in the radiation response of mouse lung during the early phase (before 28 weeks postirradiation) were investigated histologically. The nine strains tested were divided into three groups on the basis of the nature of the edema present, the occurrence of hyaline membranes, and the presence of fibrosis. Group 1 mice, three C57 strains, developed hyaline membranes, focal fibrosis, and a protein-rich edema containing fibrin. Group 3, CBA and two C3H strains, had only a protein-poor edema with little fibrin and developed no visible fibrosis. Group 2 mice had both types of edema and small quantities of focal fibrosis. The degree of lung impairment in mice dying of respiratory insufficiency was assessed by scoring lung acini as nonfunctional or open and presumably functional. Over 70% of acini were nonfunctional as a result of airflow obstruction. This was considered sufficient to account for death. Carbon perfusion immediately before sacrifice indicated that all types of lesions were at least partially perfused with blood. Pleural effusions were found in some individuals of two strains. The proportion of nonfunctional acini was similar in mice of the same strain with and without effusions, which would not be expected if the effusions contributed appreciably to respiratory distress in the early phase.

A quantitative histological study of strain-dependent differences in the effects of irradiation on mouse lung during the intermediate and late phases.

Strain differences in the intermediate and late phases of the radiation response of mouse lung were investigated histologically. The proportion of lung impairment in mice at 28 and 52 weeks postirradiation and in mice dying of respiratory insufficiency was assessed by scoring lung acini as nonfunctional due to lesions which obstructed airflow, or open and presumably functional. The nine strains tested were divided into three groups on the basis of the late fibrotic response. Group 1 mice, three C57 strains, developed extensive contracted fibrosis and usually showed enough damage to explain late deaths. Group 2, SWR, A, and BALB/c strains, developed foci of contracted fibrosis. Group 3, CBA and two C3H strains, did not form fibrotic scars. Mice in Groups 2 and 3 that died with no pleural effusions appeared to have insufficient late lung damage to account for respiratory distress. Problems with pulmonary blood flow were indicated by evidence of loss of fine vasculature and right ventricular hypertrophy. In nondistressed, late-stage mice in Groups 2 and 3, loss of capillary perfusion in lung parenchyma free of obvious lesions was demonstrated by infusion of colloidal carbon. In one strain, A, an estimate of the proportion of nonperfused lung was made on distressed late-stage mice. Almost 50% of lung acini were nonfunctional as a result of nonperfusion, and an additional 9% of acini were nonfunctional due to lesions obstructing ventilation. It is suggested that nonperfusion of apparently normal lung acini is a major factor in late-phase deaths in those mouse strains which show little or no fibrosis.

Immunohistochemical quantitation of three collagen isotypes in perfused areas and nonperfused foci of the lungs of irradiated mice.

Collagen isotypes I, III, and IV were quantitated by video image analysis of fluorescent-antibody-stained lung tissue sections from control and irradiated C57L/J and BALB/c mice. The perfusion status of lungs was determined by injecting colloidal carbon into the hepatic vein immediately prior to sacrificing the animals. Well-perfused parenchymal regions turned black, whereas nonperfused areas remained pale. Previous histological studies indicated substantial differences in the types of lesions found in the lungs of these two strains. C57L/J mice develop extensive and persistent contracted fibrosis. In lung sections of C57L/J mice examined 28 weeks after a dose of 11 Gy X rays, all three collagen isotypes were significantly elevated to levels 37-51% higher than age-matched control values in perfused regions of lung. In nonperfused areas, which had the histological appearance of contracted scar tissue, the three collagen isotype levels were further elevated to values 83-90% greater than controls. This finding suggests that in C57L/J mice, an elevation of each or all of the three collagen isotypes to levels approximately 45% greater than controls is consistent with continued pulmonary function during the intermediate phase of lung damage, whereas areas of parenchyma containing isotype levels in excess of 185% of control values coincide with functionally deficient regions. BALB/cCr//Alt. mice examined 28 weeks subsequent to 14.5 Gy X rays had a variety of visible lesion, most of which were nonperfused. In addition, one-quarter of nonperfused acini had no visible lesion. In perfused areas, the three isotypes were increased to 119-132% of control levels, with a further, significant (P less than 0.05) increase to 128-144% of control values in nonperfused parenchyma. Nonperfused areas were not characterized by contracted fibrosis; however, it would appear that the threshold level for collagen elevation associated with functional compromise during intermediate phase lies in the region of 130%. For BALB/c/J mice, 1 year after 9 Gy X rays, perfused areas of lung contained control levels of the three collagen isotypes, while nonperfused areas had isotype levels 119-131% of control values. Two of seven animals died at 41 weeks, but we were unable to ascertain collagen levels, since the lungs were not infused with colloidal carbon.

Oxygen dependence of binding of misonidazole to rodent and human tumors in vitro.

Misonidazole, a 2-nitroimidazole, has been shown to form metabolically induced adducts to cellular molecules at a very high rate in the absence of oxygen, and this rate decreases substantially as the oxygen concentration increases. Thus, it has considerable potential as a marker for hypoxic, radiation resistant cells in tumors. The dependence of the rate of adduct formation (binding) on oxygen concentration was studied for EMT6/Ed, Walker 256, and Dunning R3327-AT rodent tumors and for two human colon carcinomas, a human melanoma, and a human breast carcinoma. Fragments of these tumors were incubated with [14C]- or [3H]misonidazole in vitro at several oxygen concentrations and the quantity of misonidazole bound was determined from autoradiographs as a function of distance from the surfaces of the fragments. The Km of binding inhibition (oxygen concentration for half-maximal binding) for the tumors varied by a factor of 10. The range was centered on the range of values reported for the Km of cellular radioresistance (oxygen concentration for half-maximal radioresistance). The patterns of binding at depth within the tumor fragments indicated that gradients of cellular waste products and nutrients other than oxygen had minimal effects on binding. All tumors were capable of metabolizing oxygen to levels sufficiently low to yield the maximal binding rate, but the distance of penetration of oxygen varied, indicating a range of at least 4 in rates of oxygen consumption. The ratio of misonidazole bound by stromal tissue versus tumor cells ranged from 0.9 for a colon tumor to 0.3 for a breast tumor. These properties of misonidazole binding indicate that it should be a good marker for radiobiological hypoxia in tumors, providing adequate controls can be performed.

The density of mouse lung in vivo following X irradiation.

The lungs of mice were irradiated with single X radiation doses of 5 to 14 Gy. Six weeks after irradiation, computed tomographic (CT) scans of the mice were performed at two-week intervals. Beyond 14 weeks after irradiation, the animals were scanned at 1-week intervals. The mice irradiated to 5 and 7 Gy exhibited no change in lung density, in comparison with the unirradiated lungs of control mice up to times of 48 weeks. The mice irradiated to doses of greater than 10 Gy exhibited marked increases in lung density at 15 weeks after irradiation. Increases in density followed a similar time course for these doses, but the magnitude of the density increase was dependent on the radiation dose. An interpretation of these findings in terms of radiation pneumonitis is presented, and the possibility of using CT to monitor lung density in radiotherapy patients is discussed.

Irradiation of mouse lungs causes a dose-dependent increase in lung weight.

The lungs of Balb/c mice were irradiated with doses of 200 to 1300 rad and excised and weighed three days to 20 weeks later. In all cases the wet weights were increased relative to unirradiated controls. The weight increases were dose-dependent up to 1000 rad. The largest weight increase was 28%. Comparison of the wet and dry weights of irradiated and control lungs indicated that the material responsible for the weight increase was intermediate in water content between normal lung tissue and plasma, whereas the water content of pulmonary edema fluid produced by adrenalin injection was similar to plasma. Protection of the mediastinum during irradiation did not affect the weight increase appreciably.