Dose limits for occupational exposure to ionising radiation and genotoxic carcinogens: a German perspective.

This paper summarises the view of the German Commission on Radiological Protection ("Strahlenschutzkommission", SSK) on the rationale behind the currently valid dose limits and dose constraints for workers recommended by the International Commission on Radiological Protection (ICRP). The paper includes a discussion of the reasoning behind current dose limits followed by a discussion of the detriment used by ICRP as a measure for stochastic health effects. Studies on radiation-induced cancer are reviewed because this endpoint represents the most important contribution to detriment. Recent findings on radiation-induced circulatory disease that are currently not included in detriment calculation are also reviewed. It appeared that for detriment calculations the contribution of circulatory diseases plays only a secondary role, although the uncertainties involved in their risk estimates are considerable. These discussions are complemented by a review of the procedures currently in use in Germany, or in discussion elsewhere, to define limits for genotoxic carcinogens. To put these concepts in perspective, actual occupational radiation exposures are exemplified with data from Germany, for the year 2012, and regulations in Germany are compared to the recommendations issued by ICRP. Conclusions include, among others, considerations on radiation protection concepts currently in use and recommendations of the SSK on the limitation of annual effective dose and effective dose cumulated over a whole working life.

Radiobiology at the forefront: Hanns Langendorff and two of his disciples.

Hanns Langendorff (1902-1974) was an eminent radiobiologist and a visionary, who not only helped found the field, but also made significant scientific contributions. He was a member of the first editorial board of IJRB and actually published a paper in its first issue about the radio-protector 5-hydroxytryptamine. Langendorff started working in the field of radiobiology in 1929 and became director of the 'Radiologisches Institut' of Freiburg University in 1936. His studies impressively show the development of radiobiology over decades in areas such as radiation-induced cell death at various stages of development, as well as radiosensitivity of sea urchin, yeast and mammals. Using mice, Langendorff made many early discoveries about spermatogenesis, hematopoiesis, prenatal development, chromosomal damage and metabolic pathways after exposures to X-rays and neutrons. He also investigated aspects of target theory and dosimetry and developed personal dosimeters using films. After the atomic bomb catastrophes in Japan, Langendorff and his collaborators soon began research in mice related to acute radiation sickness and stimulated the development of radioprotectors by studying their mechanisms of action associated with cell death, as well as cellular and metabolic changes involved. Langendorff also trained a cadre of young scientists who advanced the field and brought it to its golden age in the seventies and the eighties. Research activities of two of his disciples are reviewed: Ulrich Hagen and the author. Both made significant contributions: Hagen mainly studying DNA-damage and repair in vitro as well in cells and the author investigating metabolic processes, cellular and chromosomal damage, prenatal effects, genomic instability, individual radio-sensitivity and their connections to cancer therapy.

Differential S-phase progression after irradiation of p53 functional versus non-functional tumour cells.

BACKGROUND: Many pathways seem to be involved in the regulation of the intra-S-phase checkpoint after exposure to ionizing radiation, but the role of p53 has proven to be rather elusive. Here we have a closer look at the progression of irradiated cells through S-phase in dependence of their p53 status. MATERIALS AND METHODS: Three pairs of tumour cell lines were used, each consisting of one p53 functional and one p53 non-functional line. Cells were labelled with bromodeoxyuridine(BrdU) immediately after irradiation, they were then incubated in label-free medium, and at different times afterwards their position within the S-phase was determined by means of flow cytometry. RESULTS: While in the p53 deficient cells progression through S-phase was slowed significantly over at least a few hours, it was halted for just about an hour in the p53 proficient cells and then proceeded without further delay or even at a slightly accelerated pace. CONCLUSIONS: It is clear from the experiments presented here that p53 does play a role for the progress of cells through the S-phase after X-ray exposure, but the exact mechanisms by which replicon initiation and elongation is controlled in irradiated cells remain to be elucidated.

G2-block after irradiation of cells with different p53 status.

BACKGROUND: Although it is clear that functional p53 is not required for radiation-induced G2 block, certain experimental findings suggest a role for p53 in this context. For instance, as we also confirm here, the maximum accumulation in the G2 compartment after X-ray exposure occurs much later in p53 mutants than in wild types. It remains to be seen, however, whether this difference is due to a longer block in the G2 phase itself. MATERIAL AND METHODS: We observed the movement of BrdU-labeled cells through G2 and M into G1. From an analysis of the fraction of labeled cells that entered the second posttreatment cell cycle, we were able to determine the absolute duration of the G2 and M phases in unirradiated and irradiated cells. RESULTS: Our experiments with four cell lines, two melanomas and two squamous carcinomas, showed that the radiation-induced delay of transition through the G2 and M phases did not correlate with p53 status. CONCLUSION: We conclude that looking at the accumulation of cells in the G2 compartment alone is misleading when differences in the G2 block are investigated and that the G2 block itself is indeed independent of functional p53.

Strong association between cancer and genomic instability.

After a first wave of radiation-induced chromosomal aberrations, a second wave appears 20-30 cell generations after radiation exposure and persists thereafter. This late effect is usually termed "genomic instability". A better term is "increased genomic instability". This effect has been observed in many cell systems in vitro and in vivo for quite a number of biological endpoints. The radiation-induced increase in genomic instability is apparently a general phenomenon. In the development of cancer, several mutations are involved. With increasing genomic instability, the probability for further mutations is enhanced. Several studies show that genomic instability is increased not only in the cancer cells but also in "normal" cells of cancer patients e.g. peripheral lymphocytes. This has for example been shown in uranium miners with bronchial carcinomas, but also in untreated head and neck cancer patients. The association between cancer and genomic instability is also found in individuals with a genetic predisposition for increased radiosensitivity. Several such syndromes have been found. In all cases, an increased genomic instability, cancer proneness and increased radiosensitivity coincide. In these syndromes, deficiencies in certain DNA-repair pathways occur as well as deregulations of the cell cycle. Especially, mutations are seen in genes encoding proteins, which are involved in the G(1)/S-phase checkpoint. Genomic instability apparently promotes cancer development. In this context, it is interesting that hypoxia, increased genomic instability and cancer are also associated. All these processes are energy dependent. Some strong evidence exists that the structure and length of telomeres is connected to the development of genomic instability.

Similar extent of apoptosis induction at doses of X-rays and neutrons isoeffective for cell inactivation.

BACKGROUND AND PURPOSE: The relative biological effectiveness (RBE) of neutrons differs for various biological endpoints, and for various cell and tissue types. With respect to the apoptosis induction, a whole range of values can be found in the literature, but the decisive factors are not clear. Most previous studies have used apoptosis-prone hematopoietic cells, whereas tumor cells have received little attention. The authors therefore decided to investigate apoptosis induction caused by X-rays and neutrons in a line of human melanoma cells, at doses which are isoeffective for the loss of colony-forming ability. MATERIAL AND METHODS: Human melanoma cells Be11, expressing p53 wild-type protein, were used throughout. Exponentially growing cells were exposed to two pairs of isoeffective doses (at surviving levels 10% and 1%) of 240-kV X-rays and 5.8-MeV neutrons. 1-8 days after irradiation, the frequency of apoptosis in adherent cells was assessed by two-parameter flow cytometric analysis with a DNA-dye-exclusion annexin-V-binding assay as well as by morphological examination with DAPI staining. RESULTS: Apoptosis was induced most significantly 6-7 days after irradiation. The time courses, as well as the magnitudes of apoptosis induction, after isoeffective doses of X-rays and neutrons with respect to loss of colony-forming ability appeared to be comparable. RBE values in the range of 4-5 were estimated for apoptosis 4-8 days after irradiation by both the annexin V assay and morphological examination. CONCLUSION: Radiation-induced apoptosis depends on ionization density in the same way as cell inactivation in general does, i.e., the RBE is similar, and the ratio of cells dying by apoptosis to cells dying otherwise does not depend on radiation quality.

Transgenerational transmission of radiation damage: genomic instability and congenital malformation.

The congenital malformation gastroschisis has a genetic disposition in the inbred mouse strain HLG/Zte. It is increased after preconceptional irradiation of males or females. Radiation exposures during the meiotic stages are most efficient. This malformation can also be induced by ionising radiation when the exposure takes place during the preimplantation period especially during the zygote stage. This latter effect can be transmitted to the next mouse generation. Other macroscopically visible or skeletal malformations are not significantly induced under these experimental conditions. These latter malformations are increased by radiation exposures during major organogenesis. The mechanisms for the development of the effects are different. Radiation exposure of the mouse zygote (1 to 3 hours p.c.) also leads to the induction of genomic instability in skin fibroblasts of the fetus. This phenomenon also occurs in a mouse strain (C57BL/6J) which is not susceptible to radiation-induced gastroschisis during the preimplantation period. The genomic instability is transmitted to the next mouse generation. During genomic instability chromatide breaks are dominating as in non-exposed cells. With respect to "spontaneous" malformations gastroschisis is dominating in HLG/Zte mice. Late radiation effects seem to have similar patterns as observed in non-exposed subjects, however, the rates are increased after irradiation.

Can tissue weighting factors be established for the embryo and fetus?

For the calculation of effective dose (E), tissue weighting factors (wT) are needed to represent the varying radiosensitivity of the tissues in the human body with respect to the induction of stochastic effects. The wT-values have been determined by the International Commission on Radiological Protection according to the stochastic detriment of human populations during their postnatal life. This study discusses whether these wT-values can also be used for the embryo/fetus. For this purpose, the epidemiological data and some results from animal experiments on carcinogenesis after prenatal radiation exposures have been reviewed. Most human data have been obtained from studies of childhood cancers (<19 y of age) after exposures during prenatal development. These tumours differ from those observed later in life after radiation exposures of children and adults. From animal data and more recent results from the atomic bomb survivors, it appears that not only childhood cancers but also cancers occurring during adulthood would have to be considered for the determination of possible wT-values after prenatal irradiation. From the present data it is concluded that sufficient data for defining wT-values following exposure of the embryo/fetus are not available at present.

Bystander effects, adaptive response and genomic instability induced by prenatal irradiation.

The developing human embryo and fetus undergo very radiosensitive stages during the prenatal development. It is likely that the induction of low dose related effects such as bystander effects, the adaptive response, and genomic instability would have profound effects on embryonic and fetal development. In this paper, I review what has been reported on the induction of these three phenomena in exposed embryos and fetuses. All three phenomena have been shown to occur in murine embryonic or fetal cells and structures, although the induction of an adaptive response (and also likely the induction of bystander effects) are limited in terms of when during development they can be induced and the dose or dose-rate used to treat animals in utero. In contrast, genomic instability can be induced throughout development, and the effects of radiation exposure on genome instability can be observed for long times after irradiation including through pre- and postnatal development and into the next generation of mice. There are clearly strain-specific differences in the induction of these phenomena and all three can lead to long-term detrimental effects. This is true for the adaptive response as well. While induction of an adaptive response can make fetuses more resistant to some gross developmental defects induced by a subsequent high dose challenge with ionizing radiation, the long-term effects of this low dose exposure are detrimental. The negative effects of all three phenomena reflect the complexity of fetal development, a process where even small changes in the timing of gene expression or suppression can have dramatic effects on the pattern of biological events and the subsequent development of the mammalian organism.

Analysis of the action of the restriction endonuclease AluI using three different comet assay protocols.

BACKGROUND AND PURPOSE: The comet assay offers the opportunity to measure the amount of DNA damage and the effectiveness of DNA repair in single cells. In a first part, experiments are presented comparing three different protocols of the comet assay technique with respect to the analysis of the induction of DNA damage after X-irradiation in isolated human lymphocytes and CHO cells. In a second part, the restriction enzyme AluI, an agent producing DNA double-strand breaks exclusively, was introduced into CHO cells by electroporation and the effects were analyzed using the different comet assay protocols. The experiments were carried out in order to test the assertion that comet assay techniques can measure different types of DNA damages at different pH conditions of lysis and electrophoresis. MATERIAL AND METHODS: Three different comet assay protocols were used for the analysis of DNA damage in lymphocytes and CHO cells. RESULTS: The results clearly indicate that among the three protocols the modified comet assay technique used by the authors showed the highest sensitivity in the radiotherapy-relevant dose range between 0 and 2 Gy. All three protocols were capable of detecting an effect by AluI. This effect, however, was clearly different from radiation effects. Whereas after radiation exposure all cell nuclei show a dose-dependent increase in DNA content in the comet tail, most of the cell nuclei were unaffected by an AluI uptake. Nevertheless, there was an effect by AluI that could be detected in all three assay versions: between 5% and 15% of the nuclei showed clearly abnormal comet morphologies. CONCLUSION: Neither the strictly alkaline nor the strictly neutral comet assay is applicable in the radiation dose range of about 2 Gy. The restriction enzyme results show that other factors than just DNA strand breaks contribute to DNA migration into the tail of the comets.

Perturbation of blood flow as a mechanism of anti-tumour action of direct current electrotherapy.

Anti-tumour effects of direct current electrotherapy are attributed to different mechanisms depending on the electrode configuration and on the parameters of electric current. The effects mostly arise from the electrochemical products of electrolysis. Direct toxicity of these products to tumour tissue is, however, not a plausible explanation for the observed tumour growth retardation in the case when the electrodes are placed into healthy tissue surrounding the tumour and not into the tumour itself. The hypothesis that the anti-tumour effectiveness of electrotherapy could result from disturbed blood flow in tumours was tested by the measurement of changes in blood perfusion and oxygenation in tumours with three different methods (in vivo tissue staining with Patent Blue Violet dye, polarographic oximetry, near-infrared spectroscopy). The effects induced by electrotherapy were evaluated in two experimental tumour models: Sa-1 fibrosarcoma in A/J mice and LPB fibrosarcoma in C57B1/6 mice. We found that perfusion and oxygenation were significantly decreased after electrotherapy. Good agreement between the results of different methods was observed. The effect of electrotherapy on local perfusion of tumours is probably the prevalent mechanism of anti-tumour action for the particular type of electrotherapy used in the study. The importance of this effect should be considered for the optimization of electrotherapy protocols in experimental and clinical trials. The non-invasive technique of near-infrared spectroscopy proved to be a reliable method for detecting perfusion and oxygenation changes in small solid tumours.

Effects of serum starvation on radiosensitivity, proliferation and apoptosis in four human tumor cell lines with different p53 status.

PURPOSE: The effects of serum starvation on radiation sensitivity, cell proliferation and apoptosis were investigated with particular consideration of the p53 status. MATERIAL AND METHODS: Four human tumor cell lines, Be11 (melanoma, p53 wild-type), MeWo (melanoma, p53 mutant), 4197 (squamous cell carcinoma, p53 wild-type) and 4451 (squamous cell carcinoma, p53 mutant), were used. After the cells had been incubated in starvation medium (0.5% FCS) for 1-6 days, changes in cell cycle distribution, induction of apoptosis and necrosis, and changes in radiation sensitivity were assessed by two-parameter flow cytometric measurements of DNA-dye-exclusion/Annexin V binding, and a conventional colony assay, respectively. RESULTS: p53 wild-type cell lines showed a decrease in the BrdU labeling index and an increase in the apoptotic cell frequency in starvation medium. p53 mutant cell lines showed a decrease in the BrdU labeling index but no evidence of apoptosis. These cells went into necrosis instead. The radiation sensitivity was increased in 4451 and slightly decreased in Be11 and 4197 in starvation medium. CONCLUSION: These data suggest a functional involvement of p53 in starvation-induced G1-block and apoptosis in tumor cells. Altered radiosensitivity after culture in starvation medium seemed to be explained at least in part by the starvation-induced G1-block. The frequency of starvation-induced apoptosis or necrosis was not correlated with radiation sensitivity.

Increased radiosensitivity with chronic hypoxia in four human tumor cell lines.

PURPOSE: It is well known that the radiosensitivity of tumor cells can be significantly reduced under hypoxic conditions. However, most of the reports in the literature refer to an experimental setup in which the supply of oxygen is kept low for a short period of time only. In tumors, chronic hypoxia would seem to be the more typical situation, because of an insufficient vascularization and the limited diffusion of oxygen into the tissue. Under such conditions, certain changes in the proliferation patterns of tumor cells, in which the cell cycle checkpoint protein p53 seems to play a role, have been shown to occur. We therefore decided to study radiosensitivity and cell cycle progression under conditions of chronic hypoxia in several human tumor cell lines differing in their p53 status. METHODS AND MATERIALS: Four human tumor cell lines (melanomas Be11 and MeWo and squamous carcinomas 4197 and 4451) were incubated for 3 h, 24 h, and 72 h under either oxic or hypoxic conditions and subsequently exposed to graded doses of X-rays. In some cases, cells were kept under hypoxia for the same periods of time, but then reoxygenated immediately before irradiation. Cell survival was assessed with the usual colony formation assay, and cell cycle distributions were determined by two-parameter flow cytometry after labeling with bromodeoxyuridine (BrdU). RESULTS: As expected, the oxygen enhancement ratio at 3 h was 2.0 or more in all cases. Differences, however, became evident with longer incubation times. At 24 h, the sensitivity of cells kept under hypoxic conditions both before and during irradiation was practically unchanged with cell lines Be11, 4197, and 4451, but clearly increased with MeWo. This resulted in an oxygen enhancement ratio of only 1.1 for the latter cell line when the sensitivity of aerated cells was used as reference. Cells kept under hypoxia for 24 h and reoxygenated shortly before irradiation, however, also showed an increase in sensitivity, so that the oxygen enhancement ratio based on differences in irradiation atmosphere alone was still around 2.0. At 72 h, the two p53 wild-type cell lines were not available for experiments, because they quickly degenerated under hypoxic conditions. Both mutant cell lines now showed similar results, the sensitivity being increased with irradiation under continued hypoxia as well as after reoxygenation. The oxygen enhancement ratios with reference to aerated cells were 1.3 and 1.5 for MeWo and 4451, respectively. Flow cytometric measurements after labeling with BrdU revealed that in all cell lines, the fraction of active S-phase cells during incubation tended to decrease under hypoxic conditions. Only in the p53 mutant cell lines, however, was this accompanied by an increase of the percentage of S-phase cells that were not actively incorporating BrdU. CONCLUSIONS: It is suggested that these quiescent cells in the S-phase compartment develop because of a general breakdown of cellular energy metabolism. In the p53 mutant cells, this may lead to a cessation of cell cycle progression in all phases alike, because checkpoint control has been lost; p53 wild-type cells, on the other hand, settle down preferentially in G(1) under the same conditions. Independently of the p53 status, however, energy depletion may be the cause of a decreased ability to cope with radiation damage and thus the cause of the observed increase in radiosensitivity. This would become more easily apparent in the p53 mutant cell lines, because they are less sensitive than the p53 wild types to hypoxia as such.