Mechanisms of cardiac radiation injury and potential preventive approaches

Can J Physiol Pharmacol. 2015 Sep;93(9):737-53. doi: 10.1139/cjpp-2015-0006. Epub 2015 Feb 27.

Abstract

In addition to cytostatic treatment and surgery, the most common cancer treatment is gamma radiation. Despite sophisticated radiological techniques however, in addition to irradiation of the tumor, irradiation of the surrounding healthy tissue also takes place, which results in various side-effects, depending on the absorbed dose of radiation. Radiation either damages the cell DNA directly, or indirectly via the formation of oxygen radicals that in addition to the DNA damage, react with all cell organelles and interfere with their molecular mechanisms. The main features of radiation injury besides DNA damage is inflammation and increased expression of pro-inflammatory genes and cytokines. Endothelial damage and dysfunction of capillaries and small blood vessels plays a particularly important role in radiation injury. This review is focused on summarizing the currently available data concerning the mechanisms of radiation injury, as well as the effectiveness of various antioxidants, anti-inflammatory cytokines, and cytoprotective substances that may be utilized in preventing, mitigating, or treating the toxic effects of ionizing radiation on the heart.

Keywords: antioxidants; antioxydants; atténuation; cardiac toxicity; free oxygen radicals; mechanisms of radiation injury; mitigation; mécanismes de dommage causés par l’irradiation; prevention; prévention; radiation; radicaux libres d’oxygène; toxicité cardiaque; traitement; treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antioxidants / therapeutic use
  • DNA Damage / radiation effects
  • Endothelium, Vascular / radiation effects
  • Gamma Rays / adverse effects*
  • Heart / physiopathology
  • Heart / radiation effects*
  • Humans
  • Leukocytes, Mononuclear / physiology
  • Mast Cells / physiology
  • Myocardium / pathology*
  • Peroxisome Proliferator-Activated Receptors / metabolism
  • Radiation Injuries / genetics
  • Radiation Injuries / pathology
  • Radiation Injuries / physiopathology*
  • Radiation Injuries / prevention & control*
  • Radiation-Protective Agents / pharmacology
  • Radiation-Protective Agents / therapeutic use
  • Reactive Oxygen Species / adverse effects

Substances

  • Antioxidants
  • Peroxisome Proliferator-Activated Receptors
  • Radiation-Protective Agents
  • Reactive Oxygen Species