Radiation-induced gastrointestinal and cutaneous injuries: understanding models, pathologies, assessments, and clinically accepted practices

Abstract

Purpose

A U. S. and European joint effort fostering the development of medical countermeasures (MCMs) operable in case of radiological or nuclear emergencies.

Methods

Based on the joint engagement between the U.S. National Institute of Allergy and Infectious Diseases (NIAID) and the French Institut de Radioprotection et de Sûreté Nucléaire (IRSN), a Statement of Intent to Collaborate was signed in 2014 and a series of working group meeting were established. In December 2022, the NIAID and IRSN hosted a five-day, U.S./European meeting titled ‘Radiation-Induced Cutaneous and Gastrointestinal Injuries: Advances in Understanding Pathologies, Assessment, and Clinically Accepted Practices’ in Paris, France. The goals of the meeting were to bring together U.S. and European investigators to explore new research avenues for the medical management of skin and gastrointestinal injuries, including specific diagnostics for each organ system, animal models, and promising medical countermeasures (MCMs) to mitigate radiation damage. There was also an emphasis on exploring additional areas of medicine and response to understand best practices from other emergency scenarios, which could be leveraged to improve radiation preparedness, and the importance of accurate dosimetry in preclinical work.

Results

Subsequent to the workshop, seven collaborative projects, funded by both organizations, were established on topics ranging from MCMs and predictive biomarkers, and using physical methods to assess cutaneous radiation injuries, to mechanistic studies to understand radiation-induced damage in multiple organ systems. The importance of accurate dosimetry in preclinical works was highlighted and two recently published U.S./European commentaries that focus on the need for dosimetry standardization in the reported literature had their origins in this meeting. This commentary summarizes the workshop and open discussions among academic investigators, industry researchers, and U.S. and IRSN program representatives.

Conclusions

Given the substantive progress made due to these interactions, both groups plan to expand out these meetings by incorporating high-level investigators from across the globe, while endeavoring to maintain the informal setting that was conducive to in-depth scientific discussion and enhanced the state of the science in radiation research.

Keywords:

• Biodosimetry
• medical
• emergency
• skin
• diagnosis
• intestines

Acknowledgments

The authors thank the IRSN administrative staff for their logistical work to host a successful meeting. We also thank the U. S. and European meeting participants for their valuable presentations and their willingness to work collaboratively to advance the state of the science in the field of diagnosis, mitigation, and treatment of normal tissue radiation-induced injuries.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 https://en.wikipedia.org/wiki/High_reliability_organization.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Radia Tamarat

Radia Tamarat, PhD is a Senior Expert in Medical Response in Nuclear and Radiological Emergency at the Department of Health, IRSN, Fontenay Aux Roses, France.

Merriline M. Satyamitra

Merriline M. Satyamitra, PhD in radiation biology, serves as a Program Officer, Contracting Officer’s Representative and biodosimetry lead in the Radiation and Nuclear Countermeasures Program, NIAID, NIH, Rockville, MD, USA.

Marc Benderitter

Marc Benderitter, PhD is a radiopathologist and the head of the Department of RAdiobiology and regenerative MEDicine (SERAMED) at IRSN, Fontenay Aux Roses, France.

Andrea L. DiCarlo

Andrea L. DiCarlo, PhD is the Director of the Radiation and Nuclear Countermeasures Program, NIAID, NIH, Rockville, MD, USA.