Cardiovascular diseases related to ionizing radiation: The risk of low-dose exposure (Review)

Baselet, Bjorn; Rombouts, Caroline; Benotmane, Mohammed Abderrafi; Baatout, Sarah; Aerts, An

doi:10.3892/ijmm.2016.2777

Cited by 118 publications

(98 citation statements)

References 157 publications

(202 reference statements)

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“…Similar to cardiomyocytes, studies of in vitro endothelial cells noted increased production of ROS 24-72 h post-radiation exposure (5-20 Gy) (28). In addition, Nrf2 upregulation has also been implicated in oxidative stress-induced endothelial dysfunction (1,28). Furthermore, proteomic data on C57BL/6 mice receiving 8 or 16 Gy of local heart irradiation revealed expression of proteins associated with mitochondrial dysfunction within endothelial cells (70).…”

Section: Endothelial Cell Mitochondriamentioning

confidence: 94%

“…On a molecular level, ionizing radiation directly modifies DNA, including single-and double-stranded breaks, base damage, and cross-links, all of which can lead to cell death if not repaired properly. Indirectly, radiation can lead to ROS formation, which can cause cellular stress and death (1). Mitochondrial DNA (mtDNA) is a major radiation target because it lacks the protective effects of histones (47).…”

Section: Mitochondria and Oxidative Stressmentioning

confidence: 99%

“…One cause is the formation of fibrosis, distinguished by collagen deposition in and surrounding cardiomyocytes (1,6,22). An additional cause is macrovascular and microvascular injury, developed in a multifactorial manner by endothelial cell damage and adhesion, and activation of inflammatory and atherosclerotic responses (1,6,(23)(24)(25)(26)(27)(28). Signaling pathways, including apoptosis and mitochondrial dysfunction, have also been linked to RIHD (29,30).…”

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confidence: 99%

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The Role of Mitochondrial Dysfunction in Radiation-Induced Heart Disease: From Bench to Bedside

Livingston

Schlaak

Puckett

et al. 2020

Front. Cardiovasc. Med.

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Radiation is a key modality in the treatment of many cancers; however, it can also affect normal tissues adjacent to the tumor, leading to toxic effects. Radiation to the thoracic region, such as that received as part of treatment for breast and lung cancer, can result in incidental dose to the heart, leading to cardiac dysfunction, such as pericarditis, coronary artery disease, ischemic heart disease, conduction defects, and valvular dysfunction. The underlying mechanisms for these morbidities are currently being studied but are not entirely understood. There has been increasing focus on the role of radiation-induced mitochondrial dysfunction and the ensuing impact on various cardiac functions in both preclinical models and in humans. Cardiomyocyte mitochondria are critical to cardiac function, and mitochondria make up a substantial part of a cardiomyocyte's volume. Mitochondrial dysfunction can also alter other cell types in the heart. This review summarizes several factors related to radiation-induced mitochondrial dysfunction in cardiomyocytes and endothelial cells. These factors include mitochondrial DNA mutations, oxidative stress, alterations in various mitochondrial function-related transcription factors, and apoptosis. Through improved understanding of mitochondria-dependent mechanisms of radiation-induced heart dysfunction, potential therapeutic targets can be developed to assist in prevention and treatment of radiation-induced heart damage.

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Section: Endothelial Cell Mitochondriamentioning

confidence: 94%

Section: Mitochondria and Oxidative Stressmentioning

confidence: 99%

mentioning

confidence: 99%

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The Role of Mitochondrial Dysfunction in Radiation-Induced Heart Disease: From Bench to Bedside

Livingston

Schlaak

Puckett

et al. 2020

Front. Cardiovasc. Med.

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“…It has been known for a long time that high doses of radiation, such as those delivered during radiotherapy, cause damage to the heart and vasculature and thus increase the risk of CVD. Data from animal experiments have strongly supported this observation [3][4][5][6]. However, for doses <0.5 gray (Gy), epidemiological data are suggestive rather than persuasive.…”

Section: Introductionmentioning

confidence: 95%

Selected Endothelial Responses after Ionizing Radiation Exposure

Baselet¹,

Ramadan²,

MohammedBenotmane³

et al. 2018

Endothelial Dysfunction - Old Concepts and New Challenges

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Along with the development of novel chemotherapeutic agents, radiation therapy has revolutionized the prognosis of patients with various cancers. However, with a longer life expectancy, radiation treatment-related comorbidity, like cardiovascular diseases (CVDs), becomes an issue for cancer survivors. In addition, exposure to X-rays for medical diagnostics is dramatically increasing at the present times. A pressing question is whether or not exposure to these very low doses can cause health damage. Below 0.5 gray (Gy), an increased risk cannot be evidenced by epidemiology alone, and in vitro and in vivo mechanistic studies focused on the elucidation of molecular signaling pathways are needed. Given the critical role of the endothelium in normal vascular functions, a complete understanding of radiation-induced endothelial dysfunction is crucial. In this way, the current radiation protection system could be refined if needed, making it possible to more accurately assess the cardiovascular risk in the low-dose region. Finally, radiation-induced CVD, like CVD in general, is a progressive disorder that may take years to decades to manifest. Therefore, experimental studies are warranted to fulfill the urgent need to identify noninvasive biomarkers for an early detection and potential interventions-together with a healthy lifestyle-that may prevent or mitigate these adverse effects.

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“…Increasing cardiac morbidity and mortality and risk of CVDs have been widely found after radiation therapy (RT), especially beam RT, for breast cancer, lung cancer, esophageal cancer, and even peptic ulcer [18][19][20][21]. General risk factors for CVDs, such as hypertension, diabetes, hypercholesterolemia, obesity, and smoking, probably also increase the risk of CVDs in patients treated with radiotherapy indirectly; for example, irradiation of the left kidney during para-aortic and spleen radiotherapy can result in hypertension [22][23][24][25][26].…”

Section: Medical Exposuresmentioning

confidence: 99%

Low Dose Radiation Exposure and Cardiovascular Diseases: A Review

Gao

Ding

2017

ijcp

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The International Commission on Radiological Protection (ICRP) states that particular attention should be paid to radiation effects on the cardiovascular system because of recent published observations of their effects occurring at lower doses than previously reported (ICRP, 2007 and2012). The review was based on scientific articles available in open literature and major reviews by organizations, in particular ICRP118. In this review, we describe the low-dose ionizing radiation effects, the causes of cardiovascular diseases (CVDs), the relationship between low-dose ionizing radiation and CVDs, and the importance of elucidating the relationship between low-dose ionizing radiation and CVD.

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Cardiovascular diseases related to ionizing radiation: The risk of low-dose exposure (Review)

Cited by 118 publications

References 157 publications

The Role of Mitochondrial Dysfunction in Radiation-Induced Heart Disease: From Bench to Bedside

The Role of Mitochondrial Dysfunction in Radiation-Induced Heart Disease: From Bench to Bedside

Selected Endothelial Responses after Ionizing Radiation Exposure

Low Dose Radiation Exposure and Cardiovascular Diseases: A Review

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