DNA Double-Strand Breaks after Percutaneous Transluminal Angioplasty

Geisel, Dominik; Heverhagen, Johannes T.; Kalinowski, Marc; Wagner, Hans‐Joachim

doi:10.1148/radiol.2483071686

Cited by 50 publications

(47 citation statements)

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“…A linear dependence of DSB induction related to dose-area product (r = 0.993) was found among patients who had undergone percutaneous transluminal angioplasty of the arteries of the lower extremity. The DSB were repaired quickly, the initial values measured prior to exposure (0.04 foci/cell) were not completely achieved (0.07 foci/cell) within 24 hours, however [23]. An increase in DSB was likewise shown after cardiac catheterization in children; the induced γ-H2AX foci in the low-dose range up to 5 mGy, however, correlated non-linearly with the blood dose determined using Monte Carlo simulation.…”

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confidence: 89%

“…In the case of blood lymphocytes, a range of 0.05 -0.15 per cell have been described ( • " Table 1). DSB induction results in a rapid increase of measurable foci; in some studies the highest values have been measured 5 minutes after exposure [12,13,23]. This quantity of radiation-induced foci demonstrate a dependence on the dose, which in most in-vitro and in-vivo studies was linear [7, 9,13,23,33].…”

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confidence: 99%

“…DSB induction results in a rapid increase of measurable foci; in some studies the highest values have been measured 5 minutes after exposure [12,13,23]. This quantity of radiation-induced foci demonstrate a dependence on the dose, which in most in-vitro and in-vivo studies was linear [7, 9,13,23,33]. Individual studies described non-linear relationships [14,15,24].…”

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Radiation Induced DNA Double-Strand Breaks in Radiology

Kuefner

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Engert

et al. 2015

Fortschr Röntgenstr

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Background !Shortly after the discovery of X-ray radiation, its detrimental effect on biological tissue was observed. The increasing number of X-raybased examinations in recent decades has reAbstract ! Shortly after the discovery of X-rays, their damaging effect on biological tissues was observed. The determination of radiation exposure in diagnostic and interventional radiology is usually based on physical measurements or mathematical algorithms with standardized dose simulations. γ-H2AX immunofluorescence microscopy is a reliable and sensitive method for the quantification of radiation induced DNA double-strand breaks (DSB) in blood lymphocytes. The detectable amount of these DNA damages correlates well with the dose received. However, the biological radiation damage depends not only on dose but also on other individual factors like radiation sensitivity and DNA repair capacity. Iodinated contrast agents can enhance the x-ray induced DNA damage level. After their induction DSB are quickly repaired. A protective effect of antioxidants has been postulated in experimental studies. This review explains the prinicple of the γ-H2AX technique and provides an overview on studies evaluating DSB in radiologic examinations. Key Points:▶ Radiologic examinations including CT and angiography induce DNA double-strand breaks. Even after mammography a slight but significant increase is detectable in peripheral blood lymphocytes.▶ The number of radiation induced doublestrand breaks correlates well with the radiation dose.▶ Individual factors including radiation sensitivity, DNA repair capacity and the application of iodinated contrast media has an influence on the DNA damage level. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.sulted in the heightened importance of radiation dosage and protection as clinical topics [1, 2]. Determination of dose exposure in diagnostic and interventional radiology is carried out primarily using physical methods based on standardized phantoms or relying on mathematical dosage simulations. Such estimates can determine the exposure quite well, but supply no information regarding the interaction of radiation in the patient's body. Nowadays there are indications that biological radiation damage is not solely dependent on the applied dosage, but is also related to additional individual factors that cannot be sufficiently determined using established dosimetric methods. Earlier approaches to biological dosimetry were not sensitive enough for the dosage range used in radiology [3]. Double-stand breaks (DSB) are considered the most relevant radiation-induced damage to deoxyribonucleic acid (DNA) [4]. Although such breakage is quickly repaired, defective repairs can result in mutations, causing carcinogenesis [5, 6]. An immunofluorescence microscopic approach, which is much more sensitive than previous biological processes, allows the determination of individual DNA DSB in peripheral blood lymphocytes, thus allowing an accurate estimation of the biolog...

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Radiation Induced DNA Double-Strand Breaks in Radiology

Kuefner

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Engert

et al. 2015

Fortschr Röntgenstr

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“…In vitro dose-response curves of ␥-H2AX foci in other cellular systems such as fibroblasts are reported in the literature to be linear, but a detailed analysis in the low-dose range as performed in present study is not available. 14,16,36,37 Data are also lacking relative to the dose-response curve of ␥-H2AX foci in lymphocytes based on in vitro irradiation of whole-blood samples, simulating the in vivo x-ray exposure. To elucidate the effect of the cell environment on foci formation in lymphocytes, we also determined the dose response after in vitro irradiation of isolated lymphocytes; the biphasic behavior and low-dose hypersensitivity observed after whole-blood irradiation were much less pronounced for isolated lymphocytes (data not shown).…”

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γ-H2AX Foci as a Biomarker for Patient X-Ray Exposure in Pediatric Cardiac Catheterization

et al. 2009

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Background-A better knowledge of patient x-ray dose and the associated radiation risk in pediatric interventional cardiology is warranted in view of the extensive use of x-rays and the higher radiosensitivity of children. In the present study, ␥-H2AX foci were used as a biomarker for radiation-induced effects. Patient-specific dose was assessed and radiation risks were estimated according to the linear-no-threshold model, commonly used in radiation protection, and the ␥-H2AX foci data. Methods and Results-In 49 pediatric patients (median age, 0.75 years) with congenital heart disease who underwent cardiac catheterization procedures, blood samples were taken before and shortly after the procedure. ␥-H2AX foci were determined in peripheral blood T lymphocytes. In each patient, a net increase in ␥-H2AX foci, representing DNA double-strand breaks induced by interventional x-rays, was observed. In addition, a patient-specific Monte Carlo simulation of the procedure was performed, resulting in individual blood, organ, and tissue doses. Plotting of ␥-H2AX foci versus blood dose indicated a low-dose hypersensitivity. Median effective doses calculated according to the International Commission on Radiological Protection 60 and 103 publications are 5.6 and 6.4 mSv, respectively. The lifetime-attributable risk of cancer mortality was calculated from the linear-no-threshold model and the ␥-H2AX foci data. This resulted in lifetime-attributable risk values of 1 per thousand and 4 per thousand, respectively, for the patient population under study. Conclusions-␥-H2AX foci as a biomarker for DNA damage indicate that radiation risk estimates according to the linear-no-threshold hypothesis are possibly underestimates. Great care should be taken to minimize and optimize patient radiation exposure.

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“…11 Small studies 10,12 have suggested an association between contrast media and increased DNA DSBs in individuals exposed to low-dose radiation but not necessarily highdose radiation.…”

Section: Iodinated Contrast Mediamentioning

confidence: 99%

Does iodinated contrast medium amplify DNA damage during exposure to radiation

Riley

2015

BJR

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There is a recognized increased risk of cancer following exposure of humans to ionizing radiation; this is felt to be most likely due to damage to DNA strands during exposure. Damage to DNA strands can be demonstrated microscopically following exposure to X-rays, and new evidence is emerging that this effect may be compounded by administration of iodinated contrast agents. INTRODUCTIONIt is widely accepted that there is an increased risk of cancer following exposure to ionizing radiation. The primary source of information is the Life Span Study, an epidemiological study of survivors of the atomic bombs at Hiroshima and Nagasaki. There were an excess number of deaths from leukaemia in the early follow-up years. Most recent figures published in 2011 indicate an excess relative risk for solid tumours of between 0.5 and 0.8 for doses between 5 and 200 mGy. 1 A study published in 2004 estimated that 0.9% of the cumulative cancer risk to individuals in the USA could be attributable to diagnostic X-ray exposure, equivalent to 5695 cases of newly diagnosed cancer per annum.2 Diagnostic X-rays are the largest man-made source of radiation exposure. More complex examinations, and interventional procedures are increasing in number and average dose annually throughout the developed world. In the UK in 2008, CT accounted for 7% of the total number of medical and dental examinations but 68% of their resultant total collective dose.

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DNA Double-Strand Breaks after Percutaneous Transluminal Angioplasty

Abstract: GammaH2AX focus formation can be used to determine in vivo induction of DNA DSBs after PTA. DSB repair capacity is compromised in patients who undergo PTA of lower limb arteries.

Cited by 50 publications

References 36 publications

Radiation Induced DNA Double-Strand Breaks in Radiology

Radiation Induced DNA Double-Strand Breaks in Radiology

γ-H2AX Foci as a Biomarker for Patient X-Ray Exposure in Pediatric Cardiac Catheterization

Does iodinated contrast medium amplify DNA damage during exposure to radiation

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