Medical radiation countermeasures for nuclear and radiological emergencies: Current status and future perspectives

Abstract

Nuclear and radiological emergencies (NREs) occurred globally and recent incidences in India are indicating toward the need for comprehensive medical preparedness required both at incident site and hospitals. The enhanced threat attributed toward insurgency is another causative factor of worry. The response capabilities and operational readiness of responders (both health and non-health service providers) in contaminated environment need to be supported by advancement in R & D and technological efforts to develop prophylactics and radiation mitigators. It is essential to develop phase 1 alternatives of such drugs for unseen threats as a part of initial preparedness. At the incident site and hospital level, external decontamination procedures need to be standardized and supported by protective clothing and Shudika kits developed by INMAS. The medical management of exposure requires systematic approach to perform triage, resuscitation and curative care. The internal contamination requires decorporation agents to be administered based on procedural diagnostics. Various key issues pertaining to policy decisions, R & D promotion, community awareness, specialized infrastructure for NREs preparedness has been discussed. The present review is an attempt to provide vital information about the current status of various radiation countermeasures and future perspective(s) ahead.

Mesenchymal stromal cell-derived extracellular vesicles rescue radiation damage to murine marrow hematopoietic cells

“…Radiation exposure results in different levels of tissue injury depending on dose, including the immune system, the hematopoietic system, gastrointestinal tract, kidney, skin and lung 1, 2 . Hematopoietic stem cells (HSC) are sensitive to radiation and exposure can result in bone marrow failure.…”

Interleukin-12 Preserves the Cutaneous Physical and Immunological Barrier after Radiation Exposure

“…This in turn would likely delay the administration of potential medical countermeasures for individuals exposed to radiation, which in a perfect scenario would be available to the affected population shortly after exposure (11). However, it is more realistic to assume that these mitigators would not be available until at least 24–48 h after the emergency (3, 21). In fact, a recent statement from the Centers for Medical Countermeasures against Radiation (CMCR) concerning potential mitigators of radiation-induced sickness has recommended that priority be given to “products that show efficacy when administered 24 h or later after radiation exposure”.…”

“…This type of radiation exposure can seriously compromise the wellbeing of individuals depending on their location and radiation dose, and the resulting biological effect is often referred to as acute radiation syndrome (ARS) (2, 3). This syndrome is predominately dependent on four particular organ systems that have the greatest acute sensitivity to radiation: the neurovascular, hematopoietic, gastrointestinal and cutaneous systems (4).…”

Chemical, biological, radiological, and nuclear threats-Decontamination technologies and recent patents: A review

“…Their safety and security is tentative at several place thereby rendering them easily accessible. Terrorists can make crude radiation weapons, commonly called "dirty bombs," which combine conventional explosives, such as dynamite, with radioactive materials obtained from orphan sources [19][20][21] in the form of powder or pellets. A radiological dispersal device (RDD) or (dirty bomb) or improvised nuclear weapon may cause both radiation exposure and and/or radioactive contamination of persons.…”

“…List of common radiological and nuclear contaminants [18][19][20][21]. Inhaled uranium compounds may be metabolized and excreted in the urine.…”