1
|
Wilkins RC, Beaton-Green LA. Development of high-throughput systems for biodosimetry. RADIATION PROTECTION DOSIMETRY 2023; 199:1477-1484. [PMID: 37721060 PMCID: PMC10720693 DOI: 10.1093/rpd/ncad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 09/19/2023]
Abstract
Biomarkers for ionising radiation exposure have great utility in scenarios where there has been a potential exposure and physical dosimetry is missing or in dispute, such as for occupational and accidental exposures. Biomarkers that respond as a function of dose are particularly useful as biodosemeters to determine the dose of radiation to which an individual has been exposed. These dose measurements can also be used in medical scenarios to track doses from medical exposures and even have the potential to identify an individual's response to radiation exposure that could help tailor treatments. The measurement of biomarkers of exposure in medicine and for accidents, where a larger number of samples would be required, is limited by the throughput of analysis (i.e. the number of samples that could be processed and analysed), particularly for microscope-based methods, which tend to be labour-intensive. Rapid analysis in an emergency scenario, such as a large-scale accident, would provide dose estimates to medical practitioners, allowing timely administration of the appropriate medical countermeasures to help mitigate the effects of radiation exposure. In order to improve sample throughput for biomarker analysis, much effort has been devoted to automating the process from sample preparation through automated image analysis. This paper will focus mainly on biological endpoints traditionally analysed by microscopy, specifically dicentric chromosomes, micronuclei and gamma-H2AX. These endpoints provide examples where sample throughput has been improved through automated image acquisition, analysis of images acquired by microscopy, as well as methods that have been developed for analysis using imaging flow cytometry.
Collapse
Affiliation(s)
- Ruth C Wilkins
- Consumer and Clinical Radiation Protection Bureau, Health Canada, Ottawa K1A 1C1, Canada
| | - Lindsay A Beaton-Green
- Consumer and Clinical Radiation Protection Bureau, Health Canada, Ottawa K1A 1C1, Canada
| |
Collapse
|
2
|
Lacombe J, Summers AJ, Khanishayan A, Khorsandian Y, Hacey I, Blackson W, Zenhausern F. Paper-Based Vertical Flow Immunoassay for the Point-of-Care Multiplex Detection of Radiation Dosimetry Genes. Cytogenet Genome Res 2023; 163:178-186. [PMID: 37369178 PMCID: PMC10751381 DOI: 10.1159/000531702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
In a nuclear or radiological incident, first responders must quickly and accurately measure radiation exposure among civilians as medical countermeasures are radiation dose-dependent and time-sensitive. Although several approaches have been explored to measure absorbed radiation dose, there is an important need to develop point-of-care (POC) bioassay devices that can be used immediately to triage thousands of individuals potentially exposed to radiation. Here we present a proof-of-concept study showing the use of a paper-based vertical flow immunoassay (VFI) to detect radiation dosimetry genes. Using labeled primers during amplification and a multiplex membrane, our results showed that the nucleic acid VFI can simultaneously detect two biodosimetry genes, CDKN1A and DDB2, as well as one housekeeping gene MRPS5. The assay demonstrated good linearity and precision with an inter- and intra-assay coefficient of variance <20% and <10%, respectively. Moreover, the assay showed its ability to discriminate non-irradiated controls (0 Gy) from irradiated samples (1 + 2 Gy) with an overall sensitivity of 62.5% and specificity of 100% (AUC = 0.8672, 95% CI: 0.723-1.000; p = 0.004). Interestingly, the gene combination also showed a dose-dependent response for 0, 1, and 2 Gy, similar to data obtained by real-time PCR benchmark. These preliminary results suggest that a VFI platform can be used to detect simultaneously multiple genes that can be then quantified, thus offering a new approach for a POC biodosimetry assay that could be rapidly deployed on-site to test a large population and help triage and medical management after radiological event.
Collapse
Affiliation(s)
- Jerome Lacombe
- Center for Applied NanoBioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
- Department of Basic Medical Sciences, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
| | - Alexander J. Summers
- Center for Applied NanoBioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
| | - Ashkan Khanishayan
- Center for Applied NanoBioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
| | - Yasaman Khorsandian
- Center for Applied NanoBioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
| | - Isabella Hacey
- Center for Applied NanoBioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
| | - Wyatt Blackson
- Center for Applied NanoBioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
| | - Frederic Zenhausern
- Center for Applied NanoBioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
- Department of Basic Medical Sciences, College of Medicine Phoenix, University of Arizona, Phoenix, AZ, USA
- Department of Biomedical Engineering, College of Engineering, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
3
|
Bene BJ, Blakely WF, Burmeister DM, Cary L, Chhetri SJ, Davis CM, Ghosh SP, Holmes-Hampton GP, Iordanskiy S, Kalinich JF, Kiang JG, Kumar VP, Lowy RJ, Miller A, Naeem M, Schauer DA, Senchak L, Singh VK, Stewart AJ, Velazquez EM, Xiao M. Celebrating 60 Years of Accomplishments of the Armed Forces Radiobiology Research Institute1. Radiat Res 2021; 196:129-146. [PMID: 33979439 DOI: 10.1667/21-00064.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/20/2021] [Indexed: 11/03/2022]
Abstract
Chartered by the U.S. Congress in 1961, the Armed Forces Radiobiology Research Institute (AFRRI) is a Joint Department of Defense (DoD) entity with the mission of carrying out the Medical Radiological Defense Research Program in support of our military forces around the globe. In the last 60 years, the investigators at AFRRI have conducted exploratory and developmental research with broad application to the field of radiation sciences. As the only DoD facility dedicated to radiation research, AFRRI's Medical Radiobiology Advisory Team provides deployable medical and radiobiological subject matter expertise, advising commanders in the response to a U.S. nuclear weapon incident and other nuclear or radiological material incidents. AFRRI received the DoD Joint Meritorious Unit Award on February 17, 2004, for its exceptionally meritorious achievements from September 11, 2001 to June 20, 2003, in response to acts of terrorism and nuclear/radiological threats at home and abroad. In August 2009, the American Nuclear Society designated the institute a nuclear historic landmark as the U.S.'s primary source of medical nuclear and radiological research, preparedness and training. Since then, research has continued, and core areas of study include prevention, assessment and treatment of radiological injuries that may occur from exposure to a wide range of doses (low to high). AFRRI collaborates with other government entities, academic institutions, civilian laboratories and other countries to research the biological effects of ionizing radiation. Notable early research contributions were the establishment of dose limits for major acute radiation syndromes in primates, applicable to human exposures, followed by the subsequent evolution of radiobiology concepts, particularly the importance of immune collapse and combined injury. In this century, the program has been essential in the development and validation of prophylactic and therapeutic drugs, such as Amifostine, Neupogen®, Neulasta®, Nplate® and Leukine®, all of which are used to prevent and treat radiation injuries. Moreover, AFRRI has helped develop rapid, high-precision, biodosimetry tools ranging from novel assays to software decision support. New drug candidates and biological dose assessment technologies are currently being developed. Such efforts are supported by unique and unmatched radiation sources and generators that allow for comprehensive analyses across the various types and qualities of radiation. These include but are not limited to both 60Co facilities, a TRIGA® reactor providing variable mixed neutron and γ-ray fields, a clinical linear accelerator, and a small animal radiation research platform with low-energy photons. There are five major research areas at AFRRI that encompass the prevention, assessment and treatment of injuries resulting from the effects of ionizing radiation: 1. biodosimetry; 2. low-level and low-dose-rate radiation; 3. internal contamination and metal toxicity; 4. radiation combined injury; and 5. radiation medical countermeasures. These research areas are bolstered by an educational component to broadcast and increase awareness of the medical effects of ionizing radiation, in the mass-casualty scenario after a nuclear detonation or radiological accidents. This work provides a description of the military medical operations as well as the radiation facilities and capabilities present at AFRRI, followed by a review and discussion of each of the research areas.
Collapse
Affiliation(s)
| | | | | | - Lynnette Cary
- Scientific Research Department.,Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Catherine M Davis
- Scientific Research Department.,Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Sanchita P Ghosh
- Scientific Research Department.,Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Gregory P Holmes-Hampton
- Scientific Research Department.,Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Sergey Iordanskiy
- Scientific Research Department.,Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Juliann G Kiang
- Scientific Research Department.,Medicine.,Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | | | | | | | - David A Schauer
- Radiation Sciences Department, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Vijay K Singh
- Scientific Research Department.,Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | | | | |
Collapse
|
4
|
Ryan TL, Pantelias AG, Terzoudi GI, Pantelias GE, Balajee AS. Use of human lymphocyte G0 PCCs to detect intra- and inter-chromosomal aberrations for early radiation biodosimetry and retrospective assessment of radiation-induced effects. PLoS One 2019; 14:e0216081. [PMID: 31059552 PMCID: PMC6502328 DOI: 10.1371/journal.pone.0216081] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/12/2019] [Indexed: 12/13/2022] Open
Abstract
A sensitive biodosimetry tool is required for rapid individualized dose estimation and risk assessment in the case of radiological or nuclear mass casualty scenarios to prioritize exposed humans for immediate medical countermeasures to reduce radiation related injuries or morbidity risks. Unlike the conventional Dicentric Chromosome Assay (DCA), which takes about 3–4 days for radiation dose estimation, cell fusion mediated Premature Chromosome Condensation (PCC) technique in G0 lymphocytes can be rapidly performed for radiation dose assessment within 6–8 hrs of sample receipt by alleviating the need for ex vivo lymphocyte proliferation for 48 hrs. Despite this advantage, the PCC technique has not yet been fully exploited for radiation biodosimetry. Realizing the advantage of G0 PCC technique that can be instantaneously applied to unstimulated lymphocytes, we evaluated the utility of G0 PCC technique in detecting ionizing radiation (IR) induced stable and unstable chromosomal aberrations for biodosimetry purposes. Our study demonstrates that PCC coupled with mFISH and mBAND techniques can efficiently detect both numerical and structural chromosome aberrations at the intra- and inter-chromosomal levels in unstimulated T- and B-lymphocytes. Collectively, we demonstrate that the G0 PCC technique has the potential for development as a biodosimetry tool for detecting unstable chromosome aberrations (chromosome fragments and dicentric chromosomes) for early radiation dose estimation and stable chromosome exchange events (translocations) for retrospective monitoring of individualized health risks in unstimulated lymphocytes.
Collapse
Affiliation(s)
- Terri L. Ryan
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Center/Training site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, Tennessee, United States of America
| | - Antonio G. Pantelias
- Health Physics, Radiobiology & Cytogenetics Laboratory, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, National Centre for Scientific Research “Demokritos”, Ag. Paraskevi, Athens, Greece
| | - Georgia I. Terzoudi
- Health Physics, Radiobiology & Cytogenetics Laboratory, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, National Centre for Scientific Research “Demokritos”, Ag. Paraskevi, Athens, Greece
| | - Gabriel E. Pantelias
- Health Physics, Radiobiology & Cytogenetics Laboratory, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, National Centre for Scientific Research “Demokritos”, Ag. Paraskevi, Athens, Greece
| | - Adayabalam S. Balajee
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Center/Training site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, Tennessee, United States of America
- * E-mail:
| |
Collapse
|
5
|
Balajee AS, Smith T, Ryan T, Escalona M, Dainiak N. DEVELOPMENT OF A MINIATURIZED VERSION OF DICENTRIC CHROMOSOME ASSAY TOOL FOR RADIOLOGICAL TRIAGE. RADIATION PROTECTION DOSIMETRY 2018; 182:139-145. [PMID: 30247729 DOI: 10.1093/rpd/ncy127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Indexed: 06/08/2023]
Abstract
Use of ionizing radiation (IR) in various industrial, medical and other applications can potentially increase the risk of medical, occupational or accidental human exposure. Additionally, in the event of a radiological or nuclear (R/N) incident, several tens of hundreds and thousands of people are likely to be exposed to IR. IR causes serious health effects including mortality from acute radiation syndrome and therefore it is imperative to determine the absorbed radiation dose, which will enable physicians in making an appropriate clinical 'life-saving' decision. The 'Dicentric Chromosome Assay (DCA)' is the gold standard for estimating the absorbed radiation dose but its performance is time consuming and laborious. Further, timely evaluation of dicentric chromosomes (DCs) for dose estimation in a large number of samples provides a bottleneck because of a limited number of trained personnel and a prolonged time for manual analysis. To circumvent some of these technical issues, we developed and optimized a miniaturized high throughput version of DCA (mini-DCA) in a 96-microtube matrix with bar-coded 1.4 ml tubes to enable the processing of a large number of samples. To increase the speed of DC analysis for radiation dose estimation, a semi-automated scoring was optimized using the Metafer DCScore algorithm. The accuracy of mini-DCA in dose estimation was verified and validated though comparison with conventional DCA performed in 15 ml conical tubes. The mini-DCA considerably reduced the sample processing time by a factor of 4 when compared to the conventional DCA. Further, the radiation doses estimated by mini-DCA using the triage mode of scoring (50 cells or 30 DCs) were similar to that of conventional DCA using 300-500 cells. The mini-DCA coupled with semi-automated DC scoring not only reduced the sample processing and analysis times by a factor of 4 but also enabled the processing of a large number of samples at once. Our mini-DCA method, once automated for high throughput robotic platforms, will be an effective radiological triage tool for mass casualty incidents.
Collapse
Affiliation(s)
- Adayabalam S Balajee
- Cytogenetics Biodosimetry Laboratory, Radiation Emergency Assistance Center and Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, 1299, Bethel Valley Road, Oak Ridge, TN, USA
| | - Tammy Smith
- Cytogenetics Biodosimetry Laboratory, Radiation Emergency Assistance Center and Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, 1299, Bethel Valley Road, Oak Ridge, TN, USA
| | - Terri Ryan
- Cytogenetics Biodosimetry Laboratory, Radiation Emergency Assistance Center and Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, 1299, Bethel Valley Road, Oak Ridge, TN, USA
| | - Maria Escalona
- Cytogenetics Biodosimetry Laboratory, Radiation Emergency Assistance Center and Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, 1299, Bethel Valley Road, Oak Ridge, TN, USA
| | - Nicholas Dainiak
- Cytogenetics Biodosimetry Laboratory, Radiation Emergency Assistance Center and Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, 1299, Bethel Valley Road, Oak Ridge, TN, USA
| |
Collapse
|
6
|
Garty G, Turner HC, Salerno A, Bertucci A, Zhang J, Chen Y, Dutta A, Sharma P, Bian D, Taveras M, Wang H, Bhatla A, Balajee A, Bigelow AW, Repin M, Lyulko OV, Simaan N, Yao YL, Brenner DJ. THE DECADE OF THE RABiT (2005-15). RADIATION PROTECTION DOSIMETRY 2016; 172:201-206. [PMID: 27412510 PMCID: PMC5225976 DOI: 10.1093/rpd/ncw172] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The RABiT (Rapid Automated Biodosimetry Tool) is a dedicated Robotic platform for the automation of cytogenetics-based biodosimetry assays. The RABiT was developed to fulfill the critical requirement for triage following a mass radiological or nuclear event. Starting from well-characterized and accepted assays we developed a custom robotic platform to automate them. We present here a brief historical overview of the RABiT program at Columbia University from its inception in 2005 until the RABiT was dismantled at the end of 2015. The main focus of this paper is to demonstrate how the biological assays drove development of the custom robotic systems and in turn new advances in commercial robotic platforms inspired small modifications in the assays to allow replacing customized robotics with 'off the shelf' systems. Currently, a second-generation, RABiT II, system at Columbia University, consisting of a PerkinElmer cell::explorer, was programmed to perform the RABiT assays and is undergoing testing and optimization studies.
Collapse
Affiliation(s)
- G Garty
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| | - H C Turner
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| | - A Salerno
- Department of Mechanical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027, USA
- Present address: Pratt & Whitney Canada Corp., 1000 Marie-Victorin, Longueil, QC, Canada J4G 1A1
| | - A Bertucci
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| | - J Zhang
- Department of Mechanical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027, USA
- Present address: Auris Surgical Robotics Inc., 125 Shoreway Rd, San Carlos, CA 94070, USA
| | - Y Chen
- Department of Mechanical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027, USA
| | - A Dutta
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
- Present address: BioReliance Corp., 9630 Medical Center Dr, Rockville, MD 20850, USA
| | - P Sharma
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| | - D Bian
- Department of Mechanical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027, USA
| | - M Taveras
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| | - H Wang
- Department of Mechanical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027, USA
- Present address: General Motors Co., 30500 Mound Road, Warren, MI 48090, USA
| | - A Bhatla
- Department of Mechanical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027, USA
- Present address: Curiosity Lab Inc., 54 Mallard Pl. Secaucus, NJ, 07094, USA
| | - A Balajee
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
- Present address: Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Center and Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Building SC-10, 1299, Bethel Valley Road, Oak Ridge, TN, 37830, USA
| | - A W Bigelow
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| | - M Repin
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| | - O V Lyulko
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| | - N Simaan
- Department of Mechanical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027, USA
- Present address: Department of Mechanical Engineering, Vanderbuilt University, PMB 351592, Nashville, TN, 37235, USA
| | - Y L Yao
- Department of Mechanical Engineering, Columbia University, 500 West 120th Street, New York, NY 10027, USA
| | - D J Brenner
- Center for Radiological Research, Columbia University, VC11-230, 630 West 168th Street, New York, NY 10032, USA
| |
Collapse
|
7
|
Blakely WF, Romanyukha A, Hayes SM, Reyes RA, Stewart HM, Hoefer MH, Williams A, Sharp T, Huff LA. U.S. Department of Defense Multiple-Parameter Biodosimetry Network. RADIATION PROTECTION DOSIMETRY 2016; 172:58-71. [PMID: 27886989 DOI: 10.1093/rpd/ncw295] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/12/2016] [Indexed: 06/06/2023]
Abstract
The U.S. Department of Defense (USDOD) service members are at risk of exposure to ionizing radiation due to radiation accidents, terrorist attacks and national defense activities. The use of biodosimetry is a standard of care for the triage and treatment of radiation injuries. Resources and procedures need to be established to implement a multiple-parameter biodosimetry system coupled with expert medial guidance to provide an integrated radiation diagnostic system to meet USDOD requirements. Current USDOD biodosimetry capabilities were identified and recommendations to fill the identified gaps are provided. A USDOD Multi-parametric Biodosimetry Network, based on the expertise that resides at the Armed Forces Radiobiology Research Institute and the Naval Dosimetry Center, was designed. This network based on the use of multiple biodosimetry modalities would provide diagnostic and triage capabilities needed to meet USDOD requirements. These are not available with sufficient capacity elsewhere but could be needed urgently after a major radiological/nuclear event.
Collapse
Affiliation(s)
- William F Blakely
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603, USA
| | | | | | - Ricardo A Reyes
- Defense Health Agency, Walter Reed National Military Medical Command, Bethesda, MD 20889, USA
| | | | - Matthew H Hoefer
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603, USA
| | | | - Thad Sharp
- Naval Dosimetry Center, Bethesda, MD 20889, USA
| | - L Andrew Huff
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603, USA
| |
Collapse
|
8
|
Sproull M, Camphausen K. State-of-the-Art Advances in Radiation Biodosimetry for Mass Casualty Events Involving Radiation Exposure. Radiat Res 2016; 186:423-435. [PMID: 27710702 DOI: 10.1667/rr14452.1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
With the possibility of large-scale terrorist attacks around the world, the need for modeling and development of new medical countermeasures for potential future chemical, biological, radiological and nuclear (CBRN) has been well established. Project Bioshield, initiated in 2004, provided a framework to develop and expedite research in the field of CBRN exposures. To respond to large-scale population exposures from a nuclear event or radiation dispersal device (RDD), new methods for determining received dose using biological modeling became necessary. The field of biodosimetry has advanced significantly beyond this original initiative, with expansion into the fields of genomics, proteomics, metabolomics and transcriptomics. Studies are ongoing to evaluate the use of lymphocyte kinetics for dose assessment, as well as the development of field-deployable EPR technology. In addition, expansion of traditional cytogenetic assessment methods through the use of automated platforms and the development of laboratory surge capacity networks have helped to advance our biodefense preparedness. In this review of the latest advances in the field of biodosimetry we evaluate our progress and identify areas that still need to be addressed to achieve true field-deployment readiness.
Collapse
Affiliation(s)
- Mary Sproull
- Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland
| | - Kevin Camphausen
- Radiation Oncology Branch, National Cancer Institute, Bethesda, Maryland
| |
Collapse
|
9
|
Flood AB, Ali AN, Boyle HK, Du G, Satinsky VA, Swarts SG, Williams BB, Demidenko E, Schreiber W, Swartz HM. Evaluating the Special Needs of The Military for Radiation Biodosimetry for Tactical Warfare Against Deployed Troops: Comparing Military to Civilian Needs for Biodosimetry Methods. HEALTH PHYSICS 2016; 111:169-82. [PMID: 27356061 PMCID: PMC4930006 DOI: 10.1097/hp.0000000000000538] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of this paper is to delineate characteristics of biodosimetry most suitable for assessing individuals who have potentially been exposed to significant radiation from a nuclear device explosion when the primary population targeted by the explosion and needing rapid assessment for triage is civilians vs. deployed military personnel. The authors first carry out a systematic analysis of the requirements for biodosimetry to meet the military's needs to assess deployed troops in a warfare situation, which include accomplishing the military mission. Then the military's special capabilities to respond and carry out biodosimetry for deployed troops in warfare are compared and contrasted systematically, in contrast to those available to respond and conduct biodosimetry for civilians who have been targeted by terrorists, for example. Then the effectiveness of different biodosimetry methods to address military vs. civilian needs and capabilities in these scenarios was compared and, using five representative types of biodosimetry with sufficient published data to be useful for the simulations, the number of individuals are estimated who could be assessed by military vs. civilian responders within the timeframe needed for triage decisions. Analyses based on these scenarios indicate that, in comparison to responses for a civilian population, a wartime military response for deployed troops has both more complex requirements for and greater capabilities to use different types of biodosimetry to evaluate radiation exposure in a very short timeframe after the exposure occurs. Greater complexity for the deployed military is based on factors such as a greater likelihood of partial or whole body exposure, conditions that include exposure to neutrons, and a greater likelihood of combined injury. These simulations showed, for both the military and civilian response, that a very fast rate of initiating the processing (24,000 d) is needed to have at least some methods capable of completing the assessment of 50,000 people within a 2- or 6-d timeframe following exposure. This in turn suggests a very high capacity (i.e., laboratories, devices, supplies and expertise) would be necessary to achieve these rates. These simulations also demonstrated the practical importance of the military's superior capacity to minimize time to transport samples to offsite facilities and use the results to carry out triage quickly. Assuming sufficient resources and the fastest daily rate to initiate processing victims, the military scenario revealed that two biodosimetry methods could achieve the necessary throughput to triage 50,000 victims in 2 d (i.e., the timeframe needed for injured victims), and all five achieved the targeted throughput within 6 d. In contrast, simulations based on the civilian scenario revealed that no method could process 50,000 people in 2 d and only two could succeed within 6 d.
Collapse
Affiliation(s)
- Ann Barry Flood
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Arif N. Ali
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA
| | - Holly K. Boyle
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Gaixin Du
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | | | - Steven G. Swarts
- Department of Radiation Oncology, College of Medicine, University of Florida, Gainesville, FL
| | - Benjamin B. Williams
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
- Radiation Oncology Division, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Eugene Demidenko
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Wilson Schreiber
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| | - Harold M. Swartz
- EPR Center for the Study of Viable Systems, Radiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
- Radiation Oncology Division, Geisel School of Medicine at Dartmouth, Hanover, NH 03755
| |
Collapse
|
10
|
Ramakumar A, Subramanian U, Prasanna PGS. High-throughput sample processing and sample management; the functional evolution of classical cytogenetic assay towards automation. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2015; 793:132-41. [PMID: 26520383 DOI: 10.1016/j.mrgentox.2015.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 07/23/2015] [Indexed: 10/23/2022]
Abstract
High-throughput individual diagnostic dose assessment is essential for medical management of radiation-exposed subjects after a mass casualty. Cytogenetic assays such as the Dicentric Chromosome Assay (DCA) are recognized as the gold standard by international regulatory authorities. DCA is a multi-step and multi-day bioassay. DCA, as described in the IAEA manual, can be used to assess dose up to 4-6 weeks post-exposure quite accurately but throughput is still a major issue and automation is very essential. The throughput is limited, both in terms of sample preparation as well as analysis of chromosome aberrations. Thus, there is a need to design and develop novel solutions that could utilize extensive laboratory automation for sample preparation, and bioinformatics approaches for chromosome-aberration analysis to overcome throughput issues. We have transitioned the bench-based cytogenetic DCA to a coherent process performing high-throughput automated biodosimetry for individual dose assessment ensuring quality control (QC) and quality assurance (QA) aspects in accordance with international harmonized protocols. A Laboratory Information Management System (LIMS) is designed, implemented and adapted to manage increased sample processing capacity, develop and maintain standard operating procedures (SOP) for robotic instruments, avoid data transcription errors during processing, and automate analysis of chromosome-aberrations using an image analysis platform. Our efforts described in this paper intend to bridge the current technological gaps and enhance the potential application of DCA for a dose-based stratification of subjects following a mass casualty. This paper describes one such potential integrated automated laboratory system and functional evolution of the classical DCA towards increasing critically needed throughput.
Collapse
Affiliation(s)
- Adarsh Ramakumar
- Scientific Research Department, Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bldg. 42, Bethesda, MD 20889, USA.
| | - Uma Subramanian
- Scientific Research Department, Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bldg. 42, Bethesda, MD 20889, USA
| | - Pataje G S Prasanna
- Scientific Research Department, Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bldg. 42, Bethesda, MD 20889, USA
| |
Collapse
|
11
|
Blumenthal DJ, Sugarman SL, Christensen DM, Wiley AL, Livingston GK, Glassman ES, Koerner JF, Sullivan JM, Hinds S. Role of dicentric analysis in an overarching biodosimetry strategy for use following a nuclear detonation in an urban environment. HEALTH PHYSICS 2014; 106:516-522. [PMID: 24562072 DOI: 10.1097/hp.0b013e3182a5f94f] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In the moments immediately following a nuclear detonation, casualties with a variety of injuries including trauma, burns, radiation exposure, and combined injuries would require immediate assistance. Accurate and timely radiation dose assessments, based on patient history and laboratory testing, are absolutely critical to support adequately the triage and treatment of those affected. This capability is also essential for ensuring the proper allocation of scarce resources and will support longitudinal evaluation of radiation-exposed individuals and populations. To maximize saving lives, casualties must be systematically triaged to determine what medical interventions are needed, the nature of those interventions, and who requires intervention immediately. In the National Strategy for Improving the Response and Recovery for an Improvised Nuclear Device (IND) Attack, the U.S. Department of Homeland Security recognized laboratory capacity for radiation biodosimetry as having a significant gap for performing mass radiation dose assessment. The anticipated demand for radiation biodosimetry exceeds its supply, and this gap is partly linked to the limited number and analytical complexity of laboratory methods for determining radiation doses within patients. The dicentric assay is a key component of a cytogenetic biodosimetry response asset, as it has the necessary sensitivity and specificity for assessing medically significant radiation doses. To address these shortfalls, the authors have developed a multimodal strategy to expand dicentric assay capacity. This strategy includes the development of an internet-based cytogenetics network that would address immediately the labor intensive burden of the dicentric chromosome assay by increasing the number of skilled personnel to conduct the analysis. An additional option that will require more time includes improving surge capabilities by combining resources available within the country's 150 clinical cytogenetics laboratories. Key to this intermediate term effort is the fact that geneticists and technicians may be experts in matters related to identifying chromosomal abnormalities related to genetic disorders, but they are not familiar with dosimetry for which training and retraining will be required. Finally, long-term options are presented to improve capacity focus on ways to automate parts of the dicentric chromosome assay method.
Collapse
Affiliation(s)
- Daniel J Blumenthal
- *U.S. Department of Energy, 1000 Independence Ave SW, Washington,DC 20585; †Radiation Emergency Assistance Center/Training Site, PO Box 117, MS-39, Oak Ridge, TN 37831; ‡Oak Ridge Associated Universities, 4301 Wilson Boulevard, Arlington, VA 22203; §U.S. Department of Health and Human Services, 200 Independence Ave SW, Washington, DC 20201; **Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bethesda, MD 20889
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Sullivan JM, Prasanna PGS, Grace MB, Wathen L, Wallace RL, Koerner JF, Coleman CN. Assessment of biodosimetry methods for a mass-casualty radiological incident: medical response and management considerations. HEALTH PHYSICS 2013; 105:540-54. [PMID: 24162058 PMCID: PMC3810609 DOI: 10.1097/hp.0b013e31829cf221] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual's radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual's dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a standalone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, the authors reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point.
Collapse
Affiliation(s)
- Julie M. Sullivan
- Office of Preparedness and Emergency Operations, Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC
- AAAS Science and Technology Policy Fellow, Washington DC
| | - Pataje G. S. Prasanna
- Radia on Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
| | - Marcy B. Grace
- Biomedical Advanced Research & Development Authority, Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC
| | - Lynne Wathen
- Biomedical Advanced Research & Development Authority, Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC
| | - Rodney L. Wallace
- Biomedical Advanced Research & Development Authority, Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC
| | - John F. Koerner
- Office of Preparedness and Emergency Operations, Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC
| | - C. Norman Coleman
- Office of Preparedness and Emergency Operations, Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC
- Radia on Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
| |
Collapse
|
13
|
Maznyk NA, Wilkins RC, Carr Z, Lloyd DC. The capacity, capabilities and needs of the WHO BioDoseNet member laboratories. RADIATION PROTECTION DOSIMETRY 2012; 151:611-620. [PMID: 22908357 DOI: 10.1093/rpd/ncs156] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Biodosimetry is an essential tool for providing timely assessments of radiation exposure, particularly when physical dosimetry is unavailable or unreliable. For mass-casualty events involving public exposure to ionising radiation, it is paramount to rapidly provide this dose information for medical management of casualties. The dicentric chromosome assay is currently the most reliable accepted method for biodosimetry; however, in a mass-casualty scenario, the throughput of this assay will be challenged by its time-consuming nature and the specific expertise required. To address this limitation, many countries have established expertise in cytogenetic biodosimetry and started developing surge capabilities through setting up regional networks to deal with emergency situations. To capitalise on this growing expertise and organise it into an internationally coordinated laboratory network, the World Health Organization has created and launched a global biodosimetry network (BioDoseNet). In order to determine the existing capacity of BioDoseNet member laboratories, including their expertise and in vivo experience, involvement in national and international activities, problems, needs and prospects, an in-depth survey was conducted. These survey results provide significant information on the current state of emergency cytogenetic biodosimetry capabilities around the world.
Collapse
Affiliation(s)
- N A Maznyk
- Institute for Medical Radiology of the Academy of Medical Science of Ukraine, Pushkinskaya St. 82, Kharkiv 61024, Ukraine
| | | | | | | |
Collapse
|
14
|
Flegal FN, Devantier Y, Marro L, Wilkins RC. Validation of QuickScan dicentric chromosome analysis for high throughput radiation biological dosimetry. HEALTH PHYSICS 2012; 102:143-153. [PMID: 22217587 DOI: 10.1097/hp.0b013e3182307758] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Currently, the dicentric chromosome assay (DCA) is used to estimate radiation doses to individuals following accidental radiological and nuclear overexposures when traditional dosimetry methods are not available. While being an exceptionally sensitive method for estimating doses by radiation, conventional DCA is time-intensive and requires highly trained expertise for analysis. For this reason, in a mass casualty situation, triage-quality conventional DCA struggles to provide dose estimations in a timely manner for triage purposes. In Canada, a new scoring technique, termed DCA QuickScan, has been devised to increase the throughput of this assay. DCA QuickScan uses traditional DCA sample preparation methods while adapting a rapid scoring approach. In this study, both conventional and QuickScan methods of scoring the DCA assay were compared for accuracy and sensitivity. Dose response curves were completed on four different donors based on the analysis of 1,000 metaphases or 200 events at eight to nine dose points by eight different scorers across two laboratories. Statistical analysis was performed on the data to compare the two methods within and across the laboratories and to test their respective sensitivities for dose estimation. This study demonstrated that QuickScan is statistically similar to conventional DCA analysis and is capable of producing dose estimates as low as 0.1 Gy but up to six times faster. Therefore, DCA QuickScan analysis can be used as a sensitive and accurate method for scoring samples for radiological biodosimetry in mass casualty situations or where faster dose assessment is required.
Collapse
Affiliation(s)
- F N Flegal
- Atomic Energy of Canada Limited, Chalk River Laboratories, Chalk River, ON, K0J 1J0, Canada.
| | | | | | | |
Collapse
|
15
|
Ainsbury EA, Bakhanova E, Barquinero JF, Brai M, Chumak V, Correcher V, Darroudi F, Fattibene P, Gruel G, Guclu I, Horn S, Jaworska A, Kulka U, Lindholm C, Lloyd D, Longo A, Marrale M, Monteiro Gil O, Oestreicher U, Pajic J, Rakic B, Romm H, Trompier F, Veronese I, Voisin P, Vral A, Whitehouse CA, Wieser A, Woda C, Wojcik A, Rothkamm K. Review of retrospective dosimetry techniques for external ionising radiation exposures. RADIATION PROTECTION DOSIMETRY 2011; 147:573-92. [PMID: 21183550 DOI: 10.1093/rpd/ncq499] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The current focus on networking and mutual assistance in the management of radiation accidents or incidents has demonstrated the importance of a joined-up approach in physical and biological dosimetry. To this end, the European Radiation Dosimetry Working Group 10 on 'Retrospective Dosimetry' has been set up by individuals from a wide range of disciplines across Europe. Here, established and emerging dosimetry methods are reviewed, which can be used immediately and retrospectively following external ionising radiation exposure. Endpoints and assays include dicentrics, translocations, premature chromosome condensation, micronuclei, somatic mutations, gene expression, electron paramagnetic resonance, thermoluminescence, optically stimulated luminescence, neutron activation, haematology, protein biomarkers and analytical dose reconstruction. Individual characteristics of these techniques, their limitations and potential for further development are reviewed, and their usefulness in specific exposure scenarios is discussed. Whilst no single technique fulfils the criteria of an ideal dosemeter, an integrated approach using multiple techniques tailored to the exposure scenario can cover most requirements.
Collapse
Affiliation(s)
- E A Ainsbury
- Centre for Radiation, Health Protection Agency, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire OX11 0RQ, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Wilkins RC, Romm H, Oestreicher U, Marro L, Yoshida MA, Suto Y, Prasanna PGS. Biological Dosimetry by the Triage Dicentric Chromosome Assay - Further validation of International Networking. RADIAT MEAS 2011; 46:923-928. [PMID: 21949482 DOI: 10.1016/j.radmeas.2011.03.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Biological dosimetry is an essential tool for estimating radiation doses received to personnel when physical dosimetry is not available or inadequate. The current preferred biodosimetry method is based on the measurement of radiation-specific dicentric chromosomes in exposed individuals' peripheral blood lymphocytes. However, this method is labour-, time- and expertise-demanding. Consequently, for mass casualty applications, strategies have been developed to increase its throughput. One such strategy is to develop validated cytogenetic biodosimetry laboratory networks, both national and international. In a previous study, the dicentric chromosome assay (DCA) was validated in our cytogenetic biodosimetry network involving five geographically dispersed laboratories. A complementary strategy to further enhance the throughput of the DCA among inter-laboratory networks is to use a triage DCA where dose assessments are made by truncating the labour-demanding and time-consuming metaphase-spread analysis to 20 to 50 metaphase spreads instead of routine 500 to 1000 metaphase spread analysis. Our laboratory network also validated this triage DCA, however, these dose estimates were made using calibration curves generated in each laboratory from the blood samples irradiated in a single laboratory. In an emergency situation, dose estimates made using pre-existing calibration curves which may vary according to radiation type and dose rate and therefore influence the assessed dose. Here, we analyze the effect of using a pre-existing calibration curve on assessed dose among our network laboratories. The dose estimates were made by analyzing 1000 metaphase spreads as well as triage quality scoring and compared to actual physical doses applied to the samples for validation. The dose estimates in the laboratory partners were in good agreement with the applied physical doses and determined to be adequate for guidance in the treatment of acute radiation syndrome.
Collapse
|
17
|
Beinke C, Oestreicher U, Riecke A, Kulka U, Meineke V, Romm H. Inter-laboratory comparison to validate the dicentric assay as a cytogenetic triage tool for medical management of radiation accidents. RADIAT MEAS 2011. [DOI: 10.1016/j.radmeas.2011.05.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Fenech M. Current status, new frontiers and challenges in radiation biodosimetry using cytogenetic, transcriptomic and proteomic technologies. RADIAT MEAS 2011. [DOI: 10.1016/j.radmeas.2011.01.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
19
|
Garty G, Karam A, Brenner DJ. Infrastructure to support ultra high throughput biodosimetry screening after a radiological event. Int J Radiat Biol 2011; 87:754-65. [PMID: 21675819 PMCID: PMC3169379 DOI: 10.3109/09553002.2011.583317] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE After a large-scale radiological event, there will be a pressing need to assess, within a few days, the radiation doses received by tens or hundreds of thousands of individuals. This is for triage, to prevent treatment locations from being overwhelmed, in what is sure to be a resource limited scenario, as well as to facilitate dose-dependent treatment decisions. In addition there are psycho-social considerations, in that active reassurance of minimal exposure is a potentially effective antidote to mass panic, as well as long-term considerations, to facilitate later studies of cancer and other long-term disease risks. MATERIALS AND METHODS As described elsewhere in this issue, we are developing a Rapid Automated Biodosimetry Tool (RABiT). The RABiT allows high throughput analysis of thousands of blood samples per day, providing a dose estimate that can be used to support clinical triage and treatment decisions. RESULTS Development of the RABiT has motivated us to consider the logistics of incorporating such a system into the existing emergency response scenarios of a large metropolitan area. We present here a view of how one or more centralized biodosimetry readout devices might be incorporated into an infrastructure in which fingerstick blood samples are taken at many distributed locations within an affected city or region and transported to centralized locations. CONCLUSIONS High throughput biodosimetry systems offer the opportunity to perform biodosimetric assessments on a large number of persons. As such systems reach a high level of maturity, emergency response scenarios will need to be tweaked to make use of these powerful tools. This can be done relatively easily within the framework of current scenarios.
Collapse
Affiliation(s)
- Guy Garty
- Radiological Research Accelerator Facility, Columbia University, Irvington, NY 10533, USA.
| | | | | |
Collapse
|
20
|
Li C, Wilkins R, Dai X, Sadi B, Ko R, Kramer GH. Canada's efforts in developing capabilities in radiological population monitoring. HEALTH PHYSICS 2011; 101:112-117. [PMID: 21709496 DOI: 10.1097/hp.0b013e318213a719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Population monitoring is an important component of radiological and nuclear emergency preparedness and response. Since 2002, Canada has been investing in developing national capabilities in radiological population monitoring. This paper summarizes Canada's efforts in developing methods and techniques in biological dosimetry and in vivo and in vitro bioassay techniques. There are still many gaps to fill that require further efforts. Integration of different monitoring methods and techniques in order to have the best assessment of radiation dose to support medical management and integration of Canada's efforts with international efforts are recommended.
Collapse
Affiliation(s)
- Chunsheng Li
- Radiation Protection Bureau, Health Canada, Ottawa, ON, Canada K1A 1C1.
| | | | | | | | | | | |
Collapse
|
21
|
Filiano AN, Fathallah-Shaykh HM, Fiveash J, Gage J, Cantor A, Kharbanda S, Johnson MR. Gene expression analysis in radiotherapy patients and C57BL/6 mice as a measure of exposure to ionizing radiation. Radiat Res 2011; 176:49-61. [PMID: 21361780 DOI: 10.1667/rr2419.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Dose assessment after radiological disasters is imperative to decrease mortality through rationally directed medical intervention. Our goal was to identify biomarkers capable of qualitative (nonirradiated/irradiated) and/or quantitative (dose) assessment of radiation exposure. Using real-time quantitative PCR, biodosimetry genes were identified in blood samples from cancer patients undergoing total-body irradiation. Time- (5, 12, 23, 48 h) and dose- (0-8 Gy) dependent changes in gene expression were examined in C57BL/6 mice. A training set was used to derive weighted voting classification algorithms (nonirradiated/irradiated) and continuous regression (dose assessment) models that were tested in a separate validation set of mice. Of eight biodosimetry genes identified in cancer patients ( ACTA2 , BBC3 , CCNG1 , CDKN1A , GADD45A , MDK , SERPINE1 , Tnfrsf10b ), expression of BBC3 , CCNG1 , CDKN1A , SERPINE1 and Tnfrsf10b was significantly (P < 0.05) increased in irradiated mice. CCNG1 and CDKN1A expression segregated irradiated mice from controls with an accuracy, specificity and sensitivity of 96.3, 100.0 and 94.4%, respectively, at 48 h. Multiple linear regression analysis predicted doses for the 0-, 1-, 2-, 4-, 6- and 8-Gy treatment groups as 0.0 ± 0.2, 1.6 ± 1.0, 2.9 ± 1.4, 5.1 ± 2.0, 5.3 ± 0.7 and 10.5 ± 5.6 Gy, respectively. These results suggest that gene expression analysis could be incorporated into biodosimetry protocols for qualitative and quantitative assessment of radiation exposure.
Collapse
Affiliation(s)
- Ashley N Filiano
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, AL 35294, USA
| | | | | | | | | | | | | |
Collapse
|
22
|
Redon CE, Nakamura AJ, Gouliaeva K, Rahman A, Blakely WF, Bonner WM. The use of gamma-H2AX as a biodosimeter for total-body radiation exposure in non-human primates. PLoS One 2010; 5:e15544. [PMID: 21124906 PMCID: PMC2990755 DOI: 10.1371/journal.pone.0015544] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 10/13/2010] [Indexed: 02/07/2023] Open
Abstract
Background There is a crucial shortage of methods capable of determining the extent of accidental exposures of human beings to ionizing radiation. However, knowledge of individual exposures is essential for early triage during radiological incidents to provide optimum possible life-sparing medical procedures to each person. Methods and Findings We evaluated immunocytofluorescence-based quantitation of γ-H2AX foci as a biodosimeter of total-body radiation exposure (60Co γ-rays) in a rhesus macaque (Macaca mulatta) model. Peripheral blood lymphocytes and plucked hairs were collected from 4 cohorts of macaques receiving total body irradiation doses ranging from 1 Gy to 8.5 Gy. Each cohort consisted of 6 experimental and 2 control animals. Numbers of residual γ-H2AX foci were proportional to initial irradiation doses and statistically significant responses were obtained until 1 day after 1 Gy, 4 days after 3.5 and 6.5 Gy, and 14 days after 8.5 Gy in lymphocytes and until 1 day after 1 Gy, at least 2 days after 3.5 and 6.5 Gy, and 9 days after 8.5 Gy in plucked hairs. Conclusion These findings indicate that quantitation of γ-H2AX foci may make a robust biodosimeter for analyzing total-body exposure to ionizing radiation in humans. This tool would help clinicians prescribe appropriate types of medical intervention for optimal individual outcome. These results also demonstrate that the use of a high throughput γ-H2AX biodosimeter would be useful for days post-exposure in applications like large-scale radiological events or radiation therapy. In addition, this study validates a possibility to use plucked hair in future clinical trials investigating genotoxic effects of drugs and radiation treatments.
Collapse
Affiliation(s)
- Christophe E Redon
- Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
| | | | | | | | | | | |
Collapse
|
23
|
Chauhan V, Wilkins RC. Report of the workshop on biological dosimetry: increasing capacity for emergency response. RADIATION PROTECTION DOSIMETRY 2010; 142:2-7. [PMID: 20729542 DOI: 10.1093/rpd/ncq203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Recent events have brought increased attention to the possibility and dangers of a radiological terrorist threat and its potential implication on the national capacity for radiation accident preparedness. In such an event, there is a pressing need to rapidly identify severely irradiated individuals who require prompt medical attention from those who have not been exposed or have been subject to low doses. Initial dose assessment is a key component in rapid triage and treatment, however, the development of accurate methods for rapid dose assessment remains a challenge. In this report, the authors describe a recent workshop supported by the Chemical, Biological, Radiological-Nuclear and Explosives Research and Technology Initiative regarding the international effort to increase biological dosimetry capacity to effectively mount an emergency response in a mass casualty situation. Specifically, the focus of the workshop was on the current state of biological dosimetry capabilities and capacities in North America, recent developments towards increasing throughput for biological dosimetry and to identify opportunities for developing a North American Biological Dosimetry Network and forming partnerships and collaborations within Canada and the USA.
Collapse
Affiliation(s)
- V Chauhan
- Consumer and Clinical Radiation Protection Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | | |
Collapse
|
24
|
Pandey BN, Kumar A, Tiwari P, Mishra KP. Radiobiological basis in management of accidental radiation exposure. Int J Radiat Biol 2010; 86:613-35. [DOI: 10.3109/09553001003746059] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
25
|
Garty G, Chen Y, Salerno A, Turner H, Zhang J, Lyulko O, Bertucci A, Xu Y, Wang H, Simaan N, Randers-Pehrson G, Yao YL, Amundson SA, Brenner DJ. The RABIT: a rapid automated biodosimetry tool for radiological triage. HEALTH PHYSICS 2010; 98:209-17. [PMID: 20065685 PMCID: PMC2923588 DOI: 10.1097/hp.0b013e3181ab3cb6] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
In response to the recognized need for high throughput biodosimetry methods for use after large-scale radiological events, a logical approach is complete automation of standard biodosimetric assays that are currently performed manually. The authors describe progress to date on the RABIT (Rapid Automated BIodosimetry Tool), designed to score micronuclei or gamma-H2AX fluorescence in lymphocytes derived from a single drop of blood from a fingerstick. The RABIT system is designed to be completely automated, from the input of the capillary blood sample into the machine to the output of a dose estimate. Improvements in throughput are achieved through use of a single drop of blood, optimization of the biological protocols for in situ analysis in multi-well plates, implementation of robotic-plate and liquid handling, and new developments in high-speed imaging. Automating well-established bioassays represents a promising approach to high-throughput radiation biodosimetry, both because high throughputs can be achieved, but also because the time to deployment is potentially much shorter than for a new biological assay. Here the authors describe the development of each of the individual modules of the RABIT system and show preliminary data from key modules. System integration is ongoing, followed by calibration and validation.
Collapse
Affiliation(s)
- Guy Garty
- Center for Radiological Research, Columbia University Medical Center, New York, NY 10032
| | - Youhua Chen
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Alessio Salerno
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Helen Turner
- Center for Radiological Research, Columbia University Medical Center, New York, NY 10032
| | - Jian Zhang
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Oleksandra Lyulko
- Center for Radiological Research, Columbia University Medical Center, New York, NY 10032
| | - Antonella Bertucci
- Center for Radiological Research, Columbia University Medical Center, New York, NY 10032
| | - Yanping Xu
- Center for Radiological Research, Columbia University Medical Center, New York, NY 10032
| | - Hongliang Wang
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Nabil Simaan
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | | | - Y. Lawrence Yao
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Sally A. Amundson
- Center for Radiological Research, Columbia University Medical Center, New York, NY 10032
| | - David J. Brenner
- Center for Radiological Research, Columbia University Medical Center, New York, NY 10032
| |
Collapse
|
26
|
Prasanna PG, Moroni M, Pellmar TC. Triage dose assessment for partial-body exposure: dicentric analysis. HEALTH PHYSICS 2010; 98:244-51. [PMID: 20065689 PMCID: PMC2806648 DOI: 10.1097/01.hp.0000348020.14969.4] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Partial-body biodosimetry is likely to be required after a radiological or nuclear exposure. Clinical signs and symptoms, distribution of dicentrics in circulating blood cells, organ-specific biomarkers, and physical signals in teeth and fingernails all can provide indications of non-homogeneous exposures. Organ specific biomarkers may provide early warning regarding physiological systems at risk after radiation injury. Use of a combination of markers and symptoms will be needed for clinical insights for therapeutic approaches. Analysis of dicentrics, a marker specific for radiation injury, is the "gold standard" of biodosimetry and can reveal partial-body exposures. Automation of sample processing for dicentric analysis can increase throughput with customization of off-the-shelf technologies for cytogenetic sample processing and information management. Automated analysis of the metaphase spreads is currently limited, but improvements are in development. The efforts described here bridge the technological gaps to allow the use of dicentric chromosome assay (DCA) for risk-based stratification of mass casualties. This article summarizes current knowledge on partial-body cytogenetic dose assessment, synthesizing information leading to the proposal of an approach to triage dose prediction in radiation mass casualties that is based on equivalent whole-body doses under partial-body exposure conditions and assesses the validity of using this model. An initial screening using only 20 metaphase spreads per subject can confirm irradiation above 2 Gy. A subsequent increase to 50 metaphases improves dose determination to allow risk stratification for clinical triage. Metaphases evaluated for inhomogeneous distribution of dicentrics can reveal partial-body exposures. The authors tested the validity of this approach in an in vitro model that simulates partial-body irradiation by mixing irradiated and un-irradiated lymphocytes in various proportions. Preliminary results support the notion that this approach will be effective under a range of conditions including some partial-body exposures, but may have limitations with low doses or small proportions of irradiated parts of the body. These studies address an important problem in the diagnosis of partial-body irradiation and dose assessment in mass casualties and propose a solution. However, additional work is needed to fully develop and validate the application of DCA to partial-body exposures.
Collapse
Affiliation(s)
- Pataje G.S. Prasanna
- Armed Forces Radiobiology Research Institute, 8901 Wisconsin Ave, Bldg. 42, Bethesda, MD 20889-5603, Tel: (301) 295-9210; Fax: (301) 295-6857, E-mail:
| | - Maria Moroni
- Armed Forces Radiobiology Research Institute, 8901 Wisconsin Ave, Bldg. 42, Bethesda, MD 20889-5603, Tel: (301) 295-9210; Fax: (301) 295-6857, E-mail:
| | - Terry C. Pellmar
- Armed Forces Radiobiology Research Institute, 8901 Wisconsin Ave, Bldg. 42, Bethesda, MD 20889-5603, Tel: (301) 295-9210; Fax: (301) 295-6857, E-mail:
| |
Collapse
|
27
|
Beinke C, Braselmann H, Meineke V. Establishment of an x-ray standard calibration curve by conventional dicentric analysis as prerequisite for accurate radiation dose assessment. HEALTH PHYSICS 2010; 98:261-268. [PMID: 20065692 DOI: 10.1097/hp.0b013e3181b35a53] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The dicentric assay was established to carry out cytogenetic biodosimetry after suspected radiation overexposure, including a comprehensive documentation system to record the processing of the specimen, all data, results, and stored information. As an essential prerequisite for retrospective radiation dose assessment, a dose-response curve for dicentric induction by in vitro x-ray irradiation of peripheral blood samples was produced. The accelerating potential was 240 kV (maximum photon energy: 240 keV). A total of 8,377 first-division metaphases of four healthy volunteers were analyzed after exposure to doses ranging from 0.2 to 4.0 Gy at a dose rate of 1.0 Gy min. The background level of aberrations at 0-dose was determined by the analysis of 14,522 first-division metaphases obtained from unirradiated blood samples of 10 healthy volunteers. The dose-response relationship follows a linear-quadratic equation, Y = c + alphaD + betaD, with the coefficients c = 0.0005 +/- 0.0002, alpha = 0.043 +/- 0.006, and beta = 0.063 +/- 0.004. The technical competence and the quality of the calibration curve were assessed by determination of the dose prediction accuracy in an in vitro experiment simulating whole-body exposures within a range of 0.2 to 2.0 Gy. Dose estimations were derived by scoring up to 500-1,000 metaphase spreads or more (full estimation mode) and by evaluating only 50 metaphase spreads (triage mode) per subject. The triage mode was applied by performing manifold evaluations of the full estimation data in order to test the robustness of the curve for triage purposes and to assess possible variations among the estimated doses referring to a single exposure and preparation.
Collapse
Affiliation(s)
- Christina Beinke
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany.
| | | | | |
Collapse
|
28
|
Prasanna PGS, Blakely WF, Bertho JM, Chute JP, Cohen EP, Goans RE, Grace MB, Lillis-Hearne PK, Lloyd DC, Lutgens LCHW, Meineke V, Ossetrova NI, Romanyukha A, Saba JD, Weisdorf DJ, Wojcik A, Yukihara EG, Pellmar TC. Synopsis of partial-body radiation diagnostic biomarkers and medical management of radiation injury workshop. Radiat Res 2010; 173:245-253. [PMID: 20095857 PMCID: PMC8914528 DOI: 10.1667/rr1993.1] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Radiation exposures from accidents, nuclear detonations or terrorist incidents are unlikely to be homogeneous; however, current biodosimetric approaches are developed and validated primarily in whole-body irradiation models. A workshop was held at the Armed Forces Radiobiology Research Institute in May 2008 to draw attention to the need for partial-body biodosimetry, to discuss current knowledge, and to identify the gaps to be filled. A panel of international experts and the workshop attendees discussed the requirements and concepts for a path forward. This report addresses eight key areas identified by the Workshop Program Committee for future focus: (1) improved cytogenetics, (2) clinical signs and symptoms, (3) cutaneous bioindicators, (4) organ-specific biomarkers, (5) biophysical markers of dose, (6) integrated diagnostic approaches, (7) confounding factors, and (8) requirements for post-event medical follow-up. For each area, the status, advantages and limitations of existing approaches and suggestions for new directions are presented.
Collapse
Affiliation(s)
- Pataje G. S. Prasanna
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20889
| | - William F. Blakely
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20889
| | - Jean-Marc Bertho
- Institut de Radioprotection et de Sûreté Nucléaire, 92262 Fontenay aux roses cedex, France
| | - John P. Chute
- Division of Cellular Therapy and Stem Cell Transplantation, Duke University Medical Center, Durham, North Carolina 27710
| | - Eric P. Cohen
- Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Ronald E. Goans
- MJW Corp., Amherst, New York 14228, and Radiation Emergency Assistance Center/Training Site, Oak Ridge, Tennessee, 37830
| | - Marcy B. Grace
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20889
| | - Patricia K. Lillis-Hearne
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20889
| | - David C. Lloyd
- UK Health Protection Agency, Centre for Radiation, Chemical, and Environmental Hazards, Chilton, OX11 0RQ, United Kingdom
| | - Ludy C. H. W. Lutgens
- Maastricht Radiotherapy and Oncology Clinic (MAASTRO Clinic), Maastricht, the Netherlands
| | - Viktor Meineke
- Bundeswehr Institute of Radiobiology, D-80937 Munich, Germany
| | - Natalia I. Ossetrova
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20889
| | - Alexander Romanyukha
- Naval Dosimetry Center, Bethesda, Maryland 20889, and Uniformed Services University, Bethesda, Maryland 20814
| | - Julie D. Saba
- Children's Hospital Oakland Research Institute (CHORI), Oakland, California 94609
| | | | | | | | - Terry C. Pellmar
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20889
| |
Collapse
|
29
|
Wilkins RC, Romm H, Kao TC, Awa AA, Yoshida MA, Livingston GK, Jenkins MS, Oestreicher U, Pellmar TC, Prasanna PGS. Interlaboratory Comparison of the Dicentric Chromosome Assay for Radiation Biodosimetry in Mass Casualty Events. Radiat Res 2008; 169:551-60. [DOI: 10.1667/rr1272.1] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2007] [Accepted: 01/23/2008] [Indexed: 11/03/2022]
|