Management of Casualties from Radiation Events

Exosomes: A new perspective for radiation combined injury as biomarker and therapeutics

Radiation Combined Injuries (RCI) pose formidable public health risks, particularly in the context of nuclear incidents, necessitating specialized treatments and development of biomarkers. RCI encompasses instances where ionizing radiation exposure coincides with burns, wounds, or trauma. However, the limited understanding of cellular responses hinders progress in developing effective therapies. This article underscores the pivotal role of exosomes, nano-sized particles (30-120 nm) actively secreted by cells, in addressing the intricate challenges posed by RCI. Exosomes serve as vehicles for the transportation of bioactive molecules, including proteins, lipids, and miRNA, thereby facilitating processes critical to radiotherapy, burn injury, and wound healing. Exosomes hold significant promise for the transformation of RCI management by reducing inflammation, promoting wound healing, managing sepsis, altering immunological responses, and modulating signal transduction pathways. Moreover, exosomes are also being explored as biomarker for various diseases and stress conditions including radiation exposure and associated injuries. This comprehensive review highlights the burgeoning potential of exosomes in advancing the management of RCI, thereby enhancing public health preparedness and response.

Skin Absorbed Dose Coefficients for Human Legs from Beta Radiation as a Function of Height

External exposure to skin from beta-emitter radionuclides following severe reactor accidents or nuclear testing can result in beta burning and other health complications. The skin absorbed dose coefficient (SADC) measures the energy deposition into the skin during such accidents. The U.S. Environmental Protection Agency has published several reports to measure the possible energy deposition into the skin in such accidents. However, the most recent SADC published by Federal Guidance Report (FGR) 12 was computed only at one meter above the contaminated surface. Therefore, it was necessary to develop a model to estimate the absorbed dose coefficients for skin at different heights. In this manuscript, Geant4, a Monte Carlo simulator toolkit, was used to estimate the absorbed dose coefficients from electron sources located on the soil surface with energies ranging from 0.1 to 4 MeV. The energy deposited from primary electrons, secondary electrons, and photons in a 50 µm thick layer of epidermis tissue (Basal Cells Layer) located at a depth of 50 µm from the skin surface was estimated at several discrete heights of human leg phantom. More than 40% of the total energy deposited comes from secondary electrons and photons in energy sources of 0.1 and 0.2 MeV on average, but for higher energies, this percentage is less than 1%, which indicates primary electrons are the main source of the deposited energy in the skin. Furthermore, the results showed the energy deposited into skin closer to the ground was 50–100% higher than the previously estimated doses for 1 m above the ground. The results from Geant4 showed a great correlation (R2 = 0.972) with the FGR 12 data at one meter height, and they were aligned with the published values from FGR 12, which validated the simulation results. Therefore, the calculated dose coefficients for different energy sources and different heights could be used in radiation protection measurements.