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Portu AM, Espain MS, Thorp SI, Trivillin VA, Curotto P, Monti Hughes A, Pozzi ECC, Garabalino MA, Palmieri MA, Granell PN, Golmar F, Schwint AE, Saint Martin G. Enhanced Resolution of Neutron Autoradiography with UV-C Sensitization to Study Boron Microdistribution in Animal Models. Life (Basel) 2023; 13:1578. [PMID: 37511953 PMCID: PMC10381447 DOI: 10.3390/life13071578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The assessment of boron microdistribution is essential to evaluate the suitability of boron neutron capture therapy (BNCT) in different biological models. In our laboratory, we have reported a methodology to produce cell imprints on polycarbonate through UV-C sensitization. The aim of this work is to extend the technique to tissue samples in order to enhance spatial resolution. As tissue structure largely differs from cultured cells, several aspects must be considered. We studied the influence of the parameters involved in the imprint and nuclear track formation, such as neutron fluence, different NTDs, etching and UV-C exposure times, tissue absorbance, thickness, and staining, among others. Samples from different biological models of interest for BNCT were used, exhibiting homogeneous and heterogeneous histology and boron microdistribution. The optimal conditions will depend on the animal model under study and the resolution requirements. Both the imprint sharpness and the fading effect depend on tissue thickness. While 6 h of UV-C was necessary to yield an imprint in CR-39, only 5 min was enough to observe clear imprints on Lexan. The information related to microdistribution of boron obtained with neutron autoradiography is of great relevance when assessing new boron compounds and administration protocols and also contributes to the study of the radiobiology of BNCT.
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Affiliation(s)
- Agustina Mariana Portu
- National Atomic Energy Commission (CNEA), San Martín C1429BNP, Argentina
- National Scientific and Technological Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
- School of Science & Technology, National University of San Martín (UNSAM), San Martín B1650JKA, Argentina
| | - María Sol Espain
- National Atomic Energy Commission (CNEA), San Martín C1429BNP, Argentina
- National Scientific and Technological Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
- School of Science & Technology, National University of San Martín (UNSAM), San Martín B1650JKA, Argentina
| | - Silvia Inés Thorp
- National Atomic Energy Commission (CNEA), San Martín C1429BNP, Argentina
- National Scientific and Technological Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
| | - Verónica Andrea Trivillin
- National Atomic Energy Commission (CNEA), San Martín C1429BNP, Argentina
- National Scientific and Technological Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
| | - Paula Curotto
- National Atomic Energy Commission (CNEA), San Martín C1429BNP, Argentina
| | - Andrea Monti Hughes
- National Atomic Energy Commission (CNEA), San Martín C1429BNP, Argentina
- National Scientific and Technological Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
| | | | | | - Mónica Alejandra Palmieri
- Department of Biodiversity and Experimental Biology, Faculty of Exact and Natural Sciences, University of Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires C1428EGA, Argentina
| | - Pablo Nicolás Granell
- Micro and Nanotechnology Centre of the Bicentennial (CNMB), National Institute of Industrial Technology (INTI), San Martín B1650JKA, Argentina
| | - Federico Golmar
- National Scientific and Technological Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
- School of Science & Technology, National University of San Martín (UNSAM), San Martín B1650JKA, Argentina
- Micro and Nanotechnology Centre of the Bicentennial (CNMB), National Institute of Industrial Technology (INTI), San Martín B1650JKA, Argentina
| | - Amanda Elena Schwint
- National Atomic Energy Commission (CNEA), San Martín C1429BNP, Argentina
- National Scientific and Technological Research Council (CONICET), Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
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Peter R, Sandmaier BM, Dion MP, Frost SHL, Santos EB, Kenoyer A, Hamlin DK, Wilbur DS, Stewart RD, Fisher DR, Vetter K, Seo Y, Miller BW. Small-scale (sub-organ and cellular level) alpha-particle dosimetry methods using an iQID digital autoradiography imaging system. Sci Rep 2022; 12:17934. [PMID: 36289434 PMCID: PMC9606121 DOI: 10.1038/s41598-022-22664-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/18/2022] [Indexed: 01/20/2023] Open
Abstract
Targeted radiopharmaceutical therapy with alpha-particle emitters (αRPT) is advantageous in cancer treatment because the short range and high local energy deposition of alpha particles enable precise radiation delivery and efficient tumor cell killing. However, these properties create sub-organ dose deposition effects that are not easily characterized by direct gamma-ray imaging (PET or SPECT). We present a computational procedure to determine the spatial distribution of absorbed dose from alpha-emitting radionuclides in tissues using digital autoradiography activity images from an ionizing-radiation quantum imaging detector (iQID). Data from 211At-radioimmunotherapy studies for allogeneic hematopoietic cell transplantation in a canine model were used to develop these methods. Nine healthy canines were treated with 16.9-30.9 MBq 211At/mg monoclonal antibodies (mAb). Lymph node biopsies from early (2-5 h) and late (19-20 h) time points (16 total) were obtained, with 10-20 consecutive 12-µm cryosections extracted from each and imaged with an iQID device. iQID spatial activity images were registered within a 3D volume for dose-point-kernel convolution, producing dose-rate maps. The accumulated absorbed doses for high- and low-rate regions were 9 ± 4 Gy and 1.2 ± 0.8 Gy from separate dose-rate curves, respectively. We further assess uptake uniformity, co-registration with histological pathology, and requisite slice numbers to improve microscale characterization of absorbed dose inhomogeneities in αRPT.
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Affiliation(s)
- Robin Peter
- grid.47840.3f0000 0001 2181 7878Department of Nuclear Engineering, University of California, Berkeley, CA USA ,grid.266102.10000 0001 2297 6811Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA USA
| | - Brenda M. Sandmaier
- grid.270240.30000 0001 2180 1622Fred Hutchinson Cancer Center, Seattle, WA USA ,grid.34477.330000000122986657Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA USA
| | - Michael P. Dion
- grid.135519.a0000 0004 0446 2659Oak Ridge National Laboratory, Oak Ridge, TN USA
| | - Sofia H. L. Frost
- grid.270240.30000 0001 2180 1622Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Erlinda B. Santos
- grid.270240.30000 0001 2180 1622Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Aimee Kenoyer
- grid.270240.30000 0001 2180 1622Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Donald K. Hamlin
- grid.34477.330000000122986657Department of Radiation Oncology, University of Washington, Seattle, WA USA
| | - D. Scott Wilbur
- grid.34477.330000000122986657Department of Radiation Oncology, University of Washington, Seattle, WA USA
| | - Robert D. Stewart
- grid.34477.330000000122986657Department of Radiation Oncology, University of Washington, Seattle, WA USA
| | | | - Kai Vetter
- grid.47840.3f0000 0001 2181 7878Department of Nuclear Engineering, University of California, Berkeley, CA USA
| | - Youngho Seo
- grid.47840.3f0000 0001 2181 7878Department of Nuclear Engineering, University of California, Berkeley, CA USA ,grid.266102.10000 0001 2297 6811Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA USA
| | - Brian W. Miller
- grid.134563.60000 0001 2168 186XDepartment of Radiation Oncology, Department of Medical Imaging, College of Medicine, University of Arizona, Tucson, AZ USA
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Garcia AN, Casanova NG, Valera DG, Sun X, Song JH, Kempf CL, Moreno-Vinasco L, Burns K, Bermudez T, Valdez M, Cuellar G, Gregory T, Oita RC, Hernon VR, Barber C, Camp SM, Martin D, Liu Z, Bime C, Sammani S, Cress AE, Garcia JG. Involvement of eNAMPT/TLR4 signaling in murine radiation pneumonitis: protection by eNAMPT neutralization. Transl Res 2022; 239:44-57. [PMID: 34139379 PMCID: PMC8671169 DOI: 10.1016/j.trsl.2021.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/07/2021] [Accepted: 06/10/2021] [Indexed: 01/03/2023]
Abstract
Therapeutic strategies to prevent or reduce the severity of radiation pneumonitis are a serious unmet need. We evaluated extracellular nicotinamide phosphoribosyltransferase (eNAMPT), a damage-associated molecular pattern protein (DAMP) and Toll-Like Receptor 4 (TLR4) ligand, as a therapeutic target in murine radiation pneumonitis. Radiation-induced murine and human NAMPT expression was assessed in vitro, in tissues (IHC, biochemistry, imaging), and in plasma. Wild type C57Bl6 mice (WT) and Nampt+/- heterozygous mice were exposed to 20Gy whole thoracic lung irradiation (WTLI) with or without weekly IP injection of IgG1 (control) or an eNAMPT-neutralizing polyclonal (pAb) or monoclonal antibody (mAb). BAL protein/cells and H&E staining were used to generate a WTLI severity score. Differentially-expressed genes (DEGs)/pathways were identified by RNA sequencing and bioinformatic analyses. Radiation exposure increases in vitro NAMPT expression in lung epithelium (NAMPT promoter activity) and NAMPT lung tissue expression in WTLI-exposed mice. Nampt+/- mice and eNAMPT pAb/mAb-treated mice exhibited significant histologic attenuation of WTLI-mediated lung injury with reduced levels of BAL protein and cells, and plasma levels of eNAMPT, IL-6, and IL-1β. Genomic and biochemical studies from WTLI-exposed lung tissues highlighted dysregulation of NFkB/cytokine and MAP kinase signaling pathways which were rectified by eNAMPT mAb treatment. The eNAMPT/TLR4 pathway is essentially involved in radiation pathobiology with eNAMPT neutralization an effective therapeutic strategy to reduce the severity of radiation pneumonitis.
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Affiliation(s)
- Alexander N Garcia
- Department of Radiation Oncology, University of Arizona Health Sciences, Tucson, Arizona
| | - Nancy G Casanova
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Daniel G Valera
- Department of Radiation Oncology, University of Arizona Health Sciences, Tucson, Arizona
| | - Xiaoguang Sun
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Jin H Song
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Carrie L Kempf
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | | | - Kimberlie Burns
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Tadeo Bermudez
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Mia Valdez
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Genesis Cuellar
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Taylor Gregory
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Radu C Oita
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Vivian Reyes Hernon
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Christy Barber
- Department of Medical Imaging, University of Arizona Health Sciences, Tucson, Arizona
| | - Sara M Camp
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Diego Martin
- Department of Radiology and the Translational Imaging Center, Houston Methodist Research Institute, Houston, Texas
| | - Zhonglin Liu
- Department of Medical Imaging, University of Arizona Health Sciences, Tucson, Arizona
| | - Christian Bime
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Saad Sammani
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Anne E Cress
- Department of Cell and Molecular Medicine, University of Arizona Health Sciences, Tucson, Arizona
| | - Joe Gn Garcia
- Department of Medicine, University of Arizona Health Sciences, Tucson, Arizona.
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Drouet G, Devilliers K, Van der Meeren A. In vitro evidence of the influence of complexation of Pu and Am on uptake by human lung epithelial cells Calu-3. Toxicol In Vitro 2021; 79:105279. [PMID: 34843884 DOI: 10.1016/j.tiv.2021.105279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/18/2021] [Accepted: 11/23/2021] [Indexed: 01/01/2023]
Abstract
Understanding the mechanisms involved in retention and clearance of actinides from the lungs after accidental intake is essential for the evaluation of the associated radiological risks. Although the absorption of radioelements has been shown in vivo to depend on their nature and physico-chemical properties, their mechanisms of translocation remain unknown. In this study, we have evaluated in vitro the binding and uptake by bronchial epithelial cells Calu-3 of 2 transuranic actinides, plutonium (Pu) and americium (Am), as the first steps of translocation across the pulmonary barrier. For this purpose, Calu-3 cells grown to confluence in 24-well plates were exposed to the radioelements for 24 h under various culture conditions. Two compartments were identified for the association of actinides to cells, corresponding to the membrane bound and internalized fractions. Binding of Pu was slightly higher than of Am, and depended on its initial chemical form (nitrate, citrate, colloids). Uptake of Pu and Am nitrate was higher in serum-free conditions than in supplemented medium, with an active mechanism involved in Pu internalization. Overall, our results suggest that complexation of actinides to bioligands may have an influence on their uptake by pulmonary epithelial cells, and therefore possibly on their subsequent absorption into blood.
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Griffiths NM, Van der Meeren A, Grémy O. Comparison of Local and Systemic DTPA Treatment Efficacy According to Actinide Physicochemical Properties Following Lung or Wound Contamination in the Rat. Front Pharmacol 2021; 12:635792. [PMID: 33841153 PMCID: PMC8032982 DOI: 10.3389/fphar.2021.635792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/02/2021] [Indexed: 01/15/2023] Open
Abstract
Purpose: In cases of occupational accidents in nuclear facilities or subsequent to terrorist activities, the most likely routes of internal contamination with alpha-particle emitting actinides, such as plutonium (Pu) and americium (Am), are by inhalation or following wounding. Following contamination, actinide transfer to the circulation and subsequent deposition in skeleton and liver depends primarily on the physicochemical nature of the compound. The treatment remit following internal contamination is to decrease actinide retention and in consequence potential health risks, both at the contamination site and in systemic retention organs as well as to promote elimination. The only approved drug for decorporation of Pu and Am is the metal chelator diethylenetriaminepentaacetic acid (DTPA). However, a limited efficacy of DTPA has been reported following contamination with insoluble actinides, irrespective of the contamination route. The objectives of this work are to evaluate the efficacy of prompt local and/or systemic DTPA treatment regimens following lung or wound contamination by actinides with differing solubility. The conclusions are drawn from retrospective analysis of experimental studies carried out over 10 years. Materials and Methods: Rat lungs or wounds were contaminated either with poorly soluble Mixed OXide (U, Pu O2) or more soluble forms of Pu (nitrate or citrate). DTPA treatment was administered promptly after contamination, locally to lungs by insufflation of a powder or inhalation of aerosolized solution or by injection directly into the wound site. Intravenous injections of DTPA were given either once or repeated in combination with the local treatment. Doses ranged from 1 to 30 µmol/kg. Animals were euthanized from day 7-21 and alpha activity levels were measured in urine, lungs, wound, bone and liver for determination of decorporation efficacy. Results: Different experiments confirmed that whatever the route of contamination, most of the activity is retained at the entry site after insoluble MOX contamination as compared with contamination with more soluble forms which results in very low activities reaching the systemic compartment and subsequent retention in bone and liver. Several DTPA treatment regimens were evaluated that had no significant effect on either lung or wound levels compared with untreated animals. In contrast, in all cases systemic retention (skeleton and liver) was reduced and urinary excretion were enhanced irrespective of the contamination route or DTPA treatment regimen. Conclusion: The present study demonstrates that despite limitation of retention in systemic organs, different DTPA protocols were ineffective in removing insoluble actinides deposited in lungs or wound site. For moderately soluble actinides, local or intravenous DTPA treatment reduced activity levels both at contamination and at systemic sites.
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Affiliation(s)
- Nina M. Griffiths
- Laboratoire de RadioToxicologie, CEA, Université de Paris-Saclay, Bruyères le Châtel, France
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Griffiths NM, Van der Meeren A, Angulo JF, Vincent-Naulleau S. Research on the Radiotoxicology of Plutonium Using Animals: Consideration of the 3Rs-Replace, Reduce, Refine. Health Phys 2020; 119:133-140. [PMID: 32301862 DOI: 10.1097/hp.0000000000001258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To characterize the health effects of incorporated plutonium, many experiments have been conducted using different animal models. These range from (1) applied (tissue uptake/retention determination, decorporation therapy efficacy), (2) fundamental (gene expression, cancer induction), and (3) dosimetry models. In recent years, the use of animals for scientific purposes has become a public concern. The application of the 3Rs - Replace (use of alternative methods or animals not considered capable of experiencing pain, suffering, and distress), Reduce (reduction in animal numbers), and Refine (better animal welfare and minimization of suffering, pain and distress) - has increased to address ethical concerns and legislative requirements. The introduction of novel non-animal technologies is also an important factor as complementary options to animal experimentation. In radiotoxicology research, it seems there is a natural tendency to Replace given the possibility of data reuse obtained from contamination cases in man and animal studies. The creation of "registries" and "repositories" for nuclear industry workers (civil and military) is now a rich legacy for radiotoxicological measurements. Similarly, Reduction in animal numbers can be achieved by good experimental planning with prior statistical analyses of animal numbers required to obtain robust data. Multiple measurements in the same animal over time (external body counting, excreta collection) with appropriate detection instruments also allow Reduction. In terms of Refinement, this has become "de rigueur" and a necessity given the societal and legal concerns for animal welfare. For research in radiotoxicology, particularly long-term studies, better housing conditions within the constraints of radiation protection issues for research workers are an important concern. These are all pertinent considerations for the 3Rs remit and future research in radiotoxicology.
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Affiliation(s)
- Nina M Griffiths
- Laboratoire de RadioToxicologie, CEA, Université Paris-Saclay, Bruyères-le-Châtel, 91297 ARPAJON, France
| | - Anne Van der Meeren
- Laboratoire de RadioToxicologie, CEA, Université Paris-Saclay, Bruyères-le-Châtel, 91297 ARPAJON, France
| | - Jaime F Angulo
- Laboratoire de RadioToxicologie, CEA, Université Paris-Saclay, Bruyères-le-Châtel, 91297 ARPAJON, France
| | - Silvia Vincent-Naulleau
- Bureau des Etudes Biomédicales chez l'Animal, CEA/DRF/D3P/BEBA, 92260 FONTENAY-aux-ROSES, France
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Tabatadze G, Miller BW, Tolmachev SY. Mapping 241Am Spatial Distribution Within Anatomical Bone Structures Using Digital Autoradiography. Health Phys 2019; 117:179-186. [PMID: 30299339 DOI: 10.1097/hp.0000000000000947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Digital autoradiography with the ionizing radiation quantum imaging detector is used at the US Transuranium and Uranium Registries for visualizing the microdistribution of alpha particles from Am and quantifying the activity. The radionuclide spatial distribution was investigated within cortical and trabecular regions of bone samples from US Transuranium and Uranium Registries case 0846. Multiple specimens from the humerus proximal end, humerus proximal shaft, and clavicle acromial end were embedded in plastic, and 100-μm-thick sections were taken and imaged using the ionizing radiation quantum imaging detector. The detector images were superimposed on the anatomical structure images to visualize Am distribution in cortical bone, trabecular bone, and trabecular spongiosa. Activity concentration ratios were used to characterize Am distribution within different bone regions. The trabecular-to-cortical bone and trabecular-spongiosa-to-cortical bone activity concentration ratios were quantified in both humerus and clavicle. The ionizing radiation quantum imaging detector results were in agreement with those obtained from radiochemical analysis of the remaining bone specimens. The results were compared with International Commission on Radiological Protection default biokinetic model predictions. Digital autoradiography was proven to be an effective method for microscale heterogeneous distribution studies where traditional counting methods are impractical.
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Affiliation(s)
- George Tabatadze
- US Transuranium and Uranium Registries, College of Pharmacy, Washington State University, 1845 Terminal Drive, Suite 201, Richland, WA 99354
| | - Brian W Miller
- Department of Radiation Oncology, School of Medicine, University of Colorado, 13001 E. 17th Place, Aurora, CO 80045
- College of Optical Sciences, University of Arizona, 1630 E. University Blvd., Tucson, AZ 85721
| | - Sergei Y Tolmachev
- US Transuranium and Uranium Registries, College of Pharmacy, Washington State University, 1845 Terminal Drive, Suite 201, Richland, WA 99354
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Baldacchino G, Brun E, Denden I, Bouhadoun S, Roux R, Khodja H, Sicard-Roselli C. Importance of radiolytic reactions during high-LET irradiation modalities: LET effect, role of O2 and radiosensitization by nanoparticles. Cancer Nanotechnol 2019. [DOI: 10.1186/s12645-019-0047-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Griffiths NM, Lamart S, Humbert AC, Van der Meeren A. Exploiting the “ Rat Actinide Repository “ at the Laboratory of RadioToxicology, CEA, France. BIO Web Conf 2019. [DOI: 10.1051/bioconf/20191405014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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