Post-irradiation approaches to treatment of radiation injuries in the context of radiological terrorism and radiation accidents: a review.
OBJECTIVE
Events of the recent past have focused attention on the possibility of radiological (nuclear) terrorism and on the implications of such terrorist threats for radiation accident preparedness. This review discusses recent advances in the knowledge about how radiation injuries from such events might be treated pharmacologically, and the practical barriers to clinical utilization of these approaches.


CONCLUSIONS
A wide range of pharmacological approaches are being developed in the laboratory that could greatly expand the ability to treat acute and chronic radiation injuries. However, there are currently a variety of practical and legal barriers that would prevent the actual clinical use of most of the approaches. There are also the potential weaknesses in most of the current programmes for dealing with the consequences of radiation accidents or nuclear terrorism, including the absence of widespread radiation biodosimetry capabilities and the resulting inability to triage. If a major radiation accident or terrorist event occurs, the lack of biodosimetry and treatment capabilities will be compounded by widespread public fear of 'radiation'.
Moulder
J E
JE
Radiation Oncology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. jmoulder@mcw.edu
D000016:Abnormalities, Radiation-Induced / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D002386:Cataract / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D002908:Chronic Disease; D016207:Cytokines / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007880:Legislation, Drug; D009689:Nuclear Warfare; D018579:Patient Selection; D010431:Pentoxifylline / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000331:legislation & jurisprudence; D011832:Radiation Injuries / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D011847:Radioactive Fallout / Q000009:adverse effects; D018788:Radioactive Hazard Release; D011874:Radiometry / Q000379:methods; D051437:Renal Insufficiency / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D018570:Risk Assessment / Q000379:methods*; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D023481:Terrorism; D016896:Treatment Outcome; D014218:Triage / Q000379:methods
D000806:Angiotensin-Converting Enzyme Inhibitors; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D016207:Cytokines; D011847:Radioactive Fallout; D010431:Pentoxifylline