title: Genetic and epigenetic features in radiation sensitivity. Part II: implications for clinical practice and radiation protection.
abstract: Recent progress especially in the field of gene identification and expression has attracted greater attention to the genetic and epigenetic susceptibility to cancer, possibly enhanced by ionising radiation. This issue is especially important for radiation therapists since hypersensitive patients may suffer from adverse effects in normal tissues following standard radiation therapy, while normally sensitive patients could receive higher doses of radiation, offering a better likelihood of cure for malignant tumours. Although only a small percentage of individuals are "hypersensitive" to radiation effects, all medical specialists using ionising radiation should be aware of the aforementioned progress in medical knowledge. The present paper, the second of two parts, reviews human disorders known or strongly suspected to be associated with hypersensitivity to ionising radiation. The main tests capable of detecting such pathologies in advance are analysed, and ethical issues regarding genetic testing are considered. The implications for radiation protection of possible hypersensitivity to radiation in a part of the population are discussed, and some guidelines for nuclear medicine professionals are proposed.
authors.affiliation: Direction Générale de la Sûreté Nucléaire et de la Radioprotection, 6 Place du Colonel Bourgoin, 75572, Paris Cedex 12, France. michel.bourguignon@asn.minefi.gouv.fr
authors.forename: Michel H
authors.initials: MH
authors.lastname: Bourguignon
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Gisone
authors.forename: Maria R
authors.initials: MR
authors.lastname: Perez
authors.forename: Severino
authors.initials: S
authors.lastname: Michelin
authors.forename: Diana
authors.initials: D
authors.lastname: Dubner
authors.forename: Marina Di
authors.initials: MD
authors.lastname: Giorgio
authors.forename: Edgardo D
authors.initials: ED
authors.lastname: Carosella
mesh_terms: D044127:Epigenesis, Genetic; D030342:Genetic Diseases, Inborn / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D020022:Genetic Predisposition to Disease / Q000517:prevention & control*; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011832:Radiation Injuries / Q000175:diagnosis / Q000235:genetics* / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D011836:Radiation Tolerance / Q000235:genetics*; D011839:Radiation, Ionizing; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors