title: After the bomb drops: a new look at radiation-induced multiple organ dysfunction syndrome (MODS).
abstract: OBJECTIVE
  There is increasing concern that, since the Cold War era, there has been little progress regarding the availability of medical countermeasures in the event of either a radiological or nuclear incident. Fortunately, since much is known about the acute consequences that are likely to be experienced by an exposed population, the probability of survival from the immediate hematological crises after total body irradiation (TBI) has improved in recent years. Therefore focus has begun to shift towards later down-stream effects, seen in such organs as the gastrointestinal tract (GI), skin, and lung. However, the mechanisms underlying therapy-related normal tissue late effects, resulting from localised irradiation, have remained somewhat elusive and even less is known about the development of the delayed syndrome seen in the context of whole body exposures, when it is likely that systemic perturbations may alter tissue microenvironments and homeostasis.
  
  
  CONCLUSIONS
  The sequence of organ failures observed after near-lethal TBI doses are similar in many ways to that of multiple organ dysfunction syndrome (MODS), leading to multiple organ failure (MOF). In this review, we compare the mechanistic pathways that underlie both MODS and delayed normal tissue effects since these may impact on strategies to identify radiation countermeasures.
authors.affiliation: Department of Radiation Oncology, University of Rochester Medical Center Rochester, NY 14642, USA. Jackie_Williams@urmc.rochester.edu
authors.forename: Jacqueline P
authors.initials: JP
authors.lastname: Williams
authors.forename: William H
authors.initials: WH
authors.lastname: McBride
mesh_terms: D054508:Acute Radiation Syndrome / Q000453:epidemiology* / Q000503:physiopathology*; D015897:Comorbidity; D006801:Humans; D009102:Multiple Organ Failure / Q000453:epidemiology* / Q000503:physiopathology*; D009689:Nuclear Warfare; D015995:Prevalence; D018570:Risk Assessment