title: Pilot study for the establishment of biomarkers for radiation damage after computed tomography in children.
abstract: Computed tomography (CT) is an imaging modality that exposes patients to ionizing radiation (IR). We review and report findings from our pilot study evaluating whether blood markers are altered in 17 children undergoing medically indicated CT scans. Blood was drawn before ('pre-CT') and 1 hour after ('post-CT' CT scans. Plasma carotenoids, tocopherols, Q10, ascorbic acid (AA) and uric acid (UA) were analyzed by RP-HPLC with diode-array and electrochemical detection. Dehydroascorbic acid (DHAA) was calculated by subtraction from total AA. Total antioxidant capacity (TAC) was measured using the ORAC assay. Cytokines were quantified using a multiplex immunoassay. γ-H2AX foci were visualized using immunofluorescence. Mean pre- and post-CT changes were compared using t-tests; P-levels < .05 indicated significance. All major plasma lipid soluble antioxidant levels were lower post- vs pre-CT (P < .05) possibly from the scavenging of free radicals formed by CT-induced IR. Average AA levels increased (134%) while DHAA levels were decreased (29%) post-CT, probably due to intracellular recycling of AA from DHAA. TAC levels in lipophilic and hydrophilic extracts were unchanged, suggesting that other antioxidants may have assisted in free radical quenching, which would corroborate their lower concentrations post-CT. Cytokine levels were unchanged and dose-dependent increases in γ-H2AX foci, a measure of double strand DNA breaks, were observed (P = .046, n = 3 children). Our results suggest that CT-derived IR can influence the antioxidant system and may elicit detrimental responses on the cellular level of young children. When possible and if appropriate non-IR based techniques such as ultrasound or magnetic resonance imaging should be used.
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: Brunhild M
authors.initials: BM
authors.lastname: Halm
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Franke
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Lai
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: Xingnan
authors.initials: X
authors.lastname: Li
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Custer
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: Ian
authors.initials: I
authors.lastname: Pagano
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: Robert V
authors.initials: RV
authors.lastname: Cooney
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: Helen C
authors.initials: HC
authors.lastname: Turner
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY (BMH).
authors.forename: David J
authors.initials: DJ
authors.lastname: Brenner
mesh_terms: D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D053903:DNA Breaks, Double-Stranded / Q000528:radiation effects; D005260:Female; D006657:Histones / Q000097:blood; D006801:Humans; D007223:Infant; D008297:Male; D010865:Pilot Projects; D011832:Radiation Injuries / Q000097:blood / Q000175:diagnosis*; D011839:Radiation, Ionizing; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; C468783:H2AX protein, human; D006657:Histones
keywords: children; computed tomography; free radicals; ionizing radiation; micronutrients; γ-H2AX
references.citation: J Lipid Res. 1996 Jan;37(1):67-75
references.pmid: 8820103
references.citation: J Chromatogr. 1993 Apr 21;614(1):43-57
references.pmid: 8496285
references.citation: Proc Natl Acad Sci U S A. 2003 Apr 29;100(9):5057-62
references.pmid: 12679524
references.citation: N Engl J Med. 2007 Nov 29;357(22):2277-84
references.pmid: 18046031
references.citation: Proc Natl Acad Sci U S A. 2003 Nov 25;100(24):13761-6
references.pmid: 14610281
references.citation: BMJ. 2004 Jan 3;328(7430):19
references.pmid: 14703539
references.citation: J Cell Biol. 1999 Sep 6;146(5):905-16
references.pmid: 10477747
references.citation: AJR Am J Roentgenol. 2001 Feb;176(2):289-96
references.pmid: 11159059
references.citation: Food Chem Toxicol. 1999 Sep-Oct;37(9-10):949-62
references.pmid: 10541450
references.citation: Front Oncol. 2012 Sep 25;2:120
references.pmid: 23057008
references.citation: Eur J Radiol. 2012 Jul;81(7):1495-9
references.pmid: 21596504
references.citation: Proc Natl Acad Sci U S A. 1991 Mar 1;88(5):1646-50
references.pmid: 2000375
references.citation: Radiat Res. 1994 Sep;139(3):360-3
references.pmid: 8073120
references.citation: Pediatr Radiol. 2002 Apr;32(4):228-1; discussion 242-4
references.pmid: 11956700
references.citation: J Bioenerg Biomembr. 1994 Aug;26(4):349-58
references.pmid: 7844109
references.citation: Arch Biochem Biophys. 2014 Apr 1;547:37-43
references.pmid: 24583267
references.citation: Radiat Res. 2002 Oct;158(4):486-92
references.pmid: 12236816
references.citation: Pediatr Radiol. 1996;26(1):5-14
references.pmid: 8598996
references.citation: Pediatr Radiol. 2006 Sep;36 Suppl 2:121-5
references.pmid: 16862418
references.citation: AJR Am J Roentgenol. 2001 Feb;176(2):297-301
references.pmid: 11159060
references.citation: Proc Natl Acad Sci U S A. 2005 Jun 21;102(25):8984-9
references.pmid: 15956203
references.citation: J Emerg Med. 2014 Apr;46(4):449-55
references.pmid: 24472355
references.citation: J Biol Chem. 1998 Mar 6;273(10):5858-68
references.pmid: 9488723
references.citation: DNA Repair (Amst). 2004 Aug-Sep;3(8-9):959-67
references.pmid: 15279782
references.citation: Proc Natl Acad Sci U S A. 1992 Nov 1;89(21):10316-20
references.pmid: 1332045
references.citation: Ann Emerg Med. 2007 Mar;49(3):320-4
references.pmid: 17145113
references.citation: Free Radic Biol Med. 2010 Jun 15;48(12):1610-7
references.pmid: 20226852
references.citation: Ann N Y Acad Sci. 2005 Aug;1053:319-29
references.pmid: 16179538
references.citation: Biochim Biophys Acta. 1995 May 24;1271(1):195-204
references.pmid: 7599208
references.citation: BMJ. 2013;346:f2360
references.pmid: 23694687
references.citation: Mol Cell Biol. 2003 Aug;23(16):5706-15
references.pmid: 12897142
references.citation: Proc Nutr Soc. 1994 Mar;53(1):77-87
references.pmid: 8029239
references.citation: Am J Clin Nutr. 1991 Jan;53(1 Suppl):194S-200S
references.pmid: 1985387
references.citation: Biochem Cell Biol. 2003 Jun;81(3):123-9
references.pmid: 12897845
references.citation: Lancet. 2012 Aug 4;380(9840):499-505
references.pmid: 22681860
references.citation: Pediatrics. 2003 Oct;112(4):951-7
references.pmid: 14523191
references.citation: FEBS Lett. 1993 Jul 12;326(1-3):285-8
references.pmid: 8325381
references.citation: Radiology. 1998 Oct;209(1):37-48
references.pmid: 9769810
references.citation: Free Radic Biol Med. 1999 Mar;26(5-6):746-61
references.pmid: 10218665
references.citation: Radiology. 2011 Jun;259(3):793-801
references.pmid: 21467249
references.citation: J Allergy Clin Immunol. 2003 Feb;111(2 Suppl):S460-75
references.pmid: 12592293
references.citation: Ann N Y Acad Sci. 1993 Dec 31;691:48-60
references.pmid: 8129318
references.citation: Anal Biochem. 2009 Mar 15;386(2):167-71
references.pmid: 19150323
references.citation: Iran J Allergy Asthma Immunol. 2007 Dec;6(4):181-7
references.pmid: 18094440
references.citation: J Agric Food Chem. 2003 May 21;51(11):3273-9
references.pmid: 12744654
references.citation: Mol Aspects Med. 2005 Dec;26(6):459-516
references.pmid: 16309738
references.citation: Biochem Pharmacol. 2008 Aug 1;76(3):289-302
references.pmid: 18499086
references.citation: FASEB J. 1999 Jun;13(9):1007-24
references.pmid: 10336883
references.citation: Pediatr Radiol. 2014 Oct;44(10):1310-7
references.pmid: 24756254
references.citation: J Chromatogr B Analyt Technol Biomed Life Sci. 2009 Apr 1;877(10):853-6
references.pmid: 19250886
references.citation: Int J Vitam Nutr Res. 1994;64(4):311-5
references.pmid: 7883471
references.citation: Pediatrics. 2012 Nov;130(5):e1069-75
references.pmid: 23045569
references.citation: Mitochondrion. 2007 Jun;7 Suppl:S89-93
references.pmid: 17485249