THE SKIN - ITS STRUCTURE AND RESPONSE TO IONIZING-RADIATION
THE SKIN - ITS STRUCTURE AND RESPONSE TO IONIZING-RADIATION
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DOI：
10.1080/09553009014550911
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发表时间：
1990-04-01
影响因子：
2.6
通讯作者：
HOPEWELL, JW
中科院分区：
文献类型：
--
作者：
HOPEWELL, JW
皮肤对电离辐射的反应对于通过辐射治疗恶性疾病和辐射防护都具有重要意义。描述了人类皮肤的结构组织，并与猪的结构组织进行了比较，猪的结构组织具有许多相似之处，以便更充分地了解皮肤对电离辐射的反应。对皮肤的急性辐射损伤主要是表皮变化的结果;反应高峰的时间与这一层的动态组织有关。损伤的发展速度与辐射剂量无关，因为这与表皮基底层细胞的自然损失速度有关。表皮的恢复是照射区域内存活的克隆形成基底细胞增殖的结果。毛囊管中克隆形成细胞的存在是重要的，特别是在中等能量β-发射体的非均匀照射后。当小面积的皮肤被照射时，活细胞从照射部位边缘的迁移也是显著的。对皮肤的晚期损伤主要是辐射对血管系统的影响;这在16-26周后产生一波真皮萎缩。高剂量后此时出现皮肤坏死。在> 52周后可见第二阶段的皮肤变薄，并且该后期损伤与毛细血管扩张的出现相关。对皮肤的高度局部照射，无论是照射到特定层（可能是由于暴露于极低能量的β-发射体），还是暴露于小的高放射性粒子（“热粒子”）后，都会产生明显的影响，在暴露后2周内变得明显。这些变化是由剂量> 100戈伊后间期皮肤细胞的直接杀伤引起的。根据实验和临床研究的结果，已经建立了皮肤中大多数这些确定性终点的剂量效应曲线。这些在建立皮肤的安全辐射剂量限值方面具有价值。
The response of the skin to ionizing radiation has important implications both for the treatment of malignant disease by radiation and for radiological protection. The structural organization of human skin is described and compared with that of the pig, with which it shows many similarities, in order that the response of the skin to ionizing radiation may be more fully understood. Acute radiation damage to the skin is primarily a consequence of changes in the epidermis; the timing of the peak of the reaction is related to the kinetic organization of this layer. The rate of development of damage is independent of the radiation dose, since this is related to the natural rate of loss of cells from the basal layer of the epidermis. Recovery of the epidermis occurs as a result of the proliferation of surviving clonogenic basal cells from within the irradiated area. The presence of clonogenic cells in the canal of the hair follicle is important, particularly after non-uniform irradiation from intermediate energy β-emitters. The migration of viable cells from the edges of the irradiated site is also significant when small areas of skin are irradiated. Late damage to the skin is primarily a function of radiation effects on the vasculature; this produces a wave of dermal atrophy after 16–26 weeks. Dermal necrosis develops at this time after high doses. A second phase of dermal thinning is seen to develop after > 52 weeks, and this later phase of damage is associated with the appearance of telangiectasia. Highly localized irradiation of the skin, either to a specific layer (as may result from exposure to very low energy β-emitters) or after exposure to small highly radioactive particles, ‘hot particles’, produces gross effects that become visibly manifest within 2 weeks of exposure. These changes result from the direct killing of the cells of the skin in interphase after doses > 100 Gy. Dose-effect curves have been established for the majority of these deterministic endpoints in the skin from the results of both experimental and clinical studies. These are of value in the establishment of safe radiation dose limits for the skin.