Brain Damage and Patterns of Neurovascular Disorder after Ionizing Irradiation. Complications in Radiotherapy and Radiation Combined Injury.
Brain Damage and Patterns of Neurovascular Disorder after Ionizing Irradiation. Complications in Radiotherapy and Radiation Combined Injury.
复制标题
DOI：
10.1667/rade-20-00147.1
复制
发表时间：
2021-07-01
影响因子：
3.4
通讯作者：
Kiang JG
中科院分区：
文献类型：
--
作者：
Gorbunov NV;Kiang JG
暴露于电离辐射、机械创伤、有毒化学物质或感染或其组合（即复合损伤）可引起脑组织的器质性损伤、神经血管和神经胶质细胞相互作用网络的结构紊乱，以及旁分泌和全身破坏的阵列。这导致随后的认知能力下降和心理健康失代偿。持续需要改进减轻和治疗辐射或组合损伤引起的脑损伤。颅脑照射本身可引起多因素脑病，由于脑实质和脉管系统的不同成分之间的放射敏感性差异，该脑病以辐射剂量和时间依赖性方式发生。特别值得关注的是以下方面的放射敏感性和炎症易感性： 1. 室管膜下和海马区域的神经源性和少突胶质细胞微环境； 2.微血管内皮。因此，颅脑或全身照射可导致脑组织出现大量生化和细胞紊乱，包括： 1. 神经发生和少突胶质细胞发生下降； 2.血脑屏障受损； 3.毛细血管的消融。这些变化与脑血管炎症一起构成脑病不同阶段的基础，从早期的迁延期到晚期的迟发期。显然，电离辐射与其他创伤性损伤（例如穿透伤、烧伤、爆炸、全身感染和化疗等）相结合，可以加剧辐射后遗症（反之亦然），并增加放射脑损伤的神经源性和微血管模式的严重程度。
Exposure to ionizing radiation, mechanical trauma, toxic chemicals or infections, or combinations thereof (i.e., combined injury) can induce organic injury to brain tissues, the structural disarrangement of interactive networks of neurovascular and glial cells, as well as on arrays of the paracrine and systemic destruction. This leads to subsequent decline in cognitive capacity and decompensation of mental health. There is an ongoing need for improvement in mitigating and treating radiation- or combined injury-induced brain injury. Cranial irradiation per se can cause a multifactorial encephalopathy that occurs in a radiation dose- and time-dependent manner due to differences in radiosensitivity among the various constituents of brain parenchyma and vasculature. Of particular concern are the radiosensitivity and inflammation susceptibility of: 1. the neurogenic and oligodendrogenic niches in the subependymal and hippocampal domains; and 2. the microvascular endothelium. Thus, cranial or total-body irradiation can cause a plethora of biochemical and cellular disorders in brain tissues, including: 1. decline in neurogenesis and oligodendrogenesis; 2. impairment of the blood-brain barrier; and 3. ablation of vascular capillary. These changes, along with cerebrovascular inflammation, underlie different stages of encephalopathy, from the early protracted stage to the late delayed stage. It is evident that ionizing radiation combined with other traumatic insults such as penetrating wound, burn, blast, systemic infection and chemotherapy, among others, can exacerbate the radiation sequelae (and vice versa) with increasing severity of neurogenic and microvascular patterns of radiation brain damage.