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首页> 外文期刊>International Journal of General Medicine >Acute radiation syndrome (ARS) – treatment of the reduced host defense
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Acute radiation syndrome (ARS) – treatment of the reduced host defense

机译：急性放射综合症（ARS）–降低宿主防御能力的治疗

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Background: The current radiation threat from the Fukushima power plant accident has prompted rethinking of the contingency plan for prophylaxis and treatment of the acute radiation syndrome (ARS). The well-documented effect of the growth factors (granulocyte colony-stimulating factor [G-CSF] and granulocyte-macrophage colony-stimulating factor [GM-CSF]) in acute radiation injury has become standard treatment for ARS in the United States, based on the fact that growth factors increase number and functions of both macrophages and granulocytes.Methods: Review of the current literature.Results: The lungs have their own host defense system, based on alveolar macrophages. After radiation exposure to the lungs, resting macrophages can no longer be transformed, not even during systemic administration of growth factors because G-CSF/GM-CSF does not penetrate the alveoli. Under normal circumstances, locally-produced GM-CSF receptors transform resting macrophages into fully immunocompetent dendritic cells in the sealed-off pulmonary compartment. However, GM-CSF is not expressed in radiation injured tissue due to defervescence of the macrophages. In order to maintain the macrophage’s important role in host defense after radiation exposure, it is hypothesized that it is necessary to administer the drug exogenously in order to uphold the barrier against exogenous and endogenous infections and possibly prevent the potentially lethal systemic infection, which is the main cause of death in ARS.Recommendation: Preemptive treatment should be initiated after suspected exposure of a radiation dose of at least ~2 Gy by prompt dosing of 250–400 μg GM-CSF/m2 or 5 μg/kg G-CSF administered systemically and concomitant inhalation of GM-CSF ~ 300 mcg per day for at least 14–21 days.Conclusion: The present United States standard for prevention and treatment of ARS standard intervention should consequently be modified into the combined systemic administration of growth factors and inhaled GM-CSF to ensure the sustained systemic and pulmonary host defense and thus prevent pulmonary dysfunction.
机译：背景：当前福岛核电站事故造成的辐射威胁促使人们重新考虑了预防和治疗急性辐射综合症（ARS）的应急计划。基于生长因子（粒细胞集落刺激因子[G-CSF]和粒细胞-巨噬细胞集落刺激因子[GM-CSF]）在急性放射损伤中的有据可查的作用已成为美国ARS的标准治疗方法，方法：文献综述。结果：肺有自己的基于肺泡巨噬细胞的宿主防御系统，主要是由于生长因子增加了巨噬细胞和粒细胞的数量和功能。在放射线暴露于肺部之后，静止的巨噬细胞无法再转化，即使在全身施用生长因子的过程中也是如此，因为G-CSF / GM-CSF不会穿透肺泡。在正常情况下，局部产生的GM-CSF受体会在封闭的肺室中将静止的巨噬细胞转化为完全具有免疫能力的树突状细胞。然而，由于巨噬细胞的去铁质作用，GM-CSF在辐射损伤的组织中不表达。为了维持巨噬细胞在放射线照射后在宿主防御中的重要作用，假设必须外用药物，以维持抵抗外源性和内源性感染的屏障，并可能预防潜在的致命性全身性感染。建议：建议立即全身性给予250-400μgGM-CSF / m2或5μg/ kg G-CSF剂量，以怀疑暴露了至少〜2 Gy的放射剂量后，应开始采取抢先治疗并每天至少吸食GM-CSF〜300 mcg，持续14-21天。结论：目前美国预防和治疗ARS的标准干预措施应改为全身性联合使用生长因子和吸入性GM -CSF可确保持续的全身和肺部宿主防御能力，从而预防肺功能障碍。

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