辐射防护通讯 ›› 2019, Vol. 39 ›› Issue (2): 23-33.
邱新宇, 闫玉洁, 奚可迪, 张琨岚, 胡文涛, 张健
收稿日期:
2019-03-31
出版日期:
2019-04-20
发布日期:
2019-11-07
通讯作者:
张健,gzyzhangjian@126.com
作者简介:
邱新宇(1996—),女,现就读于苏州大学放射医学专业。
基金资助:
Qiu Xinyu, Yan Yujie, Xi Kedi, Zhang Kunlan, Hu Wentao, Zhang Jian
Received:
2019-03-31
Online:
2019-04-20
Published:
2019-11-07
摘要: 放射治疗可引起照射部位骨组织产生放射性骨损伤,发生骨丢失、骨质疏松,甚至病理性骨折。放射性骨丢失的主要原因是电离辐射可促进破骨细胞的骨吸收过程,抑制成骨细胞的骨形成过程。根据电离辐射对骨组织细胞影响的具体机制,以及骨组织细胞对不同剂量的电离辐射的不同响应,可采取相应的治疗和防护措施。本文从动物水平和细胞水平两个方面介绍放射性骨丢失的研究进展,并针对其发生机制提出可能的防护措施。
中图分类号:
邱新宇, 闫玉洁, 奚可迪, 张琨岚, 胡文涛, 张健. 放射性骨丢失机制与防护研究进展[J]. 辐射防护通讯, 2019, 39(2): 23-33.
Qiu Xinyu, Yan Yujie, Xi Kedi, Zhang Kunlan, Hu Wentao, Zhang Jian. Research Progress on Radiation-induced Bone Loss and its Protection[J]. RADIATION PROTECTION BULLETIN, 2019, 39(2): 23-33.
[1] | Shih K K, Folkert M R, Kollmeier M A, et al. Pelvic insufficiency fractures in patients with cervical and endometrial cancer treated with postoperative pelvic radiation[J]. Gynecologic Oncology, 2013,128:540-543. |
[2] | Tokumaru S, Toita T, Oguchi M, et al. Insufficiency fractures after pelvic radiation therapy for uterine cervical cancer: an analysis of subjects in a prospective multi-institutional trial, and cooperative study of the Japan Radiation Oncology Group (JAROG) and Japanese Radiation Oncology Study Group (JROSG)[J]. International Journal of Radiation Oncology Biology Physics, 2012,84:e195-200. |
[3] | Elliott S P, Jarosek S L, Alanee S R, et al. Three-dimensional external beam radiotherapy for prostate cancer increases the risk of hip fracture[J]. Cancer, 2011, 117: 4557-4565. |
[4] | Zou Q, Hong W, Zhou Y, et al. Bone marrow stem cell dysfunction in radiation-induced abscopal bone loss[J]. Journal of Orthopaedic Surgery and Research, 2016,11:3. |
[5] | Wright L E, Buijs J T, Kim H-S, et al. Single-limb irradiation induces local and systemic bone loss in a murine model[J]. J Bone Miner Research, 2015,30:1268-1279. |
[6] | Willey J S, Lloyd S A, Robbins M E, et al. Early increase in osteoclast number in mice after whole-body irradiation with 2 Gy X rays[J]. Radiation Research, 2008,170:388-392. |
[7] | Kondo H, Searby N D, Mojarrab R, et al. Total-body irradiation of postpubertal mice with (137)Cs acutely compromises the microarchitecture of cancellous bone and increases osteoclasts[J]. Radiation Research, 2009,171:283-289. |
[8] | Alwood J S, Shahnazari M, Chicana B, et al. Ionizing radiation stimulates expression of pro-osteoclastogenic genes in marrow and skeletal tissue[J]. Journal of Interferon and Cytokine Research, 2015,35:480-487. |
[9] | Oest M E, Franken V, Kuchera T, et al. Long-term loss of osteoclasts and unopposed cortical mineral apposition following limited field irradiation[J]. Journal of Orthopaedic Research, 2015,33:334-342. |
[10] | Feng X, McDonald J M. Disorders of bone remodeling[J]. Annual Review of Phytopathology, 2011,6:121-145. |
[11] | Bandstra E R, Pecaut M J, Anderson E R, et al. Long-Term Dose Response of Trabecular Bone in Mice to Proton Radiation[J]. Radiation Research, 2008,169:607-614. |
[12] | Wernle J D, Damron T A, Allen M J, et al. Local irradiation alters bone morphology and increases bone fragility in a mouse model[J]. Journal of Biomechanics, 2010,43:2738-2746. |
[13] | Sun R, Zhu G, Wang J, et al. Indirect effects of X-irradiation on proliferation and osteogenic potential of bone marrow mesenchymal stem cells in a local irradiated rat model[J]. Molecular Medicine Reports, 2017,15:3706-3714. |
[14] | Xu X, Li R, Zhou Y, et al. Dysregulated systemic lymphocytes affect the balance of osteogenic/adipogenic differentiation of bone mesenchymal stem cells after local irradiation[J]. Stem Cell Research & Therapy, 2017,8:71. |
[15] | Zhang J, Zheng L, Wang Z, et al. Lowering iron level protects against bone loss in focally irradiated and contralateral femurs through distinct mechanisms[J]. Bone, 2019,120:50-60. |
[16] | Chandra A, Lin T, Young T, et al. Suppression of Sclerostin Alleviates Radiation-Induced Bone Loss by Protecting Bone-Forming Cells and Their Progenitors Through Distinct Mechanisms[J]. Journal of Bone and Mineral Research, 2017,32:360-372. |
[17] | Chandra A, Lin T, Tribble M B, et al. PTH1-34 alleviates radiotherapy-induced local bone loss by improving osteoblast and osteocyte survival[J]. Bone, 2014,67:33-40. |
[18] | Gong B, Oest M E, Mann K A, et al. Raman spectroscopy demonstrates prolonged alteration of bone chemical composition following extremity localized irradiation[J]. Bone, 2013,57:252-258. |
[19] | Oest M E, Damron T A. Focal therapeutic irradiation induces an early transient increase in bone glycation[J]. Radiation Research, 2014,181:439-443. |
[20] | Margulies B, Morgan H, Allen M, et al. Transiently increased bone density after irradiation and the radioprotectant drug amifostine in a rat model[J]. American Journal of Clinical Oncology, 2003,26:e106-e114. |
[21] | Barou O, Mekraldi S, Vico L, et al. Relationships between trabecular bone remodeling and bone vascularization: a quantitative study[J]. Bone, 2002,30:604-612. |
[22] | Michel G, Blery P, Pilet P, et al. Micro-CT analysis of radiation-induced osteopenia and bone hypovascularization in rat[J].Calcified Tissue International, 2015,97:62-68. |
[23] | Cao X, Wu X, Frassica D, et al. Irradiation induces bone injury by damaging bone marrow microenvironment for stem cells[J]. Proceedings of the National Academy of Sciences of the United States of America, 2011,108:1609-1614. |
[24] | Donneys A, Weiss D M, Deshpande S S, et al. Localized deferoxamine injection augments vascularity and improves bony union in pathologic fracture healing after radiotherapy[J]. Bone, 2013,52:318-325. |
[25] | Wang Y, Zhu G, Wang J, et al. Irradiation alters the differentiation potential of bone marrow mesenchymal stem cells[J]. Molecular Medicine Reports, 2016,13:213-223. |
[26] | Huang B, Guang M, Ye J, et al. Effect of increasing doses of γ-radiation on bone marrow stromal cells grown on smooth and rough titanium surfaces[J]. Stem Cells International, 2015, 359416:1-11. |
[27] | Nicolay N H, Lopez Perez R, Saffrich R, et al. Radio-resistant mesenchymal stem cells: mechanisms of resistance and potential implications for the clinic[J]. Oncotarget, 2015, 6:19366-19380. |
[28] | Nicolay N H, Sommer E, Lopez R, et al. Mesenchymal stem cells retain their defining stem cell characteristics after exposure to ionizing radiation[J]. International Journal of Radiation Oncology Biology Physics, 2013,87:1171-1178. |
[29] | Green D E, Rubin C T. Consequences of irradiation on bone and marrow phenotypes, and its relation to disruption of hematopoietic precursors[J]. Bone, 2014,63:87-94. |
[30] | Nicolay N H, Liang Y, Lopez Perez R, et al. Mesenchymal stem cells are resistant to carbon ion radiotherapy[J]. Oncotarget, 2015,6:2076-2087. |
[31] | Singh S, Kloss F R, Brunauer R, et al. Mesenchymal stem cells show radioresistance in vivo[J]. Journal of Cellular and Molecular Medicine, 2012,16:877-887. |
[32] | Sugrue T, Brown J A, Lowndes N F, et al. Multiple facets of the DNA damage response contribute to the radioresistance of mouse mesenchymal stromal cell lines[J]. Stem Cells, 2013,31:137-145. |
[33] | Liu N A, Sun J, Kono K, Horikoshi Y, et al. Regulation of homologous recombinational repair by lamin B1 in radiation-induced DNA damage[J]. FASEB Journal, 2015,29:2514-2525. |
[34] | Lau P, Baumstark-Khan C, Hellweg C E, et al. X-irradiation-induced cell cycle delay and DNA double-strand breaks in the murine osteoblastic cell line OCT-1[J]. Radiation and Environmental Biophysics, 2010,49:271-280. |
[35] | Hu Y, Lau P, Baumstark-Khan C, et al. X-ray induced alterations in the differentiation and mineralization potential of murine preosteoblastic cells[J]. Advances in Space Research, 2012,49:1422-1431. |
[36] | Chen M, Huang Q, Xu W, et al. Low-dose X-ray irradiation promotes osteoblast proliferation, differentiation and fracture healing[J]. PloS One, 2014,9:e104016. |
[37] | Xu W, Xu L, Chen M, et al. The effects of low dose X-irradiation on osteoblastic MC3T3-E1 cells in vitro[J]. BMC Musculoskeletal Disorders, 2012,13:1-9. |
[38] | Szymczyk K H, Shapiro I M, Adams C S. Ionizing radiation sensitizes bone cells to apoptosis[J]. Bone, 2004,34:148-156. |
[39] | Park S S, Kim K A, Lee S Y, et al. X-ray radiation at low doses stimulates differentiation and mineralization of mouse calvarial osteoblasts[J]. BMB Reports, 2012,45:571-576. |
[40] | Mauch P, Constine L, Greenberger J, et al. Hematopoietic stem cell compartment: acute and late effects of radiation therapy and chemotherapy[J]. International Journal of Radiation Oncology Biology Physics, 1995,31:1319-1339. |
[41] | Zhang J, Wang Z, Wu A, et al. Differences in responses to X-ray exposure between osteoclast and osteoblast cells[J]. Journal of Radiation Research, 2017,58:791-802. |
[42] | Yang B, Zhou H, Zhang X D, et al. Effect of radiation on the expression of osteoclast marker genes in RAW264.7 cells[J]. Molecular Medicine Reports, 2012,5:955-958. |
[43] | Lee N K, Choi Y G, Baik J Y, et al. A crucial role for reactive oxygen species in RANKL-induced osteoclast differentiation[J]. Blood, 2005,106:852-859. |
[44] | Callaway D A, Jiang J X. Reactive oxygen species and oxidative stress in osteoclastogenesis, skeletal aging and bone diseases[J]. Journal of Bone and Mineral Metabolism, 2015,33:359-370. |
[45] | Sun Y X, Xu A H, Yang Y, et al. Role of Nrf2 in bone metabolism[J]. Journal of Biomedical Science, 2015,22:1-7. |
[46] | Rana T, Schultz M A, Freeman M L, et al. Loss of Nrf2 accelerates ionizing radiation-induced bone loss by upregulating RANKL[J]. Free Radical Biology and Medicine, 2012,53:2298-2307. |
[47] | Cao X, Wu X, Frassica D, et al. Irradiation induces bone injury by damaging bone marrow microenvironment for stem cells[J]. Proceedings of the National Academy of Sciences of the United States of America, 2011,108:1609-1614. |
[48] | Xian L, Lou M, Wu X, et al. Pretreatment with antioxidants prevent bone injury by improving bone marrow microenvironment for stem cells[J]. Stem Cell Discovery, 2012,2:100-107. |
[49] | Kondo H, Yumoto K, Alwood J S, et al. Oxidative stress and gamma radiation-induced cancellous bone loss with musculoskeletal disuse[J]. Journal of Applied Physiology, 2010, 108:152-161. |
[50] | Gevorgyan A, Sukhu B, Alman B A, et al. Radiation effects and radioprotection in MC3T3-E1 mouse calvarial osteoblastic cells[J]. Plastic and Reconstructive Surgery, 2008,122:1025-1035. |
[51] | Wang C, Blough E, Dai X, et al. Protective effects of cerium oxide nanoparticles on MC3T3-E1 osteoblastic cells exposed to X-Ray irradiation[J]. Cellular Physiology and Biochemistry, 2016,38:1510-1519. |
[52] | de Freitas D Q, Ramos-Perez F M, Neves E G, et al. Radioprotective effect of sodium selenite on bone repair in the tibia of ovariectomized rats[J]. Brazilian Dental Journal, 2012,23:723-728. |
[53] | Donneys A, Tchanque-Fossuo C N, Blough J T, et al. Amifostine preserves osteocyte number and osteoid formation in fracture healing following radiotherapy[J]. J Oral Maxillofac Surg, 2014,72:559-566. |
[54] | Yamasaki M C, CavalcanteFontenele R, Nejaim Y, et al. Radioprotective effects of sodium selenite on mandible of irradiated rats[J]. Brazilian Dental Journal, 2019,30:232-237. |
[55] | Oest M E, Mann K A, Zimmerman N D, et al. Parathyroid hormone (1-34) transiently protects against radiation-induced bone fragility[J]. Calcified Tissue International, 2016,98:619-630. |
[56] | Chandra A, Lan S, Zhu J, et al. PTH prevents the adverse effects of focal radiation on bone architecture in young rats[J]. Bone, 2013,55:449-457. |
[57] | Chandra A, Lin T, Zhu J, et al. PTH1–34 Blocks Radiation-induced osteoblast apoptosis by enhancing DNA repair through canonical Wnt pathway[J]. Journal of Biological Chemistry, 2015,290:157-167. |
[58] | Zhang X H, Lou Z C, Wang A L, et al. Development of serum iron as a biological dosimeter in mice[J]. Radiation Research, 2013,179:684-689. |
[59] | Xie L H, Zhang X H, Hu X D, et al. Mechanisms of an increased level of serum iron in gamma-irradiated mice[J]. Radiation and Environmental Biophysics, 2016,55:81-88. |
[60] | Felice P A, Ahsan S, Donneys A, et al. Deferoxamine administration delivers translational optimization of distraction osteogenesis in the irradiated mandible[J]. Plastic and Reconstructive Surgery, 2013,132:542e-548e. |
[61] | Donneys A, Ahsan S, Perosky J E, et al. Deferoxamine restores callus size, mineralization, and mechanical strength in fracture healing after radiotherapy[J]. Plastic and Reconstructive Surgery, 2013,131:711e-9e. |
[62] | Donneys A, Nelson N S, Perosky J E, et al. Prevention of radiation-induced bone pathology through combined pharmacologic cytoprotection and angiogenic stimulation[J]. Bone, 2016,84:245-252. |
[63] | Rogers M J, Crockett J C, Coxon F P, et al. Biochemical and molecular mechanisms of action of bisphosphonates[J]. Bone, 2011,49: 34-41. |
[64] | Keenawinna L, Oest M E, Mann K A, et al. Zoledronic acid prevents loss of trabecular bone after focal irradiation in mice[J]. Radiation Research, 2013,180:89-99. |
[65] | Willey J S, Livingston E W, Robbins M E, et al. Risedronate prevents early radiation-induced osteoporosis in mice at multiple skeletal locations[J]. Bone, 2010,46:101-111. |
[66] | Shirazi-Fard Y, Alwood J S, Schreurs A S, et al. Mechanical loading causes site-specific anabolic effects on bone following exposure to ionizing radiation[J]. Bone, 2015,81:260-269. |
[67] | Ehrlich P J, Lanyon L E. Mechanical strain and bone cell function: a review[J]. Osteoporosis International, 2002,13:688-700. |
[68] | Bonewald L F. The amazing osteocyte[J]. Journal of Bone and Mineral Research, 2011,26:229-238. |
[69] | Pichler K, Loreto C, Leonardi R, et al. RANKL is downregulated in bone cells by physical activity (treadmill and vibration stimulation training) in rat with glucocorticoid-induced osteoporosis[J]. Histology and Histopathology, 2013,28:1185-1196. |
[70] | Tu X, Rhee Y, Condon K W, et al. Sost downregulation and local Wnt signaling are required for the osteogenic response to mechanical loading[J]. Bone, 2012,50:209-217. |
[71] | Delgado-Calle J, Sato A Y, Bellido T. Role and mechanism of action of sclerostin in bone[J]. Bone, 2017,96:29-37. |
[72] | Swift J M, Smith J T, Kiang J G. Hemorrhage trauma increases radiation-induced trabecular bone loss and marrow cell depletion in mice[J]. Radiation Research, 2015,183:578-583. |
[1] | 章诚, 张岭, 殷春许, 何廷贵, 何丽娟. DR机房建设与验收监测的要点探讨[J]. 辐射防护通讯, 2020, 40(1): 17-22. |
[2] | 刘书锋, 王利, 于丰萁, 殷爱民, 马得勋. 基层部队核事故应急防护与医学应急救援处置能力建设初步探讨[J]. 辐射防护通讯, 2020, 40(1): 23-26. |
[3] | 卞华慧, 王敏, 孙亮, 陈炜博, 王优优, 张玉松, 戴宏, 冯骏超, 魏静, 刘玉龙. 对某公司7例疑似受照放射工作人员的医学评估与思考[J]. 辐射防护通讯, 2020, 40(1): 1-5. |
[4] | 高锦, 唐波, 席悦, 袁炜烨, 沈月平, 涂彧. 某企业不同工种的放射工作人员发生甲状腺结节风险分析[J]. 辐射防护通讯, 2019, 39(2): 6-9. |
|