电离辐射调控细胞命运在放射性肺损伤中的作用及治疗进展

Role of cell fate regulation by ionizing radiation in radiation-induced lung injury and its therapeutic progress

放射性肺损伤是胸部肿瘤放疗及骨髓移植预处理后常见的并发症,是患者放疗剂量的重要限制因素。一旦放射性肺损伤进展至放射性肺纤维化阶段,将严重降低患者生活质量,同时引起患者呼吸衰竭最终导致死亡。电离辐射可诱导细胞发生凋亡、上皮间质转化、衰老、焦亡及铁死亡等命运,不同细胞响应于电离辐射下的不同损伤形式在放射性肺损伤的发生发展中具有重要作用。本文以电离辐射刺激后不同细胞发生不同命运转归为切入点,简述放射性肺损伤的发病机制,并对其临床防治进行综述。

Radiation induced lung injury(RILI)is a common complication after radiation therapy of breast tumors and bone marrow transplantation pretreatment,and it is a critical limiting factor of radiotherapy doses in patients.Once RILI progresses to the radiation-induced pulmonary fibrosis stage,it seriously reduces the patient’s quality of life,while causing the patient’s respiratory failure and eventually leading to death.Ionizing radiation(IR)can induce cell injuries,including apoptosis,epithelial-mesenchymal transition,senescence,pyroptosis and ferroptosis,and these injuries can play an important role in the occurrence and development of radioactive lung injury.Starting from discussion of the occurrence of different forms of injury in different cells after IR stimulation,this review summarizes the pathogenesis of RILI and its clinical prevention and treatment.