Understanding of radiation enteritis and its possible pathogenic mechanism
Zhang Ximei,Wang Peiguo,Yuan Zhiyong,Wang Ping
Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for cancer;Key Laboratory of Cancer Preventing and Therapy,Tianjin;Tianjin's Clinical Research Center for Cancer;Tianjin 300060,China
Abstract：Radiation enteritis significantly affects the quality of life in the patients receiving radiotherapy due to pelvic tumor. As an intestinal inflammation related to radiotherapy, radiation enteritis is an inflammation of the mucous membrane in nature based on some basic research. Studies demonstrate that programmed necroptosis might play a role in the development of inflammatory bowel disease;therefore, as a subtype of inflammatory bowel disease, programmed necroptosis also might play a role in the development and progression of radiation enteritis. This paper aims to review the studies about the nature and pathogenic mechanism in order to contribute to the treatment of radiation enteritis and improve patients’ quality of life.
Zhang Ximei,Wang Peiguo,Yuan Zhiyong et al. Understanding of radiation enteritis and its possible pathogenic mechanism[J]. Chinese Journal of Radiation Oncology, 2017, 26(9): 1099-1102.
[1] Pollack A,Zagars GK, Starkschall G,et al. Conventional vs.conformal radiotherapy for prostate cancer:preliminary results of dosimetry and acute toxicity[J].Int J Radiat Oncol Biol Phys,1996,34(3):555-564.DOI:10.1016/0360-3016(95)02103-5. [2] Abayomi JC,Kirwan J,Hackett AF.Coping mechanisms used by women in an attempt to avoid symptoms of chronic radiation enteritis[J].J Hum Nutr Diet,2009,22:310-316.DOI:10.1111/j.1365-277X.2009.00963.x. [3] Brown M.What causes the radiation gastrointestinal syndrome?:overview[J].Int J Radiat Oncol Biol Phys,2008,70(3):799-800.DOI:10.1016/j.ijrobp.2007.12.001. [4] Withers HR,Elkind MM.Microcolony survival assay for cells of mouse intestinal mucosa exposed to radiation[J]. Int J Radiat Biol Relat Stud Phys Chem Med,1970,17(3):261-267.DOI:10.1080/09553007014550291. [5] Paris F,Fuks Z,Kang A,et al. Endothelial apoptosis as the primary lesion initiating intestinal radiation damage in mice[J].Science,2001,293(5528):293-297.DOI:10.1126/science.1060191. [6] Schuller BW,Rogers AB,Cormier KS,et al. No significant endothelial apoptosis in the radiation-induced gastrointestinal syndrome[J].Int J Radiat Oncol Biol Phys,2007,68(1):205-210.DOI:10.1016/j.ijrobp.2006.12.069. [7] Bowen JM,Keefe DMK.New pathways for alimentary mucositis[J].J Oncol,2008,2008:907892.DOI:10.1155/2008/907892. [8] Ong ZY,Gibson RJ,Bowen JM,et al. Pro-inflammatory cytokines play a key role in the development of radiotherapy-induced gastrointestinal mucositis[J].Radiat Oncol,2010,5:22.DOI:10.1186/1748-717X-5-22. [9] Linard C,Ropenga A,Vozenin-Brotons MC,et al. Abdominal irradiation increases inflammatory cytokine expression and activates NF-κB in rat ileal muscularis layer[J].Am J Physiol Gastrointest Liver Physiol,2003,285(3):G556-G565.DOI:10.1152/ajpgi.00094.2003. [10] Indaram AVK,Visvalingam V,Locke M,et al. Mucosal cytokine production in radiation-induced proctosigmoiditis compared with inflammatory bowel disease[J].Am J Gastroenterol,2000,95(5):1221-1225.DOI:10.1111/j.1572-0241.2000.02013.x. [11] Christensen E,Pintilie M,Evans KR,et al. Longitudinal cytokine expression during IMRT for prostate cancer and acute treatment toxicity[J].Clin Cancer Res,2009,15(17):5576-5583.DOI:10.1158/1078-0432.CCR-09-0245. [12] Linkermann A,Green DR.Necroptosis[J].N Engl J Med,2014,370(5):455-465.DOI:10.1056/NEJMra1310050. [13] Welz PS,Wullaert A,Vlantis K,et al. FADD prevents RIP-3-mediated epithelial cell necrosis and chronic intestinal inflammation[J].Nature,2011,477(7364):330-334.DOI:10.1038/nature10273. [14] Kaczmarek A,Vandenabeele P,Krysko DV.Necroptosis:the release of damage-associated molecular patterns and its physiological relevance[J].Immunity,2013,38(2):209-223.DOI:10.1016/j.immuni.2013.02.003. [15] Bonnet MC,Preukschat D,Welz PS,et al. The adaptor protein FADD protects epidermal keratinocytes from necroptosis in vivo and prevents skin inflammation[J].Immunity,2011,35(4):572-582.DOI:10.1016/j.immuni.2011.08.014. [16] Murakami Y,Matsumoto H,Roh M,et al. Programmed necrosis,not apoptosis,is a key mediator of cell loss and DAMP-mediated inflammation in dsRNA-induced retinal degeneration[J].Cell Death Differ,2014,21(2):270-277.DOI:10.1038/cdd.2013.109. [17] Duprez L,Takahashi N,Van Hauwermeiren F,et al. RIP kinase-dependent necrosis drives lethal systemic inflammatory response syndrome[J].Immunity,2011,35(6):908-918.DOI:10.1016/j.immuni.2011.09.020. [18] Berger SB,Kasparcova V,Hoffman S,et al. Cutting edge:RIP1 kinase activity is dispensable for normal development but is a key regulator of inflammation in SHARPIN-deficient mice[J].J Immunol,2014,192(12):5476-5480.DOI:10.4049/jimmunol.1400499. [19] Dannappel M,Vlantis K,Kumari S,et al. RIPK1 maintains epithelial homeostasis by inhibiting apoptosis and necroptosis[J].Nature,2014,513(7516):90-94.DOI:10.1038/nature13608. [20] Günther C,Martini E,Wittkopf N,et al. Caspase-8 regulates TNF-α-induced epithelial necroptosis and terminal ileitis[J].Nature,2011,477(7364):335-339.DOI:10.1038/nature10400. [21] Dagenais M,Douglas T,Saleh M.Role of programmed necrosis and cell death in intestinal inflammation[J].Curr Opin Gastroenterol,2014,30(6):566-575.DOI:10.1097/MOG.0000000000000117. [22] Günther C,Neumann H,Neurath MF,et al. Apoptosis,necrosis and necroptosis:cell death regulation in the intestinal epithelium[J].Gut,2013,62(7):1062-1071.DOI:10.1136/gutjnl-2011-301364. [23] Pierdomenico M,Negroni A,Stronati L,et al. Necroptosis is active in children with inflammatory bowel disease and contributes to heighten intestinal inflammation[J].Am J Gastroenterol,2014,109(2):279-287.DOI:10.1038/ajg.2013.403. [24] Vitali R,Stronati L,Negroni A,et al. Fecal HMGB1 is a novel marker of intestinal mucosal inflammation in pediatric inflammatory bowel disease[J].Am J Gastroenterol,2011,106(11):2029-2040.DOI:10.1038/ajg.2011.231. [25] Chen Q,Xia X C,Wu S,et al. Apoptosis,necrosis,and autophagy in mouse intestinal damage after 15-Gy whole body irradiation[J].Cell Biochem Funct,2014,32(8):647-656.DOI:10.1002/cbf.3068.
2017, Vol. 26 
