[Territorial organization of a surveillance system for the patient at risk of sudden death].
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Biomedical subjects
Publications and source records attributed to G Kraft.
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This paper presents a summary of our understanding to date of the formation of DNA strand breaks induced by highly energetic particle beams (high-LET radiation). We have compared our own recent data on the formation of strand breaks induced in DNA in an aqueous solution with our previous data and those of others available from the literature for similar lesions made in cellular DNA. When the strand break induction frequency, as number of breaks per Gy per unit DNA, is plotted against LET, a series of biological effect curves (one for each particle atomic number Z) is obtained. The frequency of the formation of single-strand breaks has an RBE of less than 1 for DNA in solution and for DNA in the cell; the frequency of the formation of double-strand breaks (dsb) also has an RBE of less than 1 for DNA in a solution containing low amounts of free radical scavenger(s), while the RBE can be greater than 1 in the 50-200 keV/microns range for cellular DNA. RBE values are with respect to X-rays or cobalt gamma-rays. In cells the level of unrejoined strand breaks is also highest in the 50-200 keV/microns range and may reach 25-35% of the initial break yield depending on particle energy and Z-value. These irreparable lesions include double-strand scissions and some form(s) of single-strand breaks. The data presented cover results obtained for helium to uranium particles, with an LET range of 16 to 160,000 keV/microns. When different biological end-points are compared a strong correlation is found between induction of dsb, chromosomal abnormalities and mutation induction.
Heavy charged particles exhibit a superior dose distribution compared to all conventionally used beams. The small lateral and range straggling, combined with an increase of the dose deposition with increasing penetration depth enables the production of dose profiles shaped precisely to the contours of the treatment volume. In addition, heavy ion beams exhibit an elevated biological efficiency close to the end of the particle range. Therefore, beams of heavy ions deliver a high physical dose combined with a high biological efficiency to a tumor volume while the surrounding healthy tissue is maximally spared.
It could be demonstrated that local tumor control is considerably improved by radiation therapy with charged particles (protons or heavier ions). The advantages of heavy ion therapy compared to conventional photon therapy techniques are due to the better physical dose distributions achievable and the radiobiological characteristics of heavy ions. However, because of the expense and complexity of heavy ion therapy it is only carried out at a few facilities throughout the world. The Radiologische Universitätsklinik (Radiological University Hospital) and the Deutsches Krebsforschungszentrum (German Cancer Research Centre, DKFZ) in Heidelberg, in collaboration with the Gesellschaft für Schwerionenforschung (Laboratory for Heavy Ion, GSI) in Darmstadt, have developed a concept to use the new heavy ion synchrotron (Schwerionen-Synchroton SIS) in Darmstadt for medical-clinical irradiations. Due to the high flexibility of the SIS accelerator the medical program can be performed in addition to the planned physical experiments with minor interference only. The close geographical proximity of the three institutes involved and the accelerator which will be completed by the end of 1989 provide the unique opportunity to carry out relevant clinical, medical-physical, physical-technical, and radiobiological research in a relatively short time and, compared to similar projects in other countries, at low cost.
Diploid wild-type yeast cells were exposed to beams of heavy ions covering a wide range of linear energy transfer (LET) (43-13,700 keV/microns). Synthesis of ribosomal RNA (rRNA) was assessed as a functional measure of damage produced by particle radiation. An exponential decrease of relative rRNA synthesis with particle fluence was demonstrated in all cases. The inactivation cross sections derived were found to increase with LET over the entire range of LET studied. The corresponding values for relative biological effectiveness were slightly less than unity. Maximum cross sections measured were close to 1 micron 2, implying that some larger structure within the yeast nucleus (e.g., the nucleolus) might represent the target for an impairment of synthetic activity by very heavy ions rather than the genes coding for rRNA. Where tested, an oxygen effect for rRNA synthesis could not be demonstrated.
Free radical formation after heavy-ion bombardment was studied in solid, polycristalline pellets of DNA-constituents by analysing the dose-yield curves and the spectra obtained by ESR-spectroscopy at low (< 100 K) and ambient temperatures. The dose-yield curves were found to correlate with those found after X-irradiation but shifted to higher doses and lower saturation concentrations. The corresponding radical yields (per 100 eV) exhibit values which are one to two orders of magnitudes lower. The structural aspects as revealed from powder ESR-spectra gave a complex inter-relation between substance, LET, dose and irradiation temperature, which is discussed in terms of mechanistic models.
We have aimed to present a comprehensive review of our understanding to date of the formation of DNA strand breaks induced by high LET radiation. We have discussed data obtained from DNA in solution as well as from the formation and "repair" of strand breaks in cell DNA. There is good agreement, qualitatively, between these two systems. Results were evaluated for two parameters: (1) effectivity per particle, the cross section (sigma) in micrometers 2/particle; and (2) the strand break induction frequency as number of breaks per Gy per unit DNA (bp or dalton). A series of biological effects curves (one for each Z-number) is obtained in effectivity versus LET plots. The relationships between induction frequencies of single-strand breaks, or double-strand breaks, or the residual "irrepairable" breaks and LET-values have been evaluated and discussed for a wide spectrum of heavy ions, both for DNA in solution and for DNA in the cell. For radiation induced total breaks in cell DNA, the RBE is less than one, while the RBE for the induction of DSBs can be greater than one in the 100-200 keV/micrometers range. The level of irrepairable strand breaks is highest in this same LET range and may reach 25 percent of the initial break yield. The data presented cover results obtained for helium to uranium particles, covering a particle incident energy range of about 2 to 900 MeV/u with a corresponding LET range of near 16 to 16000 keV/micrometers.
Radiobiological effects of heavy charged particles are compared for a large variety of ions from Helium to Uranium and energies between 1 and 1000 MeV/u which correspond to LET values between 10 and 16000 keV/micrometers. The different cross section for the induction of strand breaks and chromosomal aberrations as well as for inactivation and mutation induction exhibit striking similarities when compared as function of the linear energy transfer (LET). At LET values below 100 keV/micrometers all data points of one specific effect form one single curve as a function of LET, independent of the atomic number of the ion. In this LET range, the biological effects are independ from the particle energy or track structure and depend only on the energy transfer. Therefore, LET is a good parameter in this regime. For LET values greater than 100 keV/micrometers, the curves for the different ions separate from the common curve in order of increasing atomic numbers. In this regime LET is no longer a good parameter and the physical parameters of the formation of particle tracks are important. The similarity of the sigma-LET curves for different endpoints indicates that the 'hook-structure' is produced by physical and chemical effects which occur before the biologically relevant lesions are formed. However, from the existing data of biological effects, it can be concluded that the efficiencies for cell killing are always smaller than those extrapolated from X-ray data on the basis of the energy deposition only. Therefore, cells which are directly hit by an HZE particle are not killed and undergo a finite risk of mutation and transformation.
Cell cycle effects of very high LET particles on synchronous V79 Chinese Hamster cells have been studied in a track segment experiment by means of flow cytometric methods. Cells were irradiated with 10 MeV/u Pb-ions (LET = 13500 keV/micrometers) at an average fluence of 2 particles per cell nucleus, corresponding to a survival level of about 25%. Instantaneous drastic reductions of cell proliferation in all cycle phases have been observed, which affect the cell cycle for at least 50 hours after exposure to heavy ions. These findings are in clear contrast to the results from low LET radiation experiments, where significant delays can only be observed in S-phase and G2M-phase and for comparatively short time intervals of a few hours. Additionally, high LET radiation gives rise to prolonged DNA synthesis bypassing cell division, which leads to cells with DNA content greater than that of G2M-cells.
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The relative biological effectiveness (RBE) for the induction of DNA strand breaks and the efficiency of repair of these breaks in cultured diploid bovine lens epithelial cells was measured, using accelerated heavy ions in the linear energy transfer (LET)-range up to 16,200 keV/micron. At LET values above 800 keV/micron, the number of DNA strand breaks induced per particle increases both with the atomic number of the projectile and with its kinetic energy. About 90 per cent or more of the strand breaks induced by ions with an LET of less than 10,000 keV/micron are repaired within 24 h. Repair kinetics show a dependence on the particle fluence (irradiation dose). At higher particle fluences a higher proportion of non-rejoined breaks is found, even after prolonged periods of incubation. At any LET value, repair is much slower after heavy-ion exposure than after X-irradiation. This is especially true for low energetic particles with a very high local density of energy deposition within the particle track. At the highest LET value (16,200 keV/micron), no significant repair is observed.
A broad spectrum of particles and energies has been used in the last years to study the influence of the radiation quality i.e. of the physical parameters of the particle beam on the biological effectiveness ¿2¿12¿. In these measurements a common structure of the functional dependence of the induction probability per particle (cross section) from the linear energy transfer is observed for different biological endpoints. Because of the relevance for space research, we present in this report our data from experiments with iron and nickel particles, in particular. Our experiments were designed to investigate the relationship between the inactivation and chromosome aberration in mammalian cells and the induction of single and double strand breaks in SV40 DNA in respect to the parameters of the track formation like LET and particle energy.
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Ionizing radiation causes the formation of strand breaks in cellular DNA, as well as other types of lesions in the chromatin of cells. Some of the earliest investigations of the molecular basis of radiation-induced damage and the implications of enzymatic repair were done by Dr. H. S. Kaplan. The induction frequency of DNA double-strand breaks is of special importance, and it is of interest to know the relative proportions of single-strand and double-strand breaks. This ratio changes noticeably with the radiation quality (ionization density). Because it is difficult to assay for DNA lesions in the large mammalian genome, we have developed a method of assaying for DNA double-strand breaks in the supercoiled nucleosome-complexed Simian virus 40 (SV40) genome, irradiated intracellularly. In this communication we present our measurements of the DNA double-strand breaks (DSBs) to single-strand breaks (SSBs) ratio obtained from the intracellularly irradiated SV40 genome. After cobalt gamma ray and X ray irradiations, this ratio is about 1/10. Our methods and results are compared with pertinent data in the literature. If the DSBs/SSBs ratio of 1/10 for cellular chromatin is correct, a substantial number of DNA double-strand breaks are formed in a mammalian cell after moderate doses (1 Gy) of radiation. The implications of different types of DNA double-strand breaks are discussed.
In track segment experiments, the inactivation of different mammalian cells by heavy charged particles between helium and uranium in the energy range between 1 and 1000 MeV/u has been measured at the heavy ion accelerator Unilac, Darmstadt, the Tandem Van de Graaf, Heidelberg, and the Bevalac, Berkeley. The inactivation cross sections calculated from the final slope of the dose-effect curves are given as a function of the particle energy and the linear energy transfer.
In track segment experiments cell survival and chromosome aberrations of mammalian cells have been measured for various heavy ion beams between helium and uranium in the energy range between 0.5 and 960 MeV/u, corresponding to a velocity range of 0.03 to 0.87 C, and an LET spectrum from 10 to 15 000 keV/micrometers. At low LET, the cross section (sigma) for cell killing increases with increasing LET and shows a common curve for all ions regardless of the atomic number. This indicates that in this region the track structure of the different ions is of only a minor influence, and it is rather the total energy transfer, which is important for cell killing. At higher LET values, deviations from a common sigma-LET curve can be observed which indicate a saturation effect. The saturation of the lighter ions occurs at lower LET values than for the heavier ions. These findings are also confirmed by the chromosome data, where the efficiency for the induction of chromosomal aberrations for high LET particles depends on the track structure and is nearly independent of LET. In the heavier beams (Z > or = 10) individual particles cause multiple chromosome breaks in mitotic cells.
Survival of a diploid and a haploid wild type and a radiation-sensitive rad52-mutant was investigated after exposure to accelerated ions in the presence or absence of oxygen. Ar, Kr, Xe, Sm, Pb and U ions were used with specific energies between 0.3 and 12 MeV/u. The results demonstrate that the oxygen enhancement ratios (o.e.r.) do not only depend on LET or Z*2/beta 2 but even more so on ion specific energy. The o.e.r.s are always higher with greater E/m values pointing to the importance of delta-electron action.