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Adaptive Response in Patients Treated with ¹³¹I

Department of Biomedical Physics and Radiation Protection, University of Gent, Gent
Division of Nuclear Medicine, University Hospital of Gent, Gent
Department of Histology, University of Gent, Gent, Belgium

Correspondence: For correspondence or reprints contact: Myriam Monsieurs, MS, Division of Nuclear Medicine, University Hospital of Gent, De Pintelaan 185, 9000 Gent, Belgium.

ABSTRACT

The aim of this study was to investigate whether an adaptive response (defined as the induction of radiation tolerance after a small dose of radiation) could be observed in peripheral blood lymphocytes of patients treated with ¹³¹I for thyroid disease. Methods: For each patient, blood samples were taken immediately before and 1 wk after ¹³¹I administration. Each blood sample was divided into 3 fractions and the fractions were subsequently irradiated in vitro with 0, 0.5, and 1.0 Gy ⁶⁰Co -rays. After blood culture for 70 h, cells were harvested and stained with Romanowsky-Giemsa and micronuclei were counted in 1000 binucleated cells. The increase in micronuclei by the in vitro irradiation of the blood samples taken before and after therapy was compared. In this setup, an adaptive response is represented by a significant decrease of the in vitro induced micronucleus yield after therapy compared with that before therapy. The iodine therapy can be considered as an in vivo adaptation dose, after which the subsequent in vitro irradiation acts as a challenge dose. To investigate the reproducibility of the method, 2 subsequent blood samples of healthy volunteers were taken 7 d apart. Irradiation and cell culture were performed as described. Results: In 8 of 20 patients, a significant (P = 0.0002) decrease was found in the in vitro induced micronucleus yield in the blood sample taken 1 wk after ¹³¹I administration compared with that of the blood sample taken before therapy. No significant (P > 0.1) differences were observed between these 8 patients and the other patients when the number of micronuclei induced in vivo by the iodine treatment and the resulting equivalent total body dose were compared. None of the control subjects showed a significant change in micronucleus yield after in vitro irradiation between both blood samples taken 1 wk apart. Conclusion: The iodine treatment can act as an in vivo adaptation dose and can induce an adaptive response that is observed by a decrease of the cytogenetic damage in peripheral blood lymphocytes after in vitro irradiation as a challenge dose. A large interindividual difference was observed.

Key Words: adaptive response • ¹³¹I therapy • thyrotoxicosis • thyroid carcinoma

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