Immunomodulation Through Low-Dose Radiation for Severe COVID-19: Lessons From the Past and New Developments
| Autor: | Yannic N. Hanekamp, James Giordano, Jaap C. Hanekamp, Mohammad K. Khan, Maarten Limper, Constantijn S. Venema, Samuel D. Vergunst, Joost J. C. Verhoeff, Edward J. Calabrese |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Dose-Response, Vol 18 (2020) |
| Druh dokumentu: | article |
| ISSN: | 1559-3258 15593258 |
| DOI: | 10.1177/1559325820956800 |
| Popis: | Low-dose radiation therapy (LD-RT) has historically been a successful treatment for pneumonia and is clinically established as an immunomodulating therapy for inflammatory diseases. The ongoing COVID-19 pandemic has elicited renewed scientific interest in LD-RT and multiple small clinical trials have recently corroborated the historical LD-RT findings and demonstrated preliminary efficacy and immunomodulation for the treatment of severe COVID-19 pneumonia. The present review explicates archival medical research data of LD-RT and attempts to translate this into modernized evidence, relevant for the COVID-19 crisis. Additionally, we explore the putative mechanisms of LD-RT immunomodulation, revealing specific downregulation of proinflammatory cytokines that are integral to the development of the COVID-19 cytokine storm induced hyperinflammatory state. Radiation exposure in LD-RT is minimal compared to radiotherapy dosing standards in oncology care and direct toxicity and long-term risk for secondary disease are expected to be low. The recent clinical trials investigating LD-RT for COVID-19 confirm initial treatment safety. Based on our findings we conclude that LD-RT could be an important treatment option for COVID-19 patients that are likely to progress to severity. We advocate the further use of LD-RT in carefully monitored experimental environments to validate its effectiveness, risks and mechanisms of LD-RT. |
| Databáze: | Directory of Open Access Journals |
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