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Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Ionizing Radiation | Review

The immunomodulatory properties of low-level ionizing radiation as a potential treatment for COVID-19’s life-threatening symptoms

Author: Soha M. Hussien

Published in: European Journal of Medical Research | Issue 1/2023

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Abstract

Public health experts are looking into the current coronavirus outbreak to see if there are any ways to prevent potentially fatal symptoms. Low-Dose Radiotherapy (LD-RT) induces anti-inflammatory cytokine responses that act as a counterweight to pro-inflammatory cytokines, potentially providing therapeutic benefits for COVID-19-related diseases associated with significant morbidity and mortality. This study will look into positive immuno-radiological reactions to see if they are feasible, practicable, and effective in lowering the critical inflammatory condition of the crucial stage COVID-19. This study aims to investigate the use of low-dose lung radiation in bacterial and viral pneumonia, as well as to provide a treatment plan for COVID-19-associated pneumonia. This article discusses the evidence for and against LD-RT theories in COVID-19 patients. The use of LD-RT at various stages of COVID-19 appears to be beneficial, with fewer side effects than other currently being studied treatments.
Literature
1.
go back to reference Poon LLM, Guan Y, Nicholls JM, Yuen KY, Peiris JSM. The aetiology, origins, and diagnosis of severe acute respiratory syndrome. Lancet Infect Dis. 2004;4:663–71.CrossRefPubMedPubMedCentral Poon LLM, Guan Y, Nicholls JM, Yuen KY, Peiris JSM. The aetiology, origins, and diagnosis of severe acute respiratory syndrome. Lancet Infect Dis. 2004;4:663–71.CrossRefPubMedPubMedCentral
3.
go back to reference Dhawan G, Kapoor R, Dhawan R, Singh R, Monga B, Giordano J, Calabrese EJ. Low dose radiation therapy as a potential life saving treatment for COVID-19-induced acute respiratory distress syndrome (ARDS). Radiother Oncol. 2020;147:212–6.CrossRefPubMedPubMedCentral Dhawan G, Kapoor R, Dhawan R, Singh R, Monga B, Giordano J, Calabrese EJ. Low dose radiation therapy as a potential life saving treatment for COVID-19-induced acute respiratory distress syndrome (ARDS). Radiother Oncol. 2020;147:212–6.CrossRefPubMedPubMedCentral
5.
go back to reference Kirsch DG, Diehn M, Cucinotta FA, Weichselbaum R. Lack of supporting data make the risks of a clinical trial of radiation therapy as a treatment for COVID-19 pneumonia unacceptable. Radiother Oncol. 2020;147:217–20.CrossRefPubMedPubMedCentral Kirsch DG, Diehn M, Cucinotta FA, Weichselbaum R. Lack of supporting data make the risks of a clinical trial of radiation therapy as a treatment for COVID-19 pneumonia unacceptable. Radiother Oncol. 2020;147:217–20.CrossRefPubMedPubMedCentral
6.
go back to reference Calabrese EJ, Dhawan G. How radiotherapy was historically used to treat pneumonia: could it be useful today? Yale J Biol Med. 2013;86:555.PubMedPubMedCentral Calabrese EJ, Dhawan G. How radiotherapy was historically used to treat pneumonia: could it be useful today? Yale J Biol Med. 2013;86:555.PubMedPubMedCentral
8.
go back to reference Schaue D, Jahns J, Hildebrandt G, Trott K-R. Radiation treatment of acute inflammation in mice. Int J Radiat Biol. 2005;81:657–67.CrossRefPubMed Schaue D, Jahns J, Hildebrandt G, Trott K-R. Radiation treatment of acute inflammation in mice. Int J Radiat Biol. 2005;81:657–67.CrossRefPubMed
9.
go back to reference Rödel F, Keilholz L, Herrmann M, Sauer R, Hildebrandt G. Radiobiological mechanisms in inflammatory diseases of low-dose radiation therapy. Int J Radiat Biol. 2007;83:357–66.CrossRefPubMed Rödel F, Keilholz L, Herrmann M, Sauer R, Hildebrandt G. Radiobiological mechanisms in inflammatory diseases of low-dose radiation therapy. Int J Radiat Biol. 2007;83:357–66.CrossRefPubMed
10.
go back to reference Torres Royo L, Antelo Redondo G, Árquez Pianetta M, Arenas Prat M. Low-dose radiation therapy for benign pathologies. Reports Pract Oncol Radiother. 2020;25:250–4.CrossRef Torres Royo L, Antelo Redondo G, Árquez Pianetta M, Arenas Prat M. Low-dose radiation therapy for benign pathologies. Reports Pract Oncol Radiother. 2020;25:250–4.CrossRef
11.
go back to reference Oppenheimer A. Roentgen therapy of “virus” pneumonia. Am J Roentgenol Radiat Ther. 1943;49:635–8. Oppenheimer A. Roentgen therapy of “virus” pneumonia. Am J Roentgenol Radiat Ther. 1943;49:635–8.
12.
go back to reference Correll HL, Cowan II. Primary atypical pneumonia, analysis of therapeutic results in 155 cases. US Nav M Bull. 1943;41:980–7. Correll HL, Cowan II. Primary atypical pneumonia, analysis of therapeutic results in 155 cases. US Nav M Bull. 1943;41:980–7.
13.
go back to reference Trott KR. Therapeutic effects of low radiation doses. Strahlentherapie und Onkol Organ der Dtsch Rontgengesellschaft [et al]. 1994;170:1–12. Trott KR. Therapeutic effects of low radiation doses. Strahlentherapie und Onkol Organ der Dtsch Rontgengesellschaft [et al]. 1994;170:1–12.
14.
go back to reference Fried C. The roentgen treatment of experimental pneumonia in the guinea-pig. Radiology. 1941;37(2):197–202.CrossRef Fried C. The roentgen treatment of experimental pneumonia in the guinea-pig. Radiology. 1941;37(2):197–202.CrossRef
15.
go back to reference Lieberman LM, Hodes PJ, Leopold SS. Roentgen therapy of experimental lobar pneumonia in dogs. Am. J. Med. Sci. 1941;291(1):92–100.CrossRef Lieberman LM, Hodes PJ, Leopold SS. Roentgen therapy of experimental lobar pneumonia in dogs. Am. J. Med. Sci. 1941;291(1):92–100.CrossRef
16.
go back to reference Dubin IN, Baylin GJ, Gobble Jr WG. The effect of roentgen therapy on experimental virus pneumonia; on pneumonia produced in white mice by swine influenza virus. Am J Roentgenol Radium Ther. 1946;55:478–81.PubMed Dubin IN, Baylin GJ, Gobble Jr WG. The effect of roentgen therapy on experimental virus pneumonia; on pneumonia produced in white mice by swine influenza virus. Am J Roentgenol Radium Ther. 1946;55:478–81.PubMed
17.
go back to reference Salomaa S, Cardis E, Bouffler SD, Atkinson MJ, Hamada N. Low dose radiation therapy for COVID-19 pneumonia: is there any supportive evidence? Int J Radiat Biol. 2020;96:1224–7.CrossRefPubMed Salomaa S, Cardis E, Bouffler SD, Atkinson MJ, Hamada N. Low dose radiation therapy for COVID-19 pneumonia: is there any supportive evidence? Int J Radiat Biol. 2020;96:1224–7.CrossRefPubMed
19.
go back to reference Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.CrossRefPubMedPubMedCentral Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.CrossRefPubMedPubMedCentral
21.
go back to reference Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71:762–8.CrossRefPubMed Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71:762–8.CrossRefPubMed
22.
24.
go back to reference Nakatsukasa H, Tsukimoto M, Ohshima Y, Tago F, Masada A, Kojima S. Suppressing effect of low-dose gamma-ray irradiation on collagen-induced arthritis. J Radiat Res. 2008;49:381–9.CrossRefPubMed Nakatsukasa H, Tsukimoto M, Ohshima Y, Tago F, Masada A, Kojima S. Suppressing effect of low-dose gamma-ray irradiation on collagen-induced arthritis. J Radiat Res. 2008;49:381–9.CrossRefPubMed
25.
go back to reference Nakatsukasa H, Tsukimoto M, Tokunaga A, Kojima S. Repeated gamma irradiation attenuates collagen-induced arthritis via up-regulation of regulatory T cells but not by damaging lymphocytes directly. Radiat Res. 2010;174:313–24.CrossRefPubMed Nakatsukasa H, Tsukimoto M, Tokunaga A, Kojima S. Repeated gamma irradiation attenuates collagen-induced arthritis via up-regulation of regulatory T cells but not by damaging lymphocytes directly. Radiat Res. 2010;174:313–24.CrossRefPubMed
26.
go back to reference Weng L, Williams RO, Vieira PL, Screaton G, Feldmann M, Dazzi F. The therapeutic activity of low-dose irradiation on experimental arthritis depends on the induction of endogenous regulatory T cell activity. Ann Rheum Dis. 2010;69:1519–26.CrossRefPubMed Weng L, Williams RO, Vieira PL, Screaton G, Feldmann M, Dazzi F. The therapeutic activity of low-dose irradiation on experimental arthritis depends on the induction of endogenous regulatory T cell activity. Ann Rheum Dis. 2010;69:1519–26.CrossRefPubMed
27.
go back to reference Calabrese EJ, Calabrese V. Reduction of arthritic symptoms by low dose radiation therapy (LD-RT) is associated with an anti-inflammatory phenotype. Int J Radiat Biol. 2013;89:278–86.CrossRefPubMed Calabrese EJ, Calabrese V. Reduction of arthritic symptoms by low dose radiation therapy (LD-RT) is associated with an anti-inflammatory phenotype. Int J Radiat Biol. 2013;89:278–86.CrossRefPubMed
28.
go back to reference Seegenschmiedt MH, Micke O, Muecke R. Radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines. Br J Radiol. 2015;88:20150080.CrossRefPubMedPubMedCentral Seegenschmiedt MH, Micke O, Muecke R. Radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines. Br J Radiol. 2015;88:20150080.CrossRefPubMedPubMedCentral
31.
go back to reference Kriz J, Seegenschmiedt HM, Bartels A, Micke O, Muecke R, Schaefer U, Haverkamp U, Eich HT. Updated strategies in the treatment of benign diseases—a patterns of care study of the german cooperative group on benign diseases. Adv Radiat Oncol. 2018;3:240–4.CrossRefPubMedPubMedCentral Kriz J, Seegenschmiedt HM, Bartels A, Micke O, Muecke R, Schaefer U, Haverkamp U, Eich HT. Updated strategies in the treatment of benign diseases—a patterns of care study of the german cooperative group on benign diseases. Adv Radiat Oncol. 2018;3:240–4.CrossRefPubMedPubMedCentral
32.
go back to reference Seegenschmiedt MH, Katalinic A, Makoski H-B, Haase W, Gademann G, Hassenstein E. Radiation therapy for benign diseases: patterns of care study in Germany. Int J Radiat Oncol Biol Phys. 2000;47:195–202.CrossRefPubMed Seegenschmiedt MH, Katalinic A, Makoski H-B, Haase W, Gademann G, Hassenstein E. Radiation therapy for benign diseases: patterns of care study in Germany. Int J Radiat Oncol Biol Phys. 2000;47:195–202.CrossRefPubMed
33.
go back to reference Micke O, Seegenschmiedt MH. Consensus guidelines for radiation therapy of benign diseases: a multicenter approach in Germany. Int J Radiat Oncol Biol Phys. 2002;52:496–513.CrossRefPubMed Micke O, Seegenschmiedt MH. Consensus guidelines for radiation therapy of benign diseases: a multicenter approach in Germany. Int J Radiat Oncol Biol Phys. 2002;52:496–513.CrossRefPubMed
35.
go back to reference Calabrese EJ, Dhawan G, Kapoor R, Kozumbo WJ. Radiotherapy treatment of human inflammatory diseases and conditions: optimal dose. Hum Exp Toxicol. 2019;38:888–98.CrossRefPubMed Calabrese EJ, Dhawan G, Kapoor R, Kozumbo WJ. Radiotherapy treatment of human inflammatory diseases and conditions: optimal dose. Hum Exp Toxicol. 2019;38:888–98.CrossRefPubMed
36.
go back to reference Arenas M, Sabater S, Hernández V, Rovirosa A, Lara PC, Biete A, Panes J. Anti-inflammatory effects of low-dose radiotherapy. Strahlenther Onkol. 2012;188:975–81.CrossRefPubMed Arenas M, Sabater S, Hernández V, Rovirosa A, Lara PC, Biete A, Panes J. Anti-inflammatory effects of low-dose radiotherapy. Strahlenther Onkol. 2012;188:975–81.CrossRefPubMed
38.
go back to reference McKeown SR, Hatfield P, Prestwich RJD, Shaffer RE, Taylor RE. Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation. Br J Radiol. 2015;88:20150405.CrossRefPubMedPubMedCentral McKeown SR, Hatfield P, Prestwich RJD, Shaffer RE, Taylor RE. Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation. Br J Radiol. 2015;88:20150405.CrossRefPubMedPubMedCentral
39.
go back to reference Genard G, Lucas S, Michiels C. Reprogramming of tumor-associated macrophages with anticancer therapies: radiotherapy versus chemo- and immunotherapies. Front Immunol. 2017;8:828.CrossRefPubMedPubMedCentral Genard G, Lucas S, Michiels C. Reprogramming of tumor-associated macrophages with anticancer therapies: radiotherapy versus chemo- and immunotherapies. Front Immunol. 2017;8:828.CrossRefPubMedPubMedCentral
40.
go back to reference Klug F, Prakash H, Huber PE, et al. Low-dose irradiation programs macrophage differentiation to an iNOS+/M1 phenotype that orchestrates effective T cell immunotherapy. Cancer Cell. 2013;24:589–602.CrossRefPubMed Klug F, Prakash H, Huber PE, et al. Low-dose irradiation programs macrophage differentiation to an iNOS+/M1 phenotype that orchestrates effective T cell immunotherapy. Cancer Cell. 2013;24:589–602.CrossRefPubMed
41.
go back to reference Rödel F, Frey B, Manda K, Hildebrandt G, Hehlgans S, Keilholz L, Seegenschmiedt MH, Gaipl US, Rödel C. Immunomodulatory properties and molecular effects in inflammatory diseases of low-dose x-irradiation. Front Oncol. 2012;2:120.CrossRefPubMedPubMedCentral Rödel F, Frey B, Manda K, Hildebrandt G, Hehlgans S, Keilholz L, Seegenschmiedt MH, Gaipl US, Rödel C. Immunomodulatory properties and molecular effects in inflammatory diseases of low-dose x-irradiation. Front Oncol. 2012;2:120.CrossRefPubMedPubMedCentral
42.
go back to reference Ghadimi-Moghadam A, Haghani M, Bevelacqua JJ, Jafarzadeh A, Kaveh-Ahangar A, Mortazavi SMJ, Ghadimi-Moghadam A, Mortazavi SAR. COVID-19 tragic pandemic: concerns over unintentional “directed accelerated evolution” of novel coronavirus (SARS-CoV-2) and introducing a modified treatment method for ARDS. J Biomed Phys Eng. 2020;10:241. Ghadimi-Moghadam A, Haghani M, Bevelacqua JJ, Jafarzadeh A, Kaveh-Ahangar A, Mortazavi SMJ, Ghadimi-Moghadam A, Mortazavi SAR. COVID-19 tragic pandemic: concerns over unintentional “directed accelerated evolution” of novel coronavirus (SARS-CoV-2) and introducing a modified treatment method for ARDS. J Biomed Phys Eng. 2020;10:241.
43.
go back to reference Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–62.CrossRefPubMedPubMedCentral Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–62.CrossRefPubMedPubMedCentral
44.
go back to reference Yang G, Kong Q, Wang G, Jin H, Zhou L, Yu D, Niu C, Han W, Li W, Cui J. Low-dose ionizing radiation induces direct activation of natural killer cells and provides a novel approach for adoptive cellular immunotherapy. Cancer Biother Radiopharm. 2014;29:428–34.PubMedPubMedCentral Yang G, Kong Q, Wang G, Jin H, Zhou L, Yu D, Niu C, Han W, Li W, Cui J. Low-dose ionizing radiation induces direct activation of natural killer cells and provides a novel approach for adoptive cellular immunotherapy. Cancer Biother Radiopharm. 2014;29:428–34.PubMedPubMedCentral
45.
go back to reference Thevarajan I, Nguyen THO, Koutsakos M, et al. Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19. Nat Med. 2020;26:453–5.CrossRefPubMedPubMedCentral Thevarajan I, Nguyen THO, Koutsakos M, et al. Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19. Nat Med. 2020;26:453–5.CrossRefPubMedPubMedCentral
47.
go back to reference Yazdany J, Kim AHJ. Use of hydroxychloroquine and chloroquine during the COVID-19 pandemic: what every clinician should know. Ann Intern Med. 2020;172:754–5.CrossRefPubMed Yazdany J, Kim AHJ. Use of hydroxychloroquine and chloroquine during the COVID-19 pandemic: what every clinician should know. Ann Intern Med. 2020;172:754–5.CrossRefPubMed
48.
go back to reference Trott K-R, Kamprad F. Estimation of cancer risks from radiotherapy of benign diseases. Strahlentherapie und Onkol. 2006;182:431–6.CrossRef Trott K-R, Kamprad F. Estimation of cancer risks from radiotherapy of benign diseases. Strahlentherapie und Onkol. 2006;182:431–6.CrossRef
49.
go back to reference Nikitaki Z, Nikolov V, Mavragani IV, et al. Measurement of complex DNA damage induction and repair in human cellular systems after exposure to ionizing radiations of varying linear energy transfer (LET). Free Radic Res. 2016;50:S64–78.CrossRefPubMed Nikitaki Z, Nikolov V, Mavragani IV, et al. Measurement of complex DNA damage induction and repair in human cellular systems after exposure to ionizing radiations of varying linear energy transfer (LET). Free Radic Res. 2016;50:S64–78.CrossRefPubMed
50.
go back to reference Georgakilas AG, O’Neill P, Stewart RD. Induction and repair of clustered DNA lesions: what do we know so far? Radiat Res. 2013;180:100–9.CrossRefPubMed Georgakilas AG, O’Neill P, Stewart RD. Induction and repair of clustered DNA lesions: what do we know so far? Radiat Res. 2013;180:100–9.CrossRefPubMed
Metadata
Title
The immunomodulatory properties of low-level ionizing radiation as a potential treatment for COVID-19’s life-threatening symptoms
Author
Soha M. Hussien
Publication date
01-12-2023
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-00999-7

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