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      Plasma Fibrinogen-Like 1 as a Potential Biomarker for Radiation-Induced Liver Injury

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          Abstract

          Liver damage upon exposure to ionizing radiation, whether accidental or because of therapy can contribute to liver dysfunction. Currently, radiation therapy is used for various cancers including hepatocellular carcinoma; however, the treatment dose is limited by poor liver tolerance to radiation. Furthermore, reliable biomarkers to predict liver damage and associated side-effects are unavailable. Here, we investigated fibrinogen-like 1 (FGL1)-expression in the liver and plasma after radiation exposure. We found that 30 Gy of liver irradiation (IR) induced cell death including apoptosis, necrosis, and autophagy, with fibrotic changes in the liver occurring during the acute and subacute phase in mice. Moreover, FGL1 expression pattern in the liver following IR was associated with liver damage represented by injury-related proteins and oxidative stress markers. We confirmed the association between FGL1 expression and hepatocellular injury by exposing human hepatocytes to radiation. To determine its suitability, as a potential biomarker for radiation-induced liver injury, we measured FGL1 in the liver tissue and the plasma of mice following total body irradiation (TBI) or liver IR. In TBI, FGL1 showed the highest elevation in the liver compared to other major internal organs including the heart, lung, kidney, and intestine. Notably, plasma FGL1 showed good correlation with radiation dose by liver IR. Our data revealed that FGL1 upregulation indicates hepatocellular injury in response to IR. These results suggest that plasma FGL1 may represent a potential biomarker for acute and subacute radiation exposure to the liver.

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          Most cited references28

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          Tolerance of normal tissue to therapeutic irradiation

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            Radiation-associated liver injury.

            The liver is a critically important organ that has numerous functions including the production of bile, metabolism of ingested nutrients, elimination of many waste products, glycogen storage, and plasma protein synthesis. The liver is often incidentally irradiated during radiation therapy (RT) for tumors in the upper- abdomen, right lower lung, distal esophagus, or during whole abdomen or whole body RT. This article describes the endpoints, time-course, and dose-volume effect of radiation on the liver. Published by Elsevier Inc.
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              Mechanisms of radiation-induced normal tissue toxicity and implications for future clinical trials

              To summarize current knowledge regarding mechanisms of radiation-induced normal tissue injury and medical countermeasures available to reduce its severity. Advances in radiation delivery using megavoltage and intensity-modulated radiation therapy have permitted delivery of higher doses of radiation to well-defined tumor target tissues. Injury to critical normal tissues and organs, however, poses substantial risks in the curative treatment of cancers, especially when radiation is administered in combination with chemotherapy. The principal pathogenesis is initiated by depletion of tissue stem cells and progenitor cells and damage to vascular endothelial microvessels. Emerging concepts of radiation-induced normal tissue toxicity suggest that the recovery and repopulation of stromal stem cells remain chronically impaired by long-lived free radicals, reactive oxygen species, and pro-inflammatory cytokines/chemokines resulting in progressive damage after radiation exposure. Better understanding the mechanisms mediating interactions among excessive generation of reactive oxygen species, production of pro-inflammatory cytokines and activated macrophages, and role of bone marrow-derived progenitor and stem cells may provide novel insight on the pathogenesis of radiation-induced injury of tissues. Further understanding the molecular signaling pathways of cytokines and chemokines would reveal novel targets for protecting or mitigating radiation injury of tissues and organs.
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                Author and article information

                Journal
                Cells
                Cells
                cells
                Cells
                MDPI
                2073-4409
                06 September 2019
                September 2019
                : 8
                : 9
                : 1042
                Affiliations
                [1 ]Division of Radiation Biomedical Research, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Korea (N.-K.H.) (M.G.J.) (Y.J.J.) (Y.S.) (Y.-B.L.) (Y.-J.L.)
                [2 ]Primate Resource Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk 56216, Korea
                [3 ]Division of Medical Radiation Equipment, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Korea (S.C.H.) (S.P.)
                [4 ]College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea
                [5 ]Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Korea
                Author notes
                [* ]Correspondence: hepapark@ 123456kirams.re.kr (S.C.P.); hjlee@ 123456kirams.re.kr (H.-J.L.); Tel.: +82-2-970-1638 (H.-J.L.); Fax: +82-2-970-1985 (H.-J.L.)
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-1884-6237
                https://orcid.org/0000-0002-7743-0151
                Article
                cells-08-01042
                10.3390/cells8091042
                6770824
                31489941
                27102587-f00e-48c1-9f34-e562ea855fb0
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 13 June 2019
                : 04 September 2019
                Categories
                Article

                fgl1,radiation toxicity,liver,plasma,biomarker
                fgl1, radiation toxicity, liver, plasma, biomarker

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