放射性核素内污染促排剂的机制和现状  

Mechanism and Current Situation of Decorporation Agents for Radionuclide Contamination in vivo

作　　者：寇冰燕 郭玉凤 党旭红[1] 刘晓明[1] KOU Bing-Yan;GUO Yu-Feng;DANG Xu-Hong;LIU Xiao-Ming(Institute of Radiation Medicine and Environmental Medicine,China Institute for Radiation Protection,Taiyuan 030006,China)

机构地区：[1]中国辐射防护研究院放射医学与环境医学研究所,太原030006

出　　处：《生物化学与生物物理进展》2024年第11期2960-2970,共11页Progress In Biochemistry and Biophysics

基　　金：中核集团青年英才,中核集团基础科研和中国辐射防护研究院自主科研资助项目。

摘　　要：核事故爆发后,人体可以通过吸入、食入以及完整的皮肤或伤口受到放射性核素内污染。目前,放射性核素内污染的治疗方法主要是促排疗法,除了已经投入临床使用的碘化钾(KI)、普鲁士蓝(PB)、碳酸氢钠以及二乙基三胺五乙酸(DTPA)等放射性核素促排剂外,还有正在研究中的放射性核素促排剂,如富勒烯、羟基吡啶酮、儿茶酚胺等。近年来,生物材料进入核素促排的领域,极大提高了促排效率,其中,脂质体和纳米载体的运送形式使传统的促排剂焕发了新的生命活力,具有良好的发展前景。基于此,本文从已经进入临床使用的和具有发展前景的放射性核素内污染促排剂两方面来分析和讨论促排剂的促排机制和研究现状,明确其在促排过程中发挥的作用,分析放射性内污染促排剂的发展趋势,并展望促排剂未来的发展方向,为放射性核素促排剂的研究提供借鉴。Radioactive contamination can occur during nuclear accidents,loss of radioactive sources and the use of radiation for photography,disinfection and detection.When the human body is accidentally contaminated by radionuclides,radionuclides can cause harm to the human body through inhalation,ingestion,direct transdermal absorption and contaminated wounds into body tissues and organs.In the treatment of radionuclide contamination in vivo,the main way is decorporation therapy,which mainly uses specific decorporation agents to selectively bind radionuclides to form stable non-toxic complexes,thereby preventing their deposition in the body,accelerating excretion,and reducing the total accumulation of radionuclides in human tissues.At present,internal radionuclide decorporation agents promote the release of radionuclides from the body mainly by stopping the entry of radionuclides into the body,ion exchange,chelation,and binding of exportants to carriers.But recent studies have found that lysosomal exocytosis,the natural clearing function of activated cells,also has a significant exportation effect.In this paper,we first introduced and analyzed the mechanism and research status of radionuclide decorporation agents that have been used in clinical practice,such as the blocking effect of potassium iodide,the ion exchange effect of Prussian blue,the chelation effect of DTPA,and the urine alkalinization effect of sodium bicarbonate.The second part introduces the mechanism and research status of promising radionuclide decorporation agents.Among them,3,4,3-LI(1,2-HOPO)and 5-LIO(Me-3,2-HOPO)are the most promising ones and have been approved for phase I clinical trials.Others such as catecholamines,polyethyleneimine and fullerenes are also being studied with great potential.Polyethyleneimine,as a biological macromolecular chelator,has more chelating sites and stronger targeting effects than small molecule chelators,and has achieved a real breakthrough in decorporation.Fullerenes are known as“free radical sponges”with good free

关 键 词：放射性核素 内污染 促排剂 作用机制 

分 类 号：R146[医药卫生—公共卫生与预防医学] R979.9