New Emerging Concepts in the Medical Management of Local Radiation Injury
Marc Benderittera, Alain Chapela, Radia Tamarata, Marie Pratb, Jean Jacques Latailladeb, Eric Beyc, Patrick Gourmelona
a Institut de Radioprotection et de Sûreté Nucléaire, Laboratoire de radiopathologie et de thérapie expérimentale, BP 17, 92262 Fontenay-aux-Roses, France.
b Centre de Transfusion Sanguine des Armées, Département de recherche et de thérapie cellulaire, Hôpital d'Instruction des Armées, 92141 Clamart, France.
c Service de Chirurgie plastique, Hôpital d'Instruction des Armées Percy, 92141 Clamart, France.
Treatment of severe radiation burns remains a difficult medical challenge. The response of the skin to ionizing radiation results in a range of clinical manifestations. The most severe manifestations are highly disabling. Although several therapeutic strategies (excision, skin grafting, skin or muscle flaps) have been used with some success, none have proven entirely satisfying. The concept that stem cell injections could be used for reducing normal tissue injury has been discussed for a number of years. Mesenchymal Stem Cells (MSC) therapy may be a promising therapeutic approach for improving radiation-induced skin and muscle damages. Pre-clinical and clinical benefit of MSC injection for ulcerated skin and muscle restoration after high dose radiation exposure has been successfully demonstrated. Six patients suffering from severe radiological syndrome were successfully treated in France based on autologous human-grade MSC injection combined with plastic surgery or skin graft. Stem cell therapy has to be improved to the point that hospitals can put safe, efficient and reliable clinical protocols into practice.