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2016 ; 186
(5
): 478-488
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IPW-5371 Proves Effective as a Radiation Countermeasure by Mitigating
Radiation-Induced Late Effects
#MMPMID27841740
Rabender C
; Mezzaroma E
; Mauro AG
; Mullangi R
; Abbate A
; Anscher M
; Hart B
; Mikkelsen R
Radiat Res
2016[Nov]; 186
(5
): 478-488
PMID27841740
show ga
There is an ongoing and significant need for radiation countermeasures to reduce
morbidities and mortalities associated with exposure of the heart and lungs from
a radiological or nuclear incidents. Radiation-induced late effects occur months
to years after exposure, stemming from significant tissue damage and remodeling,
resulting in fibrosis and loss of function. TGF-? is reported to play a role in
both pulmonary and cardiac fibrosis. We investigated the ability of a small
molecule TGF-? receptor 1 inhibitor, IPW-5371, to mitigate the effects of
thoracic irradiation in C57L/J mice, a murine model that most closely resembles
that observed in humans in the induction of fibrosis and dose response. To
simulate a radiological event, radiation was administered in two doses: 5 Gy
total-body irradiation (eliciting a whole-body response) and immediately after
that, a thoracic "top-up" of 6.5 Gy irradiation, for a total dose of 11.5 Gy to
the thorax. IPW-5371 was administered once daily, orally, starting 24 h
postirradiation for 6 or 20 weeks at a dose of 10 mg/kg or 30 mg/kg. Animals were
monitored for a period of 180 days for survival, and cardiopulmonary injury was
assessed by echocardiography, breathing rate and arterial oxygen saturation.
Exposure of the thorax (11.5 Gy) induced both pulmonary and cardiac injury,
resulting in a reduced life span with median survival of 135 days. IPW-5371
treatment for 6 weeks, at both 10 mg/kg and 30 mg/kg, delayed disease onset and
mortality, with median survival of 165 days. Twenty weeks of IPW-5371 treatment
at 30 mg/kg preserved arterial O(2) saturation and cardiac contractile reserve
and resulted in significant decreases in breathing frequency and cardiac and
pulmonary fibrosis. This led to dramatic improvement in survival compared to the
irradiated, vehicle-treated group (P < 0.001), and was statistically
insignificant from the nonirradiated group. We observed that IPW-5371 treatment
resulted in decreased pSmad3 tissue levels, confirming the effect of IPW-5371 on
TGF-? signaling. These results demonstrate that IPW-5371 represents a potentially
promising radiation countermeasure for the treatment of radiation-induced late
effects.