Renin-Angiotensin system suppression mitigates experimental radiation pneumonitis

Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1528-36. doi: 10.1016/j.ijrobp.2009.07.1743.

Abstract

Purpose: To find the mitigators of pneumonitis induced by moderate doses of thoracic radiation (10-15 Gy).

Methods and materials: Unanesthetized WAG/RijCmcr female rats received a single dose of X-irradiation (10, 12, or 15 Gy at 1.615 Gy/min) to the thorax. Captopril (an angiotensin-converting enzyme inhibitor) or losartan (an angiotensin receptor blocker) was administered in the drinking water after irradiation. Pulmonary structure and function were assessed after 8 weeks in randomly selected rats by evaluating the breathing rate, ex vivo vascular reactivity, and histopathologic findings. Survival analysis was undertaken on all animals, except those scheduled for death.

Results: Survival after a dose of 10 Gy to the thorax was not different from that of unirradiated rats for <or=1 year. Survival decreased to <50% by 45 weeks after 12 Gy and by 8-9 weeks after 15 Gy. Captopril (17-56 mg/kg/d) improved survival and reduced radiation-induced increases in breathing rate, changes in vascular reactivity, and histopathologic evidence of injury. Radiation-induced increases in the breathing rate were prevented even if captopril was started 1 week after irradiation or if it was discontinued after 5 weeks. Losartan, although effective in reducing mortality, was not as efficacious as captopril in mitigating radiation-induced increases in the breathing rate or altered vasoreactivity.

Conclusion: In rats, a moderate thoracic radiation dose induced pneumonitis and morbidity. These injuries were mitigated by captopril even when it was begun 1 week after radiation or if discontinued 5 weeks after exposure. Losartan was less effective in protecting against radiation-induced changes in vascular reactivity or tachypnea.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Angiotensin Receptor Antagonists*
  • Angiotensin-Converting Enzyme Inhibitors / administration & dosage
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Animals
  • Captopril / administration & dosage
  • Captopril / therapeutic use*
  • Drug Evaluation, Preclinical / methods
  • Female
  • Losartan / administration & dosage
  • Losartan / therapeutic use*
  • Lung / pathology
  • Lung / physiopathology
  • Lung / radiation effects
  • Pulmonary Artery / drug effects
  • Pulmonary Artery / physiology
  • Pulmonary Artery / radiation effects
  • Radiation Dosage
  • Radiation Injuries, Experimental / drug therapy
  • Radiation Injuries, Experimental / mortality
  • Radiation Injuries, Experimental / pathology
  • Radiation Injuries, Experimental / physiopathology
  • Radiation Pneumonitis / drug therapy*
  • Radiation Pneumonitis / mortality
  • Radiation Pneumonitis / pathology
  • Radiation Pneumonitis / physiopathology
  • Rats
  • Renin-Angiotensin System / drug effects*
  • Renin-Angiotensin System / physiology
  • Respiratory Mechanics / drug effects
  • Respiratory Mechanics / physiology
  • Respiratory Mechanics / radiation effects
  • Time Factors
  • Vasoconstriction / drug effects
  • Vasoconstriction / physiology
  • Vasoconstriction / radiation effects
  • Vasodilation / drug effects
  • Vasodilation / physiology
  • Vasodilation / radiation effects

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Captopril
  • Losartan