[ RadSafe ] Duke Could Receive $43M for Radiation Exposure Test

Glenn R. Marshall GRMarshall at philotechnics.com
Thu Jan 21 15:11:31 CST 2010

Oh, Clayton--what are you missing?  43 million dollars!

Duke University announced yesterday that it had been awarded $3.7 million
in initial federal funding for the development of an accelerated
genome-based system to indicate whether an individual has been contaminated
with radiation from a radiological "dirty bomb" or nuclear weapon (see GSN,
Jan. 20).

The contract from the U.S. Biomedical Advanced Research and Development
Authority could be worth as much as $43.6 million should the federal
government choose to continue funding the research, the North Carolina
university said in a press release.

A terrorist attack with a radiological or nuclear weapon "could kill or
injure hundreds of thousands of people," John Chute, the leading university
researcher on the project, said in the release.

"The problem is that right now, we don't have any way to rapidly screen
thousands of people to determine their level of radiation exposure. Many
people who suffer radiation injury can recover and survive if they are
promptly and properly treated," Chute said.

Chute and other researchers had previously discovered a set of 25 genes in
human peripheral blood that are "activated" following exposure to
radiation. The test involves identification of the "signature" produced by
radiation exposure.

The new funding is to be used to further confirm the findings through human
and animal testing.

Also working on the project is the California-based biotechnology firm
DxTerity Diagnostics, which intends to use the set of genes to create an
accelerated "gene expression" assay. Researchers at the University of
Arizona and Invetech Corp. are then expected to produce the device that
would perform the diagnostic test.

The final result is expected to be a compact, 30-minute assay for radiation
exposure that could be used to quickly diagnose thousands of people in the
wake of a nuclear or radiological event. The test would require only a few
droplets of blood, Chute said.

Current exposure assays require bulky technology to be performed and test
results take multiple days to arrive.

"Imagine a blast zone with a ring of triage stations at the perimeter,"
Chute said. "We believe that using our diagnostic assay in such points
would allow us to screen tens of thousands of individuals in a 24-hour
period and to distinguish true radiation victims from the uninjured" (Duke
University release, Jan. 20).
I'm still not getting the significance of this quickie exposure assay.
Treatment of acute radiation syndrome is essentially palliative isn't it?
Provide support for the systems under stress, fight opportunistic
infections, provide fluids and nutrients, etc.  But for doses for which
only stochastic effects are expected, there is no treatment at all.

So, in an emergency, unless someone is throwing up and disoriented, there
is no urgency in determining their dose.  If they're not vomiting and not
contaminated, send them home - or wherever.

If there are a lot of people throwing up and disoriented, they all require
some form of palliative treatment which should begin immediately - as the
state of the remaining healthcare systems allow.  If their symptoms
progress, the treatment would ramp up accordingly.  If the symptoms
subside, and they feel well enough to go home, then send them home - or
wherever. [Is this the group we're looking at for the quick exposure assay?
Will a half-hour assay allow providers to stop treating the vomiting-well
and concentrate on the vomiting-sick?]

I guess what I'm getting at is that for acute radiation syndrome, the
treatment is guided by the symptoms, not the dose.

What am I missing, here?

Clayton J. Bradt
Principal Radiophysicist
NYS Dept. of Health
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