Problemy radiatsiinoi medytsyny ta radiobiolohii最新文献

The article studies the historical experience of ensuring food security for the population of radioactively contaminated territories (RCTs) of Ukraine after the Chornobyl catastrophe of 1986 and analyzes the modern challengescaused by the full scale martial law. Based on the analysis of archival materials, regulatory legal acts, and scientific publications, it was established that in the first years after the accident, the government implemented a comprehensive protection system which included: centralized supply of clean products, production of safe agriculturalproducts, use of radioprotectors, organization of balanced nutrition for children, and largescale information andeducational work. However, chronic underfunding and the liquidation of specialized services led to the gradualdestruction of this system. Surveys conducted showed that, despite being aware of the radiation contamination, asignificant part of the RCT residents continue to consume local products, especially «gifts of the forest» (wildfoods), which is the main source of internal irradiation. This is due to a low level of material wellbeing and localdietary traditions. Under conditions of full scale war, where critical infrastructure is being destroyed and logisticalchains are disrupted, the issue of food security in RCTs becomes particularly acute. The authors conclude that historical experience demonstrates the need for constant funding and coordination of efforts for effective populationprotection. Modern conditions require the development of new approaches that will consider not only radiation risksbut also the challenges associated with martial law, including infrastructure destruction, economic instability, andlimited access to safe products.

The Chornobyl disaster - a largescale nuclear accident that caused significant radiation exposure to large populations of people. The work of ophthalmologists who studied its consequences radically changed scientists' understanding of the effects of ionizing radiation on the organ of vision. Before the Chornobyl accident, it was widely believed that the organ of vision was relatively resistant to the effects of ionizing radiation. It was thought that the most likely effect of radiation exposure was radiation cataracts, which were considered a deterministic effect.The objective of this study is analyze epidemiological, clinical, and experimental data on the ophthalmologicaleffects of radiation obtained after the Chоrnobyl disaster. Materials and methods. The criteria for inclusion in the analytical review were peer reviewed publications in the scientometric databases PubMed/MEDLINE, Scopus, Web of Science, and manually selected works devoted to the study of the ophthalmological consequences of the Chornobyl disaster, other radiation incidents, and the consequences of occupational radiation exposure, published in the period after the Chornobyl disaster.Results. Studies conducted after the Chornobyl disaster have significantly changed the understanding of theeffects of ionizing radiation on the vision organ. It has been shown that the eye is extremely sensitive to radiation exposure and is one of the most vulnerable structures of the body. Analyzing the results of longterm post-Chornobyl studies, we can distinguish four groups of ophthalmological diseases that occur in people affected by the Chornobyl disaster: the first group is specific radiation damage to the eye, the appearance of which is possible only as a result of ionizing radiation exposure; the second group is diseases that under normal conditions occur mainly in elderly people and the development of which is accelerated as a result of radiation exposure; the third group is functional changes that were detected in radiationexposed people; and the fourth group includes effects that occurred in people irradiated in utero.

Research activities and scientific advance achieved in 2024 at the State Institution «National Research Center for Radiation Medicine, Hematology and Oncology of the National Academy of Medical Sciences of Ukraine» (NRCRMHO) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology, hematology and oncology, collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report. The report presents the results of fundamental and applied research works of the study of radiation effects and health effects of the Chornobyl accident. The report also shows the results of scientificorganizational and health care work, staff training. The Scientific Council meeting of NAMS approved the NRCRMHO Annual Report.

Introduction: Nearly four decades after the Chornobyl Nuclear Power Plant accident, its medical and social consequences continue to require systematic evaluation, particularly in the context of formal medical expertise aimed atcertifying causal relationships between disease outcomes and radiation exposure associated with the accident. In theremote postaccidental period, medical expertise plays a central role within the national system of social protection,providing legally substantiated conclusions on health loss, disability, and causes of death among affected population.

Objective: to study and characterize the number and structure of affected population categories (cleanup workersand victims) based on materials from the National Social Service of Ukraine Register and expert cases of the CentralInterdepartmental Expert Commission of the Ministry of Health of Ukraine (CIEC) in the remote postaccidental period.

Methods: A retrospective study was conducted using data from the National Social Service of Ukraine Register(2008-2025) and materials from medical expert cases reviewed by the Central Interdepartmental Expert Commissionof the Ministry of Health of Ukraine during 2023-2025. Expert documentation was analyzed using a systematicapproach, including verification of diagnoses and assessment of medical and nonmedical parameters in accordancewith current regulatory requirements. Descriptive analytical methods were applied.

Results: The affected population demonstrated a sustained longterm decline, primarily reflecting cohort ageingand administrative status changes. Despite this reduction, the volume of medical expertise activity remained substantial. Oncological diseases constituted the predominant category of expert assessments, followed by severechronic nononcological conditions, mainly cerebrovascular and cardiovascular diseases with complications.Distinct differences were observed between lifetime and postmortem expert assessments, reflecting variations indisease severity, clinical course, and fatal outcomes rather than populationlevel disease patterns.

Conclusions: In the remote postaccidental period, medical expert assessments related to the Chornobyl accidentcontinue to be dominated by malignant neoplasms and advanced chronic diseases of circulatory system leading tosignificant loss of health, increasing disability and mortality. Expertbased data provide a specific and complementary perspective on the enduring medical and social consequences of the accident and remain essential for informeddecisionmaking within the national system of health protection and social support.

Objective: determination of the patterns of chromosome aberration formation in peripheral blood lymphocytes ofcancer patients with different types and tumors' localization, taking into account the individual radiosensitivity ofthe organism.

Methods: Test system of peripheral blood lymphocyte culture from patients with tumors of various types and locations and conditionally healthy individuals. Metaphase analysis of chromosome aberrations was performed in thefirst mitosis. Individual radiosensitivity was determined based on test irradiation of lymphocytes in the G2 periodof the mitotic cycle. Quantitative assessment of the chromosomal damage formation and construction of standardcalibration dose curves based on cytogenetic indicators in irradiated blood lymphocytes were performed using thespline regression model.

Results: In primary cancer patients with different tumor localization, the spontaneous level of chromosome aberrations in peripheral blood Tlymphocytes is already compromised before the start of radiation therapy, and thereforethe cells can only be defined as conditionally healthy (nonmalignant). At the same time, the average frequency ofchromosome aberrations (0.07 per cell), chromatidtype aberrations (0.05 per cell) and dicentrics (0.016 per cell)in peripheral blood lymphocytes of cancer patients significantly exceeds the average population level and similarindicators in the control group (conditionally healthy donors). It has been proven for the first time that the natureof the dose dependence of the aberration yield during irradiation in the range of low doses (0.1-0.5 Gy) is influenced by the individual radiosensitivity of cancer patients, determined by the chromosomal G2 test, with an increasein which the boundaries of the plateau (doseindependent area) on the doseeffect curve change.

Conclusion: Determination of individual radiosensitivity of cancer patients before the start of radiation therapyallows to reasonably identify individuals with a high risk of secondary tumors of radiation genesis, which is important for personalized planning of therapeutic radiation schemes.

Objective: to investigate chromosome abnormalities resulting from the tumor induced bystander effect (TIBE) andto assess the ability of astaxanthin to modify TIBE in nonirradiated and in vitro irradiated peripheral blood lymphocytes of glioblastoma patients.

Methods: Peripheral blood lymphocytes (PBLs) from 30 individuals (20 glioblastoma patients and 10 healthy volunteers)were cultured. Some samples were exposed to γ rays at a dose of 1.0 Gy prior to cultivation. Astaxanthin was added tothe culture medium at a final concentration of 20.0 μg/ml before PBL incubation. Chromosomal preparations wereobtained using standard protocols. Cytogenetic analysis included both chromatid and chromosometype aberrations.

Results: In the analysis of baseline cytogenetic parameters in nonirradiated peripheral blood lymphocytes ofglioblastoma patients, the mean frequency of aberrant metaphases was (5.91 ± 0.74) %, which was statistically significantly higher than that of the control group (p < 0.05). The mean frequency of chromosome aberrations was6.21 ± 0.87 per 100 cells, indicating the presence of TIBE. Following exposure to ionizing radiation, the level of chromosomal damage was also significantly higher in glioblastoma patients compared with healthy volunteers (p < 0.05).Treatment with astaxanthin in both irradiated and nonirradiated peripheral blood lymphocytes resulted in a significant reduction in the frequency of chromosome aberrations (p < 0.01), primarily due to a decrease in chromosometype aberrations. In irradiated cultures, the frequency of chromosomal aberrations decreased from 23.99 ± 2.24 to12.01 ± 1.21 per 100 cells on average. Notably, astaxanthin did not affect the frequency of single fragments.

Conclusion: Astaxanthin at a concentration of 20.0 μg/ml significantly reduces the manifestation of the tumorinduced bystander effect at the cytogenetic level in cultures of both nonirradiated and irradiated peripheral bloodlymphocytes from glioblastoma patients.

Background: The use of targeted therapy for chronic myeloid leukemia (CML) - tyrosine kinase inhibitors (TKIs) - has led to significant success in the treatment of patients with CML. The life expectancy of patients with newly diagnosed CML is almost equal to that of the general population. A significant proportion of patients on TKI therapy achieve stable and long'term remission, and after two or more years, it is possible to safely discontinue therapy. The increase in patient life expectancy has contributed to an increased risk of developing resistance to therapy, which is largely associated with mutations in the kinase domain of the BCR::ABL1gene, which are of decisive clinical importance.The objectiveof this article is to evaluate the role of the mutation status of the kinase domain of the BCR::ABL1gene and other somatic mutations in patients with CML in the development of resistance to tyrosine kinase inhibitors and the impact of mutations on treatment efficacy based on literature data.

Data sources: The study used publications from 2015-2025, selected from the PubMed and Scopus databases and specialized scientific journals using the keywords (chronic myeloid leukemia, BCR::ABL1, tyrosine kinase inhibitors (TKIs), T315Imutation, TKI resistance, mutation status, imatinib, dasatinib, nilotinib, ponatinib, asciminib).

Study selection: After reviewing the full texts of the articles, those that directly addressed the mutation status in CML, as well as some general aspects of CML (pathogenesis, clinical course, diagnosis, treatment), were selected for further analysis.

Results: The analysis demonstrated a high prevalence of clinically significant mutations, particularly T315I, which cause resistance to TKIs. The available data indicate that third' and fourth'generation TKIs, in particular ponatinib, as well as the new allosteric inhibitor asciminib, have significant potential in the treatment of patients with resistant forms of CML, including carriers of the T315Imutation. There are cases of compound mutations that remain a serious therapeutic challenge. To effectively combat resistant clones, it is necessary to determine the mutation status and select therapy according to the sensitivity of the clone.

Conclusions: A personalized approach that takes into account the BCR::ABL1mutation profile is key to optimizing therapeutic strategies for CML. Further research is needed to more clearly define the mechanisms of resistance and the optimal sequence of use of available TKIs in clinical practice.

Objective: To assess the impact of neoadjuvant chemotherapy on the size and spread of the tumor process and indicators of proliferative activity in breast cancer patients who suffered from the Chornobyl accident.

Materials and methods: The 96 patients with breast cancer (BC) who were exposed to ionizing radiation as a resultof the Chernobyl accident were examined. Clinical, radiological, instrumental, morphological, and immunohistochemical research methods were used.

Results and conclusions: Before neoadjuvant cytostatic therapy, criteria T0, Tis, T1 was not diagnosed in anypatient. As a result of treatment, complete clinical and morphological regression of the tumor was established in16.7 % of patients. A decrease in staging criteria after neoadjuvant chemotherapy (NCT) was diagnosed in 60.4 %of patients. Analysis of patients with breast cancer by stage grouping before and after NCT showed that there wereno patients at all in the study before the start of treatment. After neoadjuvant therapy, in 29.2 % of women, tumorsin the breast gland were classified as stage I by their criteria. Only 2.1 % of women started treatment with stage IIA. After NCT, the prevalence of the primary tumor met the criteria for stage II A in 20.8 % of patients. 53.1 % ofpatients started treatment with stage II B, and after neoadjuvant therapy, this stage was in 14.6 % of patients. StageIII A was detected in 22.9 % of patients before treatment, after therapy the number of patients with this stagedecreased to 14.6 % of patients. 14.6 % of women started treatment with stage III B, after treatment only 3.1 % ofpatients were classified as this stage. Stage III C was detected in 6.2 % of patients at the beginning of treatment,after NCT, no patients with criteria related to this stage were identified. Stage IV was detected in 1.04 % of patients,both before and after NCT. A decrease in Ki67 values under the influence of NCT was observed in 76 % of patients,and in another 16.7 % of patients complete clinical and pathomorphological regression of the tumor was observed.Thus, according to the values of proliferative activity, positive dynamics for neoadjuvant cytostatic chemotherapywas recorded in 92.7 % of patients.

Introduction: The full scale war in Ukraine has created unprecedented psychosocial stress for children, leading toincreased anxiety. An additional adverse factor may be living in radiationcontaminated areas. At the same time,individual genetic vulnerability (5-HTTLPR polymorphism of the serotonin transporter gene) can modulate theresponse to chronic stress. This study aimed to determine how war and radiation stressors affect the level of traitanxiety in children and whether this relationship is modulated by the 5HTTLPR genotype.

Objective: to assess the interaction between war related stress factors and variants of the 5-HTTLPR polymorphismof the serotonin transporter gene ( SLC6A4) on anxiety levels in schoolage children.

Methods: A crosssectional survey included 231 children aged 10-17 from three regions of Ukraine that had beenaffected by military operations (some of the participants lived in radioactively contaminated areas). The questionnaire covered data on war stressors (forced displacement, occupation, frequency of air raid alerts, etc.) and psychometric scales, in particular STAI (trait ity anxiety). Genotyping of 5-HTTLPR was performed using allelespecific PCR.The data were analysed using regression methods to assess associations and gene x environment (G x E) interactions.

Results: Children who experienced intense war stressors or were regularly exposed to air raid sirens had significantly higher levels of trait anxiety (p < 0.01). The strongest predictor of high anxiety was a high level of response toair raid sirens (OR ≈ 31; p < 0.001). Living in a radiation control zone had no significant effect on anxiety (p = 0.48).The effect of cumulative stress on anxiety was almost twice as strong in children carrying the S allele of 5-HTTLPRthan in those carrying the L/L genotype (G x E effect, p < 0.001).

Conclusions: Chronic war stressors significantly increase children's anxiety levels, with genetically vulnerable individuals (carriers of the S allele of 5-HTTLPR) responding much more strongly to stress. The results emphasise theneed to take into account genetic factors in psychosocial assistance to children experiencing war, with a focus onthe most vulnerable (displaced persons, military families).