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Contribution des atteintesgastro-intestinales dans le développement du syndrome de défaillance multi-viscérale radio-induit

Published online by Cambridge University Press:  07 March 2006

P. Monti ,
A. Van Der Meeren  and
N. M. Griffiths
P. Monti
Affiliation:
IRSN/DRPH/SRBE, Laboratoire de thérapie cellulaire et radioprotection accidentelle, BP 17, 92262 Fontenay-aux-Roses Cedex, France.
A. Van Der Meeren
Affiliation:
IRSN/DRPH/SRBE, Laboratoire de thérapie cellulaire et radioprotection accidentelle, BP 17, 92262 Fontenay-aux-Roses Cedex, France. Adresse actuelle : CEA, DSV/DRR, Laboratoire de radiotoxicologie, BP 12, 91680 Bruyères-le-Chatel, France.
N. M. Griffiths
Affiliation:
IRSN/DRPH/SRBE, Laboratoire de thérapie cellulaire et radioprotection accidentelle, BP 17, 92262 Fontenay-aux-Roses Cedex, France. Adresse actuelle : CEA, DSV/DRR, Laboratoire de radiotoxicologie, BP 12, 91680 Bruyères-le-Chatel, France.
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Abstract

Une atteinte sévère au niveau de la sphère gastro-intestinale, consécutive à une exposition aux rayonnements ionisants à forte dose, est un risque majeur et peut impliquer le pronostic vital de la personne irradiée. En effet, de par sa radiosensibilité importante, l’intestin représente une cible directe lors d’une irradiation, mais peut également être affecté de façon indirecte via les lésions qui apparaissent au niveau d’autres organes, comme les brûlures cutanées ou l’atteinte du système hématopoïétique. De façon similaire à ce qui peut être observé dans d’autres cas d’agressions sévères du tractus gastro-intestinal, l’exposition aux rayonnements ionisants se caractérise notamment par la perte d’intégrité de la barrière intestinale qui peut entraîner, voire perpétuer la libération de médiateurs inflammatoires et/ou anti-inflammatoires ; ce type de réponse pourrait à son tour générer des atteintes au niveau d’autres organes. Dans ce contexte, l’intestin « lésé » peut être considéré comme jouant un rôle clé dans la mise en place du syndrome de défaillance multi-viscérale (SDMV) radio-induit. La spécificité des effets de l’irradiation repose sur le fait que les compartiments tissulaires et vasculaires sont conjointement altérés avec une aplasie cellulaire plus ou moins intense, une atteinte de la fonction de barrière et la présence d’un état inflammatoire ; ainsi, tous ces éléments doivent être pris en considération dans la réponse radio-induite de l’intestin, afin de mieux déterminer le rôle de cette dernière dans la pathologie mixte du syndrome aigu d’irradiation (SAI) à court et à long terme.

Keywords

radiation exposuregastrointestinal tractmulti-organ dysfunction syndrome/failure
Type
Other
Information
Radioprotection , Volume 41 , Issue 1 , January 2006 , pp. 65 - 84
Copyright
© EDP Sciences, 2006

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