Radiomitigators: Breakthroughs in Post-Radiation Recovery

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Ionizing radiation (IR) exposure poses a significant biomedical challenge in clinical, occupational, and emergency contexts, highlighting the urgent need for effective medical countermeasures against acute radiation syndrome (ARS) and delayed effects of radiation exposure (DEARE). Depending on the timing of administration, radiation countermeasures are classified as radioprotectors, radiomitigators, or therapeutics. Among these, radiomitigators offer a critical advantage by attenuating IR-induced damage when administered after exposure, thereby expanding their applicability in unanticipated radiation incidents. This review provides an overview of the pathophysiological mechanisms underlying IR-induced injury and summarizes the current FDA-approved radiation countermeasures. It then focuses on radiomitigators that have demonstrated efficacy in preclinical animal models, together with available evidence from clinical studies, emphasizing their translational potential for both emergency preparedness and oncological settings. We examine routes of administration and key mechanisms of action, including modulation of oxidative and nitrosative stress, enhancement of DNA damage response pathways, preservation of mitochondrial function, regulation of inflammatory and immune signaling, attenuation of fibrotic remodeling, maintenance of vascular integrity, and promotion of tissue regenerat

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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