20.500.12556/RUL-107405 Lokalni in sistemski učinki radioterapije na imunski odziv telesa magistrsko delo Local and systemic effects of radiotherapy on the immune response of the body master thesis Uvod: Radioterapija (RT) ne deluje samo na DNK molekulo kot glavno tarčo, vendar povzroči tudi posredovan učinek (angl. bystander effect, BSE) in pa distalen posredovan učinek (angl. abcopal effect, AE). Izraz BSE uporabljamo takrat, ko priležne celice, ki niso neposredno izpostavljene sevanju, vseeno kažejo znake izpostavljenosti, kot so spremembe v procesu translacije, genskega izražanja, celične proliferacije, apoptoze in celične smrti. V primeru AE pa gre za dogodek, ki se zgodi zunaj obsevanega območja, vendar znotraj istega organizma. Govorimo o spontani regresiji tumorjev. Strategije, testirane v predkliničnih študijah, kažejo obetavne rezultate v kombiniranju RT z nekaterimi pristopi, ki se razvijajo na področju imunoterapije. Namen: Glavni namen dela je pregled obstoječe literature o učinkih RT na imunski sistem, saj gre za eno od trenutno zelo aktualnih tem na področju radiobiologije. Metode dela: Gre za obsežen pregled literature domače in predvsem tuje strokovne literature na izbrano temo, in sicer o učinkih RT na imunski sistem. Članke sem pridobila v elektronskih bazah Elsevier, PubMed, ScienceDirect, COBISS, DKUM in Dlib ter preko knjižnične izposoje strokovne literature (0.A.S.E. – Fachbibliothek Medizin Düsseldorf, IAEA Library UNOV, Universitätsbibliothek Medizinische Universität Wien). Ključne besede, ki sem jih uporabila v iskalniku, so »abscopal effect«, radioterapija, imunski sistem in radioterapija, »bystander effect«, imunoterapija. Razprava: V literaturi se BSE prvič omenja že v 50. letih prejšnjega stoletja. Gre za dolgoletne raziskave in dolgotrajno spremljanje bolnikov. Klinične študije so opisane tako v in vitro kot v in vivo situacijah. V zadnjem času je opaznih vse več kliničnih študij in kliničnih primerov, kjer se beleži uspešna kombinacija RT in imunoterapije ter posrednih učinkov sevanja. Rezultati teh študij so izredno obetavni. Opisane so tudi negativne lastnosti RT v povezavi z BSE in genotoksičnimi odzivi ter predlagani novi RT pristopi, kot je npr. obsevanje s težkimi delci.Zaključek: Na podlagi pregledane literature lahko sklenem, da ima RT velik vpliv na imunski sistem in da so raziskave v pojasnjevanju teh učinkov sevanja znatno v porastu. Prav tako ugotavljam, da se v klinični uporabi vse bolj uporablja nova metoda zdravljenja, t. j. imunoterapija, s pomočjo katere se vsesplošno preživetje onkoloških bolnikov lahko znatno izboljša in zmanjša negativne stranske učinke. Introduction: Radiation therapy (RT) does not affect just the DNA molecule as the main target, but also results as a bystander effect (BSE) and as an abscopal effect (AE). The term BSE is used when the bystander unexposed cells show all the signs of exposure to the radiation. These changes are, for example, changes in the translation process and gene expression, cell proliferation, apoptosis, and cell death. In the case of AE, the event outside the irradiated area but within the same organism is meant. We talk about spontaneous tumor regression. Strategies tested in the preclinical studies show some promising results when combining RT with some approaches that are developed in the field of immunotherapy. Purpose: The main purpose of the thesis is to review the existing literature on the effects of RT on the immune system, as it is one of the currently very actual topics in the field of radiobiology.Methods: This paper is an extensive review of the literature, mainly of a foreign scientific data on the selected topic, dealing with the effects of RT on the immune system. Articles were collected from the scientific database Elsevier, PubMed, ScienceDirect, COBISS, DKUM and Dlib, and through the library lending (O.A.S.E. – Fachbibliothek Medizin Düsseldorf, IAEA Library UNOV, Universitätsbibliothek Medizinische Universität Wien). The keywords used in the search engine were an abscopal effect, radiotherapy, immune system and radiotherapy, bystander effect, and immunotherapy. Discussion: In the literature, BSE is mentioned for the first time in the 1950s. This effect requires a long-term research and a long-term follow-up of patients. Clinical studies and cases were described in both in vitro and in vivo situations. Recently, more and more clinical studies and cases have been describing the successful combination of RT and immunotherapy and the bystander effects of radiation. The results of these studies are extremely promising. The negative effects of RT are also described and are associated with the induction of BSE and genotoxic responses. The scientific database also proposes new RT approaches, for example, irradiation with heavy particles. Conclusion: Based on the literature reviewed, it can be concluded that RT has a major impact on the immune system and that the researches exploring these radiation effects are significantly increasing. The new treatment approach is increasingly used in the clinics with immunotherapy, through which the overall survival of oncological patients can be significantly improved and negative side effects reduced. bystander efekt abscopal efekt radioterapija imunoterapija učinki radioterapije bystander effect abscopal effect radiotherapy immunotherapy effects of radiotherapy true false false Slovenski jezik Angleški jezik Magistrsko delo/naloga 2019-04-11 07:45:42 2019-04-11 07:45:49 2022-08-19 03:49:22 0000-00-00 00:00:00 2019 0 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 90265 5603691 6622.pdf 6622.pdf 1 038D44B57ACC0009093F759058B6641B 1914fbcbfbb857f3a08ae561cce6cc2534256ac7a1b80500687aad222e82033f 6ce37298-a1b6-11eb-a523-00155dcfd717 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=118222 Zdravstvena fakulteta 0 0 0