Prediction biochimique du MODS.

L. Roy, J.M Bertho, M. Souidi, M.C Vozenin, P. Voisin, M. Benderitter, Radiation Induced Multi-Organ Involvement, 12-15 novembre 2003, ULM (Allemegne).

  Variation in many biological parameters can be directly measured on different tissues after radiation exposure. They are a useful complement of the sometimes non-existent clinical symptomatology and of an often incomplete physical reconstruction in situation of accidental radiation exposure. For many years, the scoring of unstable chromosome aberrations in peripheral blood lymphocytes stated an accurate reference in case of acute, whole-body and homogeneous irradiation. However, most of radiation overexposure are heterogeneous, fractionated or their evaluation delayed. New methods were thus added to the conventional cytogenetic ones in order to set up a multiparametric panel of biological dosimetry. They have been developed in cytogenetic area (translocations, micronuclei, prematurely condensed chromosomes, Qrd, Dolphin) on circulant lymphocytes but also on resident cells, in order to assess the dose received locally. The dose itself is not sufficient to predict Multiple Organ Dysfunction Syndrome (MODS). In fact at the level of the organ, biological dosimetric indicators should be completed by bioindicators of prognosis and of diagnosis. Some of these indicators looked promising and are presented here in this paper (FLT-3, Citrulline, Oxysterols). They refer to either structural or functional alterations. The final purpose should be to establish a cartography of the dose received by various organs and to assess damages as soon as possible in order to predict Multiple Organ Dysfunction Syndrome leading to an eventual Multiple Organ Failure.