Individuals spontaneously present different sensitivities to ionizing radiation, measured by the severity of their post-radiotherapy side-effects. Cells from some patients with extreme clinical radiosensitivity have shown altered cellular radiosensitivity measured by different endpoints as apoptosis or DNA damage. Linking clinical and cellular sensitivity is of fundamental importance to establish a clinical test capable of predicting a person‟s radiosensitivity from a sample. Easily sampled, peripheral blood lymphocytes (PBL) are an appealing cellular model to study individual radiosensitivity as they have been shown to be the most radiosensitive hematopoietic cells. DNA damages and repair can be visualized by observing the kinetics of appearance and disappearance of gamma-H2AX foci on DNA double-strand breaks through immunofluorescence microscopy. The experimental strategy chosen here was to follow lymphocyte gamma-H2AX foci kinetics in response to different levels of irradiation as delayed gamma-H2AX foci disappearance has been observed in cells of individuals with high clinical radiosensitivity.
For our initial study we irradiated in vitro samples of radiotherapy patients with different clinical radiosensitivities. The groups of distinct clinical sensitivities showed no corresponding differences in their cellular gamma-H2AX response. In addition, several samples were lost, mainly due to the long transportation period before being treated in our lab.
To render this method usable for clinical applications, several changes were made: after improving sample viability, speed was increased by automation of image acquisition (Metasystem) and gamma-H2AX focus scoring (freeware CellProfiler). This technique was able to detect doses as low as 0.005 Gy and gave similar results to manual focus scoring. The possibility of discriminating different lymphocyte subsets (CD4, CD8 and CD19) during analysis was added to identify among the lymphocyte subsets the one producing more gamma-H2AX foci in response to irradiation. Using the methodological tools developed during this thesis we established for the various lymphocyte subsets the relationship between radiation dose and gamma-H2AX foci frequency as well as the kinetics of appearance/disappearance of gamma-H2AX foci.
Finally, since no additional samples from patients of known radiosensitivity were available to continue the initial study with the improved protocol, we focused on radiosensitivity in another context: radio-adaptive response. This phenomenon corresponds to a lower cellular response to high dose of ionizing radiation exposure if it is preceded by an exposure to low doses. With the conditions used here we did not observe a radio-adaptive response in terms of gamma-H2AX signalling regardless of the lymphocyte subpopulation studied. However, the translocation rate of pre-irradiated CD4-positive lymphocytes was significantly different when compared to cells only irradiated acutely. This result thus indicates a differential repair of double strand breaks in lymphocytes after a radio-adaptation.