**4. Local signs of whole-body irradiation and efficacy of application-sorption therapy**

External exposure to ionizing irradiation frequently results in radiation burns of the skin. Leukopenia just deepens the injury because of oppressing the regeneration processes. A retrospective report on injuries caused by the atomic bombing of Hiroshima showed that up to 65% of all type of injuries were "radiation-combined injury," when ionizing irradiation was coupled with burns, wounds and infections [61]. Regarding these facts and negative contribution of leukopenia also, we want to demonstrate the efficiency of activated carbon. The remarkable result was observed on the model of the thermal non-full depth burn in Albino rats [62]. The early application (within first

**223**

*Sorption Detoxification as an Addition to Conventional Therapy of Acute Radiation Sickness…*

*The dynamics of healing of the non-full depth burn after application of the gauze and carbon dressing.*

*DOI: http://dx.doi.org/10.5772/intechopen.85690*

**Figure 8.**

**Figure 9.**

**Figure 10.**

*depth burn. H&E. ×200.*

60 min) of the highly active carbon fabrics (SBET > 2000 m2

ings use, respectively (**Figure 8**).

*Morphological structure of normal skin. H&E. ×200.*

the non-full burn (**Figures 9**–**11**).

healing time: 10.80 ± 1.27 and 20.60 ± 0.86 days for adsorptive carbon and gauze dress-

*Morphological structure of burned skin after use of gauze dressing on the 7th day after the thermal non-full* 

Histological analysis demonstrated that adsoptive carbon dressings' application promoted the restoration of skin structure on the 7th day after injury in rats with

Similar results were observed on the burns caused by external irradiation at the dose of 8 Gy. Epithelialization of burn wounds has been completed on 21.1 ± 4.1 versus 27.3 ± 5.7 days after trauma for carbon and gauze dressings use, respectively. One

/g) twofold reduced the

*Sorption Detoxification as an Addition to Conventional Therapy of Acute Radiation Sickness… DOI: http://dx.doi.org/10.5772/intechopen.85690*

#### **Figure 8.**

*Cells of the Immune System*

**Figure 7.**

*Spleen structure of rat of the DOX + CeO2 group. H&E. ×600.*

with untreated DOX-induced cardiomyopathy).

effects of radiation therapy and cytostatic drugs.

**application-sorption therapy**

**4. Local signs of whole-body irradiation and efficacy of** 

External exposure to ionizing irradiation frequently results in radiation burns of the skin. Leukopenia just deepens the injury because of oppressing the regeneration processes. A retrospective report on injuries caused by the atomic bombing of Hiroshima showed that up to 65% of all type of injuries were "radiation-combined injury," when ionizing irradiation was coupled with burns, wounds and infections [61]. Regarding these facts and negative contribution of leukopenia also, we want to demonstrate the efficiency of activated carbon. The remarkable result was observed on the model of the thermal non-full depth burn in Albino rats [62]. The early application (within first

color of cytoplasm. It witnesses that the synthetic function of the liver was partly

Biochemical indices of lipid and protein peroxidation, antioxidant defense system showed that CeO2 increased the activity of catalase by 24.6%, raised the level of reduced glutathione by 10.9% and decreased the level of oxidative modification of protein and lipids by 28.1 and 23.6%, respectively (compared to the group

Bakht M.K. et al. proposed to reduce the actual radiation burden in patients exposed to radioisotope studies by arranging radiolabels for cerium oxide [59], and Colon J. et al. could achieve a good prophylactic result for radiation pneumonitis in mice that received nanocrystalline dioxide Ce [60]. One more fact should be mentioned here: because of bone marrow suppression and leukopenia development, lungs are fragile to injury by ionizing irradiation. They have their own host defense system, based on alveolar macrophages. Because of leukocytes toxic damage (by ionizing injury or radiation therapy or as the side effects of anti-cancer chemotherapy), resting macrophages can no longer be transformed which lead to radiation pneumonitis [24]. Heslet L. et al. showed that systemic administration of myelo stimulative cytokines was not helpful to prevent it because they do not penetrate the alveoli. That is why we suggest that oral adsorbents and/or parenteral use of CeO2 (it penetrated the alveoli and prevents radiation pneumonitis on mice model) will enhance the prophylaxis and treatment of ARS and decrease the intensity of side

restored. Concerning the kidneys, no positive changes had been found.

**222**

*The dynamics of healing of the non-full depth burn after application of the gauze and carbon dressing.*

**Figure 9.** *Morphological structure of normal skin. H&E. ×200.*

**Figure 10.**

*Morphological structure of burned skin after use of gauze dressing on the 7th day after the thermal non-full depth burn. H&E. ×200.*

60 min) of the highly active carbon fabrics (SBET > 2000 m2 /g) twofold reduced the healing time: 10.80 ± 1.27 and 20.60 ± 0.86 days for adsorptive carbon and gauze dressings use, respectively (**Figure 8**).

Histological analysis demonstrated that adsoptive carbon dressings' application promoted the restoration of skin structure on the 7th day after injury in rats with the non-full burn (**Figures 9**–**11**).

Similar results were observed on the burns caused by external irradiation at the dose of 8 Gy. Epithelialization of burn wounds has been completed on 21.1 ± 4.1 versus 27.3 ± 5.7 days after trauma for carbon and gauze dressings use, respectively. One

#### **Figure 11.**

*Morphological structure of the burned skin after use of carbon dressing on the 7th day after the thermal non-full depth burn. H&E. ×200.*

more fact relates to the treatment ultraviolet radiation-induced burns. Application of adsorptive carbon dressings significantly (by 1.5–1.7 times) accelerated the burnhealing time. All these data will be published soon.

These results presented the undoubted perspective for use of high capacity carbon fabrics for the treatment of superficial skin lesions, especially complicated by concomitant leukopenia.

## **5. Enterosorption for leukopenia management**

Hemoperfusion as a procedure requires well-trained staff, specific equipment and sterility. It means that such method of sorption detoxification is not adapted to emergency exposure situations, during war-time and large human contingent injury. That is why the use of enteral sorption therapy (ingestion of activated carbon) is a more prospective method for such situations. Among the early studies, the great results were observed in the patients with lymphogranulomatosis undergoing radiotherapy [63], who were treated with fibrous carbon oral adsorbent. Enterosorption treatment allowed to continue planned schemes of radiation therapy and was more efficient than conventional methods for leukopenia healing. In the next study [64], cyclophosphane was given to Guerin tumor-grafted rats at the dose of 100 mg/kg of body weight on 10th and 13th days after tumor transplantation; enterosorption with synthetic SCN carbons (bulk density 0.3–0.4 g/cm3 ) was administered next day after cyclophosphane injection. These expressed myeloprotective effects we approved and confirmed in the clinic. One more radiomimetic anti-cancer agent cisplatin was used in an experiment on Guerin tumor-grafted rats [65] and highly activated fibrous carbon material Carboline (Ukraine) successfully ameliorated a wide range of its side effects. Carboline is used in clinical practice also and demonstrates promising results [66].

Our latest experiments on rats exposed to X-ray irradiation in a total dose of 6 Gy (63 Rad per min, t = 11 min) demonstrated great results of novel oral carbon adsorbents administration to ameliorate radiation-caused leukopenia. We used two granulated activated carbons (AC) with a diameter of granules (0.25–0.5 mm) and bulk density 0.1 and 0.2 g/cm3 (ES1 and ES2, respectively). Enterosorbents were administrated as radioprotectors, radiomitigators and therapeutic agents (at the dose of 10 ml/kg, admixed to the food, three days before and nine days after ionizing irradiation exposure). Irradiation caused a 10-fold decrease in the white blood

**225**

*Sorption Detoxification as an Addition to Conventional Therapy of Acute Radiation Sickness…*

*/L) in X-ray irradiation at the dose of 6 Gy and oral adsorbents administration.* 

cells count. ES1 administration raised the index twice on the 9th day after X-ray

The same effect was observed concerning the lymphocytes count (**Figure 13**). Structural differences among those two carbon adsorbents are estimated. These

*/L) in X-ray irradiation at the dose of 6 Gy and oral adsorbents administration.* 

So, as we observed, specific oral adsorbents with specified porosity and pores distribution are quite successful to fight the iatrogenic leukopenia because of the

Oral carbon materials have a high capability to decrease the emesis caused by

Thus, enterosorption for the results on the animal study and use in clinics do prevent hematotoxicity of anti-cancer treatment and significantly ameliorated

diarrhea action, which could be implemented in the clinics for the treatment of ARS-induced gastrointestinal subsyndrome as well as for dyspepsia syndrome

anti-cancer treatment [66, 67]. Also, it is a unique mean with anti-

exposure, while ES2 produced fewer results (**Figure 12**).

*Notes. p < 0.05 compared to: \*—the control group, \*\*—X-ray irradiation group.*

*Notes: p < 0.05 compared to: \*—the control group, \*\*—X-ray irradiation group.*

results will be published soon in detail.

caused by tumoricidal therapy.

leukopenia and its consequences.

influence of ARS or anti-cancer treatment.

*DOI: http://dx.doi.org/10.5772/intechopen.85690*

**Figure 12.**

**Figure 13.**

*Lymphocytes count (109*

*White blood cells count (109*

*Sorption Detoxification as an Addition to Conventional Therapy of Acute Radiation Sickness… DOI: http://dx.doi.org/10.5772/intechopen.85690*

#### **Figure 12.**

*Cells of the Immune System*

**Figure 11.**

*non-full depth burn. H&E. ×200.*

by concomitant leukopenia.

carbons (bulk density 0.3–0.4 g/cm3

bulk density 0.1 and 0.2 g/cm3

healing time. All these data will be published soon.

**5. Enterosorption for leukopenia management**

*Morphological structure of the burned skin after use of carbon dressing on the 7th day after the thermal* 

more fact relates to the treatment ultraviolet radiation-induced burns. Application of adsorptive carbon dressings significantly (by 1.5–1.7 times) accelerated the burn-

These results presented the undoubted perspective for use of high capacity carbon fabrics for the treatment of superficial skin lesions, especially complicated

Hemoperfusion as a procedure requires well-trained staff, specific equipment and sterility. It means that such method of sorption detoxification is not adapted to emergency exposure situations, during war-time and large human contingent injury. That is why the use of enteral sorption therapy (ingestion of activated carbon) is a more prospective method for such situations. Among the early studies, the great results were observed in the patients with lymphogranulomatosis undergoing radiotherapy [63], who were treated with fibrous carbon oral adsorbent. Enterosorption treatment allowed to continue planned schemes of radiation therapy and was more efficient than conventional methods for leukopenia healing. In the next study [64], cyclophosphane was given to Guerin tumor-grafted rats at the dose of 100 mg/kg of body weight on 10th and 13th days after tumor transplantation; enterosorption with synthetic SCN

injection. These expressed myeloprotective effects we approved and confirmed in the clinic. One more radiomimetic anti-cancer agent cisplatin was used in an experiment on Guerin tumor-grafted rats [65] and highly activated fibrous carbon material Carboline (Ukraine) successfully ameliorated a wide range of its side effects. Carboline

Our latest experiments on rats exposed to X-ray irradiation in a total dose of 6 Gy (63 Rad per min, t = 11 min) demonstrated great results of novel oral carbon adsorbents administration to ameliorate radiation-caused leukopenia. We used two granulated activated carbons (AC) with a diameter of granules (0.25–0.5 mm) and

administrated as radioprotectors, radiomitigators and therapeutic agents (at the dose of 10 ml/kg, admixed to the food, three days before and nine days after ionizing irradiation exposure). Irradiation caused a 10-fold decrease in the white blood

is used in clinical practice also and demonstrates promising results [66].

) was administered next day after cyclophosphane

(ES1 and ES2, respectively). Enterosorbents were

**224**

*White blood cells count (109 /L) in X-ray irradiation at the dose of 6 Gy and oral adsorbents administration. Notes: p < 0.05 compared to: \*—the control group, \*\*—X-ray irradiation group.*

#### **Figure 13.**

*Lymphocytes count (109 /L) in X-ray irradiation at the dose of 6 Gy and oral adsorbents administration. Notes. p < 0.05 compared to: \*—the control group, \*\*—X-ray irradiation group.*

cells count. ES1 administration raised the index twice on the 9th day after X-ray exposure, while ES2 produced fewer results (**Figure 12**).

The same effect was observed concerning the lymphocytes count (**Figure 13**). Structural differences among those two carbon adsorbents are estimated. These results will be published soon in detail.

So, as we observed, specific oral adsorbents with specified porosity and pores distribution are quite successful to fight the iatrogenic leukopenia because of the influence of ARS or anti-cancer treatment.

Oral carbon materials have a high capability to decrease the emesis caused by anti-cancer treatment [66, 67]. Also, it is a unique mean with anti-

diarrhea action, which could be implemented in the clinics for the treatment of ARS-induced gastrointestinal subsyndrome as well as for dyspepsia syndrome caused by tumoricidal therapy.

Thus, enterosorption for the results on the animal study and use in clinics do prevent hematotoxicity of anti-cancer treatment and significantly ameliorated leukopenia and its consequences.
