Antioxidant premedication reduces mitochondrial and nuclear DNA damage repair in interventional physicians performing X-ray-guided angiography procedures: a pilot clinical intervention study.

BACKGROUND: To examine effects of naturally occurring antioxidants on DNA damage repair acute responses of ionizing radiation sustained by interventional physicians during angiography. METHODS: The study cohort included 20 interventional physicians (19 males, 1 female; mean age: 45.4 ± 13.2 years) performing angiography fluoroscopically guided procedures. Participants were allocated to a treatment group receiving oral antioxidants (N = 10/group) before starting day cases or to an untreated control group performing procedures without antioxidants (N = 10/group). mRNA biomarkers of nuclear and mitochondrial DNA injury repair response in peripheral blood lymphocytes were assessed before and after workday. RESULTS: Baseline DNA repair biomarkers and procedural fluoroscopic exposures were similar between the study groups. Individual pre-post changes in MRNA levels were not significant for any biomarkers in the antioxidant-treated group but were significantly increased in the untreated control group for P53 (P = 0.006), NF-κB (P = 0.002), and COX4i1 (P = 0.004). Between-group differences in post-exposure gene expression were significantly (P = 0.024) higher with P53 being 78% higher in the untreated versus the treated group and COX4i1 levels also significantly (P = 0.028) higher by 46% in the untreated group. Absolute change in the STAT3 mRNA level was higher by 54% in the untreated group but between-group difference was not significant (P = 0.066). There was a lower burden of NF-κB mRNA levels of inflammation in the treatment than the untreated group (18 ± 8% versus 60 ± 15%) with significant between-group difference (P = 0.020). CONCLUSIONS: Significant elevations in peripheral blood lymphocytes of mRNA biomarkers of nuclear and mitochondrial DNA injury repair response occurred in untreated interventional physicians exposed to ionizing radiation during fluoroscopically guided interventions. In physicians pretreated with a novel antioxidant formulation, biomarkers of DNA repair responses were significantly attenuated suggesting a decreased acute IR-induced oxidative stress-mediated DNA damage response.