Protective Effects of Amino Acids on Plasmid DNA Damage Induced by Therapeutic Carbon Ions.

Radioprotectors with few side effects are useful for carbon-ion therapy, which directly induces clustering damage in DNA. With the aim of finding the most effective radioprotector, we investigated the effects of selected amino acids which might have chemical DNA-repair functions against therapeutic carbon ions. In the current study, we employed five amino acids: tryptophan (Trp), cysteine (Cys), methionine (Met), valine (Val) and alanine (Ala). Samples of supercoiled pBR322 plasmid DNA with a 17 mM amino acid were prepared in TE buffer (10 mM Tris, 1 mM ethylenediaminetetraacetic acid, pH 7.5). Phosphate buffered saline (PBS) was also used in assays of the 0.17 mM amino acid. The samples were irradiated with carbon-ion beams (290 MeV/u) on 6 cm spread-out Bragg peak at the National Institute of Radiological Sciences and Heavy Ion Medical Accelerator in Chiba, Japan. Breaks in the DNA were detected as changes in the plasmids and quantified by subsequent electrophoresis on agarose gels. DNA damage yields and protection factors for each amino acid were calculated as ratios relative to reagent-free controls. Trp and Cys showed radioprotective effects against plasmid DNA damage induced by carbon-ion beam, both in PBS and TE buffer, comparable to those of Met. The double-strand break (DSB) yields and protective effects of Trp were comparable to those of Cys. The yields of both single-strand breaks and DSBs correlated with the scavenging capacity of hydroxyl radicals (rate constant for scavenging hydroxyl radicals multiplied by the amino acid concentration) in bulk solution. These data indicate that the radioprotective effects of amino acids against plasmid DNA damage induced by carbon ions could be explained primarily by the scavenging capacity of hydroxyl radicals. These findings suggest that some amino acids, such as Trp, Cys and Met, have good potential as radioprotectors for preventing DNA damage in normal tissues in carbon-ion therapy.

Halloysite/Keratin Nanocomposite for Human Hair Photoprotection Coating.

We propose a novel keratin treatment of human hair by its aqueous mixtures with natural halloysite clay nanotubes. The loaded clay nanotubes together with free keratin produce micrometer-thick protective coating on hair. First, colloidal and structural properties of halloysite/keratin dispersions and the nanotube loaded with this protein were investigated. Above the keratin isoelectric point (pH = 4), the protein adsorption into the positive halloysite lumen is favored because of the electrostatic attractions. The ζ-potential magnitude of these core-shell particles increased from -35 (in pristine form) to -43 mV allowing for an enhanced colloidal stability (15 h at pH = 6). This keratin-clay tubule nanocomposite was used for the immersion treatment of hair. Three-dimensional-measuring laser scanning microscopy demonstrated that 50-60% of the hair surface coverage can be achieved with 1 wt % suspension application. Hair samples have been exposed to UV irradiation for times up to 72 h to explore the protection capacity of this coating by monitoring the cysteine oxidation products. The nanocomposites of halloysite and keratin prevent the deterioration of human hair as evident by significant inhibition of cysteic acid. The successful hair structure protection was also visually confirmed by atomic force microscopy and dark-field hyperspectral microscopy. The proposed formulation represents a promising strategy for a sustainable medical coating on the hair, which remediates UV irradiation stress.

Radioprotective role of uric acid: evidence from studies in Drosophila and human dermal fibroblast cells.

Exposure to ionizing radiation (IR) is a common phenomenon during medical diagnosis and treatment. IRs are deleterious because cellular exposure to IR can cause a series of molecular events that may lead to oxidative stress and macromolecular damage. Radiation protection is therefore essential and significant for improving safety during these procedures. Over decades several antioxidant molecules have been screened to explore their potential as radio-protectors with little success. Therefore, the current study was carried out to confirm the role of uric acid (UA)-a putative antioxidant molecule in radioprotection using radio-resistant insect Drosophila and human dermal fibroblast (HDF) cells. Here, we demonstrate the depleted levels of UA in the mutant flies of Drosophila melanogaster-rosy and by targeting xanthine oxidase (XO an enzyme involved in UA metabolism), through maintaining flies on an allopurinol mixed diet. Allopurinol is a drug that reduces UA levels by inhibiting XO; it reduces the survival percentage in D. melanogaster compared to wild type flies following gamma irradiation at a dose of 1000 Gy. Enzymatic antioxidants such as superoxide dismutase (SOD), catalase, D. melanogaster glutathione peroxidase (DmGPx) and levels of non-enzymatic antioxidants were measured to evaluate the importance of UA. The results indicate that lack of UA reduces the total antioxidant capacity. The activity of SOD was lowered in male flies. Furthermore, we show that supplementation of UA to HDFs cells in media improved their survival rate following gamma irradiation (2 Gy). From the present study we conclude that UA is a potent antioxidant molecule present in high levels among insects. Also, it appears that UA contributes to the radiation resistance of Drosophila flies. Hence, UA emerges as a promising molecule for mitigating radiation-induced oxidative damage in higher organisms.

Transparent Nanostructured BiVO4 Double Films with Blue Light Shielding Capabilities to Prevent Damage to ARPE-19 Cells.

The hazards posed by blue light to human eyes are attracting significant attention owing to increasing exposure to electronic devices as well as artificial illumination. Therefore, in this study, nanostructured BiVO4 (BVO) double films were developed using an economical and environmentally friendly sol-gel spin-coating method; the films exhibited excellent blue light shielding capabilities. They could block 65.25% of the blue light in the 415-455 nm wavelength range while simultaneously maintaining an average transmittance greater than 85% in the 500-800 nm wavelength range. Moreover, the damp heat test (85 °C, 85% relative humidity) showed the excellent stability of the BVO filters as their transmittances remained unchanged for 15 days. Importantly, cell experiments were performed to further confirm the protective effects of the BVO filters against the hazards posed by blue light to ARPE-19 cells (human retinal pigment epithelium cell line). Furthermore, the blue light weighted radiance LB decreased by 34.32%, and the color rendering index showed negligible differences after applying an upscaled BVO filter to a phone screen. These cost-efficient, ecofriendly, highly reliable, and large-area nanostructured BVO films with high blue light shielding efficiency have potential applications in various areas.

Tocol Prophylaxis for Total-body Irradiation: A Proteomic Analysis in Murine Model.

The aim of this study was to analyze the changes in mouse jejunum protein expression in response to prophylactic administration of two promising tocols, γ-tocotrienol (GT3) and α-tocopherol succinate (TS), as radiation countermeasures before irradiation to elucidate the molecular mechanism(s) of their radioprotective efficacy. Mice were administered GT3 or TS (200 mg kg) subcutaneously 24 h prior to exposure to 11 Gy Co γ-radiation, a supralethal dose for mice. Jejunum was harvested 24 h post-irradiation. Results of the two-dimensional differential in-gel electrophoresis (2D-DIGE), coupled with mass spectrometry, and advanced bioinformatics tools suggest that the tocols have a corresponding impact on expression of 13 proteins as identified by mass spectrometry. Ingenuity Pathway Analysis (IPA) reveals a network of associated proteins involved in inflammatory response, organismal injury and abnormalities, and cellular development. Relevant signaling pathways including actin cytoskeleton signaling, RhoA signaling, and Rho family GTPase were identified. This study reveals the major proteins, pathways, and networks involved in preventing the radiation-induced injury in gut that may be contributing to enhanced survival.

Discovery of Novel UV-Filters with Favorable Safety Profiles in the 5-Arylideneimidazolidine-2,4-dione Derivatives Group.

Effective protection from the harmful effects of UV radiation may be achieved by using sunscreens containing organic or inorganic UV filters. The number of currently available UV filters is limited and some of the allowed molecules possess limitations such as systemic absorption, endocrine disruption properties, contact and photocontact allergy induction, and low photostability. In the search for new organic UV filters we designed and synthesized a series consisting of 5-benzylidene and 5-(3-phenylprop-2-en-1-ylidene)imidazolidine-2,4-dione (hydantoin) derivatives. The photoprotective activity of the tested compounds was confirmed in methanol solutions and macrogol formulations. The most promising compounds possessed similar UV protection parameter values as selected commercially available UV filters. The compound diethyl 2,2'-((Z)-4-((E)-3-(4-methoxyphenyl)allylidene)-2,5-dioxoimidazolidine-1,3-diyl)diacetate (4g) was characterized as an especially efficient UVA photoprotective agent with a UVA PF of 6.83 ± 0.05 and favorable photostability. Diethyl 2,2'-((Z)-4-(4-methoxybenzylidene)-2,5-dioxo- imidazolidine-1,3-diyl)diacetate (3b) was the most promising UVB-filter, with a SPFin vitro of 3.07 ± 0.04 and very good solubility and photostability. The main photodegradation products were geometric isomers of the parent compounds. These compounds were also shown to be non-cytotoxic at concentrations up to 50 µM when tested on three types of human skin cells and possess no estrogenic activity, according to the results of a MCF-7 breast cancer model.

Determination of energy absorption and exposure buildup factors by using G-P fitting approximation for radioprotective agents.

PURPOSE: Recently, there has been an increase in interest into research into radioprotective agents. Radioprotectors are compounds that protect against radiation injury when given orally (through drinking water) prior to radiation exposure. The purpose is to achieve preferred protection of normal tissues against injury inflicted by ionizing radiation used to treat tumors. The main aim of this work is to investigate energy absorption (EABF) and exposure buildup factors (EBF) of commonly used some radioprotective agents. MATERIALS AND METHODS: We have used the Geometric Progression (G-P) fitting method for calculating the equivalent atomic number (Zeq), for EABF and EBF buildup factors of the radioprotective agents in the energy range 0.015-15 MeV for penetration depths up to 40 mean free path. RESULTS: Significant variations in both EABF and EBF values were observed for several agents at the moderate energy region. At energies below 0.1 MeV, EABF and EBF values increased with decreasing equivalent atomic number Zeq of the samples. At energies >0.15 MeV, EABF and EBF values were found to decrease with decreasing Zeq of all agents. In addition, EABF and EBF were the largest for carnosin, tempol, melatonin, interferon gamma and orientine at 0.05 and 0.06 MeV, respectively, and the minimum values of buildup factors were at 0.1 MeV for cysteine, amifostine, penicillamine and glutathione. CONCLUSIONS: Cysteine and amifostine are good compounds for gamma rays absorption applications among the selected compounds. The presented results in this study are expected to be helpful in radiation dosimetry.

Effective protection of biological membranes against photo-oxidative damage: Polymeric antioxidant forming a protecting shield over the membrane.

We have prepared a chitosan polymer modified with gallic acid in order to develop an efficient protection strategy biological membranes against photodamage. Lipid bilayers were challenged with photoinduced damage by photosensitization with methylene blue, which usually causes formation of hydroperoxides, increasing area per lipid, and afterwards allowing leakage of internal materials. The damage was delayed by a solution of gallic acid in a concentration dependent manner, but further suppressed by the polymer at very low concentrations. The membrane of giant unilamellar vesicles was covered with this modified macromolecule leading to a powerful shield against singlet oxygen and thus effectively protecting the lipid membrane from oxidative stress. The results have proven the discovery of a promising strategy for photo protection of biological membranes.

Tris-biphenyl triazine, a new ultraviolet filter studied in terms of photoprotective efficacy.

There are relatively few authorized ultraviolet filters in Europe and this presents a certain number of problems when we want to formulate a sun protection product which both ensures a high level of protection and respects the recommendations in force in terms of broad-spectrum efficacy, with, in particular, a critical wavelength (λc) greater than or equal to 370 nm. A new ultraviolet filter has just been launched on the market. Known as tris-biphenyl triazine, it is the first filter to be registered on Annexe VI of "Cosmetics Regulation" (EC) No. 1223/2009 of the European Parliament and of the Council, which gives a list of the ultraviolet filters allowed in cosmetic products, since the regulation came into force in July 2013. This filter is both very effective (as it enables 2 SPF units and 1 UVA-PF units to be obtained respectively, by percentage of use) and very photostable (since the SPF and UVA-PF do not vary after 2h of irradiation in a solar simulator). Its broad spectrum associated with its qualities in terms of efficacy and photostability make it a choice ingredient for the formulation of sun protection products.

Analysis of the antioxidative function of the radioprotective Japanese traditional (Kampo) medicine, hangeshashinto, in an aqueous phase.

Oral mucositis (OM) is a common and painful complication of radiotherapy for head and neck cancer. Hangeshashinto (HST), a Japanese traditional medicine, is known to alleviate radiotherapy- and/or chemotherapy-induced OM; however, the detailed mechanism has not yet been clarified. The aim of the present study was to clarify the details of the antioxidative functions of HST against reactive oxygen species (ROS) produced by radiation. The hydroxyl radical (•OH)-scavenging ability and the reduction ability was simultaneously measured using a modified electron paramagnetic resonance (EPR) spin-trapping method. The superoxide (O(2) (•-))-scavenging ability was estimated by an EPR redox probing method. Water suspensions of powdered HST and of its seven constitutive crude drugs were tested. In addition, some of the main water-soluble ingredients of the crude drugs were also tested. HST was found to scavenge both •OH and O(2) (•-). Furthermore, HST was observed to reduce relatively stable nitroxyl radicals. Glycyrrhizae Radix (kanzo), Ginseng Radix (ninjin), Zizyphi Fructus (taiso) and glycyrrhizin (an ingredient of kanzo) were all found to be relatively good •OH scavengers. Scutellariae Radix (ogon) and Coptidis Rhizoma (oren) demonstrated reducing ability. In addition, acteoside and berberine chloride, which are water-soluble ingredients of ogon and oren, respectively, also demonstrated reducing ability. Oren exhibited oxidative ability at higher concentrations, which may have a function in maintaining catalytic redox action. The antioxidative function of HST probably worked via a balance of scavenging ROS, reducing stable free radicals, and some minor oxidizing activities.

A study of the energy absorption and exposure buildup factors of some anti-inflammatory drugs.

Human radiation exposure is increasing due to radiation development in science and technology. The development of radioprotective agents is important for protecting patients from the side effects of radiotherapy and for protecting the public from unwanted irradiation. Radioprotective agents are used to reduce the damage caused by radiation in healthy tissues. There are several classes of radioprotective compounds that are under investigation. Analgesics and anti-inflammatory compounds are being considered for treating or preventing the effects of damage due to radiation exposure, or for increasing the chance of survival after exposure to a high dose of radiation. In this study, we investigated the radioprotective effects of some analgesic and anti-inflammatory compounds by evaluating buildup factors. The gamma ray energy absorption (EABF) and exposure buildup factors (EBF) were calculated to select compounds in a 0.015-15 MeV energy region up to a penetration depth of 40 mfp (mean free path). Variations of EABF and EBF with incident photon energy and penetration depth elements were also investigated. Significant variations in both EABF and EBF values were observed for several compounds at the moderate energy region. At energies below 0.15 MeV, EABF and EBF values increased with decreasing equivalent atomic number (Z(eq)) of the samples. In addition, EABF and EBF were the largest for ibuprofen, aspirin, paracetamol, naproxen and ketoprofen at 0.05 and 0.06 MeV, respectively, and the EABF value was 0.1 MeV for aceclofenac. From these results, we concluded that the buildup of photons is less for aceclofenac compared to other materials.

Antioxidant marine algae phlorotannins and radioprotection: a review of experimental evidence.

Radiation has been widely used for cancer therapy in human medicine. However, the side effects of radiation are problematic and can limit its application. Radiation generates reactive oxygen species, leading to cell death via multiple signaling pathways. The blocking of certain signaling cascades using antioxidants represents a compensatory therapy of radiation-induced tissue injury. Although synthetic chemicals have been investigated in recent decades, anti-oxidants from natural resources have been searched for continuously. Among them, phlorotannins from marine algae, including Ecklonia cava, have been shown to protect cells from radiation-induced injury as well as oxidative stress. In the present review, the radioprotective capacity of phlorotannins derived from marine algae and the mechanisms involved are discussed.

Carnosol, radiation and melanoma: a translational possibility

PURPOSE: To compare the genoprotective and radioprotective effect of carnosol (COL) against damage induced by ionizing radiation with similar effects produced by different antioxidant compounds. METHODS: The genoprotective effect was studied by means of the micronucleus test for antimutagenic activity in which the reduction in the frequency of micronuclei was evaluated in cytokinesis-blocked cells of human lymphocytes. The radioprotective effects were studied by cell viability test (MTT) in PNT2 (normal prostate) and B16F10 (melanoma) cell lines when they were administered before exposure to different X-ray doses (4, 6, 8, 10 and 0 Gy). RESULTS: Carnosol shows a significant genoprotective capacity (p < 0.001) against radiation with a protection factor of 50 %, and a dose-reduction factor of 4.3. Cell survival obtained with COL administered before exposure to 10 Gy of X-rays showed a protection factor of 55.1 %, eliminating 39 % of radiation-induced cell death in normal epithelial cells of prostate (PNT2) (p < 0.001). However, in the melanoma cell lines (B16F10) assayed, COL acted not as a radioprotector, but as a sensitizing agent increasing the cellular death by 34 % (p < 0.01) and producing an enhancement ratio of 2.12. CONCLUSIONS: Carnosol may be developed as a radioprotective agent in the non-tumoral cells. However, in the B10F16 melanoma cells, melanogenesis is activated by COL leading to redistribution of the enzymatic balances of glutathione and cysteine-lyase production, which could compromise the intracellular redox defence system. This effect appears as an increase in the capacity of ionizing radiation-induced damage, and thus exhibits a paradoxical protective effect of COL on melanoma cells (AU)

UVA/B exposure promotes the biosynthesis of dehydroretinol in cultured human keratinocytes.

Retinol and its metabolites modulate epithelial differentiation and serve as cellular UV sensors through changes in retinoid status. Of note is the dehydroretinol family which may serve functions distinct from parental retinol. This study focuses on the metabolism of this family and its potential participation in the response of normal epidermal human keratinocytes to UV irradiation. There were three findings. First, keratinocytes contain two pools of dehydroretinyl esters, one of which is shielded from UVB-, but not from UVA-induced decomposition. Second, using a novel in vitro assay we demonstrated that both UVA and UVB promote dehydroretinol biosynthesis in keratinocytes, but only UVB exposure promotes retinoid ester accretion by enhancing the activity of at least one acyl transferase. Finally, dehydroretinol sufficiency reduces UVA/B driven apoptosis more effectively than retinol sufficiency. This may in part be due to differences in the expression of Fas ligand, which we found to be upregulated by retinoic acid, but not dehydroretinoic acid. These observations implicate a role of dehydroretinol and its metabolites in UVA/B adaptation. Thus, the keratinocyte response to UV is jointly shaped by both the retinoids and dehydroretinoids.

Spectroscopic studies on interaction and sonodynamic damage of metallochlorophyllin (Chl-M (M=Fe, Zn and Cu)) to protein under ultrasonic irradiation.

In this paper, the chlorophyll derivatives, metallochlorophyllin (Chl-M) (M=Fe, Zn and Cu) including chlorophyllin iron (Chl-Fe), chlorophyllin zinc (Chl-Zn) and chlorophyllin copper (Chl-Cu), were adopted as sonosensitizers to combine with ultrasonic irradiation, and the sonodynamic damage of bovine serum albumin (BSA) was investigated. At first, the interaction of Chl-M with BSA was studied by fluorescence spectroscopy. The results show that the quenching mechanism belongs to a static process and among them the affinity of Chl-Fe to BSA is the most obvious. Then, some influence factors on the sonodynamic damage of BSA molecules in the presence of Chl-M under ultrasonic irradiation were also studied. Synchronous fluorescence spectra show that the binding and damage sites of Chl-M to BSA molecule are mainly on the tryptophan (Trp) residues. The generation of ROS in Chl-M sonodynamic process is estimated by the method of Oxidation-Extraction Spectrometry (OEP). This paper may offer some valuable references for the study of the sonodynamic activity of Chl-M and the effect of the central metals. Synchronously, it contributes to the application of Chl-M in SDT for tumor treatment.

[Update on photoprotection]. / Novedades en fotoprotección.

Photoprotection is the primary preventive and therapeutic strategy against photoaging and skin cancer. This review presents the most important new advances in both topical and systemic photoprotection. Starting with innovations in the traditional physical and chemical filtering agents, we go on to discuss the growing number of antioxidants, the novel strategies for repairing light-induced DNA damage, and current research on substances that stimulate melanogenesis. A final section deals with protection against infrared radiation.

Laboratory and outdoor assessment of UV protection offered by flax and hemp fabrics dyed with natural dyes.

The safest protection from UV radiation (UVR) exposure is offered by clothing and its protectiveness depends on fabric composition (natural, artificial or synthetic fibers), fabric parameters (porosity, weight and thickness) and dyeing (natural or synthetic dyes, dye concentration, UV absorbing properties, etc.). In this study the UV protection properties of two fabrics made of natural fibers (flax and hemp) dyed with some of the most common natural dyes were investigated. UVR transmittance of fabrics was measured by two methods: one based on the utilization of a spectrophotometer equipped with an integrating sphere (in vitro test), and the other based on outdoor measurements taken by a spectroradiometer. Transmittance measurements were used to calculate the ultraviolet protection factor (UPF). Experimental results revealed that natural dyes could confer good UV protection, depending mainly on their different UVR-absorbing properties, provided that the fabric construction already guaranteed good cover. An increase in cover factor caused by the dyeing process was also detected. Weld-dyed fabrics gave the highest protection level. The comparison between the two methods applied to measure fabric transmittance pointed out that the UPFs calculated by in vitro measurements were generally lower than those based on outdoor data, indicating an underestimation of the actual protection level of tested fabrics assessed by the in vitro test.

Conformations of substituted benzophenones.

The inclination of the two aryl rings (ring twists) in a series of benzophenone molecules has been examined. For each structure the dihedral angle (between the planes of the two sets of six aromatic C atoms) relates to both the steric considerations of the single molecule and the packing forces related to the crystal structure. Six new benzophenone structures are incorporated into the study including 2,2'-dihydroxy-4,4'-dimethoxybenzophenone (I), C(15)H(14)O(5), that appears to have the smallest reported twist angle, 37.85 (5) degrees , of any substituted benzophenone reported to date. Three further benzophenones, 4,4'-bis(diethylamino)benzophenone (II), C(21)H(28)N(2)O, 3,4-dihydroxybenzophenone (III), C(13)H(10)O(3), and 3-hydroxybenzophenone (IV), C(13)H(10)O(2), have similar ring twists [49.83 (5), 49.84 (5) and 51.61 (5) degrees , respectively] that are comparable with the value of 54 degrees found for the orthorhombic form of unsubstituted benzophenone. 4-Chloro-4'-hydroxybenzophenone (V), C(13)H(9)ClO(2), has a ring twist of 64.66 (8) degrees that is close to the value of 65 degrees found in the metastable monoclinic form of unsubstituted benzophenone and 2-amino-2',5-dichlorobenzophenone (VI), C(13)H(9)Cl(2)NO(2), has a large ring twist of 83.72 (6) degrees . Comparisons with a further 98 substituted benzophenone molecules from the Cambridge Structural Database (CSD) have been made.

Radiosterilization of drugs in aqueous solutions may be achieved by the use of radioprotective excipients.

The aim of this study was to assess the feasibility of radiosterilization of drugs aqueous solutions and to evaluate the effects of some additives, such as mannitol, nicotinamide and pyridoxine, which might protect the drug from degradation. Metoclopramide was selected as a model drug. The structures of the degradation products were determined to gain insight on the radiolysis mechanisms in aqueous solution in order to design strategies to lower the drug degradation. Metoclopramide hydrochloride aqueous solutions with and without excipients were irradiated either with gamma rays or high-energy electrons. HPLC-DAD was used to measure the loss of chemical potency and to quantify the degradation products which were also characterized by LC-APCI-MS-MS. Metoclopramide recovery for gamma and electron beam-irradiated solutions containing either mannitol, pyridoxine or nicotinamide meets the pharmacopoeial specifications for metoclopramide content up to a 15 kGy irradiation so that metoclopramide solutions containing these excipients might be radiosterilized at 15 kGy either with gamma rays or high-energy electrons. Structures are proposed for the majority of radiolysis products. Similar radiolysis products were detected for gamma and electron beam irradiations but the chromatographic profiles were different (differences in the distribution of radiolysis products).

Chemical radiosensitizers for use in radiotherapy.

Radiosensitizers are intended to enhance tumour cell killing while having much less effect on normal tissues. Some drugs target different physiological characteristics of the tumour, particularly hypoxia associated with radioresistance. Oxygen is the definitive hypoxic cell radiosensitizer, the large differential radiosensitivity of oxic vs hypoxic cells being an attractive factor. The combination of nicotinamide to reduce acute hypoxia with normobaric carbogen breathing is showing clinical promise. 'Electron-affinic' chemicals that react with DNA free radicals have the potential for universal activity to combat hypoxia-associated radioresistance; a nitroimidazole, nimorazole, is clinically effective at tolerable doses. Hypoxia-specific cytotoxins, such as tirapazamine, are valuable adjuncts to radiotherapy. Nitric oxide is a potent hypoxic cell radiosensitizer; variations in endogenous levels might have prognostic significance, and routes to deliver nitric oxide specifically to tumours are being developed. In principle, many drugs can be delivered selectively to hypoxic tumours using either reductase enzymes or radiation-produced free radicals to activate drug release from electron-affinic prodrugs. A redox-active agent based on a gadolinium chelate is being evaluated clinically. Pyrimidines substituted with bromine or iodine are incorporated into DNA and enhance free radical damage; fluoropyrimidines act by different mechanisms. A wide variety of drugs that influence the nature or repair of DNA damage are being evaluated in conjunction with radiation; it is often difficult to define the mechanisms underlying chemoradiation regimens. Drugs being evaluated include topoisomerase inhibitors (e.g. camptothecin, topotecan), and the hypoxia-activated anthraquinone AQ4N; alkylating agents include temozolomide. Drugs involved in DNA repair pathways being investigated include the potent poly(ADP ribose)polymerase inhibitor, AG14,361. Proteins involved in cell signalling, such as the Ras family, are attractive targets linked to radioresistance, as are epidermal growth factor receptors and linked kinases (drugs including vandetanib [ZD6,474], cetuximab and gefitinib), and cyclooxygenase-2 (celecoxib). The suppression of radioprotective thiols seems to offer more potential with alkylating agents than with radiotherapy, although it remains a strategy worthy of exploration.