After defining a gene expression signature that predicted radiation exposure dose with high accuracy in human peripheral white blood cells irradiated ex vivo, we now demonstrate the predictive power of gene expression signatures in blood from patients undergoing total body irradiation. Using whole genome microarray analysis, we have identified genes that respond to radiation exposure in cancer patients in vivo. A 3-nearest neighbor classifier built from these genes correctly predicted samples as exposed to 0, 1.25 or 3.75 Gy with 94% accuracy even when samples from healthy donor controls were included. The same samples were classified with 98% accuracy using a signature previously defined from ex vivo irradiation data. The samples could also be classified as exposed or not exposed with 100% accuracy using multiple methods. The demonstration that ex vivo irradiation is an appropriate model that can provide meaningful prediction of in vivo exposure, and that the signatures are robust across diverse disease states, is an important advance in the application of gene expression for biodosimetry. Translation of these signatures to a fully automated “lab-on-a-chip” device will enable high-throughput screening for large-scale radiological emergencies, as well as making such tests practical for clinical uses.
Overall design
Radiation induced gene expression was measured in vivo in TBI patients at 4 hours after 1.25Gy exposure or at 24 hours after 3.75Gy exposure with three 1.25Gy split doses (approximately 4 hours apart). A total of 18 TBI patients, diagnosed with a variety of cancers were used in this study. Blood from 14 healthy control individuals was also used for comparison.
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