CLINICAL MANAGEMENT OF RADIOLOGICAL EMERGENCIES

In the event of a radiological disaster, medical response will be complicated by the often “silent” and delayed symptoms of acute radiation syndrome (ARS), as well as the high level of fear that many people have of radiation. Detonation of an Improvised Nuclear Device in a major population center is likely to result in many thousands of injured, as well as an even larger population of ”worried well.” A Radiation biodosimetry test, which estimates absorbed radiation dose using an individual’s biological response, will play a critical role in the effective management of a mass scale event.

Introducing the REDI-Dx® Biodosimetry Test system (for investigational use only), a high-throughput, molecular test being developed to estimate absorbed radiation dose from a blood sample collected and stabilized for ambient transport using DxCollect® Blood Collection Tubes. The system estimates dose by analyzing the relative expression of a panel of 18 genes related to cell cycle control, cell signaling, and DNA repair using a combination of multiplex PCR and capillary electrophoresis (CE) fragment analysis and the ABI 3500Dx Genetic Analyzer with associated REDI-Dx® Biodosimetry Interpretative Software.

RESPONDERS

CLINICIANS

REDI-Dx®

REDI-Dx® Rapid Response

Emergency Responders will need to make rapid, difficult decisions about patient care in an environment of very limited resources. Hospital beds will be in short supply and drugs to treat acute radiation syndrome (ARS) are expensive, limited in supply, and must be administered shortly after exposure to be effective. Radiation biodosimetry tests must integrate with emergency response plans, be implemented at a large scale quickly and have a rapid turnaround time. As such, REDI-Dx® is being developed to be compatible with existing high throughput, clinical testing infrastructure, and to be able to deliver same-day results with prioritized processing.

Physicians will be faced with difficult decisions regarding which patients to prioritize for treatment versus those that can be sent home, or given palliative care only. Established radiation treatment guidelines are based on dose. However, individuals exposed to the same dose will show varied response, requiring adjusted patient care based on symptoms, resource availability, and treatment. Results from the REDI-Dx® test system should not be the sole basis of treatment decisions, but used along with clinical signs, symptoms, and hematology to determine care.

REDI-Dx® is a molecular assay that measures rapid, complex, and predictable changes in an individual’s cellular gene expression following exposure to ionizing radiation. The test is being developed to integrate easily into existing emergency response plans and molecular diagnostic laboratory workflows to provide same-day results to the physician. The REDI-Dx® Test provides a rapid turnaround time for delivery of critical information that is needed in order to intersect with the narrow therapeutic windows where medical countermeasures can be utilized.