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New basic science initiatives for improved understanding of radiation-induced multi-organ dysfunction syndrome (MODS)

¹ Departments of Radiation Oncology and Pharmacology, Case Western Reserve University, Cleveland, OH, USA and ² Dermatology Clinic, The Saarland University Hospital, Homburg/Saar, Germany

Correspondence: David A Boothman, PhD, Professor, Department of Radiation Oncology, Associate Director for Basic Research, Co-Leader, Experimental Therapeutics Program, Ireland Comprehensive Cancer Center, Case School of Medicine, Case Western Reserve University, The University Hospitals, and the Cleveland Clinic Foundation, 10900 Euclid Avenue (BRB-326 East), Cleveland, OH 44106-4942, USA; E-mail: dab30@po.cwru.edu. Priv-Doz Dr Jörg Reichrath, MD, Dermatology Clinic, The Saarland University Hospital, 66421 Homburg/Saar, Germany; E-mail: hajrei@uniklinik-saarland.de

Multi-organ dysfunction syndrome (MODS), which may lead to multi-organ failure (MOF), is a major clinical problem in patients following accidental exposure to ionising radiation (IR). Although inflammatory "one hit" and "two hit" models have recently been proposed to account for the development of MOF, we are only just beginning to understand the complex pathophysiology of IR-induced MODS and MOF. This paper summarises the main findings of a recent panel discussion at "The Advanced Research Workshop on Radiation-induced Multi-organ Involvement and Failure: a challenge for pathogenetic, diagnostic and therapeutic approaches and research", which was held on 14 November 2003 at the Science Conference Center at Schloss Reisensburg of the University of Ulm. This panel discussion focused on future molecular and clinical research priorities to improve our knowledge regarding possible initiation events following IR exposure that may lead to MODS. Additionally, specific recommendations for improving our understanding of the events that initiate and control MODS were summarised.