The fidelity of repair of radiation damage

Ionising radiation (IR) induces a range of DNA damage similar to that which arises endogenously from reactive oxygen species generated as by-products of metabolism. However, due to non-homogeneous energy deposition, the damage from IR frequently occurs in clusters producing unique 'complex' lesions. Cells have evolved a range of mechanisms to respond to DNA damage, which include pathways of DNA repair and processes that prevent the proliferation of damaged cells. However, the repair mechanisms are not fool proof and clustered radiation-induced lesions pose a particular problem. Whether DNA damage created by IR can be repaired accurately, mis-repaired or not repaired at all is of utmost importance in considering the impact of radiation exposure. Here, the current knowledge is discussed of the repair of double strand breaks, a biologically important lesion induced by IR, in the context of the fidelity of the repair mechanisms and the consequences of mis-repair or lack of repair.