Tackling the acute radiation syndrome: Hemoperfusion with activated carbon revisited

Almost three decades ago Dr. Nikolaev and co-authors reported a remarkable finding that a single-course low-volume hemoperfusion through uncoated spherical activated carbon led to a significant increase in survival of dogs acutely irradiated with X-rays of the dose of 5.25 Gy (Artif. Organs. 1993; 17: 362-8). In those studies, the adsorptive detoxification, which is characteristic for carbon adsorbents, was less likely to play a predominant role in radioprotection, thus prompting the authors to assume that some other, unknown, mechanisms were involved. This article is aimed to interpret the radioprotective effect of activated carbon, based on the mounting evidence that it is capable of reducing the oxidative stress and promoting the recovery in various tissues and organs (including hematopoietic) with an active involvement of relatively radioresistant tissue-resident macrophages.