Advances in the Regulation of Hematopoietic Homeostasis by Programmed Cell Death Under Radiation Conditions

The application of nuclear energy and the frequent occurrence of nuclear contamination have made radiation safety a major challenge to global public health. As a radiation-sensitive target organ, bone marrow is susceptible to both acute and chronic damage effects of ionizing radiation on the hematopoietic system. Researchers have demonstrated that radiation disrupts hematopoietic homeostasis through direct damage to hematopoietic stem cells, which inhibits hematopoietic regeneration indirectly through damage to hematopoietic progenitor cells and their downstream cell populations. However, the multi-target regulatory mechanism of radiation perturbation of hematopoietic homeostasis remains to be systematically elucidated. Recent studies have revealed that, in addition to the classical apoptotic pathway, non-apoptotic programmed cell death modes (e.g. pyroptosis, necroptosis, and ferroptosis) may be involved in the regulation of radiation-induced hematopoietic injury. A systematic review of the roles of the aforementioned programmed death pathways was presented in radiation-damaged hematopoietic cells, with a view to providing a scientific basis for targeted intervention in radiation-induced myelosuppression.