Mechanistic Effects of Environmental and Medical Low-Dose Radiation Exposure of the Lung

Ionizing radiation has been an important tool in medical diagnosis and treatment. While the use of radiation for diagnostic purposes has been successful, clinicians are wary of the possible negative effects radiation may have on the patient. According to the linear no-threshold model, all levels of radiation are considered harmful and there is no safe threshold. However, some studies suggest there may instead be a hormetic response at lower doses typically defined as exposure below 100 mGy, and that low doses may be beneficial as a possible immunomodulatory therapeutic. Therefore, it is increasingly important to understand the effects of exposure to low doses of radiation. The lung is frequently exposed to radiation from both environmental and medical sources. The effects of low doses of radon, the most heavily studied public radiation exposure source, are still contested, as well as the potential risk from medical X-ray imaging and computed tomography exposures during diagnostic procedures. In order to appropriately evaluate the potential risks and benefits of a low-dose exposure, it is necessary to understand the mechanism(s) of action, particularly the role of DNA damage, reactive oxygen species, inflammation and immune response. Here, we review the mechanistic evidence of low-dose radiation exposure effects on the lung in the current literature and discuss the implications of these results on the validity of the LNT model as well as potential hormetic or adaptive responses.