Cellular radiosensitivity in ataxia-telangiectasia

Hypersensitivity to both the cell-killing and chromosome-damaging effects of ionizing radiations, and other agents causing DNA breakage, is a consistent feature of cells from individuals with the cancer-prone disorder ataxia-telangiectasia (A-T). Evidence for a defect in DNA strand break rejoining is slight, but a higher-than-normal level of chromosomal breaks persists in irradiated A-T cells. There is also evidence for elevated frequencies of DNA recombination and deletion mutation in A-T cells; these responses may be linked through a loss of fidelity in rejoining DNA breaks through recombination mechanisms. Additionally the regulation of cell-cycle responses is altered in A-T cells: in all phases of the cycle there is some loss of 'checkpoint' function shortly after irradiation, allowing cells to continue cycling despite extensive DNA damage. However, on present evidence, radiation hypersensitivity cannot be explained simply by this loss of regulatory function. It is suggested that the A-T gene product acts in the early stages of a DNA damage-recognition pathway, normally interacting with regulatory proteins such as p53, but also with proteins involved in the processing of DNA breaks. Reduced efficiency in this type of signalling function could well explain the link between radiosensitivity and cancer proneness.