<p>Diss. (sammanfattning) Umeå : Umeå universitet, 1983, härtill 5 uppsatser</p> / digitalisering@umu

Les résultats insuffisants de la radiochimiothérapie conventionnelle ont motivé l’évaluation de nouvelles cibles afin de moduler la radiosensibilité tumorale: voies intrinsèques impliquées dans la réponse aux rayonnements ionisants, vascularisation tumorale, stroma non vasculaire. A travers cette thèse, nous avons évalué trois nouvelles stratégies de radiosensibilisation pharmacologique. Nous avons d’abord étudié en association à la radiothérapie l’intérêt de la modulation de l’axe p53/Mdm2 par le JNJ26854165, un inhibiteur de la dégradation de p53 par le protéasome. Les résultats in vitro et in vivo dans des xénogreffes sous-cutanées de cancers bronchiques non à petites cellules (CBNPC) montrent que cette stratégie permet d’améliorer significativement l’efficacité de la radiothérapie. Nous avons également rapporté des résultats encourageants in vitro dans plusieurs lignées cellulaires tumorales avec un nouvel agent antivasculaire ciblant la tubuline, l’EHT 6706. Cette stratégie augmentait l’efficacité de l’irradiation et potentialisait l’effet antiprolifératif de certains agents de chimiothérapie conventionnelle. Enfin, le développement le plus abouti a consisté en l’évaluation de l’association d’un triple inhibiteur de MET/AXL/FGFR en association à l’irradiation in vitro et dans des modèles de CBNPC implantés en xénogreffes sous-cutanées, mais également sous forme de tumeurs pulmonaires orthotopiques. Cet agent pharmacologique potentialisait l’efficacité de la radiothérapie dans des lignées ne surexprimant pas MET. Il est apparu que l’activité de la drogue faisait intervenir, au moins partiellement, l’inhibition de l’activité d’acteurs de la cytocinèse. Ces trois évaluations, qui s’inscrivent dans la recherche translationnelle, montrent l’importance de la recherche préclinique pour les études d’association aux rayonnements ionisants. Seul un développement préclinique rationnel permettra de faire émerger de nouveaux standards dans le domaine de la biomodulation pharmacologique de la radiosensibilité tumorale. / Insufficient results of conventional chemoradiation have encouraged assessment of new targets for radiosensitization: intrinsic cellular pathways involved in radiation response, tumor angiogenesis, and nonvascular stroma. We have investigated these three strategies for pharmacological radiosensitization. First, we examined the usefulness of targeting p53/Mdm2 pathway in combination with irradiation. In vitro and in vivo results obtained in non-small cell lung carcinoma (NCSLC) showed that this strategy was promising for enhancing radiation efficacy. We also found encouraging results within several cell lines with a novel vascular disrupting agent targeting tubulin. This strategy enhanced radiation effects and also increased the antiproliferative effects of various chemotherapeutics. Finally, the most advanced preclinical development was obtained with a novel MET/AXL/FGFR inhibitor, which improved effectiveness of radiation therapy in vitro and in subcutaneous and orthotopic models of non MET-dependent cell cancer lines. This effect was not only related to an inhibition of stroma/cancer cell interactions, as it probably involved activity toward actors of cytocinesis. These studies, which are part of translational research, highlight the importance of preclinical investigations in the area of radiation research. Only rationale preclinical development will allow new standards to emerge for pharmacological modulation of tumor radiosensitivity.

This study evaluated the potential use of an antimicrobial packaging system in combination with electron beam irradiation to enhance quality of fresh produce. Irradiated romaine lettuce up to 3.2 kGy showed negligible (p > 0.05) changes in color, but texture and sensory attributes were less acceptable with increased dose. We established the antimicrobial effectiveness of various active compounds incorporated into the low-density polyethylene (LDPE)/polyamide films to increase radiation sensitivity of surrogate bacteria (Listeria innocua and Escherichia coli). All films showed inhibition zones in an agar diffusion test. In the liquid culture test, the active compounds reduced the specific growth rate and decreased final cell concentration of strains. Films incorporated with active compounds increased the radiation sensitivity of the tested strains, demonstrating their potential to reduce the dose required to control microbial contamination using electron beam technology. The active compounds maintained their antimicrobial activity by exposure to ionizing radiation up to 3 kGy. Antimicrobial activity of LDPE/polyamide films incorporated with transcinnamaldehyde was tested with fresh-cut romaine lettuce. Total aerobic plate counts (APC) and yeast and mold counts (YMC) were determined as a function of dose (0, 0.5, and 1.0 kGy) for 14 days of storage at 4°C. Irradiation exposure significantly lowered APCs of lettuce samples by 1-log CFU/g compared to the non-irradiated controls; however, it only slightly reduced YMCs. The effectiveness of using irradiation with antimicrobial films was enhanced with increased radiation dose and transcinnamaldehyde concentration. Electron beam irradiation up to 20 kGy did not affect the tensile strength and toughness of the polymeric films. The film’s flexibility and barrier properties were significantly improved by exposure to 20 kGy. The addition of an active compound did not affect the tensile strength and barrier properties of the films, but decreased the percent elongation-at-break and toughness, making them slightly more brittle. Ionizing radiation affected the release kinetics of the antimicrobial agent from the packaging material into a model food system. Irradiated films exhibited slower release rates than non-irradiated film by 69%. In addition, release rate was lower at 4ºC by 62.6% than at 21-35ºC. The pH of the simulant solution affected release rate with pH 4 yielding higher rates than pH 7 and 10.

Das Tumormikromilieu beeinflusst maßgeblich Tumorwachstum und -progression sowie das Ansprechen von Tumorzellen auf Strahlen- und Chemotherapie. Weiterhin ist bekannt, dass Wachstumsfaktoren, Sauerstoffgehalt und extrazelluläre Matrix (EZM) als Resistenzfaktoren das Zellüberleben nach Exposition mit ionisierender Strahlung oder zytotoxischen Substanzen bestimmen. Weitere zelluläre Parameter, wie Zellmorphologie, Zytoskelettarchitektur und Chromatinkondensation, werden ebenfalls in Abhängigkeit der Wachstumsbedingungen moduliert, wie vergleichende Untersuchungen an physiologischeren drei- (3D) mit herkömmlichen zwei-dimensionalen (2D) Zellkulturen zeigen. Veränderungen der Chromatindichte beeinflussen zudem die Genexpression, wodurch wichtige zelluläre Prozesse, wie Überleben, Proliferation und Differenzierung der Zellen, reguliert werden. Außerdem ist die Chromatinkondensation für eine effektive Reparatur strahleninduzierter DNA-Schäden, wie DNA-Doppelstrangbrüche (DSB), von großer Bedeutung. Das Ziel der vorliegenden Arbeit bestand darin, die zelluläre Strahlenempfindlichkeit unter Berücksichtigung der Chromatinkondensation in humanen Bronchial- (A549) und Plattenepithelkarzinomzellen (UTSCC-15) in Abhängigkeit der Wachstumsbedingungen zu analysieren. Da die molekularen Mechanismen der Wechselwirkung zwischen Chromatindichte und Reparatur strahleninduzierter DSB bis heute unklar sind, war die Untersuchung dieser Zusammenhänge unter 2D, 3D und in vivo Wachstumsbedingungen von besonderem Interesse. Die Ergebnisse dieser Arbeit zeigen, dass das Zellwachstum in einer physiologischen 3D Matrix im Vergleich zur herkömmlichen 2D Zellkultur zu einer geringeren Anzahl an strahleninduzierten residuellen DSB (rDSB) und letalen Chromosomenaberrationen führen kann, was wiederum für ein verbessertes Zellüberleben nach Bestrahlung verantwortlich sein könnte. Des Weiteren konnte in 3D im Zusammenhang mit einer höheren Chromatinkondensierung eine Erhöhung der zellulären Strahlenresistenz gezeigt werden. Auf molekularer Ebene zeigen die Ergebnisse dieser Arbeit außerdem, dass eine siRNA-vermittelte Hemmung chromatinmodifizierender Histondeacetylasen (HDAC 1, 2 und 4) zu keiner Strahlensensibilisierung führt, während durch die Behandlung mit dem pharmakologischen HDAC-Inhibitor Panobinostat (LBH589) neben der Chromatindekondensierung auch eine erhöhte Strahlenempfindlichkeit der Zellen erreicht werden konnte. In Abhängigkeit der untersuchten Wachstumsbedingungen konnten Unterschiede in der Verteilung strahleninduzierter DSB zwischen hetero- und euchromatischen DNA-Bereichen nachgewiesen werden. Interessanterweise nimmt in 2D dosisabhängig der prozentuale Anteil der Heterochromatin (HC)-assoziierten Foci ab, wohingegen in 3D und im Xenografttumormodell dosisunabhängig etwa die Hälfte der Foci mit heterochromatischen DNA-Bereichen assoziiert sind. Diese Daten zeigen, dass Tumorzellen in 3D und in vivo in Abhängigkeit der veränderten Zellmorphologie und Chromatinkondensierung deutlich mehr HC-assoziierte rDSB besitzen als in 2D, was die Hypothese einer beeinträchtigten Reparatur im HC unterstützt. Dennoch zeigt die Korrelation zwischen der deutlich geringeren rDSB Gesamtanzahl und dem erhöhtem Zellüberleben in 3D, dass neben dem Anteil an kondensiertem Chromatin auch die Gesamtanzahl rDSB ein wichtiger Einflussfaktor der zellulären Strahlenempfindlichkeit zu sein scheint. Die Ergebnisse dieser Arbeit liefern somit wichtige Erklärungsansätze für einen direkten Zusammenhang zwischen Zellmorphologie, Chromatinkondensation und zellulärer Strahlenempfindlichkeit. Des Weiteren unterstreichen diese Untersuchungen das verwendete 3D Zellkulturmodell als Annäherung an die in vivo Situation. Damit sind diese Daten von großer Relevanz für ein besseres Verständnis der zellulären Strahlenempfindlichkeit auf molekularer Ebene und können entscheidend dazu beitragen die Behandlung von Tumorerkrankungen sowie die Heilungschancen der Patienten zu verbessern.

Recent work using low-doses of ionising radiations, both in vitro and in ViVO, has suggested that the responses of biological systems in the region of less than 1 Gray may not be predicted by simple extrapolation from the responses at higher doses. Additional experiments, using high-LET radiations at doses of much less than one alpha particle traversal per cell nucleus, have shown responses in a greater number of cells than have received a radiation dose. These findings, and increased concern over the effects of the exposure of the general population to low-levels of background radiation, for example due to radon daughters in the lungs, have stimulated the investigation of the response of mammalian cells to ionising radiations in the extreme low-dose region. In all broad field exposures to particulate radiations at low-dose levels an inherent dose uncertainty exists due to random counting statistics. This dose variation produces a range of values for the measured biological effect within the irradiated population, therefore making the elucidation of the dose-effect relationship extremely difficult. The use of the microbeam irradiation technique will allow the delivery of a controlled number of particles to specific targets within an individual cell with a high degree of accuracy. This approach will considerably reduce the level of variation of biological effect within the irradiated cell population and will allow low-dose responses of cellular systems to be determined. In addition, the proposed high spatial resolution of the microbeam developed will allow the investigation of the distribution of radiation sensitivity within the cell, to provide a better understanding of the mechanisms of radiation action. The target parameters for the microbeam at the Gray Laboratory are a spatial resolution of less than 1 urn and a detection efficiency of better than 99 %. The work of this thesis was to develop a method of collimation, in order to produce a microbeam of 3.5 MeV protons, and to develop a detector to be used in conjunction with the collimation system. In order to determine the optimum design of collimator necessary to produce a proton microbeam, a computer simulation based upon a Monte-Carlo simulation code, written by Dr S J Watts, was developed. This programme was then used to determine the optimum collimator length and the effects of misalignment and divergence of the incident proton beam upon the quality of the collimated beam produced. Designs for silicon collimators were produced, based upon the results of these simulations, and collimators were subsequently produced for us using techniques of micro-manufacturing developed in the semiconductor industry. Other collimator designs were also produced both in-house and commercially, using a range of materials. These collimators were tested to determine both the energy and spatial resolutions of the transmitted proton beam produced. The best results were obtained using 1.6 mm lengths of 1.5 µm diameter bore fused silica tubing. This system produced a collimated beam having a spatial resolution with 90 % of the transmitted beam lying within a diameter of 2.3 ± 0.9 µm and with an energy spectrum having 75 % of the transmitted protons within a Gaussian fit to the full-energy peak. Detection of the transmitted protons was achieved by the use of a scintillation transmission detector mounted over the exit aperture of the collimator. An approximately 10 urn thick ZnS(Ag) crystal was mounted between two 30 urn diameter optical fibres and the light emitted from the crystal transmitted along the fibres to two photomultiplier tubes. The signals from the tubes were analyzed, using coincidence counting techniques, by means of electronics designed by Dr B Vojnovic. The lowest counting inefficiencies obtained using this approach were a false positive count level of 0.8 ± 0.1 % and an uncounted proton level of 0.9 ± 0.3 %. The elements of collimation and detection were then combined in a rugged microbeam assembly, using a fused silica collimator having a bore diameter of 5 urn and a scintillator crystal having a thickness of - 15 µm. The microbeam produced by this initial assembly had a spatial resolution with 90 % of the transmitted protons lying within a diameter of 5.8 ± 1.6 µm, and counting inefficiencies of 0.27 ± 0.22 % and 1.7 ± 0.4 % for the levels of false positive and missed counts respectively. The detector system in this assembly achieves the design parameter of 99 % efficiency, however, the spatial resolution of the beam is not at the desired I urn level. The diameter of the microbeam beam produced is less than the nuclear diameter of many cell lines and so the beam may be used to good effect in the low-dose irradiation of single cells. In order to investigate the variation in sensitivity within a cell the spatial resolution of the beam would require improvement. Proposed methods by which this may be achieved are described.

Das Tumormikromilieu beeinflusst maßgeblich Tumorwachstum und -progression sowie das Ansprechen von Tumorzellen auf Strahlen- und Chemotherapie. Weiterhin ist bekannt, dass Wachstumsfaktoren, Sauerstoffgehalt und extrazelluläre Matrix (EZM) als Resistenzfaktoren das Zellüberleben nach Exposition mit ionisierender Strahlung oder zytotoxischen Substanzen bestimmen. Weitere zelluläre Parameter, wie Zellmorphologie, Zytoskelettarchitektur und Chromatinkondensation, werden ebenfalls in Abhängigkeit der Wachstumsbedingungen moduliert, wie vergleichende Untersuchungen an physiologischeren drei- (3D) mit herkömmlichen zwei-dimensionalen (2D) Zellkulturen zeigen. Veränderungen der Chromatindichte beeinflussen zudem die Genexpression, wodurch wichtige zelluläre Prozesse, wie Überleben, Proliferation und Differenzierung der Zellen, reguliert werden. Außerdem ist die Chromatinkondensation für eine effektive Reparatur strahleninduzierter DNA-Schäden, wie DNA-Doppelstrangbrüche (DSB), von großer Bedeutung. Das Ziel der vorliegenden Arbeit bestand darin, die zelluläre Strahlenempfindlichkeit unter Berücksichtigung der Chromatinkondensation in humanen Bronchial- (A549) und Plattenepithelkarzinomzellen (UTSCC-15) in Abhängigkeit der Wachstumsbedingungen zu analysieren. Da die molekularen Mechanismen der Wechselwirkung zwischen Chromatindichte und Reparatur strahleninduzierter DSB bis heute unklar sind, war die Untersuchung dieser Zusammenhänge unter 2D, 3D und in vivo Wachstumsbedingungen von besonderem Interesse. Die Ergebnisse dieser Arbeit zeigen, dass das Zellwachstum in einer physiologischen 3D Matrix im Vergleich zur herkömmlichen 2D Zellkultur zu einer geringeren Anzahl an strahleninduzierten residuellen DSB (rDSB) und letalen Chromosomenaberrationen führen kann, was wiederum für ein verbessertes Zellüberleben nach Bestrahlung verantwortlich sein könnte. Des Weiteren konnte in 3D im Zusammenhang mit einer höheren Chromatinkondensierung eine Erhöhung der zellulären Strahlenresistenz gezeigt werden. Auf molekularer Ebene zeigen die Ergebnisse dieser Arbeit außerdem, dass eine siRNA-vermittelte Hemmung chromatinmodifizierender Histondeacetylasen (HDAC 1, 2 und 4) zu keiner Strahlensensibilisierung führt, während durch die Behandlung mit dem pharmakologischen HDAC-Inhibitor Panobinostat (LBH589) neben der Chromatindekondensierung auch eine erhöhte Strahlenempfindlichkeit der Zellen erreicht werden konnte. In Abhängigkeit der untersuchten Wachstumsbedingungen konnten Unterschiede in der Verteilung strahleninduzierter DSB zwischen hetero- und euchromatischen DNA-Bereichen nachgewiesen werden. Interessanterweise nimmt in 2D dosisabhängig der prozentuale Anteil der Heterochromatin (HC)-assoziierten Foci ab, wohingegen in 3D und im Xenografttumormodell dosisunabhängig etwa die Hälfte der Foci mit heterochromatischen DNA-Bereichen assoziiert sind. Diese Daten zeigen, dass Tumorzellen in 3D und in vivo in Abhängigkeit der veränderten Zellmorphologie und Chromatinkondensierung deutlich mehr HC-assoziierte rDSB besitzen als in 2D, was die Hypothese einer beeinträchtigten Reparatur im HC unterstützt. Dennoch zeigt die Korrelation zwischen der deutlich geringeren rDSB Gesamtanzahl und dem erhöhtem Zellüberleben in 3D, dass neben dem Anteil an kondensiertem Chromatin auch die Gesamtanzahl rDSB ein wichtiger Einflussfaktor der zellulären Strahlenempfindlichkeit zu sein scheint. Die Ergebnisse dieser Arbeit liefern somit wichtige Erklärungsansätze für einen direkten Zusammenhang zwischen Zellmorphologie, Chromatinkondensation und zellulärer Strahlenempfindlichkeit. Des Weiteren unterstreichen diese Untersuchungen das verwendete 3D Zellkulturmodell als Annäherung an die in vivo Situation. Damit sind diese Daten von großer Relevanz für ein besseres Verständnis der zellulären Strahlenempfindlichkeit auf molekularer Ebene und können entscheidend dazu beitragen die Behandlung von Tumorerkrankungen sowie die Heilungschancen der Patienten zu verbessern.

<p>In this thesis, a model of tissue oxygenation is presented, that takes into account the heterogeneous nature of tumor vasculature. Even though the model is rather simple, the resulting oxygen distributions agree very well with clinically observed oxygen distributions for most tumors and healthy normal tissues. The model shows that the vascular density may not describe the oxygenation of a tissue sufficiently well, unless the heterogeneity of the vascular system is taken into account. Based on the oxygen distributions from the tissue model, the associated radiation response at low and high doses can be determined. </p><p>The radiation response of heterogeneous tumors should preferably be described by two clonogen compartments, one resistant and one sensitive, dominating the response at high and low radiation doses, respectively. Furthermore, each compartment should be characterized by the effective radiation resistance and the effective clonogen number. The resistant-sensitive model of radiation response has been analyzed in great detail. It accurately describes the response of severely heterogeneous tumors, both at low and high doses and LET values. The effective response parameters are given as integrals, averaged over the whole spectrum of radiation resistance. The parameters can also be determined from clinically established dose-response relations. </p><p>The main properties of the dose-response relation for a generally heterogeneous tumor is described in some detail. The normalized dose-response gradient has been generalized to take heterogeneities in both dose delivery and radiation response into account. This quantity is important for accurate treatment plan optimization using intensity modulated radiation therapy for individual patients. </p>

In this thesis, a model of tissue oxygenation is presented, that takes into account the heterogeneous nature of tumor vasculature. Even though the model is rather simple, the resulting oxygen distributions agree very well with clinically observed oxygen distributions for most tumors and healthy normal tissues. The model shows that the vascular density may not describe the oxygenation of a tissue sufficiently well, unless the heterogeneity of the vascular system is taken into account. Based on the oxygen distributions from the tissue model, the associated radiation response at low and high doses can be determined. The radiation response of heterogeneous tumors should preferably be described by two clonogen compartments, one resistant and one sensitive, dominating the response at high and low radiation doses, respectively. Furthermore, each compartment should be characterized by the effective radiation resistance and the effective clonogen number. The resistant-sensitive model of radiation response has been analyzed in great detail. It accurately describes the response of severely heterogeneous tumors, both at low and high doses and LET values. The effective response parameters are given as integrals, averaged over the whole spectrum of radiation resistance. The parameters can also be determined from clinically established dose-response relations. The main properties of the dose-response relation for a generally heterogeneous tumor is described in some detail. The normalized dose-response gradient has been generalized to take heterogeneities in both dose delivery and radiation response into account. This quantity is important for accurate treatment plan optimization using intensity modulated radiation therapy for individual patients.

Fifty percent of solid cancers are treated with radiation therapy (RT). The dose used in RT is adjusted to the most sensitive individuals so that not more than 5% of the patients will have severe adverse healthy tissue effects. As a consequence, the majority of the patients will receive a suboptimal dose, as they would have tolerated a higher total dose and received a better tumor control. Thus, if RT could be individualized based on radiation sensitivity (RS), more patients would be cured and the most severe adverse reactions could be avoided. At present the mechanisms behind RS are not known. The long term aim of this thesis was to develop diagnostic tools to assess the individual RS of breast cancer patients and to better understand the mechanisms behind the RS and radiation effects after low dose exposures. The approach was based on the hypothesis that biomarkers of individual RS, in terms of acute adverse skin reactions after breast cancer RT, can be found in whole blood that has been stressed by low doses of ionizing radiation (IR).  To reach this goal two different approaches to identify biomarkers of RS have been investigated. A protocol for the analysis of differential protein expression in response to low dose in vitro irradiated whole blood was developed (paper I). This protocol was then used to investigate the proteomic profile of radiation sensitive and normo-sensitive patients, using isotope-coded protein labeled proteomics (ICPL). The results from the ICPL study (paper III) show that the two patient groups have different protein expression profiles both at the basal level and after IR. In paper II the potential biomarker 8-oxo-dG was investigated in serum after IR. The relative levels of IR induced 8-oxo-dG from radiation sensitive patients differ significantly from normo-sensitive patients. This indicates that the sensitive patients differ in their cellular response to IR and that 8-oxo-dG is a potential biomarker for RS. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 3: Manuscript.</p>

Human response to ionising radiation (IR) shows a wide variation. This is most clearly seen in the radiation-response of cells as measured by frequencies of chromosomal aberrations. Different frequencies of IR-induced aberrations can be conveniently observed in phytohaemagglutin-stimulated peripheral blood T-lymphocytes from both normal individuals and sporadic cancer cases, in either metaphase chromosomes or as micronuclei in the following cell cycle. Metaphase cells show frequent chromatid breaks, defined as chromatid discontinuities or terminal deletions, if irradiated in the G 2 -phase of the cell cycle. It has been shown that the frequency of chromatid breaks in cells from approximately 40% of sporadic breast cancer patients, are significantly higher than in groups of normal individuals. This suggests that elevated radiation-induced chromatid break frequency may be linked with susceptibility to breast cancer. It is known that chromatid breaks are initiated by a double strand break (DSB), but it appears that the two are linked only indirectly as repair kinetics for DSBs and chromatid breaks do not match. Therefore, the underlying causes of the wide variation in frequencies of chromatid breaks in irradiated T-lymphocytes from different normal individuals and from sporadic breast cancer cases are still unclear but it is unlikely to be linked directly to DSB rejoining. My research has focused on the mechanism through which chromatid breaks are formed from initial DSBs. The lack of a direct association suggested that a signalling process might be involved, connecting the initial DSB and resulting chromatid break. The signal model, suggested that the initial DSB is located within a chromatin loop that leads to an intra- or interchromatid rearrangement resulting in incomplete mis-joining of chromatin ends during the decatenation of chromatids during G 2 . It was therefore proposed that topoisomerase II alpha (topo IIα) might be involved, mainly because of its ability to incise DNA and its role in sister chromatid decatenation. During my PhD research I have used a strategy of altering topo II activity or expression and studying whether this alters IR-induced chromatid break frequency. The first approach involved cell lines that varied in topo IIα expression. The frequency of IR-induced chromatid breaks was found to correlate positively with topo IIα expression level, as measured in three different cell lines by immunoblotting, i.e. two cell lines with lower topo IIα expression exhibited lower chromatid break frequency. Topo II activity in these three cell lines was also estimated indirectly by the ability of a topo IIα poison to activate the G 2 /M checkpoint, and this related well with topo IIα expression. A second approach involved ‘knocking down’ topo IIα protein expression by silencing RNA (siRNA). Lowered topo IIα expression was confirmed by immunoblotting and polymerase chain reaction. SiRNA-lowered topo IIα expression correlated with a decreased IR-induced chromatid break frequency. In a third series of experiments cells were treated with ICRF-193, a topo IIα catalytic inhibitor. It was shown that inhibition of topo IIα also significantly reduced IR-induced chromatid breaks. I also showed that lowered chromatid break frequency was not due to cells with high chromatid break frequencies being blocked in G 2 as the mitotic index was not altered significantly in cells with lowered topo IIα expression or activity. These experiments show that topo IIα is involved in IR-induced chromatid break formation. The final experiments reported here attempted to show how topo II might be recruited in the process of forming IR-induced chromatid breaks. Hydrogen peroxide was used as a source of reactive oxygen species (reported to poison topo IIα) and it was shown that topo IIα under these conditions is involved in the entanglement of metaphase chromosomes and formation of chromatin ‘dots’ as well as chromatid breaks. Experiments using atomic force microscopy attempted to confirm these dots as excised chromatin loops. The possible role of topo IIα in both radiation- and hydrogen peroxide-induced primary DNA damage was also tested. It was shown that topo IIα does not affect radiation-induced DSBs, even though it does affect chromatid break frequency. Also, topo IIα does not affect hydrogen peroxide-induced DNA damage at low doses. The results support the idea that topo IIα is involved in the conversion of DSBs to chromatid breaks after both irradiation and treatment with hydrogen peroxide at a low concentrations. I have demonstrated that topo IIα is involved in forming IR-induced chromatid breaks, most likely by converting the initial DSBs into chromosomal aberrations as suggested by the signal model.