Regulatory role of growth factors during N-acetylcysteine administration in the model of radiation-induced pancreatic injury
https://doi.org/10.17709/2410-1893-2025-12-4-5
EDN: TOJWTF
Abstract
Purpose of the study. To evaluate the roles of the growth factors IGF‑1, TGF-β, and VEGF-A in regulating delayed regenerative mechanisms induced by N-acetylcysteine (NAC) administered prior to local pancreatic irradiation with electrons at a total dose of 30 Gy.
Materials and methods. An experimental study was conducted on 60 male Wistar rats, which were divided into four groups: Group 1 (control, n = 10): rats received an intraperitoneal injection of NaCl solution without local electron irradiation; Group 2 (n = 20): intraperitoneal administration of 0.9 % NaCl solution prior to local electron irradiation in a fractionated mode with a total focal dose (TFD) of 30 Gy; Group 3 (n = 20): intraperitoneal administration of N-AC at a dose of 120 mg/kg prior to local electron irradiation in a fractionated mode with a TFD of 30 Gy; Group 4 (n = 10): intraperitoneal administration of N-AC at a dose of 120 mg/kg without local electron irradiation. Thirty days after irradiation, blood levels of glucose, insulin, and amylase were measured. Histological analysis of pancreatic islet architecture, the degree of perivascular fibrosis (Masson’s trichrome staining), and the expression of IGF‑1, TGF-β, and VEGF-A were assessed by immunohistochemistry through counting positively stained cells.
Results. Irradiation resulted in elevated blood glucose and amylase levels and decreased insulin levels. Signs of radiation-induced pancreatic injury were accompanied by reduced expression of IGF‑1 and VEGF-A in the islets by 39 % and 56 %, respectively, while the proportion of TGF-β-positive cells exceeded the control values by 3.4‑fold. Pre-irradiation administration of NAC partially preserved biochemical parameters within the normal range, suppressed TGF-β expression, and maintained the numbers of IGF‑1- and VEGF-A-positive endocrine cells at levels 2.5 and 3 times higher than those in the irradiation-only group, respectively.
Conclusion. Pre-irradiation administration of NAC exerts a modulatory effect on the expression of growth factors IGF‑1, TGF-β, and VEGF-A in the late period following local electron irradiation of the pancreas, promoting restoration of the organ’s structural integrity and endocrine function. The obtained data suggest that N-AC is a promising agent for the prevention of delayed post-radiation complications, including fibrosis as well as metabolic and secretory insufficiency of the pancreatic islets.
Keywords
About the Authors
G. A. DemyashkinRussian Federation
Grigory A. Demyashkin – MD, Dr. Sci. (Medicine), pathologist, Head of the Laboratory of Histology and Immunohistochemistry; Head of the Department of Digital Oncomorphology
AuthorID: 645433
Scopus Author ID: 57200415197
WoS ResearcherID: ABD-7650-2021
Moscow
Competing Interests:
the authors declare that there are no obvious and potential conflicts of interest associated with the publication of this article
M. A. Vadyukhin
Russian Federation
Matvey А. Vadyukhin – graduate student of Institute of Translational Medicine and Biotechnology; Researcher of the Department of Digital Oncomorphology
AuthorID: 1150399
Scopus Author ID: 57539187100
MoscowCompeting Interests:
the authors declare that there are no obvious and potential conflicts of interest associated with the publication of this article
V. I. Shchekin
Russian Federation
Vladimir I. Shchekin – graduate student of Institute of Translational Medicine and Biotechnology; Researcher of the Department of Digital Oncomorphology
AuthorID: 1109647
Scopus Author ID: 57222109527
Moscow
Competing Interests:
the authors declare that there are no obvious and potential conflicts of interest associated with the publication of this article
D. V. Belokopytov
Russian Federation
Dmitriy V. Belokopytov – graduate student of Institute of Translational Medicine and Biotechnology; Researcher of the Department of Digital Oncomorphology
Moscow
Competing Interests:
the authors declare that there are no obvious and potential conflicts of interest associated with the publication of this article
References
1. Coleman CN, Buchsbaum JC, Prasanna PGS. Moving Forward in the Next Decade: Radiation Oncology Sciences for Patient-Centered Cancer Care. JNCI Cancer Spectr. 2021;5(4):pkab046. https://doi.org/10.1093/jncics/pkab046
2. Calvo FA, Serrano J, Cambeiro M, et al. Intra-Operative Electron Radiation Therapy: An Update of the Evidence Collected in 40 Years to Search for Models for Electron-FLASH Studies. Cancers (Basel). 2022;14(15):3693. https://doi.org/10.3390/cancers14153693
3. Ronga MG, Cavallone M, Patriarca A, et al. Back to the Future: Very High-Energy Electrons (VHEEs) and Their Potential Application in Radiation Therapy. Cancers (Basel). 2021;13(19):4942. https://doi.org/10.3390/cancers13194942
4. Wydmanski J, Polanowski P, Tukiendorf A, Maslyk B. Radiation-induced injury of the exocrine pancreas after chemoradiotherapy for gastric cancer. Radiother Oncol. 2016;118(3):535-539. https://doi.org/10.1016/j.radonc.2015.11.033
5. You SH, Cho MY, Sohn JH, Lee CG. Pancreatic radiation effect in apoptosis-related rectal radiation toxicity. J Radiat Res. 2018;59(5):529–540. https://doi.org/10.1093/jrr/rry043
6. Baek JY, Lim DH, Oh D, Nam H, Kim JJ, Lee JH, Min BH, Lee H. Increased Risk of Diabetes after Definitive Radiotherapy in Patients with Indolent Gastroduodenal Lymphoma. Cancer Res Treat. 2022;54(1):294–300. https://doi.org/10.4143/crt.2021.073
7. Bacarella N, Ruggiero A, Davis AT, Uberseder B, Davis MA, Bracy DP, et al. Whole Body Irradiation Induces Diabetes and Adipose Insulin Resistance in Nonhuman Primates. Int J Radiat Oncol Biol Phys. 2020;106(4):878-886. https://doi.org/10.1016/j.ijrobp.2019.11.034
8. Singh VK, Seed TM. Pharmacological management of ionizing radiation injuries: current and prospective agents and targeted organ systems. Expert. Opin. Pharmacother. 2020;21(3):317–337. https://doi.org/10.1080/14656566.2019.1702968
9. Campesi I, Brunetti A, Capobianco G, Galistu A, Montella A, Ieri F, Franconi F. Sex Differences in X-ray-Induced Endothelial Damage: Effect of Taurine and N-Acetylcysteine. Antioxidants. 2023;12:77. https://doi.org/10.3390/antiox12010077
10. Topcu A, Mercantepe F, Rakici S, Tumkaya L, Uydu HA, Mercantepe T. An investigation of the effects of N-acetylcysteine on radiotherapy-induced testicular injury in rats. Naunyn Schmiedebergs Arch. Pharmacol. 2019;392(2):147–157. https://doi.org/10.1007/s00210-018-1581-6
11. Mantawy EM, Said RS, Kassem DH, Abdel-Aziz AK, Badr AM. Novel molecular mechanisms underlying the ameliorative effect of N-acetyl-L-cysteine against ϒ-radiation-induced premature ovarian failure in rats. Ecotoxicol Environ Saf. 2020;206:111190. https://doi.org/10.1016/j.ecoenv.2020.111190
12. Ezeriņa D, Takano Y, Hanaoka K, Urano Y, Dick TP. N-Acetyl Cysteine Functions as a Fast-Acting Antioxidant by Triggering Intracellular H2S and Sulfane Sulfur Production. Cell Chem Biol. 2018;25(4):447-459.e4. https://doi.org/10.1016/j.chembiol.2018.01.011
13. Lu Q, Liang Y, Tian S, Jin J, Zhao Y, Fan H. Radiation-Induced Intestinal Injury: Injury Mechanism and Potential Treatment Strategies. Toxics. 2023;11(12):1011. https://doi.org/10.3390/toxics11121011
14. Mercantepe F, Topcu A, Rakici S, Tumkaya L, Yilmaz A. The effects of N-acetylcysteine on radiotherapy-induced small intestinal damage in rats. Exp. Biol. Med. (Maywood). 2019;244(5):372–379. https://doi.org/10.1177/1535370219831225
15. Talasaz AH, Khalili H, Jenab Y, Salarifar M, Broumand MA, Darabi F. N-Acetylcysteine effects on transforming growth factor-β and tumor necrosis factor-α serum levels as pro-fibrotic and inflammatory biomarkers in patients following ST-segment elevation myocardial infarction. Drugs R D. 2013;13(3):199–205. https://doi.org/10.1007/s40268-013-0025-5
16. Wang B, Wang H, Zhang M, Ji R, Wei J, Xin Y, Jiang X. Radiation-induced myocardial fibrosis: Mechanisms underlying its pathogenesis and therapeutic strategies. J Cell Mol Med. 2020;24(14):7717–7729. https://doi.org/10.1111/jcmm.15479
17. Li P, Zhou H, Yang Y, Wu M, Zhao D, Wang L, et al. Dietary supplementation with N-acetylcysteine confers a protective effect on muscle and liver in lipopolysaccharide-challenged piglets. Front Nutr. 2024;11:1458912. https://doi.org/10.3389/fnut.2024.1458912
18. Sahasrabudhe SA, Terluk MR, Kartha RV. N-acetylcysteine Pharmacology and Applications in Rare Diseases-Repurposing an Old Antioxidant. Antioxidants (Basel). 2023;12(7):1316. https://doi.org/10.3390/antiox12071316
19. Barlaz Us S, Vezir O, Yildirim M, Bayrak G, Yalin S, Balli E, et al. Protective effect of N-acetyl cysteine against radiotherapy-induced cardiac damage. Int J Radiat Biol. 2020;96(5):661–670. https://doi.org/10.1080/09553002.2020.1721605
20. Kusakabe J, Anderson B, Liu J, Williams GA, Chapman WC, Doyle MMB, et al. Long-Term Endocrine and Exocrine Insufficiency After Pancreatectomy. J Gastrointest Surg. 2019;23(8):1604–1613. https://doi.org/10.1007/s11605-018-04084-x
21. Shiba S, Miyasaka Y, Okamoto M, Komatsu S, Okazaki S, Shibuya K, Ohno T. Deterioration of pancreatic exocrine function in carbon ion radiotherapy for pancreatic cancer. Clin Transl Radiat Oncol. 2021;31:80–85. https://doi.org/10.1016/j.ctro.2021.09.007
22. Hall EJ, Giaccia AJ. Radiobiology for the Radiologist. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008.
23. Demyashkin G, Vadyukhin M, Shchekin V, Borovaya T, Zavialova O, Belokopytov D, et al. New Cellular Interactions Due to the Radioprotective Effect of N-Acetylcysteine in a Model of Radiation-Induced Pancreatitis. Int J Mol Sci. 2025;26(11):5238. https://doi.org/10.3390/ijms26115238
24. Frangogiannis N. Transforming growth factor-β in tissue fibrosis. J Exp Med. 2020;217(3):e20190103. https://doi.org/10.1084/jem.20190103
25. Zhang Q, Ye W, Liu Y, Niu D, Zhao X, Li G, et al. S-allylmercapto-N-acetylcysteine ameliorates pulmonary fibrosis in mice via Nrf2 pathway activation and NF-κB, TGF-β1/Smad2/3 pathway suppression. Biomed Pharmacother. 2023;157:114018. https://doi.org/10.1016/j.biopha.2022.114018
26. Sisto M, Ribatti D, Lisi S. Organ Fibrosis and Autoimmunity: The Role of Inflammation in TGFβ-Dependent EMT. Biomolecules. 2021;11(2):310. https://doi.org/10.3390/biom11020310
27. Bignold R, Johnson JR. Effects of cytokine signaling inhibition on inflammation-driven tissue remodeling. Curr Res Pharmacol Drug Discov. 2021;2:100023. https://doi.org/10.1016/j.crphar.2021.100023
28. Yu XY, Sun Q, Zhang YM, Zou L, Zhao YY. TGF-β/Smad Signaling Pathway in Tubulointerstitial Fibrosis. Front Pharmacol. 2022;13:860588. https://doi.org/10.3389/fphar.2022.860588
29. Kim DS, Song L, Gou W, Kim J, Liu B, Wei H, et al. GRP94 is an IGF-1R chaperone and regulates beta cell death in diabetes. Cell Death Dis. 2024;15(5):374. https://doi.org/10.1038/s41419-024-06754-y
30. Friedman DN, Moskowitz CS, Hilden P, Howell RM, Weathers RE, Smith SA, et al. Radiation Dose and Volume to the Pancreas and Subsequent Risk of Diabetes Mellitus: A Report from the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2020;112(5):525–532. https://doi.org/10.1093/jnci/djz152
31. Aggarwal M, Jayapal N, Mittal D, et al. Risk and mechanism of metabolic syndrome associated with radiation exposure. Radiation Medicine and Protection. 2023;4(2):100048. https://doi.org/10.1016/j.radmp.2023.05.001
32. Tóthová Z, Šemeláková M, Solárová Z, Tomc J, Debeljak N, Solár P. The Role of PI3K/AKT and MAPK Signaling Pathways in Erythropoietin Signalization. Int J Mol Sci. 2021;22(14):7682. https://doi.org/10.3390/ijms22147682
33. Handayaningsih AE, Iguchi G, Fukuoka H, Nishizawa H, Takahashi M, Yamamoto M, et al. Reactive oxygen species play an essential role in IGF-I signaling and IGF-I-induced myocyte hypertrophy in C2C12 myocytes. Endocrinology. 2011;152(3):912–921. https://doi.org/10.1210/en.2010-0981
34. Wiszniak S, Schwarz Q. Exploring the Intracrine Functions of VEGF-A. Biomolecules. 2021;11(1):128. https://doi.org/10.3390/biom11010128
35. Han Z, Dong Y, Lu J, Yang F, Zheng Y, Yang H. Role of hypoxia in inhibiting dendritic cells by VEGF signaling in tumor microenvironments: mechanism and application. Am J Cancer Res. 2021;11(8):3777–3793.
36. Han C, Barakat M, DiPietro LA. Angiogenesis in Wound Repair: Too Much of a Good Thing? Cold Spring Harb Perspect Biol. 2022;14(10):a041225. https://doi.org/10.1101/cshperspect.a041225
37. Bakleh MZ, Al Haj Zen A. The Distinct Role of HIF-1α and HIF-2α in Hypoxia and Angiogenesis. Cells. 2025;14(9):673. https://doi.org/10.3390/cells14090673
Review
For citations:
Demyashkin G.A., Vadyukhin M.A., Shchekin V.I., Belokopytov D.V. Regulatory role of growth factors during N-acetylcysteine administration in the model of radiation-induced pancreatic injury. Research and Practical Medicine Journal. 2025;12(4):56-67. (In Russ.) https://doi.org/10.17709/2410-1893-2025-12-4-5. EDN: TOJWTF


















