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Delineating the Effects of Ionizing Radiation on Erythropoietic Lineage—Implications for Radiation Biodosimetry

Nimker, Shwetanjali1,2; Sharma, Kanupriya1; Saraswathy, Radha2; Chandna, Sudhir1

doi: 10.1097/HP.0000000000000975

The overall lethality/morbidity of ionizing radiation exposure involves multiple forms of inhibitory or cytotoxic effects that may manifest in different tissues with a varying dose and time response. One of the major systemic effects leading to lethality of radiation includes its suppressive effect on hematopoiesis, which could be observed even at doses as low as 1–2 Gy, whereas effects on gastrointestinal and nervous systems appear at relatively higher doses in the same order. This article reviews the effects of radiation on the three distinct stages of erythropoiesis—formation of erythroid progenitor cells, differentiation of erythroid precursor cells, and terminal maturation. During these stepwise developmental processes, erythroid progenitor cells undergo rapid expansion to form terminally differentiated red blood cells that are continuously replenished from bone marrow into the circulating peripheral blood stream. Cellular radiation response depends upon many factors such as cell lineage, rate of proliferation, and differentiation status. Therefore, we discuss radiation-induced alterations during the progenitor, precursor, and terminal maturation stages and the implications thereof. Since biomarkers of ionizing radiation exposure in human populations are of great interest for assessing normal tissue injury as well as for biodosimetry in the event of accidental or incidental radiation exposures, we also highlight blood-based biomarkers that have potential utility for medical management.

1Division of Natural Radiation Response Mechanisms, Institute of Nuclear Medicine and Allied Sciences, Timarpur, Delhi, India;

2School of Biosciences and Technology, Vellore Institiute of Technology, Vellore, Tamil Nadu, India.

The authors declare no conflicts of interest.

For correspondence contact Sudhir Chandna, Division of Natural Radiation Response Mechanisms, Institute of Nuclear Medicine and Allied Sciences, Brig. SK Mazumdar Road, Delhi-110054, India, or email at or

(Manuscript accepted 8 August 2018)

© 2019 by the Health Physics Society