Citation

Jackson IL, Doyle-Eisele M. Disaster Med. Public Health Prep. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Society for Disaster Medicine and Public Health, Publisher Cambridge University Press)

DOI

10.1017/dmp.2023.180

PMID

37937347

Abstract

Development of medical countermeasures (MCM) to mitigate and/or treat the pulmonary complications associated with exposure to chemical, radiological, and/or nuclear weapons is a United States (U.S.) national public health preparedness posture priority. Pulmonary exposure to either sulfur mustard vapor or radiation causes oxidative damage, vascular injury, hyperinflammation, and pro-fibrotic signaling cascades that lead to life-threatening and potentially debilitating lung disease. There is no MCM currently approved by the U.S. Food and Drug Administration (FDA) to mitigate and/or treat lung injury caused by sulfur mustard or radiation exposure. Thus, there remains a major unmet public health need for development of threat-agnostic, host-directed therapeutics that target common pathophysiological mechanisms underlying the progression of acute and/or late lung injury independent of the etiology of disease. This review describes the clinical manifestations and underlying mechanisms of sulfur mustard and radiation-induced lung injury and regulatory considerations for MCM development under the non-traditional Animal Rule pathway.

Language: en

Keywords

acute lung injury; fibrosis; medical countermeasures; Radiation; sulfur mustard