Lung tissue is one of the most sensitive organs to ionizing radiation. The main side effects of lung exposure to radiation include acute inflammation (pneumonitis) and late fibrosis, which may appear months to years following exposure (
1). These side effects may pose a threat to the lives of patients who had undergone radiotherapy for chest cancer as well as for people who have been exposed to an accidental nuclear or radiological event (
2,
3). In recent years, several studies have been conducted to develop effective agents for better amelioration of radiation injury (
4-
6). Amifostine is an FDA-approved radioprotector for the management of xerostomia in patients with head and neck cancer (
7). However, its radioprotective effect is limited to some organs (
8). In addition, its high toxicity is the main limiting factor for clinical applications. Some studies reported termination of the radiotherapy procedure, resulting from high toxicity of amifostine (
9). In this situation, amifostine treatment may lead to the reduction of therapeutic outcome due to the repopulation of tumor cells (
10). Hence, for effective alleviation of the complications to normal tissues, it is necessary to develop low toxic agents with suitable radioprotective effects (
11). It is also important that these agents do not interfere with the eradication of cancer cells by ionizing radiation (
12).
Knowledge of the mechanisms involved in radiation-induced lung injury can aid the development of new compounds for better radioprotection of injured organs (
13,
14). Studies have proposed that mechanisms of radiation injury can be various in different organs. Emerging evidence from published studies have shown that there is an important interrelationship between inflammatory responses and reduction/oxidation (redox) interactions, which mediate radiation toxicity in several organs (
15,
16). However, signaling pathways for these interactions may be different. It has been confirmed that an increased level of both inflammatory and fibrotic cytokines such as IL-1, IL-2, IL-6, IL-8, IL-4, IL-13, IL-33, TNF-α, TGF-β, and IFN-γ are involved in the late effects of lung injury by ionizing radiation (
17). On the other hand, it is well-known that these cytokines, through upregulation of genes involved in the redox system such as NADPH oxidase, COX-2, iNOS, lipoxygenases, and mitochondria, stimulate continuous production of free radicals, including both reactive oxygen species (ROS) and reactive nitrogen species (RNS) (
18-
22). So far, studies have confirmed the role of some of these genes, such as NADPH oxidase 1 (NOX1), NOX4, COX-2, iNOS, and mitochondria, in radiation lung injury (
23). However, the roles of some others, such as dual oxidases (Duox1 and Duox2), remain to be elucidated.
With regards to the above-mentioned points, it is important to target both inflammatory and fibrotic processes, as well as oxidative injury, for effective protection of the lung against ionizing radiation. Curcumin is a potent modulator of immune responses that can alleviate both inflammation and fibrosis (
24). On the other hand, L-selenomethionine is a potent antioxidant that has been shown to be more effective for the amelioration of radiation-induced DNA damage (
25).