Page 65 - ARNM-3-1

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
The preventive and protective effects of aspirin

on radiation-induced skin injury

3
1
Zhaoming Zhou 1,2 , Yong Feng *, and Wei Qiao *
1 Department of Radiation Oncology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer
Research and the Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
2 Department of Radiation Medicine, Guangdong Provincial Key Laboratory of Tropical Disease
Research, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
3 Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and The
Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

Abstract
Radiation-induced skin injury (RISI) is a frequent complication of radiotherapy that
can severely hinder treatment and endanger patients’ lives. Current treatments
offer limited efficacy in reducing symptoms. This study explores the protective
effect of aspirin (ASP) on RISI and its underlying mechanisms. As in vivo RISI models,
8 – 12-week-old C57BL/6 mice were irradiated with a single dose of 20 Gy X-rays
to the skin of the right thigh, with sham-irradiated mice serving as controls. ASP
was administered orally for 7 days before irradiation. Skin samples were collected
on day 14 post-irradiation for single-cell RNA sequencing (sc-RNAseq). RISI severity
*Corresponding authors:
Yong Feng was assessed daily using a modified RTOG/EORTC scoring system (scores ranging
(fengyong@njmu.edu.cn) from 1 to 5.5). Our results showed that ASP delayed the onset of RISI and reduced its
Wei Qiao severity. The sc-RNAseq revealed an increased number of interfollicular epidermal
(13914707452@njmu.edu.cn)
cycling (IFE C) cells in irradiated skin, with some cells showing G2M cell cycle arrest.
Citation: Zhou Z, Feng Y, Qiao W. These IFE C cells exhibited elevated expression of stemness markers, indicating their
The preventive and protective
effects of aspirin on radiation- importance in both RISI damage and subsequent repair. The ASP-treated group
induced skin injury. Adv Radiother showed delayed skin injury onset and reduced peak severity compared to untreated
Nucl Med. 2025;3(1):57-70. controls. Furthermore, ASP appeared to promote homologous recombination
doi: 10.36922/arnm.5829 repair of radiation-induced DNA damage, contributing to its protective effect. In
Received: November 9, 2024 conclusion, IFE C cells undergo G2M arrest to repair radiation-induced damage. ASP
Revised: December 9, 2024 shows potential in preventing RISI, possibly through enhancing DNA repair. These
findings suggest a novel therapeutic role for ASP in mitigating RISI.
Accepted: January 3, 2025
Published online: January 27,
2025 Keywords: Radiation-induced skin injury; Single-cell RNA sequencing; Interfollicular
epidermal cells; Aspirin; G2/M cell cycle arrest; DNA repair
Copyright: © 2025 Author(s).
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution, 1. Introduction
and reproduction in any medium,
provided the original work is Radiation-induced skin injury (RISI) is a common complication in patients undergoing
properly cited. radiotherapy, particularly in cancers that involve the skin or adjacent tissues. The
Publisher’s Note: AccScience severity of RISI can range from mild erythema to severe necrosis, posing a significant
Publishing remains neutral with risk to patient well-being and potentially necessitating interruptions in the course of
regard to jurisdictional claims in
published maps and institutional radiotherapy. Such disruptions can compromise the effectiveness of cancer treatment,
1,2
affiliations leading to poorer outcomes for patients . The clinical manifestations of RISI include

Volume 3 Issue 1 (2025) 57 doi: 10.36922/arnm.5829