Patent Application: US-58198009-A

Abstract:
the invention refers to a specific isoform of mnsod and its uses for protecting and curing subjects exposed to radiations , specifically space radiations .

Description:
the author of the instant invention have shown that a new active recombinant human mnsod ( rmnsod ; disclosed in mancini et al . int j . cancer 119 ; 932 - 943 , 2006 and in wo03 / 072768 ), easily administrable in vivo , exerts the same radioprotective effect on the normal cells and organisms as any mnsod , and it is also radio - sensitizing for tumour cells ( borrelli a ., et al . free radic biol med . 2009 46 : 110 - 6 ). rmnsod has the following aa . sequence ( swiss prot . acc . no p04179 ; seq id no . 1 ): no data are available on the protective effect on radiations present in the atmosphere and more general in the space , as ionizing and protonizing radiations . authors here show how healthy animals , exposed to lethal dose of ionizing and protonizing radiations and daily injected with rmnsod , resulted protected by radio - damages and were still alive 30 days after the irradiation . animals treated with only pbs solution , while in the absence of rmnsod , died after 7 - 8 days from the radio - treatments . the molecular analysis of all irradiated tissues revealed that the anti - apoptotic aven gene ( uniprotkb / swiss - prot : aven_human , q9nqs1 ) is activated only in the animals treated in the presence of rmnsod . the data suggest that rmnsod deserves to be considered as a pharmaceutical tool to make radiotherapy more selective on cancer cells and to prevent and / or cure the accidental damages derived by the exposure to ionizing and protonizing radiations . authors show the radio - protective role of a specific isoform of a human recombinant protein ( rmnsod ) which possesses the specific sod antioxidative and antiradical activity and which can be easily administrated in vivo through the systemic pathway , reaching and penetrating into the cells , without require any additional manipulation ( 9 , 10 ). rmnsod effects were studied in vitro , on irradiated normal and cancer cells , and in vivo , on normal c57bl / 6j mice exposed to lethal doses of ionizing radiations . the results demonstrated that rmnsod exerts a radio - protective effect on normal cells ( in vitro ) and on normal tissues ( in vivo ) while it is radiosensitizing for cancer cells ( in vitro ). moreover , while the animals treated in the absence of rmnsod would survive no longer than 6 - 7 days after radiations , those treated with rmnsod survived for a much longer period up to 30 days considered as the experimental time point . therefore it is an object of the instant invention a method for protecting a subject from exposure to radiations comprising the administration of an effective protective amount of rmnsod of seq id no . 1 , or functional fragments thereof . preferably the rmnsod is administered in an amount from 0 . 08 g / kg body weight to 0 . 1 g / kg body weight for at least 30 days before the exposure to radiations . in another preferred embodiment said radiations are from anti - tumoral metabolic therapies administration of radioactive isotopes or radiating therapies . such application is particularly useful for protecting the kidney parenchyma of subjects treated with radio - isotopes and for protecting from skin burns and ulcers . in another preferred embodiment said radiations from radioactive isotopes for radio - diagnostics . in another preferred embodiment said radiations are ionizing and / or protonizing radiations . it is another object of the invention a method for treating a subject exposed to radiations comprising the administration of an effective therapeutically active amount of rmnsod of seq id no . 1 . or functional fragments thereof . preferably the rmnsod is administered in an amount from 0 . 08 g / kg body weight to 0 . 1 g / kg body weight for at least 30 days after the exposure to radiations . in another preferred embodiment said radiations are ionizing and / or protonizing radiations . fig1 the cell strains were treated in the presence of rmnsod ( 0 - 1 . 5 μm ). 1 days after irradiation , the cells were detached with trypsin - edta , and plated at a concentration of 200 cells / dishes in drug - free medium . fourteen days later the colonies were fixed and counted by using a crystal violet staining to evaluate the number of colonies present in the dishes . fig2 on the mrc - 5 normal cells the sole irradiation induces a dose - dependent radiodamage that with 3 gy of x - rays leads to the death of cells ( rad ). the same radio - treatment , in the presence of 0 . 5 μm rmnsod , results in a significant radioprotection and survival of cells ( rad + sod ). fig3 on the mcf - 7 , the sole radiation with 3 gy of x - rays ( rad ) led to the death of the cells after 14 days , whereas the same cells are killed when they are irradiated with 2 gy and in the presence of 0 . 5 μm rmnsod ( rad + sod ). fig4 on the lsa cells , the sole irradiation with 6 gy of x - rays ( rad ) do not effect the cell survival of lsa cells ( rad ). on the contrary , when the lsa cells are irradiated with only 3 gy , in the presence of 0 . 5 μm rmnsod , the cells are killed ( rad + sod ). fig5 ( a - r ) histologic sections of organs of normal mice underwent to a lethal dose of ionizing radiations , treated in the presence or in the absence of rmnsod heart : the histological examination revealed that in the heart of mice which didn &# 39 ; t receive the rmnsod , were present intensive areas of miofibrillolisis and a hydropic degeneration ( a ), × 250 , and the absence of endogenous expression of rmnsod at the immunochemical evaluation ( b )× 250 . on the contrary , in the hearts of animals treated in presence of rmnsod , the tissue integrity was clear ( c )× 250 , and rmnsod was strongly represented in the interstitial space , at immunochemical detection ( d )× 250 cervix uteri : the histological examination revealed that in the cervix uteri of mice which didn &# 39 ; t receive the rmnsod , were present intensive areas of structural discontinuity ( e )× 250 , and the absence of endogenous expression of rmnsod at the immunochemical evaluation ( f )× 250 . on the contrary , in the cervix uteri of mice treated in presence of rmnsod , the tissue integrity was clear ( g )× 250 , and was also evident the presence of rmnsod in the cytoplasm and in the interstitial space , at immunochemical detection ( h )× 250 liver : the lobulo - laminar structure resulted preserved both in the control ( i ) and in the treated section ( l ). the positive immunochemical reaction has been evident either in the sinusoid that in the hepatocytes cells , particularly it is evident the positivity of the membrane , ( m ) with high increasing in the treated animals ( n )× 250 . kidney : the histological examination revealed that in the kidney of mice which didn &# 39 ; t receive the rmnsod , showed a glomerular coarctation and tubular degeneration ( o )× 250 , and the absence of endogenous expression of rmnsod at the immunochemical evaluation ( p )× 250 ., while the animal &# 39 ; s kidneys treated in presence of rmnsod , a total integrity of the structures ( q )× 250 , with an ubiquitous presence of rmnsod in the interstitial space , at immunochemical detection ( r )× 250 . the quantitative evaluations of immunochemical reaction were obtained by using an imaging analyzer leica50 . fig6 aven expression in irradiated mice in the presence or in the absence of rmnsod . the figure showed the amplified fragments of aven gene ( 352 bp ) in the different experimental groups . three groups of inbreed c57bi 6 mice were used in pcr experiments . the first group was of untreated control animals ; the second group received high lethal dose of ionizing radiations and at the third group was treated before irradiation 0 . 08 mg / kg / die , for 15 days of in the presence of recombinant rmnsod . the actin transcripts ( 500 bp ) was shown as control of cdna quantity ( inferior line ). fig7 target cells , in three independent experiments , were exposed to radiations by a proton beams having an energy of 62 mev with a dose of 6 gy . on the normal cells ( mrc - 5 ) the killing effect of the sole radiations resulted of 67 % of the cell death , but when the same cells were irradiated in the presence of rmnsod , 86 . 9 % of them survived to radio - treatment . on tumor cells , the sole proton beams produced a killing effect of 34 % for mcf - 7 cells and 29 % for lsa cells . on the contrary , when these tumor cells were irradiated in the presence of rmnsod the killing effect was of 96 % for mcf - 7 cells and 56 % for lsa cells . rmnsod was obtained as previously described ( 9 ), while its enzymatic activity evaluated according to mccord and fridovich ( 11 ). commercial cu / zn - sod was from sigma . the cell lines investigated here ( mcf - 7 , mrc - 5 ) are described and available from attc ( mcf - 7 : cat . n ° htb - 22 ™; mrc - 5 : ca . n ° ccl - 171 ™). cells were grown in dulbecco &# 39 ; s modified eagle &# 39 ; s medium supplemented with 5 % of fetal bovine serum ( fcs ) at 37 ° c . in a humidified atmosphere containing 5 % of co 2 . the culture medium was replaced every 3 - 4 days . the liposarcoma - derived cell line ( lsa ) was obtained and cultured as previously described ( 12 ; wo03 / 072768 ; dsmz n . 2029 ). clonogenic tests on cells following x - rays treatment in the presence or in the absence of rmnsod confluent 75 cm2 flasks of cells were trypsinized , counted with a haemocytometer and diluted in complete media to obtain 100 cells ml . two ml of cell suspension was plated in each well of a 6 well tissue culture plate to obtain 200 cells per well . for each cell line used in the present experiments were performed , in triplicate , clonogenic tests on four different cells groups : a : ctrl as cells cultured in their specific medium and considered as negative control b : sod as cells treated in the presence of the sole rmnsod to determine the effect of rmnsod on clonogenic survival . the cells were treated with different concentration of rmnsod ( 0 - 1 . 5 μm ), trypsinized after 24 h and plated in drug - free medium . c : rad as cells irradiated in the absence of rmnsod to determine the effect of radiation on clonogenic survival . the cells were irradiated ( 0 - 6 gy ) with x photons generated by a linear accelerator philips sl 75 having nominal acceleration potential of 6 mv , and with 42 , 127 u / monitor and a dose - rate of 300 cgy / min . d : rad + sod as cells irradiated in the presence of rmnsod to determine the effect of combination treatment on clonogenic survival . in the clonogenic tests to evaluate the effect of the sole rmnsod on the normal or tumoural cells , it was noted that the concentration of 0 . 5 μm of rmnsod is the concentration of which were not observed any harmful effects on the cell lines used . so to test the radiosensitizing or radioprotective effect of rmnsod was chosen precisely the concentration of 0 . 5 μm . the cells were treated with 0 . 5 μm rmnsod for 24 h , irradiated and plated after 1 h . colonies were stained with crystal violet after 14 days and those containing at last 30 cells were counted as surviving colonies . the plating efficiency and the survival fraction , for each cell line after each treatment , were calculated according to the method proposed by franken ( 13 ) averaged approximately 80 % for all cell lines . survival was calculated in comparison to non - irradiated samples using an average of three determinations for the same dose - rate to cells (± se ). the surviving fraction of cells following the above mentioned dose of x - rays exposure , was used as a measure of cell sensitivity to x - rays and radioprotection of rmnsod . in particular , the surviving fraction at a fixed x - rays exposure was used as a measure of cell sensitivity as several reports indicate that the clonogenic survival of cells at a fixed dose ( usually 2 gy of ionizing radiation ) is a single parameter of the survival curve that correlates well with cell sensitivity ( 14 - 18 ). the surviving fraction of cells following 0 to 6 gy / min was able to discriminate between the radio - sensitivity of normal and cancer cells ( 19 , 20 ). average values with standard deviation were determined from 3 independent experiments using different rmnsod preparations . thirty - five female c57bl / 6j mice , from charles river , were used for all experimental procedures . fifteen of them were divided into three groups of five animals each . the first ( 1st ) group was exposed to a lethal dose of ionizing radiations , achieved by using x - ray generated by a linac ( philips sl 75 ) with a nominal potential of 6 mv and a dose - rate of 300 u . m ./ min . the mice were put in a dedicated phantom ( 21 × 30 × 35 cm3 ) and were irradiated with an isocentric technique . the prescription dose to mice ( 6 gy ) was delivered with two opposing fields ( 30 × 25 cm2 ), at source - phantom distance of 89 . 5 cm and depth of 10 . 5 cm . it was estimated , for each mouse , a minimum dose ( at skin ) of 5 gy and a maximum dose ( at mouse mid - line ) of 6 . 3 gy . immediately after the radio - treatments , mice of 1st group were treated in the presence of 0 . 08 mg / kg rmnsod in 100 μl pbs while the 2nd group received a daily injection of pbs . the 3rd group of animals did not receive the irradiation but was injected in the presence of 100 μl pbs . all animals were maintained in the standard feeding condition and with a cycle of dark and light . seven days later the mice were sacrificed through cervical dislocation and their organs were examined in search of structural modifications and for the detection of the rmnsod by immunochemical analysis . the other twenty animals were divided into four groups of five each . the first group received irradiation only , the second group received irradiation plus rmnsod , the third group received rmnsod only and the fourth group received only pbs . the animals were used to evaluate their survival after being exposed to ionizing radiation , in the presence or in the absence of rmnsod . the observation of animals continued until 30 days that was considered as the experimental time point . 50 mg of tissue derived from liver , kidney , ovary and heart of experimental c57bi / 6 mice exposed to ionizing radiations was used for total rna extraction ( rnazol , invitrogen ) ( 21 ) according to the manufacturer &# 39 ; s instructions and the integrity of all tested total rna was verified by agarose gel electrophoresis . reverse transcription : 2 μg of total rna in a final volume of 20 μl was reverse - transcribed by avian myeloblastosis virus ( amv ) reverse transcriptase ( gibco brl - invitrogen ) according to manufacturer &# 39 ; s instruction in presence of random examer primers at 37 ° c . per 60 min . pcr analysis of aven gene expression was performed by using a gene amp pcr system 9700 ( applied biosystem ) with taq gold ( applera ) and mouse sequence - specific primers . actin was used as housekeeping control gene . the primer used were : the pcr condition was : initial denaturation at 95 ° per 10 min followed by 36 cycles : 95 °, 45 ″; 58 °, 45 ″ and 72 ° 45 ″ with a final extension at 72 ° per 10 min . the amplification products were run on 1 % agarose gel in 0 . 5 × tbe ( tris borate edta ) buffer for the control of the amplicons length . light microscopy and immunochemical determinations were performed according to the methods previously described ( 9 ). the quantitative evaluation of the immunochemical determinations was obtained by using an imaging analyzer leica q50 . data obtained from the clonogenic tests on all cell lines ( mcf - 7 , mrc - 5 , lsa ) in two different condition : irradiated in absence ( rad ) and in the presence of rmnsod ( rad + sod ), were statistically analysed by using the linear - quadratic ( lq ) formulation e -( αd + βd2 ) as model of biological response to radiation . clonogenic assay of cells irradiated in the presence or in the absence of rmnsod the biological effect of the sole rmnsod on mrc - 5 cells produces only a low inhibition of their growth rate , suggesting that rmnsod at 0 . 5 or 1 . 5 μm is poorly toxic for normal cells . ( fig1 ), while the exposure to ionizing radiations of mrc - 5 cells , in the absence of rmnsod resulted in the 90 % of cell death . on the contrary , 80 % of these cells , irradiated in the presence of rmnsod , survived to radio - treatment and 14 days later , many colonies were counted ( fig2 ). in the test performed on mcf - 7 cells , to kill all cancer cells with the sole rmnsod , was enough a dose of 1 . 5 μm ( fig1 ), and with the sole radiations , the killing effect was obtained with 5 gy . ( fig3 ). the same result was reached by irradiating the cells in the presence of 0 . 5 μm and 3 gy of x - rays ( fig3 ). on the lsa cells was not found any damage when the cells were treated with the sole protein ( fig1 ) or with the sole radiations ( fig4 ), but a rapid mortality of lsa cells was observed when the cells were irradiated with a dose of 3 gy and in the presence of 0 . 5 μm rmnsod ( fig4 ). the statistical analysis of the clonogenic tests on the cell lines underwent to irradiation in the presence or in the absence of rmnsod by using the linearquadratic ( lq ) formulation e −( αd + βd 2 ) as model of biological response to radiation , was significant and allowed the determination of the α / β ratio for all treated cells lines . by these data it is possible to observe that rmnsod exerts a radiosensitizing effect on the mcf - 7 and lsa cells , while for the mrc - 5 cell line the rmnsod provides a radio - resistance ( α / β radsod & lt ; α / β rad ) ( table ii ). table ii r 2 α β α / β mcf - 7 cells rad 0 . 969 − 0 . 33 ± 0 . 18 0 . 21 ± 0 . 07 − 1 . 5 ± 0 . 9 rad + rmnsod 0 . 999 − 0 . 13 ± 0 . 11 071 ± 0 . 10 0 . 2 ± 0 . 2 mrc - 5 cells rad 0 . 985 − 0 . 19 ± 0 . 11 0 . 19 ± 0 . 04 − 1 . 0 ± 0 . 6 rad + rmnsod 0 . 536 − 0 . 03 ± 0 . 007 0 . 0011 ± 0 . 0011 − 3 ± 7 lsa cells rad 0 . 709 − 0 . 014 ± 0 . 006 0 . 0016 ± 0 . 0010 − 9 ± − 7 rad + rmnsod 0 . 993 − 0 . 18 ± 0 . 08 − 0 . 21 ± 0 . 03 − 0 . 8 ± 0 . 4 after radio - treatment each animal of the test group ( 3rd ), received an intraperitoneal injection ( i . p ) of rmnsod ( 0 . 08 mg / kg ), and the injections continued for 6 additional days . the control group ( 2nd ) received only an equal volume of pbs i . p . at the histological analysis , the selected organs ( heart , cervix uterus , liver and kidneys ) of animals treated in the presence of rmnsod , did not show signs of radio - damages . the presence of rmnsod in the animal &# 39 ; s tissues exposed to radio - treatments was detected and quantified , by immunochemical analysis , using an imaging analyzer leica q50 . the presence of rmnsod was only observed in the interstitial spaces of the animal &# 39 ; s tissues who underwent radiotreatment in the presence of rmnsod . on the contrary , the control mice , which did not receive rmnsod injections , showed clear signs of radio - necrosis , and their tissues were found free of rmnsod in the interstitial space ( fig5 a - r ). moreover , in parallel experiments , 80 % of animals irradiated and daily treated in the presence of rmnsod , ( 0 . 08 mg / kg ) were still alive after 30 days from the radio - treatment , considered as the time point of experiment , while the control group irradiated in the absence of rmnsod died after 6 - 7 days from the radiotreatment ( table i ). the quantitative analysis of the immunochemical localization of rmnsod in the animal &# 39 ; s tissue irradiated in the presence or in the absence of rmnsod was correlated to its radioprotective effect . the differences in radioprotection on animals between rmnsod and mock - treated groups of mice were assessed using the fisher &# 39 ; s exact test ( p & lt ; 0 . 02 ). table i % positive % positive statistic stromal parenchimal evaluation cells cells on 50 areas heart control 2 % 3 % p & gt ; 0 . 001 treated 25 % 30 % kidney control 6 % 10 % p & gt ; 0 . 005 treated 6 % 40 % liver control 6 % 10 % p & gt ; 0 . 001 treated 60 % 80 % cervix control 1 % 2 % p & gt ; 0 . 001 utery treated 60 % 40 % aven expression in irradiated mice in presence o in the absence of rmnsod the aven anti - apoptotic gene was found constitutively activated in the healthy animals who did not receive any kind of treatments . in the group of animals who underwent to lethal doses of x - rays , in the absence of rmnsod , the aven gene was found completely switched off and their organs structurally degenerated . on the contrary , at the 7th day of treatment the aven gene expression was decreased in the animal &# 39 ; s organs who were treated with rmnsod , following the lethal dose of x - rays . however after 14 days from irradiation , the gene resulted fully active , indicating that the radio - damage was recovered ( fig6 ). the data presented show that rmnsod , a specific human recombinant isoform of manganese superoxide dismutase liposarcoma derived , produces a radio - protective effect on normal cells while it is radio - sensitizing for cancer cells , both in vitro and in vivo . in particular , we have observed that the exposure to ionizing irradiation of human normal fibroblasts ( mrc - 5 cell line ) with different doses of x - rays , have point out that the radio - damages were dose dependent ( as expected ) and that the 3 gy of x - rays could be sufficient to kill cells after 14 days from irradiation . the same cells , grown in the presence of the sole rmnsod , at a growing concentrations , until the maximal dose of 1 . 5 μm / 100 μl pbs , did not influence negatively on the cell growth in the clonogenic test . on the contrary , when the same cells were exposed to lethal dose ( 6 gy ) of x - rays and in the presence of 0 . 5 μm / 100 μl pbs rmnsod , the cells were clearly protected from radio - damage . on the tumor cells the effect of rmnsod was radio - sensitizing . indeed , while for the mcf - 7 cells , the killing effect with the sole radiation was reached with 4 gy , or with the sole rmnsod with 0 . 5 μm / 100 μl pbs . the same significant killing effect was obtained by the exposure of these cells with only 2 gy of ionizing radiations , and in the presence of only 0 . 5 μm / 100 μl pbs . also in the case of liposarcoma , the same radio - sensitizing effect of rmnsod was observed , although with some difference that reflects the characteristic radioresistance of liposarcoma . on these cells the sole lethal dose ( 6 gy ) of x - rays or the sole maximal dose of rmnsod , i . e . 1 . 5 μm / 100 μl pbs , not have the slightest impact on the cell growth and therefore their survival . on the contrary , when the lsa cells were irradiated with only 3 gy of x - rays and in the presence of 0 . 5 μm / 100 μl pbs rmnsod , a significant killing effect was registered , thereby indicating that the protein has a clear radio - sensitizing role on the cancer cells tested . although have been used only two cancer cell lines , the fact that ionizing radiations produce free radicals in all the cells , suggests that the rmnsod could be useful to amplify the radio - damage effect for all kind of cancers . moreover , the convinction that it is precisely the rmnsod to provide radioprotection or radio - sensitizing , derives by the observations that when it was used a commercial sod or a thermal inactivated rmnsod both the effects were not highlighted . both the observed effect , respectively , on the normal and tumoural cells could have a common molecular base which was previously discussed ( 9 , 10 ). briefly , it is being linked to the fact that in cancer cells , unlike normal cells , are produced limited amounts of catalase ( 22 , 23 ) which converts hydrogen peroxide into molecular oxygen . since ionizing radiations , as indeed any other anticancer molecule , induce the production of high levels of free radicals both in normal cells and in cancer cells , the threshold of toxicity will be achieved more easily in cancer cells than in normal ones and thus leading tumor cells to apoptosis ( 10 ). the presence of rmnsod in the irradiated cells might create an oxidative difference that leads to preferential inhibition of cell proliferation and increases cell death in cancer cells . such mechanism seems to be very promising since it could foresee a therapeutic use of rmnsod to amplify the effect of anticancer radiotherapies , especially in the case of radio - resistant tumours like liposarcoma and , at the same time , to reduce their dose - rate . further the study was extended to investigate if the radioprotective effect of rmnsod is obtained also when the cells are exposed to proton beams , in the presence or in the absence of the rmnsod . thus normal ( mrc - 5 ) and tumoral ( mcf - 7 and lsa ) cells were exposed to 62 mev equivalent from proton beams . the results clearly indicated that the rmnsod provide the same selective effect also in the case of proton beams ( fig7 ). such protection is of relevance as protective and therapeutic means of subjects exposed to space radiations . radio - protective and radio - sensitizing effects of mnsod have already been reported by using molecular medicine and gene - therapy methods ( 24 - 28 ). however prior art cases require methods necessitating the manipulation of the mnsod , to get the molecule into the cells . in the case of the rmnsod used in the instant invention , the protein is easily administrable in vivo , and does not require any prior manipulation . this is an undoubted advantage for therapeutic applications . the radio - protective effect of rmnsod was also studied in vivo . animals exposed to lethal doses of x - rays and daily injected with 0 . 08 mg / kg rmnsod resulted protected by the damages generated by ionizing radiations . the animal &# 39 ; s organs irradiated in the presence of rmnsod showed an high and statistically significant concentration of rmnsod at the interstitial spaces level that was absolutely absent in the animals who did not receive the rmnsod treatment following the ionizing radiation . moreover , in all of animals which did not receive the rmnsod , the organs resulted completely degenerated , leading to animals death after only 7 - 8 days from the radio - treatments . on the contrary , animals who received the rmnsod treatment were still alive 30 days after the radiation . also in these cases , the thermally inactivated rmnsod or the commercially available sod ( sigma ) used as control , did not show the same radio - protection effect or survival rate . these data suggest that rmnsod might protect the mitochondria thus contributing to maintain their integrity . this hypotheses , is indeed strongly supported by the results obtained by molecular analysis of the expression of the anti - apoptotic aven gene in all the examined animal &# 39 ; s tissues . the aven gene was actively expressed in control animals that had not undergone radiating treatment , while it appeared completely switched off in those animals irradiated in the absence of rmnsod . in the animals irradiated in the presence of rmnsod , the aven gene was partially inactivated up to the 7th day after the irradiation . however , after 14 days , the aven gene turned to be fully active , suggesting that the damaged tissues were completely restored , and that rmnsod provided protection of the normal cells by inhibiting the apoptotic pathway , and it is appropriate to point out that these data also agree with that one observed in vitro , on normal fibroblasts . the product of the aven gene binds the cytochrome - c released by the injuried mitochondria during apoptosis . a high amount of cytochrome - c inactivates the aven gene facilitating the caspases activation , which in turn will lead damaged cells to death ( 29 - 32 ). then rmnsod provides a protective effect by inhibiting the inactivation of the aven gene , and more probably by shielding the mitochondria from radio - damages , inhibiting cytochrome - c release . by considering the enzymatic nature of rmnsod , usually confined into the mitochondrial matrix , we believe that this latter hypotheses could be more reasonable , although it has not yet been well investigated and not yet clarified . the use of a single and lethal dose radiation in experiments on animals is certainly restraining and does not allow us to understand exactly the limits within which rmnsod exerts its radio - protective effect or its radio - sensitizing one in cancer cells . notwithstanding , we believe that the enhanced survival of the animals treated was due to the sole rmnsod . therefore , among the several observed radioprotection structural , ultra - structural or molecular indicators , both in vitro and in vivo , the one related to the survival of animals exposed to lethal dose of x - rays is the most convincing . a further study on a large population of animals is , however , necessary . new experiments will have to test , for instance , the effects of larger doses of ionizing radiations and rmnsod , as we have done with the in vitro experiments . at the same time , it will also be necessary to extent the investigation rmnsod &# 39 ; s radioprotection effect on all the wide range of ionizing radiations , included those produced by protons and heavy ions , which are particularly present in the cosmic space and in our lab we are currently working on such topics . in conclusion , the data presented clearly indicate that the rmnsod provides a radio - protection for normal cells and confirm also the previous observations of a radio - protective effect of mnsod proposed by others researches . at the same time , the rmnsod was radio - sensitizing for tumour cells , and both the effects resulted statistically significant . such data could lead to direct applications in clinical practice , especially because the molecule does not require any manipulation to be safely injected into organisms , its therapeutic potentiality , as well as the possibility to prevent the damages generated by exposure of normal cells to ionizing radiations , indicate that the rmnsod deserves to be considered as a tool to amplify the effects of cancer radio - 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