Episode 57: Lauren Jackson discusses radiation exposure, including the effects of a nuclear strike

Today’s interview features Dr. Lauren Jackson, a nationally known expert in the field of tumor and normal-tissue radiobiology. She is especially recognized for her expertise in medical countermeasure development for acute radiation sickness and delayed effects of acute radiation exposure.

Lauren is the deputy director of the Division of Translational Radiation Sciences within the Department of Radiation Oncology at the University of Maryland School of Medicine.

Lauren, who also goes by Isabel, received her bachelors in science in microbiology from North Carolina State University in 2006, and her PhD in pathology from Duke University in 2012.

She currently is a principal or collaborating investigator on a number of industry and federally sponsored contracts and research grants. She has published extensively on the characterization and refinement of animal models of radiation-induced normal tissue injury that recapitulate the response in humans. Models developed in Lauren’s laboratory have gone on to receive FDA concurrence as appropriate for use in medical countermeasure screens.

Lauren is a senior associate editor for Advances in Radiation Oncology, a journal of the American Society of Therapeutic Radiation Oncology, and serves as an ad hoc reviewer for several peer-reviewed journals. She also is the author of several book chapters on normal tissue tolerance to radiation, mechanisms of injury, and potential therapeutic interventions.

Links:

Jackson’s University of Maryland web page: http://www.medschool.umaryland.edu/profiles/Jackson-Isabel/

Radiation Emergency Medical Management website: https://www.remm.nlm.gov

Centers for Disease Control website: https://www.emergency.cdc.gov/radiation/index.asp

BARDA website: https://www.phe.gov/about/BARDA/Pages/default.aspx

NIAID website: https://www.niaid.nih.gov

Show notes:

5:06: Dawn begins interview by asking Lauren about her childhood and if it’s true that she was one of those children who was always asking questions?

5:39: Lauren talks about how she was more interested in history and the humanities in high school and wanted nothing to do with science.

5:59: Dawn asks Lauren about her decision to attend the University of Georgia to major in journalism and political science.

6:28: Ken comments on how even though Lauren was just 18 at the time, she was one of two students picked to represent the University of Georgia at the Center for the Presidency in Washington, D.C. Lauren then talks about how thanks to that experience, she decided journalism and political science weren’t the right majors for her.

7:38: Dawn points out that when Lauren first went to college, she took the minimum number of science classes.  Lauren goes on to talk about how after spending time in D.C., she ended up applying to North Carolina State University and switching her major to microbiology.

8:52: While at N.C. State, Lauren worked for Dr. Hosni Hassan, an expert on Oxidative Stress. Dawn asks Lauren about the focus of her research with Dr. Hassan.

9:58 Dawn talks about how when Lauren was an undergrad at N.C. State, she became interested in tumors and cancer treatment, and found a professor down the road at Duke University who was doing interesting work in that area. Dawn asks Lauren if that’s why she ended up going to Duke for her doctorate.

10:52 Dawn asks Lauren to elaborate on how her background in journalism and political science connected her towards the path of radiation countermeasure research.

 11:42 Dawn points out that as a graduate student at Duke, Lauren took part in projects that looked at radiation injury. Dawn asks Lauren to give an overview of what sort of work was involved in the projects.

 12:46 Ken asks Lauren to explain the difference between clinical radiation exposure and radiation that someone would experience as a consequence of a nuclear attack.

13:59: Ken shifts the conversation to human space flight, asking Lauren to discuss the radiation astronauts will experience outside the protection of the Earth’s magnetosphere, such as galactic cosmic radiation and solar particle events. He also asks how they relate to the other previously mentioned clinical- and weapons-based radiation.

14:52: Ken asks Lauren to describe what the lifetime limits are for radiation exposure, how they are produced, and what is the biggest source of radiation exposure for the average person.

16:06: Dawn asks if it’s possible to translate the findings in clinical radiation to these other types of radiation exposures, such as nuclear weapons and space radiation.

16:40: Dawn asks if clinical radiation research is playing a role in the work that’s being done in space research as well as research into the effects of nuclear-weapons attack.

17:27: Ken asks Lauren to explain how radiation doses are defined.

18:28: Ken mentions that Lauren’s work has focused on both the acute and chronic effects of radiation exposure, then asks her to give an overview on how the body would respond at the cellular and physiological levels to an acute exposure.

19:56: Dawn mentions how proximity to the event, in the event of a nuclear attack, would be a variable factor as to the level of exposure, then asking what else determines the degree of an acute response.

22:35: Dawn asks if the impact of radiation exposure is different based on different systems in the body, further asking which systems are more or less susceptible and what the different responses are.

24:06: Dawn mentions how Lauren has focused a large part of her research on the effects of radiation exposure to the pulmonary system, then asking her to talk about those chronic and lifetime affects following initial exposure.

25:38: Ken remarks how oxidative stress is a major focus on Lauren’s research, and follows up by asking about the impact of oxidative stress on the tissue, surrounding tissue, and its role in the overall injury response.

26:54: Ken remarks on the evidence that shows that animals fed a diet high in blueberries have some degree of resistance to the inflammatory response due to the blueberry’s antioxidant activity. He asks if antioxidants, more broadly, could play a role in the prevention of radiation injury.

27:46: Dawn asks about genetic susceptibility to radiation injury, and if we know of any individuals who are more or less susceptible to injury based on their genetic makeup.

28:48: Ken wonders if the genetic screening for radiation tolerance were developed adequately, that perhaps it could have an application in the selection process for long-duration missions into deep space.

29:25: Ken inquiries about the counterintuitive fact that smokers have a reduced incidence of radiation-induced lung cancer.

30:07: Dawn asks if gender or age play a role in a person’s susceptibility to radiation injury.

31:13: Dawn mentions how we know that epigenetic modifications (changes with respect to how a gene is expressed) can occur in response to a wide variety of different stressors or environmental influences. She then asks if we are seeing modifications that occur as a result of radiation exposure at the epigenetic level.

31:47: Dawn mentions that Randy Gerald was at Duke at the same time that she and Lauren were at Duke, and that he was the founder of epigenetic modifications.

32:15: Ken asks that in regards to a point-of-care test that could identify individuals who have been exposed to radiation and injured, what are the potential markers that Lauren would look for.

34:01: Dawn asks if markers of tissue injury, such as lung-radiation injury, are found in the blood.

35:44 Ken mentions the importance of timing from the point of injury as being critical with most biomarkers. He then asks that given the temporal nature of radiation injury, is there a time effect on biomarkers of radiation injury.

36:37: Ken asks about the effects of radon.

37:30: Ken notes that some areas are inherently much higher in radon levels than others, such as New England, and parts of Florida. He asks if there is a level that Lauren would consider safe for basements.

38:42: Dawn asks about the current position Lauren holds at the University of Maryland School of Medicine as the Deputy Director of the Division of Translational Research Sciences, and the Department of Radiation Oncology, and her research team that she has there.

40:32: Dawn asks about the different categories of potential countermeasures for radiation injury that Lauren has been looking at.

41:28: Dawn mentions how Lauren also works alongside the FDA, where she serves as a subject-matter expert for the review committees. She asks Lauren to describe her work with the FDA and in particular the FDA animal rule and the role that plays in countermeasure approval for humans.

44:03: Lauren explains the role that the NIAID (National Institute for Allergy and Infectious Disease) plays in countermeasure development.

45:56: Ken asks if countermeasures that we might develop to limit the damage from a nuclear attack might potentially be used for applications such as clinical radiation or space radiation exposure.

47:12: Dawn asks about a countermeasure drug called Bio300 that Lauren worked on with a company called Humanetics Corporation, asking where it stands with respect to research and potential clinical applications in humans.

48:37: Dawn asks Lauren to talk about the approval process and the specifics of Neupogen and Neulasta, (the first two drugs ever approved as potential countermeasures for acute radiation syndrome) that were approved on the basis of data generated at Lauren’s laboratory.

49:58: Ken notes that Neupogen has demonstrated improved survival in people exposed to lethal radiation doses on Earth, then asks if Neupogen, Neulasta, or some other bone-marrow active medical countermeasures have applications in human space flight.

50:54: Dawn asks if there is a one-size-fits-all drug to target all the physiological systems in response to radiation exposure, or if a patient would need to take an array of countermeasures to cover each of the different systems.

52:22: Dawn notes that after Fukushima, potassium iodine pills were flying off the shelves, and asks if that is a viable option for protection against acute radiation syndrome.

53:32: Ken asks if there are any prophylactic treatments approved or in development for radiation exposure.

54:46: Ken asks Lauren to talk a little more about BARDA (Biomedical Advanced Research and Development Authority) and the role it plays in radiation injury research and countermeasure development.

56:44: Dawn notes that Lauren has served as the program director for the BARDA Radiological and Nuclear Model Development Program, asking her to talk about that position and what that work entails.

57:25: Lauren talks about how it seemed that no one was interested in radiation after the Cold War, but that recent interest in radiation research has grown significantly.

59:48: Dawn mentions that four or five years ago you couldn’t get any companies interested in looking at ways to improve survival in case of a nuclear attack, but that in just the last two weeks of November that Lauren has had 22 companies reach out to her.

1:01:48: Dawn asks what the current threats of nuclear or radiological terrorism or nuclear attack are.

1:02:18: Ken asks how much protection to radiation exposure, arising from a weapon’s detonation, does a basement offer.

1:03:05: Ken remarks how, in regards to basements, those that do not have windows would be preferable in the context of protecting against radiation exposure.

1:04:13: Ken asks if any of the countermeasures developed thus far could be effective against space radiation, and thereby offer NASA an ability to leverage the BARDA investment.

1:05:26: Ken remarks how he is glad to hear that the federal agencies are wisely leveraging each other’s investments, rather than independently pursuing them.

1:06:31: Ken talks about long-duration missions in deep space and the possibility that astronauts might experience serious cognitive deficits caused by radiation exposure. He also points out the need for a countermeasure against cognitive decline as a result of radiation is not yet met here on Earth, citing that workers who cleaned up the Chernobyl nuclear disaster experienced serious cognitive decline close to ten years after the incident.

1:08:22: Ken asks if potential neurocognitive medical countermeasures exist today or if they may be available in the near future, and would a single agent be effective for both terrestrial exposures and the galactic cosmic radiation found in space.

1:09:18: Dawn wraps up the interview by asking Lauren if she is an N.C. State fan or a Duke fan when it comes to basketball.