Radiomitigators: Breakthroughs in Post-Radiation Recovery.

Authors

Elena Obrador, José M Estrela, Rafael López-Blanch, Paz Moreno-Murciano, Alegría Montoro, María Oriol-Caballo

Published in

Antioxidants (Basel, Switzerland). Volume 15. Issue 3. Mar 18, 2026. Epub Mar 18, 2026.

Abstract

Ionizing radiation (IR) exposure poses a significant biomedical challenge in clinical, occupational, and emergency contexts, highlighting the urgent need for effective medical countermeasures against acute radiation syndrome (ARS) and delayed effects of radiation exposure (DEARE). Depending on the timing of administration, radiation countermeasures are classified as radioprotectors, radiomitigators, or therapeutics. Among these, radiomitigators offer a critical advantage by attenuating IR-induced damage when administered after exposure, thereby expanding their applicability in unanticipated radiation incidents. This review provides an overview of the pathophysiological mechanisms underlying IR-induced injury and summarizes the current FDA-approved radiation countermeasures. It then focuses on radiomitigators that have demonstrated efficacy in preclinical animal models, together with available evidence from clinical studies, emphasizing their translational potential for both emergency preparedness and oncological settings. We examine routes of administration and key mechanisms of action, including modulation of oxidative and nitrosative stress, enhancement of DNA damage response pathways, preservation of mitochondrial function, regulation of inflammatory and immune signaling, attenuation of fibrotic remodeling, maintenance of vascular integrity, and promotion of tissue regeneration and repair. Finally, challenges associated with clinical translation and strategies to optimize radiomitigators for the management of radiation-induced injury are discussed. By integrating these insights and consolidating existing knowledge, this review aims to guide basic and clinical research toward more effective radiomitigative strategies and combination therapies to improve survival, limit tissue damage, and preserve long-term quality of life in individuals exposed to IR.

PMID:
41897526
Bibliographic data and abstract were imported from PubMed on 17 Sep 2026.

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