Targeted and non-targeted effects of ionizing radiation

For a long time it was generally accepted that effects of ionizing radiation such as cell death, chromosomal aberrations, DNA damage, mutagenesis, and carcinogenesis result from direct ionization of cell structures, particularly DNA, or from indirect damage through reactive oxygen species produced by radiolysis of water, and these biological effects were attributed to irreparable or misrepaired DNA damage in cells directly hit by radiation. Using linear non-threshold model (LNT), possible risks from exposure to low dose ionizing radiation (below 100 mSv) are estimated by extrapolating from data obtained after exposure to higher doses of radiation. This model has been challenged by numerous observations, in which cells that were not directly traversed by the ionizing radiation exhibited responses similar to those of the directly irradiated cells. Therefore, it is nowadays accepted that the detrimental effects of ionizing radiation are not restricted only in the irradiated cells, but also to non-irradiated bystander or even distant cells manifesting various biological effects.