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Undesirable exposure of diaphragm to radiation during thoracic radiation therapy has not been fully considered over the past decades. Our study aims to examine the potential biological effects on diaphragm induced by radiation. One-time ionizing irradiation of 10 Gy was applied either to the diaphragmatic region of mice or to the cultured C2C12 myocytes. Each sample was then assayed for muscle function, oxidative stress, or cell viability on days 1, 3, 5, and 7 after irradiation. Our mouse model shows that radiation significantly reduced muscle function on the 5th and 7th days and increased reactive oxygen species (ROS) formation in the diaphragm tissue from days 3 to 7. Similarly, the myocytes exhibited markedly decreased viability and elevated oxidative stress from days 5 to 7 after radiation. These data together suggested that a single dose of 10-Gy radiation is sufficient to cause acute adverse effects on diaphragmatic muscle function, redox balance, and myocyte survival. Furthermore, using the collected data, we developed a physical model to formularize the correlation between diaphragmatic ROS release and time after irradiation, which can be used to predict the biological effects of radiation with a specific dosage. Our findings highlight the importance of developing protective strategies to attenuate oxidative stress and prevent diaphragm injury during radiotherapy.

Effects of Ionizing Irradiation on Mouse Diaphragmatic Skeletal Muscle