{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:20:44Z","timestamp":1791354044241,"version":"4.3.1"},"reference-count":119,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Caen Normandy within the Young researcher program","award":["SM2014-4016"],"award-info":[{"award-number":["SM2014-4016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Nuclear factor erythroid 2-related factor 2 (NRF2) is a key transcription factor that controls the antioxidant response to oxidative stress, especially after exposure to ionizing radiation (IR). This review examines NRF2\u2019s emerging role as a complementary biomarker in radiobiological dosimetry for assessing radiation exposure and its potential health effects. When cells encounter IR, the resulting reactive oxygen species (ROS) interfere with the NRF2 repressor KEAP1, leading to NRF2 activation and the expression of cytoprotective genes such as HO-1, NQO1, and GCLC. Evidence suggests that NRF2 levels increase in a dose- and time-dependent manner, primarily at low to moderate radiation doses, highlighting its potential for early detection of radiation exposure. However, at high doses (&gt;8 Gy), NRF2 activation may be suppressed due to apoptosis or irreversible damage, which limits its reliability in those situations. The review also compares NRF2 with other biomarkers used in biodosimetry, discussing its advantages, such as sensitivity and early response, along with its limitations, including variability in activation at high doses and expression influenced by other oxidative factors. The authors introduce a comprehensive radiobiological model that illustrates how low-dose IR exposure affects NRF2 expression patterns, thereby improving the understanding of dose-dependent oxidative stress mechanisms. Additionally, the role of NRF2 in inflammation and general health risk assessment is emphasized, suggesting broader applications beyond biodosimetry. Overall, NRF2 holds significant promise for use in evaluating radiation exposure, developing radioprotection strategies, and informing future radiobiological research frameworks.<\/jats:p>","DOI":"10.3390\/antiox14121393","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T09:02:07Z","timestamp":1763974927000},"page":"1393","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Nuclear Factor Erythroid 2-Related Factor 2 (NRF2) as a Biomarker for Radiation Dosimetry and Health Risk Assessment: A Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Kave","family":"Moloudi","sequence":"first","affiliation":[{"name":"Laser Research Centre, Faculty of Health Sciences, Doornfontein Campus, University of Johannesburg, Johannesburg 2028, South Africa"},{"name":"Laboratoire Aliments, Bioproc\u00e9d\u00e9s, Toxicologie Environnements (ABTE, UR4651), University of Caen, Normandy, Cedex 04, F-14050 Caen, France"},{"name":"Advanced Resource Center for HADrontherapy in Europe (ARCHADE), F-14000 Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4051-8376","authenticated-orcid":false,"given":"Traimate","family":"Sangsuwan","sequence":"additional","affiliation":[{"name":"Laboratoire Aliments, Bioproc\u00e9d\u00e9s, Toxicologie Environnements (ABTE, UR4651), University of Caen, Normandy, Cedex 04, F-14050 Caen, France"},{"name":"Advanced Resource Center for HADrontherapy in Europe (ARCHADE), F-14000 Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2436-8048","authenticated-orcid":false,"given":"Satoru","family":"Monzen","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Hirosaki University Graduate School of Health Sciences, Hirosaki University, Aomori-ken 036-8560, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Fujishima","sequence":"additional","affiliation":[{"name":"Department of Risk Analysis and Biodosimetry, Institute of Radiation Emergency Medicine, Hirosaki University, Aomori-ken 036-8560, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6716-4059","authenticated-orcid":false,"given":"Donovan","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Risk Analysis and Biodosimetry, Institute of Radiation Emergency Medicine, Hirosaki University, Aomori-ken 036-8560, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6743-3351","authenticated-orcid":false,"given":"Benjamin","family":"Frey","sequence":"additional","affiliation":[{"name":"Translational Radiobiology, Department of Radiation Oncology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3104-2134","authenticated-orcid":false,"given":"Tomisato","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Risk Analysis and Biodosimetry, Institute of Radiation Emergency Medicine, Hirosaki University, Aomori-ken 036-8560, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0601-3060","authenticated-orcid":false,"given":"Samayeh","family":"Azariasl","sequence":"additional","affiliation":[{"name":"Department of Radiation Biophysics, Research Institute for Radiation Biology and Medicine, Hiroshima University, Kasumi, Minami-ku 734-8553, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3081-6230","authenticated-orcid":false,"given":"Hiroshi","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Radiation Biophysics, Research Institute for Radiation Biology and Medicine, Hiroshima University, Kasumi, Minami-ku 734-8553, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2867-4774","authenticated-orcid":false,"given":"Siamak","family":"Haghdoost","sequence":"additional","affiliation":[{"name":"Laboratoire Aliments, Bioproc\u00e9d\u00e9s, Toxicologie Environnements (ABTE, UR4651), University of Caen, Normandy, Cedex 04, F-14050 Caen, France"},{"name":"Advanced Resource Center for HADrontherapy in Europe (ARCHADE), F-14000 Caen, France"},{"name":"Department of Risk Analysis and Biodosimetry, Institute of Radiation Emergency Medicine, Hirosaki University, Aomori-ken 036-8560, Japan"},{"name":"Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, SE-10691 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Obrador, E., Salvador-Palmer, R., Villaescusa, J.I., Gallego, E., Pellicer, B., Estrela, J.M., and Montoro, A. (2022). Nuclear and radiological emergencies: Biological effects, countermeasures and biodosimetry. Antioxidants, 11.","DOI":"10.3390\/antiox11061098"},{"key":"ref_2","first-page":"12","article-title":"The EURADOS work towards a review on retrospective dosimetry after incorporation of radionuclides","volume":"186","author":"Giussani","year":"2019","journal-title":"Radiat. Prot. Dosim."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s00411-020-00845-y","article-title":"Eurados review of retrospective dosimetry techniques for internal exposures to ionising radiation and their applications","volume":"59","author":"Giussani","year":"2020","journal-title":"Radiat. Environ. Biophys."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"108287","DOI":"10.1016\/j.mrrev.2019.108287","article-title":"Retrospective biodosimetry techniques: Focus on cytogenetics assays for individuals exposed to ionizing radiation","volume":"783","author":"Herate","year":"2020","journal-title":"Mutat. Res.\/Rev. Mutat. Res."},{"key":"ref_5","first-page":"90","article-title":"New approaches to biological dosimetry: Development of complex biodosimetric systems (review of foreign literature)","volume":"4","author":"Sotnik","year":"2019","journal-title":"Medico-Biol. Socio-Psychol. Probl. Saf. Emerg. Situat."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3390\/radiation1020009","article-title":"Use of biological dosimetry for monitoring medical workers occupationally exposed to ionizing radiation","volume":"1","author":"Piotrowski","year":"2021","journal-title":"Radiation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"100132","DOI":"10.1016\/j.physo.2022.100132","article-title":"Reflections on the future developments of research in retrospective physical dosimetry","volume":"14","author":"Fattibene","year":"2023","journal-title":"Phys. Open"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Azariasl, S., and Yasuda, H. (2025). The effects of age and other individual factors on radiation induced ESR signals from fingernails. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1531253"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09553002.2025.2561815","article-title":"Preliminary analysis of the integrated EPR signals of fingernails to validate the dosimetry method based on peak-to-peak amplitudes","volume":"101","author":"Yasuda","year":"2025","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"776","DOI":"10.3109\/09553002.2011.573612","article-title":"The RABiT: A rapid automated biodosimetry tool for radiological triage. II. Technological developments","volume":"87","author":"Garty","year":"2011","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1667\/RADE-23-00120.1","article-title":"RABiT-III: An automated micronucleus assay at a non-specialized biodosimetry facility","volume":"201","author":"Repin","year":"2024","journal-title":"Radiat. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09553002.2025.2536108","article-title":"Application of an imaging flow cytometry \u03b3-H2AX assay for biodosimetry using supervised machine learning","volume":"101","author":"Hassan","year":"2025","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1667\/RR14452.1","article-title":"State-of-the-art advances in radiation biodosimetry for mass casualty events involving radiation exposure","volume":"186","author":"Sproull","year":"2016","journal-title":"Radiat. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"108350","DOI":"10.1016\/j.mrrev.2020.108350","article-title":"Potential application of \u03b3-H2AX as a biodosimetry tool for radiation triage","volume":"787","author":"Raavi","year":"2021","journal-title":"Mutat. Res.\/Rev. Mutat. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.ijrobp.2023.11.029","article-title":"In vivo verification of electron paramagnetic resonance biodosimetry using patients undergoing radiation therapy treatment","volume":"119","author":"Draeger","year":"2024","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100202","DOI":"10.1016\/j.envadv.2022.100202","article-title":"The international biodosimetry capacity, capabilities, needs and challenges: The 3rd WHO BioDoseNet survey results","volume":"8","author":"Wilkins","year":"2022","journal-title":"Environ. Adv."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1093\/rpd\/ncs157","article-title":"Realising the European network of biodosimetry (RENEB)","volume":"151","author":"Kulka","year":"2012","journal-title":"Radiat. Prot. Dosim."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"100265","DOI":"10.1016\/j.envadv.2022.100265","article-title":"Current developments in biodosimetry tools for radiological\/nuclear mass casualty incidents","volume":"9","author":"Escalona","year":"2022","journal-title":"Environ. Adv."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Shimura, T., Nakashiro, C., Narao, M., and Ushiyama, A. (2020). Induction of oxidative stress biomarkers following whole-body irradiation in mice. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0240108"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Moloudi, K., and Haghdoost, S. (2025). An Update on Role of Ionizing Radiation to Enhance Proliferation and Differentiation of Normal Stem Cells via Activation of NRF2 Pathway. Antioxidants, 14.","DOI":"10.3390\/antiox14080986"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.radmp.2020.06.002","article-title":"Research progress on biodosimeters of ionizing radiation damage","volume":"1","author":"Xiao","year":"2020","journal-title":"Radiat. Med. Prot."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"010503","DOI":"10.1088\/1361-6498\/ac2434","article-title":"Early molecular markers for retrospective biodosimetry and prediction of acute health effects","volume":"42","author":"Abend","year":"2022","journal-title":"J. Radiol. Prot."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1667\/RR15203.1","article-title":"Dose-dependent increase of Nrf2 target gene expression in mice exposed to ionizing radiation","volume":"191","author":"Miura","year":"2019","journal-title":"Radiat. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1080\/09553002.2021.1928784","article-title":"Transcriptomics for radiation biodosimetry: Progress and challenges","volume":"99","author":"Amundson","year":"2023","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1900035","DOI":"10.1002\/prca.201900035","article-title":"Time-Dependent Measurement of Nrf2-Regulated Antioxidant Response to Ionizing Radiation Toward Identifying Potential Protein Biomarkers for Acute Radiation Injury","volume":"13","author":"Liu","year":"2019","journal-title":"Proteom.\u2013Clin. Appl."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1093\/jrr\/rrab119","article-title":"Biological and internal dosimetry for radiation medicine: Current status and future perspectives","volume":"63","author":"Sudprasert","year":"2022","journal-title":"J. Radiat. Res."},{"key":"ref_27","unstructured":"Hall, E.J., and Giaccia, A.J. (2006). Radiobiology for the Radiologist. Int. J. Radiat. Oncol. Biol. Phys., 66."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"162","DOI":"10.2188\/jea.JE20170321","article-title":"Japanese legacy cohorts: The life span study atomic bomb survivor cohort and survivors\u2019 offspring","volume":"28","author":"Ozasa","year":"2018","journal-title":"J. Epidemiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"568","DOI":"10.2307\/3572080","article-title":"Somatic chromosome aberrations induced by human whole-body irradiation: The \u201cRecuplex\u201d criticality accident","volume":"29","author":"Bender","year":"1966","journal-title":"Radiat. Res."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ricoul, M., Gnana-Sekaran, T., Piqueret-Stephan, L., and Sabatier, L. (2016). Cytogenetics for biological dosimetry. Cancer Cytogenetics: Methods and Protocols, Springer.","DOI":"10.1007\/978-1-4939-6703-2_17"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1038\/226717a0","article-title":"Mammalian cell fusion: Induction of premature chromosome condensation in interphase nuclei","volume":"226","author":"Johnson","year":"1970","journal-title":"Nature"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/BF01574257","article-title":"A simple method for premature chromosome condensation induction in primary human and rodent cells using polyethylene glycol","volume":"9","author":"Pantelias","year":"1983","journal-title":"Somat. Cell Genet."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1002\/mrd.1080340409","article-title":"Okadaic acid induces premature chromosome condensation reflecting the cell cycle progression in one-cell stage mouse embryos","volume":"34","author":"Dyban","year":"1993","journal-title":"Mol. Reprod. Dev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2220\/biomedres.16.63","article-title":"Inhibition of protein serine\/threonine phosphatases directly induces premature chromosome condensation in mammalian somatic cells","volume":"16","author":"Gotoh","year":"1995","journal-title":"Biomed. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S149","DOI":"10.1269\/jrr.42.S149","article-title":"Cytogenetical dose estimation for 3 severely exposed patients in the JCO criticality accident in Tokai-mura","volume":"42","author":"Hayata","year":"2001","journal-title":"J. Radiat. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1159\/000530947","article-title":"Radiation-induced gene expression changes used for biodosimetry and clinical outcome prediction: Challenges and promises","volume":"163","author":"Abend","year":"2023","journal-title":"Cytogenet. Genome Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3390\/radiation2010006","article-title":"The potential of omics in biological dosimetry","volume":"2","author":"Hladik","year":"2022","journal-title":"Radiation"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1080\/09553002.2024.2442694","article-title":"Integration of multi-omics and benchmark dose modeling to support adverse outcome pathways","volume":"101","author":"Vuong","year":"2025","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_39","first-page":"385","article-title":"Manual scoring with shortened 48 h cytokinesis-block micronucleus assay feasible for triage in the event of a mass-casualty radiation accident","volume":"199","author":"Fujishima","year":"2023","journal-title":"Radiat. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1093\/mutage\/geq078","article-title":"The micronucleus assay as a biological dosimeter of in vivo ionising radiation exposure","volume":"26","author":"Vral","year":"2011","journal-title":"Mutagenesis"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Selvan, G.T., and Venkatachalam, P. (2024). Potentials of cytokinesis blocked micronucleus assay in radiation triage and biological dosimetry. J. Genet. Eng. Biotechnol., 22.","DOI":"10.1016\/j.jgeb.2024.100409"},{"key":"ref_42","unstructured":"International Organization for Standardization (2019). Radiological Protection\u2013Performance Criteria for Laboratories Using Fluorescence In Situ Hybridization (FISH) Translocation Assay for Assessment of Exposure to Ionizing Radiation, ISO Geneva."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1080\/09553000412331283498","article-title":"Long-term persistence of translocations in stable lymphocytes from victims of a radiological accident","volume":"80","author":"Lindholm","year":"2004","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/jrr\/rrv028","article-title":"Retrospective biodosimetry using translocation frequency in a stable cell of occupationally exposed to ionizing radiation","volume":"56","author":"Cho","year":"2015","journal-title":"J. Radiat. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1080\/09553002.2018.1503429","article-title":"Automated scoring of dicentric chromosomes differentiates increased radiation sensitivity of young children after low dose CT exposure in vitro","volume":"94","author":"Oestreicher","year":"2018","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3857\/roj.2021.00339","article-title":"Cytogenetic biological dosimetry assays: Recent developments and updates","volume":"39","author":"Gnanasekaran","year":"2021","journal-title":"Radiat. Oncol. J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.mrgentox.2015.07.011","article-title":"High-throughput sample processing and sample management; the functional evolution of classical cytogenetic assay towards automation","volume":"793","author":"Ramakumar","year":"2015","journal-title":"Mutat. Res.\/Genet. Toxicol. Environ. Mutagen."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Saha, S., Buttari, B., Panieri, E., Profumo, E., and Saso, L. (2020). An overview of Nrf2 signaling pathway and its role in inflammation. Molecules, 25.","DOI":"10.3390\/molecules25225474"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Hammad, M., Salma, R., Balosso, J., Rezvani, M., and Haghdoost, S. (2024). Role of oxidative stress signaling, Nrf2, on survival and stemness of human adipose-derived stem cells exposed to X-rays, protons and carbon ions. Antioxidants, 13.","DOI":"10.3390\/antiox13091035"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"8886","DOI":"10.1158\/0008-5472.CAN-10-0171","article-title":"Ionizing radiation activates the Nrf2 antioxidant response","volume":"70","author":"McDonald","year":"2010","journal-title":"Cancer Res."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Hammad, M., Raftari, M., Ces\u00e1rio, R., Salma, R., Godoy, P., Emami, S.N., and Haghdoost, S. (2023). Roles of oxidative stress and Nrf2 signaling in pathogenic and non-pathogenic cells: A possible general mechanism of resistance to therapy. Antioxidants, 12.","DOI":"10.3390\/antiox12071371"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ccell.2014.11.019","article-title":"Glutathione and thioredoxin antioxidant pathways synergize to drive cancer initiation and progression","volume":"27","author":"Harris","year":"2015","journal-title":"Cancer cell"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Shrestha, J., Limbu, K.R., Chhetri, R.B., Paudel, K.R., Hansbro, P.M., Oh, Y.S., Baek, D.J., Ki, S.-H., and Park, E.-Y. (2024). Antioxidant genes in cancer and metabolic diseases: Focusing on Nrf2, Sestrin, and heme oxygenase 1. Int. J. Biol. Sci., 20.","DOI":"10.7150\/ijbs.98846"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Morgenstern, C., Lastres-Becker, I., Demird\u00f6\u011fen, B.C., Costa, V.M., Daiber, A., Foresti, R., Motterlini, R., Kalyoncu, S., Arioz, B.I., and Genc, S. (2024). Biomarkers of NRF2 signalling: Current status and future challenges. Redox Biol., 72.","DOI":"10.1016\/j.redox.2024.103134"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1158\/2159-8290.CD-20-0282","article-title":"KEAP1\/NFE2L2 mutations predict lung cancer radiation resistance that can be targeted by glutaminase inhibition","volume":"10","author":"Binkley","year":"2020","journal-title":"Cancer Discov."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"10484","DOI":"10.1038\/s41467-024-54852-4","article-title":"Imaging NRF2 activation in non-small cell lung cancer with positron emission tomography","volume":"15","author":"Greenwood","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Chen, M., Carpenter, D., Leng, J., Qazi, J., Wan, Z., Niedzwiecki, D., Alder, L., Clarke, J., Kirkpatrick, J., and Floyd, S. (2024). Impact of KEAP1\/NFE2L2 Mutations on Local Recurrence in Patients Receiving Stereotactic Radiosurgery for Non-Small Cell Lung Cancer Brain Metastases. Int. J. Radiat. Oncol. Biol. Phys., 120.","DOI":"10.1016\/j.ijrobp.2024.07.502"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"15593258221092365","DOI":"10.1177\/15593258221092365","article-title":"Low-dose gamma radiation modulates liver and testis tissues response to acute whole body irradiation","volume":"20","author":"Haroun","year":"2022","journal-title":"Dose-Response"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Sangsuwan, T., Khavari, A.P., Blomberg, E., Romell, T., De, P.R.d.A.V., Harms-Ringdahl, M., and Haghdoost, S. (2023). Oxidative stress levels and dna repair kinetics in senescent primary human fibroblasts exposed to chronic low dose rate of ionizing radiation. Front. Biosci.-Landmark, 28.","DOI":"10.31083\/j.fbl2811296"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Bradfield, D.T., Slaven, J.E., Rittase, W.B., Rusnak, M., Symes, A.J., Brehm, G.V., Muir, J.M., Lee, S.-H., Anderson, J.A., and Day, R.M. (2025). Cell death and iron deposition in the liver in two murine models of acute radiation syndrome. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0324361"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1667\/RR15059.1","article-title":"The role of Nrf2 in the response to normal tissue radiation injury","volume":"190","author":"Cameron","year":"2018","journal-title":"Radiat. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1269\/jrr.10002","article-title":"Low-dose gamma-ray irradiation induces translocation of Nrf2 into nuclear in mouse macrophage RAW264. 7 cells","volume":"51","author":"Tsukimoto","year":"2010","journal-title":"J. Radiat. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3199","DOI":"10.1016\/j.celrep.2017.09.013","article-title":"Low-dose irradiation promotes persistent oxidative stress and decreases self-renewal in hematopoietic stem cells","volume":"20","author":"Moreno","year":"2017","journal-title":"Cell Rep."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Fr\u00e9chard, T., Bachelot, F., M\u00e9nard, V., Brizais, C., Mac\u00e9, L., Elie, C., Cailler Gruet, N., Teulade, T., Havet, C., and Voyer, F. (2025). Co-exposure to inhaled tungsten particles and low-dose gamma rays: Neurotoxicological outcome in rats. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-02278-3"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1667\/RR15179.1","article-title":"Radiation-induced phosphorylation of serine 360 of SMC1 in human peripheral blood mononuclear cells","volume":"191","author":"Park","year":"2019","journal-title":"Radiat. Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1667\/RR15355.1","article-title":"Developing gender-specific gene expression biodosimetry using a panel of radiation-responsive genes for determining radiation dose in human peripheral blood","volume":"192","author":"Li","year":"2019","journal-title":"Radiat. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"140","DOI":"10.2307\/3576452","article-title":"The use of peripheral blood mononuclear cell prematurely condensed chromosomes for biological dosimetry","volume":"99","author":"Pantelias","year":"1984","journal-title":"Radiat. Res."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Schaue, D., Micewicz, E.D., Ratikan, J.A., Iwamoto, K.S., Vlashi, E., McDonald, J.T., and McBride, W.H. (2022). NRF2 mediates cellular resistance to transformation, radiation, and inflammation in mice. Antioxidants, 11.","DOI":"10.3390\/antiox11091649"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09553002.2022.1998706","article-title":"Establishment and validation of surface model for biodosimetry based on \u03b3-H2AX foci detection","volume":"98","author":"Puig","year":"2022","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2478\/ctb-2018-0002","article-title":"Advances in EPR dosimetry in terms of retrospective determination of absorbed dose in radiation accidents","volume":"41","author":"Kubiak","year":"2018","journal-title":"Curr. Top. Biophys."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"A75","DOI":"10.1269\/jrr.47.A75","article-title":"The suitability of FISH chromosome painting and ESR-spectroscopy of tooth enamel assays for retrospective dose reconstruction","volume":"47","author":"Khvostunov","year":"2006","journal-title":"J. Radiat. Res."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1140\/epjp\/s13360-021-01447-3","article-title":"Cytogenetic bio-dosimetry techniques in the detection of dicentric chromosomes induced by ionizing radiation: A review","volume":"136","author":"Ludovici","year":"2021","journal-title":"Eur. Phys. J. Plus"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"503087","DOI":"10.1016\/j.mrgentox.2019.503087","article-title":"Optimization and validation of automated dicentric chromosome analysis for radiological\/nuclear triage applications","volume":"847","author":"Ryan","year":"2019","journal-title":"Mutat. Res.\/Genet. Toxicol. Environ. Mutagen."},{"key":"ref_74","first-page":"121","article-title":"Cytogenetic biodosimetry in radiation emergency medicine: 5. The dicentric chromosome and its role in biodosimetry","volume":"12","author":"Anderson","year":"2023","journal-title":"Radiat. Environ. Med."},{"key":"ref_75","unstructured":"World Health Organization (2011). Cytogenetic Dosimetry: Applications in Preparedness for and Response to Radiation Emergencies, International Atomic Energy Agency, Department of Nuclear Safety and Security, Incident and Emergency Centre."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1080\/09553002.2019.1664788","article-title":"Construction of fluorescence in situ hybridization (FISH) translocation dose-response calibration curve with multiple donor data sets using R, based on ISO 20046: 2019 recommendations","volume":"95","author":"Goh","year":"2019","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1667\/RR14294.1","article-title":"Adaption of the cytokinesis-block micronucleus cytome assay for improved triage biodosimetry","volume":"185","author":"Beinke","year":"2016","journal-title":"Radiat. Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/HP.0000000000000371","article-title":"Validation of the cytokinesis-block micronucleus assay using imaging flow cytometry for high throughput radiation biodosimetry","volume":"110","author":"Rodrigues","year":"2016","journal-title":"Health Phys."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Feinendegen, L.E., Pollycove, M., and Sondhaus, C.A. (2004). Responses to low doses of ionizing radiation in biological systems. Nonlinearity Biol. Toxicol. Med., 2.","DOI":"10.1080\/15401420490507431"},{"key":"ref_80","unstructured":"Mollaheydar, E. (2024). A Multiscale Model of Tumor Growth, Pharmacokinetics and Radiobiology for Radiopharmaceutical Therapy Optimization. [Doctoral Dissertation, University of British Columbia]."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s00432-019-02851-0","article-title":"NRF2 orchestrates the redox regulation induced by radiation therapy, sustaining embryonal and alveolar rhabdomyosarcoma cells radioresistance","volume":"145","author":"Marampon","year":"2019","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1089\/ars.2010.3219","article-title":"Gain of Nrf2 function in non-small-cell lung cancer cells confers radioresistance","volume":"13","author":"Singh","year":"2010","journal-title":"Antioxid. Redox Signal."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Schmidlin, C.J., de la Vega, M.R., Perer, J., Zhang, D.D., and Wondrak, G.T. (2020). Activation of NRF2 by topical apocarotenoid treatment mitigates radiation-induced dermatitis. Redox Biol., 37.","DOI":"10.1016\/j.redox.2020.101714"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2298","DOI":"10.1016\/j.freeradbiomed.2012.10.536","article-title":"Loss of Nrf2 accelerates ionizing radiation-induced bone loss by upregulating RANKL","volume":"53","author":"Rana","year":"2012","journal-title":"Free. Radic. Biol. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"E2949","DOI":"10.1073\/pnas.1207718109","article-title":"Targeting of Nrf2 induces DNA damage signaling and protects colonic epithelial cells from ionizing radiation","volume":"109","author":"Kim","year":"2012","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"9109","DOI":"10.1093\/nar\/gkaa631","article-title":"NRF2 preserves genomic integrity by facilitating ATR activation and G2 cell cycle arrest","volume":"48","author":"Sun","year":"2020","journal-title":"Nucleic Acids Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"15593258211016237","DOI":"10.1177\/15593258211016237","article-title":"Exposure to low to moderate doses of ionizing radiation induces a reduction of pro-inflammatory Ly6chigh monocytes and a U-curved response of T cells in ApoE-\/-mice","volume":"19","author":"Rey","year":"2021","journal-title":"Dose-Response"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e85655","DOI":"10.5812\/zjrms.85655","article-title":"Oxidative stress as the underlying biomechanism of detrimental outcomes of ionizing and non-ionizing radiation on human health: Antioxidant protective strategies","volume":"21","author":"Akbari","year":"2019","journal-title":"Zahedan J. Res. Med. Sci."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"2751","DOI":"10.2174\/0929867330666230407104208","article-title":"Crosstalk between oxidative stress and inflammation induced by ionizing radiation in healthy and cancerous cells","volume":"31","author":"Mohammadgholi","year":"2024","journal-title":"Curr. Med. Chem."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s11010-015-2532-x","article-title":"Mitochondrial DNA maintenance: An appraisal","volume":"409","author":"Akhmedov","year":"2015","journal-title":"Mol. Cell. Biochem."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Tian, X., Wang, F., Luo, Y., Ma, S., Zhang, N., Sun, Y., You, C., Tang, G., Li, S., and Gong, Y. (2018). Protective role of nuclear factor-erythroid 2-related factor 2 against radiation-induced lung injury and inflammation. Front. Oncol., 8.","DOI":"10.3389\/fonc.2018.00542"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e29492","DOI":"10.1016\/j.heliyon.2024.e29492","article-title":"Nrf-2 as a novel target in radiation induced lung injury","volume":"10","author":"Chen","year":"2024","journal-title":"Heliyon"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Gao, W., Guo, L., Yang, Y., Wang, Y., Xia, S., Gong, H., Zhang, B.-K., and Yan, M. (2022). Dissecting the crosstalk between Nrf2 and NF-\u03baB response pathways in drug-induced toxicity. Front. Cell Dev. Biol., 9.","DOI":"10.3389\/fcell.2021.809952"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"2534643","DOI":"10.1155\/2020\/2534643","article-title":"Targeting NRF2, regulator of antioxidant system, to sensitize glioblastoma neurosphere cells to radiation-induced oxidative stress","volume":"2020","author":"Godoy","year":"2020","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Aebisher, D., Przyg\u00f3rzewska, A., and Bartusik-Aebisher, D. (2024). Natural Photosensitizers in Clinical Trials. Appl. Sci., 14.","DOI":"10.3390\/app14188436"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Luo, J., Zhi, Q., Li, D., Xu, Y., Zhu, H., Zhao, L., Ren, G., Wang, J., and Liu, N. (2025). Low dose radiotherapy combined with immune checkpoint inhibitors induces ferroptosis in lung cancer via the Nrf2\/HO-1\/GPX4 axis. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1558814"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1016\/j.arbres.2024.06.021","article-title":"NRF2 signaling pathway in chemo\/radio\/immuno-therapy resistance of lung cancer: Looking beyond the tip of the iceberg","volume":"60","author":"Ramisetti","year":"2024","journal-title":"Arch. Bronconeumol."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Ngo, V., and Duennwald, M.L. (2022). Nrf2 and oxidative stress: A general overview of mechanisms and implications in human disease. Antioxidants, 11.","DOI":"10.3390\/antiox11122345"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.freeradbiomed.2015.04.035","article-title":"Nrf2 promotes survival following exposure to ionizing radiation","volume":"88","author":"Sekhar","year":"2015","journal-title":"Free. Radic. Biol. Med."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"681","DOI":"10.7150\/thno.88899","article-title":"NRF2 promotes radiation resistance by cooperating with TOPBP1 to activate the ATR-CHK1 signaling pathway","volume":"14","author":"Sun","year":"2024","journal-title":"Theranostics"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"100215","DOI":"10.1016\/j.ijpt.2024.100215","article-title":"The Role of Nrf2 Signaling in Surival and Differentiation of Primary Stem Cells Exposed to Particle Radiation","volume":"12","author":"Haghdoost","year":"2024","journal-title":"Int. J. Part. Ther."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Yagishita, Y., Gatbonton-Schwager, T.N., McCallum, M.L., and Kensler, T.W. (2020). Current landscape of NRF2 biomarkers in clinical trials. Antioxidants, 9.","DOI":"10.3390\/antiox9080716"},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Rooney, J.P., Chorley, B., Hiemstra, S., Wink, S., Wang, X., Bell, D.A., van de Water, B., and Corton, J.C. (2020). Mining a human transcriptome database for chemical modulators of NRF2. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0239367"},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Helou, D.G., Martin, S.F., Pallardy, M., Chollet-Martin, S., and Kerdine-R\u00f6mer, S. (2019). Nrf2 involvement in chemical-induced skin innate immunity. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.01004"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1101\/gad.237081.113","article-title":"The circadian clock regulates rhythmic activation of the NRF2\/glutathione-mediated antioxidant defense pathway to modulate pulmonary fibrosis","volume":"28","author":"Gibbs","year":"2014","journal-title":"Genes Dev."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"190","DOI":"10.3892\/etm.2021.9622","article-title":"Mechanism of circadian regulation of the NRF2\/ARE pathway in renal ischemia-reperfusion","volume":"21","author":"Sun","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1089\/ars.2012.5082","article-title":"Fasting induces nuclear factor E2-related factor 2 and ATP-binding Cassette transporters via protein kinase A and Sirtuin-1 in mouse and human","volume":"20","author":"Kulkarni","year":"2014","journal-title":"Antioxid. Redox Signal."},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Lettieri-Barbato, D., Minopoli, G., Caggiano, R., Izzo, R., Santillo, M., Aquilano, K., and Faraonio, R. (2020). Fasting drives Nrf2-related antioxidant response in skeletal muscle. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21207780"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1007\/s11033-020-06041-x","article-title":"The effect of dietary phytochemicals on nuclear factor erythroid 2-related factor 2 (Nrf2) activation: A systematic review of human intervention trials","volume":"48","author":"Clifford","year":"2021","journal-title":"Mol. Biol. Rep."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Wu, X., Wei, J., Yi, Y., Gong, Q., and Gao, J. (2022). Activation of Nrf2 signaling: A key molecular mechanism of protection against cardiovascular diseases by natural products. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.1057918"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1038\/nprot.2007.77","article-title":"Cytokinesis-block micronucleus cytome assay","volume":"2","author":"Fenech","year":"2007","journal-title":"Nat. Protoc."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"5057","DOI":"10.1073\/pnas.0830918100","article-title":"Evidence for a lack of DNA double-strand break repair in human cells exposed to very low x-ray doses","volume":"100","author":"Rothkamm","year":"2003","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1146\/annurev-pharmtox-011112-140320","article-title":"Role of nrf2 in oxidative stress and toxicity","volume":"53","author":"Ma","year":"2013","journal-title":"Annu. Rev. Pharmacol. Toxicol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.mrrev.2012.05.003","article-title":"Ionizing radiation biomarkers for potential use in epidemiological studies","volume":"751","author":"Pernot","year":"2012","journal-title":"Mutat. Res.\/Rev. Mutat. Res."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.mrrev.2017.01.001","article-title":"Ionizing radiation biomarkers in epidemiological studies\u2013An update","volume":"771","author":"Hall","year":"2017","journal-title":"Mutat. Res.\/Rev. Mutat. Res."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.freeradbiomed.2021.03.034","article-title":"Regulation of Nrf2 by phosphorylation: Consequences for biological function and therapeutic implications","volume":"168","author":"Liu","year":"2021","journal-title":"Free. Radic. Biol. Med."},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Sun, Z., Huang, Z., and Zhang, D.D. (2009). Phosphorylation of Nrf2 at multiple sites by MAP kinases has a limited contribution in modulating the Nrf2-dependent antioxidant response. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0006588"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/s41420-025-02491-z","article-title":"Targeting epigenetic and post-translational modifications of NRF2: Key regulatory factors in disease treatment","volume":"11","author":"Yang","year":"2025","journal-title":"Cell Death Discov."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.freeradbiomed.2009.07.035","article-title":"Nrf2: INrf2 (Keap1) signaling in oxidative stress","volume":"47","author":"Kaspar","year":"2009","journal-title":"Free Radic. Biol. Med."}],"container-title":["Antioxidants"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3921\/14\/12\/1393\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T09:33:52Z","timestamp":1763976832000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3921\/14\/12\/1393"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,22]]},"references-count":119,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["antiox14121393"],"URL":"https:\/\/doi.org\/10.3390\/antiox14121393","relation":{},"ISSN":["2076-3921"],"issn-type":[{"value":"2076-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,22]]}}}