{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:15:35Z","timestamp":1788498935500,"version":"build-2803163510"},"reference-count":49,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009898","name":"Defense Health Agency","doi-asserted-by":"publisher","award":["75-13266"],"award-info":[{"award-number":["75-13266"]}],"id":[{"id":"10.13039\/100009898","id-type":"DOI","asserted-by":"publisher"}]},{"award":["75-13266"],"award-info":[{"award-number":["75-13266"]}],"id":[{"id":"https:\/\/ror.org\/03df8gj37","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["10650"],"award-info":[{"award-number":["10650"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["12080"],"award-info":[{"award-number":["12080"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["13586"],"award-info":[{"award-number":["13586"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"award":["10650"],"award-info":[{"award-number":["10650"]}],"id":[{"id":"https:\/\/ror.org\/04r3kq386","id-type":"ROR","asserted-by":"publisher"}]},{"award":["12080"],"award-info":[{"award-number":["12080"]}],"id":[{"id":"https:\/\/ror.org\/04r3kq386","id-type":"ROR","asserted-by":"publisher"}]},{"award":["13586"],"award-info":[{"award-number":["13586"]}],"id":[{"id":"https:\/\/ror.org\/04r3kq386","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Acute radiation syndrome is characterized by progressive hematologic decline and biochemical imbalances, yet the transition from recoverable injury to the preterminal state remains incompletely characterized using routine laboratory assays. Prior proteomic, metabolomic, and transcriptomic studies have revealed biological signatures in preterminal serum and plasma samples from irradiated nonhuman primates, suggesting that the preterminal state represents a distinct phenotype. In this study, complete blood count and serum biochemistry data collected from male and female rhesus macaques (Macaca mulatta) exposed to total-body doses of 60Co \u03b3-radiation were monitored from seven days prior to irradiation through 60 days post-irradiation. Preterminal samples were collected immediately prior to euthanasia upon determination of moribundity. A series of analyses was performed to characterize differences in injury severity and recovery between survivors and non-survivors. Our findings showed shared early cytopenic decreases in both survivors and non-survivors, consistent with expected radiation-induced hematopoietic injury. Preterminal samples collected between days 14\u201322 post-irradiation were characterized by erythroid decline and lymphocyte depletion. Most notably, red blood cells, hemoglobin, and hematocrit showed a delayed decline, with significant decreases associated with non-survival. Serum chemistry data was less discriminatory during scheduled sampling, but preterminal comparisons demonstrated significant changes prior to mortality. These results suggest that conventional clinical metrics can help characterize the preterminal phenotype.<\/jats:p>","DOI":"10.3390\/ijms27177709","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:31:13Z","timestamp":1788251473000},"page":"7709","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Blood-Based Biomarkers for the Preterminal Stage Using Rhesus Macaques Exposed to Acute Total-Body Radiation"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9361-3263","authenticated-orcid":false,"given":"Matthew W.","family":"Brink","sequence":"first","affiliation":[{"name":"Division of Radioprotectants, Department of Pharmacology and Molecular Therapeutics, F. Edward H\u00e9bert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2108-2274","authenticated-orcid":false,"given":"Alana D.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Division of Radioprotectants, Department of Pharmacology and Molecular Therapeutics, F. Edward H\u00e9bert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1729-5139","authenticated-orcid":false,"given":"Rachel C.","family":"Mingus","sequence":"additional","affiliation":[{"name":"Division of Radioprotectants, Department of Pharmacology and Molecular Therapeutics, F. Edward H\u00e9bert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-7570","authenticated-orcid":false,"given":"Sarah A.","family":"Petrus","sequence":"additional","affiliation":[{"name":"Division of Radioprotectants, Department of Pharmacology and Molecular Therapeutics, F. Edward H\u00e9bert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7942-2497","authenticated-orcid":false,"given":"Oluseyi O.","family":"Fatanmi","sequence":"additional","affiliation":[{"name":"Division of Radioprotectants, Department of Pharmacology and Molecular Therapeutics, F. Edward H\u00e9bert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7613-7455","authenticated-orcid":false,"given":"Stephen Y.","family":"Wise","sequence":"additional","affiliation":[{"name":"Division of Radioprotectants, Department of Pharmacology and Molecular Therapeutics, F. Edward H\u00e9bert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6631-3849","authenticated-orcid":false,"given":"Vijay K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Radioprotectants, Department of Pharmacology and Molecular Therapeutics, F. 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Hematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.annemergmed.2007.12.021","article-title":"Medical response to a radiologic\/nuclear event: Integrated plan from the Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services","volume":"53","author":"Coleman","year":"2009","journal-title":"Ann. Emerg. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.1001\/dmp.2011.17","article-title":"Radiation injury after a nuclear detonation: Medical consequences and the need for scarce resources allocation","volume":"5","author":"DiCarlo","year":"2011","journal-title":"Disaster Med. Public Health Prep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1667\/RADE-21-00213.1","article-title":"Development of biomarkers for radiation biodosimetry and medical countermeasures research: Current status, utility, and regulatory pathways","volume":"197","author":"Winters","year":"2022","journal-title":"Radiat. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/1535370217750088","article-title":"Biomarker definitions and their applications","volume":"243","author":"Califf","year":"2018","journal-title":"Exp. Biol. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1088\/1361-6498\/ac0d3f","article-title":"United States medical preparedness for nuclear and radiological emergencies","volume":"41","author":"DiCarlo","year":"2021","journal-title":"J. Radiol. Prot."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"584","DOI":"10.3390\/ebj4040039","article-title":"Management of Casualties from Radiation Events","volume":"4","author":"Dent","year":"2023","journal-title":"Eur. Burn. J."},{"key":"ref_9","unstructured":"Jarrett, D.G. (1999). Medical Management of Radiological Casualities Handbook, Armed Forces Radiobiology Research Institute."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S0301-472X(02)00802-0","article-title":"Hematologic consequences of exposure to ionizing radiation","volume":"30","author":"Dainiak","year":"2002","journal-title":"Exp. Hematol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1182\/asheducation-2003.1.473","article-title":"The hematologist and radiation casualties","volume":"2003","author":"Dainiak","year":"2003","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"ii54","DOI":"10.1093\/jrr\/rry004","article-title":"Medical management of acute radiation syndrome and associated infections in a high-casualty incident","volume":"59","author":"Dainiak","year":"2018","journal-title":"J. Radiat. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1159\/000531444","article-title":"Biomarkers for biodosimetry and their role in predicting radiation injury","volume":"163","author":"Aryankalayil","year":"2023","journal-title":"Cytogenet. Genome Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1667\/RADE-24-00065.1","article-title":"Effect of age at time of irradiation, sex, genetic diversity, and granulopoietic cytokine radiomitigation on lifespan and lymphoma development in murine H-ARS survivors","volume":"202","author":"Plett","year":"2024","journal-title":"Radiat. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1667\/RADE-22-00071.1","article-title":"Age and sex divergence in hematopoietic radiosensitivity in aged mouse models of the hematopoietic acute radiation syndrome","volume":"198","author":"Patterson","year":"2022","journal-title":"Radiat. Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Yamaguchi, M., Tatara, Y., Sato, Y., and Kashiwakura, I. (2025). Acute radiation exposure in mice reveals traces of oxidation-mediated modifications in serum albumin. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0330925"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.annemergmed.2013.02.005","article-title":"Systematic review of strategies to manage and allocate scarce resources during mass casualty events","volume":"61","author":"Timbie","year":"2013","journal-title":"Ann. Emerg. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"23930","DOI":"10.1038\/s41598-024-75225-3","article-title":"Metabolomic changes in preterminal serum samples of rhesus macaques exposed to two different lethal doses of total-body gamma-radiation","volume":"14","author":"Carpenter","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Carpenter, A.D., Fatanmi, O.O., Wise, S.Y., Petrus, S.A., Tyburski, J.B., Cheema, A.K., and Singh, V.K. (2024). Metabolomic changes in plasma of preterminal stage of rhesus nonhuman primates exposed to lethal dose of radiation. Metabolites, 14.","DOI":"10.1038\/s41598-024-64316-w"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"13571","DOI":"10.1038\/s41598-024-64316-w","article-title":"Proteomic analysis of plasma at the preterminal stage of rhesus nonhuman primates exposed to a lethal total-body dose of gamma-radiation","volume":"14","author":"Carpenter","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1667\/RADE-25-00029.1","article-title":"Proteomic changes in preterminal serum samples of rhesus macaques exposed to two different doses of acute lethal total-body gamma radiation","volume":"204","author":"Carpenter","year":"2025","journal-title":"Radiat. Res."},{"key":"ref_22","first-page":"17","article-title":"Gene expression changes in a prefinal health stage of lethally irradiated male and female rhesus macaques","volume":"199","author":"Schule","year":"2023","journal-title":"Radiat. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"802","DOI":"10.3109\/09553002.2011.556177","article-title":"Radiation metabolomics and its potential in biodosimetry","volume":"87","author":"Coy","year":"2011","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1080\/09553002.2016.1269218","article-title":"Metabolomic applications in radiation biodosimetry: Exploring radiation effects through small molecules","volume":"93","author":"Pannkuk","year":"2017","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4143","DOI":"10.1021\/pr5005295","article-title":"Metabolic phenotyping reveals a lipid mediator response to ionizing radiation","volume":"13","author":"Laiakis","year":"2014","journal-title":"J. Proteome Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1667\/RR3967.1","article-title":"Metabolomic profiling of urine samples from mice exposed to protons reveals radiation quality and dose specific differences","volume":"183","author":"Laiakis","year":"2015","journal-title":"Radiat. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1667\/RR14656.1","article-title":"Metabolic Dysregulation after Neutron Exposures Expected from an Improvised Nuclear Device","volume":"188","author":"Laiakis","year":"2017","journal-title":"Radiat. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/SMJ.0b013e3181ddd571","article-title":"Acute radiation syndrome: Assessment and management","volume":"103","author":"Donnelly","year":"2010","journal-title":"South. Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1080\/14737159.2018.1533404","article-title":"Biomarkers for acute radiation syndrome: Challenges for developing radiation countermeasures following animal rule","volume":"18","author":"Singh","year":"2018","journal-title":"Expert. Rev. Mol. Diagn."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1259\/bjr\/49063618","article-title":"A rapid multiparametric method for victim triage in cases of accidental protracted irradiation or delayed analysis","volume":"82","author":"Bertho","year":"2009","journal-title":"Br. J. Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kiang, J.G., Woods, A.K., and Cannon, G. (2024). Effects of hemorrhage on hematopoietic cell depletion after a combined injury with radiation: Role of white blood cells and red blood cells as biomarkers. Int. J. Mol. Sci., 25.","DOI":"10.20944\/preprints202402.0885.v1"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Medhora, M., Gao, F., Gasperetti, T., Narayanan, J., Himburg, H., Jacobs, E.R., Clough, A.V., Fish, B.L., and Szabo, A. (2023). Biomarkers to Predict Lethal Radiation Injury to the Rat Lung. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24065627"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/j.1600-0684.1997.tb00042.x","article-title":"Advantages and limitations of nonhuman primates as animal models in genetic research on complex diseases","volume":"26","author":"VandeBerg","year":"1997","journal-title":"J. Med. Primatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1093\/toxsci\/kfi243","article-title":"Comparison of non-human primate and human whole blood tissue gene expression profiles","volume":"87","author":"Dillman","year":"2005","journal-title":"Toxicol. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1667\/RR1880.1","article-title":"Animal models for medical countermeasures to radiation exposure","volume":"173","author":"Williams","year":"2010","journal-title":"Radiat. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1097\/HP.0000000000001327","article-title":"Defining the concomitant multiple organ injury within the ARS and DEARE in an animal model research platform","volume":"119","author":"MacVittie","year":"2020","journal-title":"Health Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1667\/RR13940.1","article-title":"Pegfilgrastim improves survival of lethally irradiated nonhuman primates","volume":"183","author":"Hankey","year":"2015","journal-title":"Radiat. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1358\/dot.2015.51.9.2386730","article-title":"Filgrastim for the treatment of hematopoietic acute radiation syndrome","volume":"51","author":"Farese","year":"2015","journal-title":"Drugs Today (Barc)"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.ijrobp.2023.05.008","article-title":"Survival and hematologic benefits of romiplostim after acute radiation exposure supported FDA approval under the animal rule","volume":"17","author":"Bunin","year":"2023","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1358\/dot.2022.58.3.3367994","article-title":"An update on romiplostim for treatment of acute radiation syndrome","volume":"58","author":"Singh","year":"2022","journal-title":"Drugs Today"},{"key":"ref_41","unstructured":"Kashiv BioSciences (2025, October 20). RELEUKO (Filgrastim-Ayow) Injection, for Subcutaneous or Intravenous Use, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2025\/761082s014lbl.pdf."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1080\/09553002.2021.1969054","article-title":"Radiation countermeasures for hematopoietic acute radiation syndrome: Growth factors, cytokines and beyond","volume":"97","author":"Singh","year":"2021","journal-title":"Int. J. Radiat. Biol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1586\/14737159.2016.1121102","article-title":"Use of biomarkers for assessing radiation injury and efficacy of countermeasures","volume":"16","author":"Singh","year":"2016","journal-title":"Expert. Rev. Mol. Diagn."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1007\/s13361-016-1438-5","article-title":"Rapid and high-throughput detection and quantitation of radiation biomarkers in human and nonhuman primates by differential mobility spectrometry-mass spectrometry","volume":"27","author":"Chen","year":"2016","journal-title":"J. Am. Soc. Mass. Spectrom."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.exphem.2020.03.004","article-title":"Deposition of iron in the bone marrow of a murine model of hematopoietic acute radiation syndrome","volume":"84","author":"Rittase","year":"2020","journal-title":"Exp. Hematol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1667\/RR14436.1","article-title":"Understanding the pathophysiology and challenges of development of medical countermeasures for radiation-induced vascular\/endothelial cell injuries: Report of a NIAID workshop, August 20, 2015","volume":"186","author":"Satyamitra","year":"2016","journal-title":"Radiat. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1667\/RR14127.1","article-title":"Radioprotective efficacy of gamma-tocotrienol in nonhuman primates","volume":"185","author":"Singh","year":"2016","journal-title":"Radiat. Res."},{"key":"ref_48","unstructured":"National Research Council (2011). Guide for the Care and Use of Laboratory Animals, National Academies Press. [8th ed.]."},{"key":"ref_49","unstructured":"Leary, S., Underwood, W., Anthony, R., Cartner, S., Grandin, T., Greenacre, C.B., Gwaltney-Bran, S., McCrackin, M.A., Meyer, R., and Miller, D. (2020). AVMA Guidelines for Euthanasia of Animals, American Veterinary Medical Association."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/17\/7709\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:25:24Z","timestamp":1788495924000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/17\/7709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":49,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["ijms27177709"],"URL":"https:\/\/doi.org\/10.3390\/ijms27177709","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]}}}