Аннотация (русский):
В обзоре рассмотрены причины, не позволяющие использовать радиационный гормезис для нужд здравоохранения и для профилактики заболеваний у населения. Отмечается, что доказательства гормезисных эффектов малых доз радиации с низкой ЛПЭ получены только в лабораторных экспериментах на клетках и животных, с использованием гипотетико-дедуктивного метода и адекватных контролей. Некоторое подтверждение выявлено в бальнеологии (радонотерапия) и в клинике (иммуностимуляция у больных раком). В то же время, в эпидемиологических, обсервационных исследованиях, предусматривающих в основном метод индукции, нет однозначных данных о гормезисных эффектах по частоте канцерогенеза. Это обусловлено тем, что в области малых доз (до 0,1 Гр), помимо линейной, равновероятны любые формы зависимости от дозы, и нет возможности вычленить лучевой эффект вследствие вмешательства нелучевых факторов, а также конфаундеров и смещений. Эпидемиологические дизайны, использованные для подтверждения радиационного гормезиса по частоте злокачественных новообразований, имеют значительные недостатки и ограничения для малых величин эффектов, и это, согласно принципам эпидемиологии, не позволяет сделать выводы о существования гормезиса. Сказанное является в том числе позицией НКДАР ООН, МКРЗ, BEIR и NCRP, которая в соответствующих документах, однако, изложена недостаточно. Эта позиция для многих исследователей-экспериментаторов и клиницистов (любого ранга), не знакомых с азами классической эпидемиологии и описательных дисциплин, так и остается непонятной и непонятой. Сделан вывод, что хотя гормезис при малых дозах радиации, возможно, и существует, доказать и, тем более, использовать его в эпидемиологии и медицине для профилактики заболеваемости здорового населения вряд ли будет возможно. В то же время, следует активнее развивать клиническое использование облучения в малых дозах, но только как терапевтическую иммуностимуляцию при тяжелых патологиях.

Ключевые слова:
радиационный гормезис, малые дозы облучения, радиобиология, эпидемиология, здравоохранение, защита от канцерогенеза

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