The effect of irradiation on function in self-renewing normal tissues with differing proliferative organisation.

The primary effect of irradiation on self-renewing normal tissues is sterilisation of their proliferative cells, but how this translates into failure of tissue function depends on the mode of organisation of the tissue concerned. It has recently been suggested (Michalowski, 1981) that proliferative normal tissues may be classed as "hierarchical" (like haemopoietic tissues) or as "flexible" (like liver parenchyma) and that radiation injury to tissue function develops by different pathways in these tissues. Mathematical model studies confirm the different radiation responses of differently organized tissues. Tissues of the "flexible" or "F-type" category display a variety of novel radiobiological properties, different from those of the more familiar "hierarchical" or "H-type" tissues. The "F-type" responses are strongly influenced by radiation-sterilised ("doomed") cells, and it is suggested that the rôle of "doomed" cells has been undervalued relative to that of clonogenic survivors. Since "F-type" tissues have characteristically low rates of cell renewal, it is possible that these tissues are preferentially responsible for late effects of irradiation in clinical radiotherapy.