Antioxidant Supplement Blunts Radiation-Linked DNA Repair Signals in Interventional Physicians

Interventional physicians who spend their days guiding catheters through blood vessels under live X-ray imaging face a quiet occupational hazard: chronic, low-dose ionizing radiation. A new pilot clinical intervention study published in CVIR Endovascular reports that a single morning dose of an oral antioxidant formulation measurably blunted the acute DNA damage repair response that normally surges in these physicians’ blood cells after a day of fluoroscopically guided angiography procedures.

The cohort comprised 19 men and one woman, with a mean age of 45.4 years. All participants had more than five years of experience performing image-guided procedures at the same institute and worked in the same procedure rooms, and all wore standard lead aprons and thyroid collars during their cases. Participants were sequentially allocated into two equally sized groups of ten: one received two oral antioxidant capsules an hour before starting their day’s procedures, while the untreated control group performed their usual cases without any intervention.

The antioxidant formulation, marketed as DNA Halo, contained a blend of naturally occurring compounds selected for their established roles in cellular protection: vitamin C, vitamin E, vitamin B12, folate, selenium, quercetin, coenzyme Q10, alpha-lipoic acid, astaxanthin, and zeaxanthin. Several ingredients, notably coenzyme Q10, vitamin E, and alpha-lipoic acid, were included because of prior evidence that they improve mitochondrial function in patients with mitochondrial disease. The researchers reasoned that a multi-ingredient approach would exploit additive and synergistic effects, since different antioxidants neutralize reactive species through distinct mechanisms, including free-radical chain termination, oxygen scavenging, and direct ROS quenching.

To capture the biological signature of a typical working day, each physician provided a blood sample in the morning, one hour before starting cases and before taking any antioxidant premedication, and a second sample in the evening after completing cases that same day. Peripheral blood lymphocytes were isolated from 5 to 8 milliliter whole blood draws, processed within two hours, and stored frozen before analysis. Laboratory staff were blinded to which participants had received the antioxidant capsules, and biospecimens were analyzed anonymously with respect to treatment assignment.

The study focused on messenger RNA biomarkers of DNA damage repair and inflammatory signaling in lymphocytes. The primary nuclear DNA repair marker was P53, a transcription factor that activates critical DNA damage detection and repair pathways. Secondary markers included STAT3, COX4i1, a cytochrome c oxidase subunit reflecting mitochondrial DNA injury responses, and NF-κB, a key indicator of inflammatory activation. Expression levels were quantified by reverse transcription-polymerase chain reaction, normalized to the reference gene B2M, and expressed as fold changes relative to each participant’s morning baseline.

The results revealed a striking contrast between the two groups. In the untreated control physicians, P53 mRNA rose by 97 percent on average between morning and evening samples, a statistically significant increase. NF-κB mRNA climbed by 60 percent, and COX4i1 increased by 41 percent, all significant within-group changes. In the antioxidant-treated group, by contrast, none of these within-day changes reached statistical significance: P53 rose only 19 percent, NF-κB 17 percent, and COX4i1 actually declined slightly, by 5 percent. STAT3 increased 52 percent in controls but was essentially unchanged in the treated group, though the between-group difference for this marker did not reach statistical significance.

Between-group comparisons confirmed the pattern. Post-exposure P53 expression change was 78 percent higher in untreated physicians than in treated ones, a significant difference, and COX4i1 levels were 46 percent higher in the untreated group, also significant. The inflammatory burden difference was particularly pronounced: NF-κB mRNA levels increased by 18 percent in the treatment group versus 60 percent in the untreated group, a significant between-group difference. Importantly, baseline gene expression levels and procedural fluoroscopic exposures, including both radiation dose and fluoroscopy duration on the test day and on a comparison day the prior week, were similar between groups, with the sole exception of a higher baseline NF-κB level in the antioxidant group.

The authors interpret these findings as evidence that antioxidant premedication attenuated the acute, oxidative stress-mediated DNA damage response triggered by occupational low-dose ionizing radiation. Ionizing radiation inflicts most of its cellular damage indirectly, through the radiolysis of water, which generates unstable reactive oxygen and nitrogen species that attack proteins, lipids, and DNA. The faster such damage is repaired or removed, the less likely it is to progress to a permanent mutation, a key early event in cancer initiation. Elevated repair biomarkers in the untreated physicians therefore reflect a cellular compensatory response to genuine radiation-induced injury during a routine workday, while the near-absence of this response in treated physicians suggests reduced oxidative damage burden.

The study’s context is sobering. Hospital medical staff constitute the largest group of occupationally and chronically exposed workers to low-dose ionizing radiation, and interventional physicians can accumulate lifetime exposures in the range of 50 to 200 millisieverts depending on their practice, potentially exceeding the International Commission on Radiological Protection’s regulatory maximum of 100 millisieverts over five consecutive years. Prior research has documented increased cancer risk, particularly for leukemia and thyroid cancers, among endovascular operators, and a study of brain tumors in interventional physicians found that 85 percent were left-sided, consistent with the physician’s typical position relative to the X-ray tube. Deterministic effects, including a significantly elevated cataract risk among interventional cardiologists, have also been reported.

The authors are careful to frame these results as preliminary. The study was a pilot with a small convenience sample and no formal sample size calculation, participants were not randomized, and neither physicians nor the treatment allocation could be blinded, though the quantitative laboratory outcomes and blinded lab staff reduce the risk of bias from participant awareness. Individual dosimetry was unavailable, so scatter radiation exposure could only be inferred from fluoroscopic dose indices, and heterogeneity in individual biomarker responses raises the risk of false negatives. Only acute, single-day effects were assessed, and the oncologic protective benefit of antioxidants remains implied rather than demonstrated. The authors call for larger, multi-institution studies with long-term follow-up, both in interventional physicians and in other radiation-exposed occupational groups, before antioxidant premedication can be recommended as a standard component of radiation protection alongside existing shielding and dose-reduction practices.

Subject of Research: A pilot intervention study testing whether oral antioxidant premedication reduces acute radiation-induced DNA damage repair biomarkers in interventional physicians performing fluoroscopically guided angiography.

Article Title: Antioxidant premedication reduces mitochondrial and nuclear DNA damage repair in interventional physicians performing X-ray-guided angiography procedures: a pilot clinical intervention study

Article References: Murphy, K., Lindsay, T., Tan, K., Lau, S., Elias, G., Luke, K., Nederveen, J., Xhuti, D., Minhas, M., Lok, B., Zhu, S., Pron, G., & Tarnopolsky, M. (2026). Antioxidant premedication reduces mitochondrial and nuclear DNA damage repair in interventional physicians performing X-ray-guided angiography procedures: a pilot clinical intervention study. CVIR Endovascular, 9(1), Article 123. https://doi.org/10.1186/s42155-026-00777-6

Image Credits: AI Generated

DOI: 10.1186/s42155-026-00777-6

Keywords: ionizing radiation, interventional physicians, antioxidants, DNA damage repair, angiography, fluoroscopy, oxidative stress, P53, NF-kB, mitochondrial DNA, occupational health, pilot study