Therapeutic radiation exposure of the abdomen during childhood induces chronic adipose tissue dysfunction

Childhood cancer survivors who received abdominal radiotherapy (RT) or total body irradiation (TBI) are at increased risk for cardiometabolic disease, but the underlying mechanisms are unknown. We hypothesize that RT-induced adipose tissue dysfunction contributes to the development of cardiometabolic disease in the expanding population of childhood cancer survivors. We performed bulk RNA-sequencing of abdominal subcutaneous adipose tissue from adult childhood cancer survivors previously exposed to TBI, abdominal RT, or chemotherapy alone, alongside a group of healthy controls. We find that irradiated adipose tissue is characterized by a gene expression signature indicative of a complex macrophage expansion, which is also associated with dysregulated adipokine secretion. The full cohort is 30 subjects; however, 3 participants (2 in CHM group, 1 in CTL group) declined to share their sequencing data in a public database. Overall design: Observational cohort with 4 groups: CTL (healthy controls); CHM (chemotherapy only); ABM (chemo+abdominal radiation); TBI (chemo+total body irradiation).