Early knowledge of the absorbed dose is of paramount importance in radiation emergencies in order to focus the available resources only on those subjects who need urgent medical treatment. Several biomarkers have been established for measuring dose, the count of dicentrics or micronuclei are the main utilized techniques but give results only from 2 to 3 days after. It is therefore highly needed a tool to sort subjects un-exposed or exposed to very low doses, from those patients likely to develop health consequences, requiring medical evaluation and intervention. With the aim of validating a novel tool of early biomarkers for assessing the absorbed range of dose early after the exposure to radiation recently NATO SPS has funded an Italian-Egyptian collaborative project, still running. The selected biomarkers include blood count, radio-inducible proteins, Comet assay, H2AX foci and for validation also the micronuclei count. Patients recruited in Rome and in Alexandria are sampled before and 3 h after the first exposure to 250; 340 or > 500 cGy of X rays for therapeutic purposes. Recently in the frame of a bilateral collaborative research call, launched by the Italian Ministry of Foreign Affairs and International Cooperation and the Egyptian STD we have received a further funding for integrating the NATO SPS project, in particular for what concerns increasing training, the addition of a further sampling time points (24 h after RT), the analysis of immune-response and the characterization of the circulating exosomes as potential biomarkers. Preliminary results are presented. © 2022, Springer Nature B.V.

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