Simulation of complex DNA damage enhancement and biological effect validation for Proton-CAT
Lang Dong, Dechao An, Junxiang Wu, Tianle Wang, Zhao Sun, Jiajun Kang, Xianliang Wang, Lintao Li, Shun Lu, Tianli Qiu, Da Zhang, Zhencen He, Zhimin Hu

TL;DR
This study combines DNA damage simulations and cell experiments to validate that Proton-CAT enhances complex DNA damage via nitrogen enrichment, potentially improving proton therapy's efficacy.
Contribution
It provides a multi-scale simulation and experimental validation of Proton-CAT's mechanism, highlighting nitrogen enrichment's role in increasing DNA damage.
Findings
$^{15}$N enrichment significantly increases complex DNA damage.
High concentrations of $^{15}$N-Glu do not cause significant cytotoxicity.
Proton-CAT's enhanced effect mainly results from increased complex DNA damage.
Abstract
Proton therapy has been rapidly advancing due to its excellent conformal index, but its relatively low relative biological effect (RBE) has somewhat limited its therapeutic efficacy for certain tumors. To address this, we previously proposed a nitrogen-targeting Proton-Carbon-Alpha-Therapy (Proton-CAT) enhancement method. In this letter, we present combined multi-scale DNA damage simulations and in vitro cell experiments, further investigating the mechanism of the Proton-CAT. It has been show that N enrichment significantly enhances complex DNA damage induced by high linear energy transfer(LET) particles within tumor regions. Under 30\% N conditions, and C particle induced DSB++ increased by 175.19\% and 52.94\%, respectively. Furthermore, in vitro cell experiments using N-glutamine (N-Glu) as the N carrier indicated that high…
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