In Israel, a unique medicine for radiation sickness has been developed, using new technologies and research. Ukraine has already ordered it.

In the event of a nuclear catastrophe, the drug PLX-R18 can be administered to thousands of people, significantly reducing mortality. Ukraine has already ordered 12,000 doses of this revolutionary drug from an Israeli company in Haifa. Details about the production process and the possible integration of the drug into Israel’s strategic reserves were investigated.

Blood Factory

Bone marrow is the first victim of radiation sickness, as it produces new blood cells. In the event of radiation exposure, the risk of death arises from problems with hematopoiesis, making bone marrow transplantation a particularly relevant topic. The first successful bone marrow transplant for radiation victims took place in 1959 in Europe.

However, such an operation is risky and requires genetic compatibility, making its mass application impossible. In fact, many radiation victims do not need new bone marrow — their usual blood stem cells are still available in their bodies. The problem is the loss of microenvironment cells responsible for their proper development.

These cells die or cease to function under radiation. As a result, stem cells do not receive the signals necessary to turn into full-fledged blood cells. This can lead to anemia, platelet deficiency, or diseases due to the lack of leukocytes.

To save such patients, it is necessary to restore the production of signaling molecules or replace them with analogs. This is precisely the task that PLX-R18, developed by the Israeli company Pluri, addresses.

The development is not new — the US already has drugs in strategic reserves that replace some signaling molecules. However, PLX-R18 is fundamentally different — it uses living cells to adapt the functions of damaged microenvironment cells.

“At the injection site, they become factories for producing the necessary molecules,” shares Arik Avni, who leads radiation protection projects at the company.

Blood cells are diverse, and PLX-R18 is currently the only drug that restores all areas of hematopoiesis. There is no need for individual diagnostics: treatment can be conducted en masse, saving time.

The first injection of the drug should be administered within 72 hours after the catastrophe, making its applicability in emergency situations particularly important.

Mice, Monkeys, and Patients After Transplantation

PLX-R18 can be administered prophylactically in advance, for example, to soldiers before potential radioactive contamination. Experiments on mice showed excellent results: survival increased from 23% to 81%. When used on animals under radiation conditions, survival increased from 29% to 97% in successful trials.

In 2017, the drug was also tested on macaques, where survival in the control group was 50%, and in the experimental group — 85%. Problems arise in human trials, as irradiating a person to test the drug is unethical. The FDA has a special “Animal Rule” procedure that allows research only on animals.

However, exceptions are made in extraordinary cases, where the use of PLX-R18 in radiation disasters is approved. The drug was also tested on patients who faced problems after bone marrow transplantation.

Eight patients received small doses to check safety, and data shows a significant reduction in the need for donor blood. Mortality decreased from 29% to 18% within a year. Currently, the company focuses on treating radiation sickness. The first order has already been placed: Ukraine is purchasing 12,000 doses of the drug.

The partner among Ukrainian organizations is the Hemafund Organization, responsible for the proper storage of cells necessary for drug production, as they require special conditions. This drug requires freezing to -196 degrees Celsius.

Scale Problem

The Pluri factory occupies 600 square meters in the Haifa tech park. Despite the presence of bioreactors, insufficient capacity severely limits the company’s capabilities. Each automated reactor produces 10,000 doses per year — one dose is enough for one patient.

The created technology of three-dimensional cell cultivation allows improving their production process. “Unlike two-dimensional growth, we were able to create three-dimensional structures,” notes Anna Hyman, a leading production specialist.

The equipment is modern and exclusive: the company has registered 140 patents, with another 120 in process. Parallel development of other drugs aimed at specific medical needs is part of a carefully constructed strategy.

The key source of cells for PLX-R18 is the placenta. The need to strictly consider the material — the consequences of natural childbirth can affect its quality. Researchers obtain about 25,000 doses from one placenta. Calculations suggest that 800 placentas are needed to provide for 10 million Israelis.

Success in meeting all necessary conditions will allow creating a reserve in case of atomic war, but there is still a long way to go before final results. Nevertheless, a drug with unique properties already exists.