恐怖分子使用核武器和辐射事故会使人类面临暴露在威胁生命的辐射水平下的风险。遭受致命辐射暴露的受害者面临潜在的致命急性伤害，而急性阶段的幸存者则在暴露后数年内遭受慢性的多器官损伤困扰。开发治疗辐射暴露的有效医学对策( MCM )是迫切需要的，这主要依赖于根据FDA动物准则在可靠和充分表征的动物模型中进行的研究。尽管已经在几个物种中开发了相关的动物模型，并且现在有四种治疗急性辐射综合征的MCM已经获得了FDA的认可，但是用于急性辐射暴露的延迟效应（DEARE）的动物模型是最近才开发出来的，也没有任何针对DEARE的许可MCM。在这里，我们对DEARE进行了综述，包括从人类数据和动物获得的关键特征、多器官DEARE的共同机制、用于研究DEARE的小型和大型动物模型以及正在开发的有前途的新的或重新定位的MCM，以缓解DEARE的影响。加强研究工作和支持，以更好地了解DEARE的机制和自然历史，是迫切需要的，这样的知识提供了迈向为全球人类造福的有效缓解DEARE的MCM的设计和开发所需的第一步。 在高剂量辐射暴露（高于2Gy）的情况下，例如核电站灾难和核战争的发生，迫切需要有效的医学对策（MCM）。在高剂量电离辐射暴露不到24小时后，受害者会出现一系列称为急性辐射综合征（ARS）的多系统症状。 ARS的幸存者有患上急性辐射暴露的延迟效应（DEARE）的风险，这是涉及多个器官系统的慢性疾病，发生时间介于几个月到数年之间。 DEARE被认为是ARS幸存者中氧化应激、炎症、衰老、纤维化和干细胞自我更新潜力丧失的某种组合的结果。 DEARE仍然是辐射损伤的一个研究不足的领域，大部分知识都是通过观察原子弹幸存者和放射治疗癌症幸存者获得的。

Terrorist use of nuclear weapons and radiation accidents put the human population at risk for exposure to life-threatening levels of radiation. Victims of lethal radiation exposure face potentially lethal acute injury, while survivors of the acute phase are plagued with chronic debilitating multi-organ injuries for years after exposure. Developing effective medical countermeasures (MCM) for the treatment of radiation exposure is an urgent need that relies heavily on studies conducted in reliable and well-characterized animal models according to the FDA Animal Rule. Although relevant animal models have been developed in several species and four MCM for treatment of the acute radiation syndrome are now FDA-approved, animal models for the delayed effects of acute radiation exposure (DEARE) have only recently been developed, and there are no licensed MCM for DEARE. Herein, we provide a review of the DEARE including key characteristics of the DEARE gleaned from human data as well as animal, mechanisms common to multi-organ DEARE, small and large animal models used to study the DEARE, and promising new or repurposed MCM under development for alleviation of the DEARE.Intensification of research efforts and support focused on better understanding of mechanisms and natural history of DEARE are urgently needed. Such knowledge provides the necessary first steps towards the design and development of MCM that effectively alleviate the life-debilitating consequences of the DEARE for the benefit of humankind worldwide.There is an urgent demand for effective medical countermeasures (MCM) in the event of high-dose radiation exposure (prompt exposures of >2Gy (Coleman et al. 2015; Winters et al. 2023)) ranging from nuclear plant disasters to nuclear warfare. Less than 24 hours after exposure to high-dose ionizing radiation, victims develop a continuum of multi-system symptoms referred to as acute radiation syndrome (ARS). Survivors of ARS are at risk for developing the delayed effects of acute radiation exposure (DEARE), a spectrum of chronic illnesses involving multiple organ systems and occurring months to years after radiation exposure. The DEARE are believed to result from some combination of oxidative stress, inflammation, senescence, fibrosis, and loss of stem cell self-renewal potential in the ARS survivors (Robbins and Zhao 2004; Zhao and Robbins 2009; Chua et al. 2012; Unthank et al. 2015; Wang et al. 2016; Al-Jumayli et al. 2022). DEARE remain an understudied area of radiation injury, with most knowledge gleaned from observing atomic bomb survivors and post-radiotherapy cancer survivors.