IntroductionThe Organisation for Economic Co-operation and Development (OECD) Adverse Outcome Pathway (AOP) framework is used to organize scientific knowledge in toxicology into linear sequences of causally related events that lead to adverse toxicological endpoints (Ankley et al., 2010; OECD, 2018). AOPs describe the critical interactions of a chemical or non-chemical stressor within a biological system. AOPs begins with a molecular initiating event (MIE) that leads to intermediate key events (KEs) and culminate in an adverse outcome (AO). KEs are connected by key event relationships (KERs) for which causality is evaluated using the modified Bradford-Hill criteria (Becker et al., 2015). These criteria include biological plausibility, evidence for the essentiality of KEs, and empirical evidence in the form of dose-, temporal- and incidence-concordance. The strength of these directional and causal relationships is evaluated through a weight of evidence analysis for each KER (Villeneuve et al., 2014). AOPs are purposefully simplified, describing KEs that can be routinely measured and are essential to pathway progression, to facilitate regulatory utility and test strategy development (Ankley et al., 2010). AOPs are developed in a linear manner; however, shared KEs lead to networks of AOPs. Through these networks, multiple MIEs can converge to lead to the same AOs. In addition, multiple different types of stressors may interact with the same MIE to progress AOPs. Thus, although simple in concept, the AOP network is the fundamental unit of application for risk assessment and can broadly reflect complex, multi-stressor interactions and outcomes. AOPs have primarily been used to describe the impacts of chemicals on human and ecological outcomes. However, there is growing interest in applying AOPs in the radiation field (NCRP 2020, Chauhan et al., 2019; Chauhan et al., 2024). A case example AOP to lung cancer that is relevant to stressors such as radon inhalation has been endorsed by the Nuclear Energy Agency (NEA) and the Working Group of the National Coordinators of the Test Guidelines Programme (WNT) and Working Party on Hazard Assessment (WPHA) of the OECD (https://aopwiki.org/aops/272). Furthermore, since June 2021, a Radiation/Chemical AOP Joint Topical Group under the auspices of the NEA High Level Group on Low Dose Research has been working to promote and integrate AOPs into radiation research and risk assessments (Chauhan, Beaton et al., 2022a; Chauhan, Hamada et al., 2022b; Chauhan, Beaton et al., 2024). As part of these efforts, AOPs are being developed to multiple AOs including those relevant to space exploration (Kozbenko et al., 2024; Carrothers et al., 2024; Sleiman et al., 2024; Sandhu et al., 2024). Herein we describe four AOPs (AOP#478; AOP#483; AOP#470; AOP#482) that form a network leading to non-cancer AOs of relevance to space travel.

The understanding of radiation-induced non-cancer effects on the central nervous system (CNS) is essential for the medical setting (e.g., radiotherapy), and occupational exposures, such as nuclear workers or astronauts. Herein, the adverse outcome pathway (AOP) approach was used to consolidate relevant studies in the area of cognitive decline for identification of research gaps, countermeasure development, and for eventual use in risk assessments. AOPs are an analytical construct describing critical events to an adverse outcome (AO) in a simplified form beginning with a molecular initiating event (MIE). An AOP was constructed utilizing mechanistic information to build empirical support for the key event relationships (KERs) between the MIE of deposition of energy to the AO of learning and memory impairment through multiple key events (KEs). The evidence for the AOP was developed through a scoping review of the literature. In this AOP, the MIE is connected to the AO via six KEs of increased oxidative stress, increased deoxyribonucleic acid (DNA) strand breaks, altered signaling pathways, tissue resident cell activation, increased pro-inflammatory mediators and neural remodeling. Deposition of energy directly leads to oxidative stress, increased DNA strand breaks, an increase of pro-inflammatory mediators and tissue resident cell activation. These KEs, which are themselves interconnected, converge through increased DNA strand breaks, altered signaling pathways and pro-inflammatory routes and directly lead to neural remodeling. Broadly, it is envisioned that the outcome of these efforts could be applied to other cognitive disorders and support ongoing work by international authorities to review the system of radiological protection.