化疗诱发的周围神经病变:病理生理学和治疗的最新进展

Life Pub Date : 2024-08-09 DOI:10.3390/life14080991
Marina Mattar, Florence Umutoni, Marwa A. Hassan, M. W. Wamburu, Reagan Turner, James S. Patton, Xin Chen, Wei Lei
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摘要

化疗引起的周围神经病变(CIPN)是某些化疗药物的一种主要的长期副作用,威胁着癌症患者的生存率。CIPN 主要影响感觉神经元,偶尔也会影响运动神经元,导致上肢和下肢麻木、刺痛、不适和灼痛。CIPN 的病理生理学尚不完全清楚,但一般认为化疗会直接损伤线粒体、损害离子通道功能、触发免疫机制和破坏微管,从而诱发周围神经病变。CIPN 的治疗是一项医学挑战,目前还没有获得批准的药物治疗方案。目前,临床上常用度洛西汀和其他抗抑郁剂、抗氧化剂、抗炎和离子通道靶向疗法来缓解 CIPN 的症状。其他几种药物,如大麻素、sigma-1 受体拮抗剂和烟酰胺核糖,正在临床前和临床研究中接受评估。本文概述了与 CIPN 的生理学和可用于治疗这种病症的药物有关的信息。
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Chemotherapy-Induced Peripheral Neuropathy: A Recent Update on Pathophysiology and Treatment
Chemotherapy-induced peripheral neuropathy (CIPN) is a major long-lasting side effect of some chemotherapy drugs, which threatens cancer survival rate. CIPN mostly affects sensory neurons and occasionally motor neurons, causing numbness, tingling, discomfort, and burning pain in the upper and lower extremities. The pathophysiology of CIPN is not completely understood; however, it is believed that chemotherapies induce peripheral neuropathy via directly damaging mitochondria, impairing the function of ion channels, triggering immunological mechanisms, and disrupting microtubules. The treatment of CIPN is a medical challenge, and there are no approved pharmacological options. Currently, duloxetine and other antidepressants, antioxidant, anti-inflammatory, and ion-channel targeted therapies are commonly used in clinics to relieve the symptoms of CIPN. Several other types of drugs, such as cannabinoids, sigma−1 receptor antagonists, and nicotinamides ribose, are being evaluated in preclinical and clinical studies. This paper summarizes the information related to the physiology of CIPN and medicines that could be used for treating this condition.
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