Apfel S C, Arezzo J C, Lipson L, Kessler J A
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461.
Ann Neurol. 1992 Jan;31(1):76-80. doi: 10.1002/ana.410310114.
Cisplatin is a widely used antitumor agent, the dose-limiting toxicity of which is predominantly large-fiber sensory neuropathy. Prevention of such a neuropathy would extend the usefulness of this agent, allowing higher doses and longer periods of treatment. We report here that we have successfully established cisplatin neuropathy in mice measured by using behavioral, biochemical, and electrophysiological techniques, and that subcutaneous administration of human recombinant nerve growth factor (NGF) prevents or delays the neuropathy. Cisplatin administration reduced sensory ganglion levels of the peptide transmitter, calcitonin gene-related peptide, slowed nerve conduction in the tail and impaired proprioception as measured by the ability to balance on a rotating dowel. NGF coadministration appeared to prevent all these abnormalities. Treatment of the human toxic neuropathy with its well-established time of onset, simple clinical course, and the accessibility of nerve to NGF administered systemically may provide the best clinical setting for the first human trials of NGF.
顺铂是一种广泛使用的抗肿瘤药物,其剂量限制性毒性主要是大纤维感觉神经病变。预防这种神经病变将扩大该药物的应用范围,从而能够使用更高剂量并延长治疗时间。我们在此报告,我们已通过行为、生化和电生理技术成功在小鼠中建立了顺铂神经病变模型,并且皮下注射人重组神经生长因子(NGF)可预防或延缓这种神经病变。给予顺铂会降低肽类递质降钙素基因相关肽的感觉神经节水平,减缓尾部神经传导,并通过在旋转木钉上保持平衡的能力来衡量,损害本体感觉。同时给予NGF似乎可预防所有这些异常情况。人类毒性神经病变具有明确的发病时间、简单的临床病程,且全身给予的NGF可作用于神经,这可能为NGF的首次人体试验提供最佳临床环境。