Höke Ahmet, Ray Mitali
ILAR J. 2014;54(3):273-81. doi: 10.1093/ilar/ilt053.
Peripheral neuropathy is a common and dose-limiting side effect of many chemotherapeutic drugs. These include platinum compounds, taxanes, vinca alkaloids, proteasome inhibitors, and others such as thalidomide and suramin. Although many rodent models have been developed using either mice or rats, there is limited consistency in the dose or mode of delivery of the drug; the sex, age, and genetic background of the animal used in the study; and the outcome measures used in evaluation of the peripheral neuropathy. Behavioral assays are commonly used to evaluate evoked sensory responses but are unlikely to be a good representation of the spontaneous sensory paresthesias that the patients experience. Electrophysiologic tests evaluate the integrity of large myelinated populations and are useful in drugs that cause either demyelination or degeneration of large myelinated axons but are insensitive to degeneration of unmyelinated axons in early stages of neuropathy. Histopathologic tools offer an unbiased way to evaluate the degree of axonal degeneration or changes in neuronal cell body but are often time consuming and require processing of the tissue after the study is completed. Nevertheless, use of drug doses and mode of delivery that are relevant to the clinical protocols and use of outcome measures that are both sensitive and objective in evaluation of the length-dependent distal axonal degeneration seen in most chemotherapy-induced peripheral neuropathies may improve the translational utility of these rodent models.
周围神经病变是许多化疗药物常见的剂量限制性副作用。这些药物包括铂类化合物、紫杉烷类、长春花生物碱、蛋白酶体抑制剂,以及沙利度胺和苏拉明等其他药物。尽管已经利用小鼠或大鼠建立了许多啮齿动物模型,但在药物的给药剂量或方式、研究中所用动物的性别、年龄和遗传背景,以及评估周围神经病变时所采用的结局指标方面,一致性有限。行为学检测通常用于评估诱发的感觉反应,但不太可能很好地反映患者所经历的自发性感觉异常。电生理检测评估大的有髓神经纤维群体的完整性,对于导致大的有髓轴突脱髓鞘或变性的药物有用,但对神经病变早期无髓轴突的变性不敏感。组织病理学方法提供了一种客观评估轴突变性程度或神经元细胞体变化的方法,但通常耗时较长,且需要在研究完成后对组织进行处理。然而,使用与临床方案相关的药物剂量和给药方式,并采用在评估大多数化疗诱导的周围神经病变中所见的长度依赖性远端轴突变性时既敏感又客观的结局指标,可能会提高这些啮齿动物模型的转化应用价值。