Neuro-Oncology Unit-IDIBELL, Hospital Universitari de Bellvitge-Institut Català d'Oncologia L'Hospitalet, Barcelona, Spain; Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona, and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain.
Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona, and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain.
J Pain Symptom Manage. 2017 Dec;54(6):815-825. doi: 10.1016/j.jpainsymman.2017.04.021. Epub 2017 Aug 8.
Neuropathic pain can be present in patients developing chemotherapy-induced peripheral neuropathy (CIPN). Nerve growth factor (NGF) is trophic to small sensory fibers and regulates nociception.
We investigated the changes in serum NGF and intraepidermal nerve fiber density in skin biopsies of cancer patients receiving neurotoxic chemotherapy in a single-center prospective observational study.
Patients were evaluated before and after chemotherapy administration. CIPN was graded with Total Neuropathy Score, nerve conduction studies, and National Common Institute-Common Toxicity Criteria for Adverse Events scale. Neuropathic pain was defined according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN20 questionnaire.
Neuropathic pain was present in 13 of 60 patients (21%), who reported shooting or burning pain in the hands (n = 9) and the feet (n = 12). Patients displaying painful CIPN presented higher NGF after treatment compared with patients with painless or absent CIPN (8.7 ± 11.9 vs. 2.5 ± 1.4 pg/mL, P = 0.016). The change of NGF significantly correlated with neuropathic pain. Patients with painful CIPN did not show significant loss of IEFND compared with patients with painless or absent CIPN (6.16 ± 3.86 vs. 8.37 ± 4.82, P = 0.12). No correlation between IEFND and NGF was observed.
Serum NGF increases in cancer patients receiving taxane or platinum with painful CIPN, suggesting that it might be a potential biomarker of the presence and severity of neuropathic pain in this population. Long-term comprehensive studies to better define the course of NGF in relation with neurological outcomes would be helpful in the further design of therapies for CIPN-related neuropathic pain.
化疗引起的周围神经病（CIPN）可导致神经性疼痛。神经生长因子（NGF）对小感觉纤维具有营养作用，并调节伤害感受。
我们在一项单中心前瞻性观察研究中调查了接受神经毒性化疗的癌症患者血清 NGF 和表皮内神经纤维密度的变化。
患者在化疗前后进行评估。CIPN 采用总神经病变评分、神经传导研究和国家癌症研究所常见毒性标准进行分级。神经性疼痛根据欧洲癌症研究与治疗组织生活质量问卷-CIPN20 问卷进行定义。
60 例患者中有 13 例（21%）出现神经性疼痛，表现为手部（n=9）和足部（n=12）的刺痛或灼痛。与无痛或无 CIPN 的患者相比，出现疼痛性 CIPN 的患者治疗后 NGF 更高（8.7±11.9 vs. 2.5±1.4 pg/mL，P=0.016）。NGF 的变化与神经性疼痛显著相关。与无痛或无 CIPN 的患者相比，出现疼痛性 CIPN 的患者 IEFND 无明显丧失（6.16±3.86 vs. 8.37±4.82，P=0.12）。未观察到 IEFND 与 NGF 之间存在相关性。
接受紫杉醇或铂类化疗且伴有疼痛性 CIPN 的癌症患者血清 NGF 增加，表明其可能是该人群神经性疼痛存在和严重程度的潜在生物标志物。长期全面的研究有助于更好地定义 NGF 与神经学结局的关系，从而有助于进一步设计 CIPN 相关神经性疼痛的治疗方法。
