Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA.
Laboratory of Investigative Toxicology, Frederick National Laboratory for Cancer Research, Frederick, MD, USA.
Toxicol Pathol. 2020 Jan;48(1):190-201. doi: 10.1177/0192623319861937. Epub 2019 Jul 22.
Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect caused by several classes of widely used anticancer therapeutics. Chemotherapy-induced peripheral neuropathy frequently leads to dose reduction or discontinuation of chemotherapy regimens, and CIPN symptoms can persist long after completion of chemotherapy and severely diminish the quality of life of patients. Differences in the clinical presentation of CIPN by widely diverse classifications of anticancer agents have spawned multiple mechanistic hypotheses that seek to explain the pathogenesis of CIPN. Despite its clinical relevance, common occurrence, and extensive investigation, the pathophysiology of CIPN remains unclear. Furthermore, there is no unequivocal gold standard for the prevention and treatment of CIPN. Herein, we review in vivo and in vitro models of CIPN with a focus on histopathological changes and morphological features aimed at understanding the pathophysiology of CIPN and identify gaps requiring deeper exploration. An elucidation of the underlying mechanisms of CIPN is imperative to identify potential targets and approaches for prevention and treatment.
化疗引起的周围神经病(CIPN)是由几类广泛使用的抗癌治疗药物引起的不良反应。化疗引起的周围神经病常导致化疗方案剂量减少或停止,并且 CIPN 症状在化疗完成后很长时间仍然存在,并严重降低患者的生活质量。广泛不同类别的抗癌药物对 CIPN 的临床表现的差异产生了多种旨在解释 CIPN 发病机制的机制假说。尽管 CIPN 具有临床相关性、常见性和广泛的研究,但 CIPN 的病理生理学仍不清楚。此外,CIPN 的预防和治疗也没有明确的金标准。在此,我们综述了 CIPN 的体内和体外模型,重点关注旨在了解 CIPN 病理生理学的组织病理学变化和形态特征,并确定需要进一步探索的空白点。阐明 CIPN 的潜在机制对于确定预防和治疗的潜在靶点和方法至关重要。