University of Manitoba, Winnipeg, MB, Canada.
Neurorehabil Neural Repair. 2019 Oct;33(10):792-799. doi: 10.1177/1545968319860486. Epub 2019 Jul 25.
One in 2 Canadians is expected to acquire cancer in their lifetime. Many cancers, including breast, ovarian, and lung cancer, are treated using taxane chemotherapy with curative intent. A major adverse effect with the use of taxane chemotherapeutic agents is taxane-induced peripheral neuropathy (TIPN). Both positive (spontaneous pain, heightened sensitivity with light touch, tingling, itching, burning) and negative (loss of touch, loss of hot/cold sensations, and loss of pain) sensory symptoms can be experienced in the hands and feet and worsen with increasing dose and treatment duration. The pathophysiology of TIPN is still unknown but likely involves multiple mechanisms, including microtubule impairment, neuroimmune and inflammatory changes, ion channel remodeling, impaired mitochondrial function, and genetic predisposition. This review highlights current theories on the pathophysiology for TIPN, the cellular responses thought to maintain neuropathic pain, and the growing support for exercise in the treatment and prevention of peripheral neuropathy and neuropathic pain in both animal and human models.
预计每两个加拿大人中就有一个会在一生中患上癌症。许多癌症，包括乳腺癌、卵巢癌和肺癌，都采用有治愈意图的紫杉烷化疗进行治疗。紫杉烷化疗药物的一个主要不良反应是紫杉烷引起的周围神经病变（TIPN）。手和脚都会出现阳性（自发性疼痛、轻触时敏感度增加、刺痛、瘙痒、烧灼感）和阴性（触觉丧失、冷热感觉丧失和疼痛丧失）感觉症状，并且随着剂量增加和治疗时间延长而恶化。TIPN 的病理生理学仍不清楚，但可能涉及多种机制，包括微管损伤、神经免疫和炎症变化、离子通道重塑、线粒体功能受损和遗传易感性。本文综述了 TIPN 病理生理学的当前理论、被认为维持神经病理性疼痛的细胞反应，以及越来越多的证据支持运动在治疗和预防动物和人类模型中的周围神经病变和神经病理性疼痛方面的作用。
