Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan.
Department of Breast Surgery, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan.
Cancer Res. 2021 Apr 15;81(8):2207-2219. doi: 10.1158/0008-5472.CAN-20-2799. Epub 2021 Feb 19.
Chemotherapy-induced peripheral neuropathy (CIPN) is a severe dose-limiting side effect of taxanes such as paclitaxel and docetaxel. Despite the high medical needs, insufficient understanding of the complex mechanism underlying CIPN pathogenesis precludes any endorsed causal therapy to prevent or relieve CIPN. In this study, we report that elevation of plasma galectin-3 level is a pathologic change common to both patients with taxane-treated breast cancer with CIPN and a mouse model of taxane-related CIPN. Following multiple intraperitoneal injections of paclitaxel in mice, galectin-3 levels were elevated in Schwann cells within the sciatic nerve but not in other peripheral organs or cells expressing galectin-3. Consistent with this, paclitaxel treatment of primary cultures of rat Schwann cells induced upregulation and secretion of galectin-3. migration assays revealed that recombinant galectin-3 induced a chemotactic response of the murine macrophage cell line RAW 264.7. In addition, perineural administration of galectin-3 to the sciatic nerve of naive mice mimicked paclitaxel-induced macrophage infiltration and mechanical hypersensitivity. By contrast, chemical depletion of macrophages by clodronate liposomes suppressed paclitaxel-induced mechanical hypersensitivity despite the higher level of plasma galectin-3. Deficiency ( mice) or pharmacologic inhibition of galectin-3 inhibited paclitaxel-induced macrophage infiltration and mechanical hypersensitivity. In conclusion, we propose that Schwann cell-derived galectin-3 plays a pronociceptive role via macrophage infiltration in the pathogenesis of taxane-induced peripheral neuropathy. Therapies targeting this phenomenon, which is common to patients with CIPN and mouse models, represent a novel approach to suppress taxane-related CIPN. SIGNIFICANCE: These findings demonstrate that the elevation of plasma galectin-3 is a CIPN-related pathologic change common to humans and mice, and that targeting galectin-3 is a therapeutic option to delay CIPN progression.
化疗引起的周围神经病变(CIPN)是紫杉醇和多西紫杉醇等紫杉烷类药物的严重剂量限制副作用。尽管医疗需求很高,但对 CIPN 发病机制复杂机制的理解不足,阻止了任何被认可的因果治疗方法来预防或缓解 CIPN。在这项研究中,我们报告血浆半乳糖凝集素-3 水平升高是 CIPN 患者和紫杉烷类相关 CIPN 小鼠模型中常见的病理变化。在小鼠多次腹腔注射紫杉醇后,半乳糖凝集素-3 在坐骨神经中的施万细胞中升高,但在外周其他器官或表达半乳糖凝集素-3 的细胞中没有升高。与此一致的是,紫杉醇处理大鼠施万细胞原代培养物诱导了半乳糖凝集素-3 的上调和分泌。迁移实验表明,重组半乳糖凝集素-3 诱导了鼠巨噬细胞系 RAW 264.7 的趋化反应。此外,半乳糖凝集素-3 鞘内给药到神经未损伤的小鼠坐骨神经中模拟了紫杉醇诱导的巨噬细胞浸润和机械性超敏反应。相比之下,氯膦酸脂质体化学耗竭巨噬细胞尽管血浆半乳糖凝集素-3 水平较高,但抑制了紫杉醇诱导的机械性超敏反应。半乳糖凝集素-3 缺陷(Gal-3-/- 小鼠)或药理学抑制抑制了紫杉醇诱导的巨噬细胞浸润和机械性超敏反应。总之,我们提出施万细胞来源的半乳糖凝集素-3 通过巨噬细胞浸润在紫杉烷类引起的周围神经病变发病机制中发挥促伤害作用。针对这种现象的治疗方法,常见于 CIPN 患者和小鼠模型,代表了抑制紫杉烷类相关 CIPN 的新方法。意义:这些发现表明,血浆半乳糖凝集素-3 升高是 CIPN 相关的病理变化,在人类和小鼠中常见,靶向半乳糖凝集素-3 是延缓 CIPN 进展的治疗选择。