紫杉醇通过抑制初级感觉神经元中的 KCNQ 通道来引发痛性周围神经病的发生。

Paclitaxel Inhibits KCNQ Channels in Primary Sensory Neurons to Initiate the Development of Painful Peripheral Neuropathy.

机构信息

Department of Neurobiology, University of Texas Medical Branch, Galveston, TX 77555, USA.

出版信息

Cells. 2022 Dec 15;11(24):4067. doi: 10.3390/cells11244067.

Abstract

Cancer patients undergoing paclitaxel infusion usually experience peripheral nerve degeneration and serious neuropathic pain termed paclitaxel-induced peripheral neuropathy (PIPN). However, alterations in the dose or treatment schedule for paclitaxel do not eliminate PIPN, and no therapies are available for PIPN, despite numerous studies to uncover the mechanisms underlying the development/maintenance of this condition. Therefore, we aimed to uncover a novel mechanism underlying the pathogenesis of PIPN. Clinical studies suggest that acute over excitation of primary sensory neurons is linked to the pathogenesis of PIPN. We found that paclitaxel-induced acute hyperexcitability of primary sensory neurons results from the paclitaxel-induced inhibition of KCNQ potassium channels (mainly KCNQ2), found abundantly in sensory neurons and axons. We found that repeated application of XE-991, a specific KCNQ channel blocker, induced PIPN-like alterations in rats, including mechanical hypersensitivity and degeneration of peripheral nerves, as detected by both morphological and behavioral assays. In contrast, genetic deletion of KCNQ2 from peripheral sensory neurons in mice significantly attenuated the development of paclitaxel-induced peripheral sensory fiber degeneration and chronic pain. These findings may lead to a better understanding of the causes of PIPN and provide an impetus for developing new classes of KCNQ activators for its therapeutic treatment.

摘要

接受紫杉醇输注的癌症患者通常会经历外周神经退化和严重的神经病理性疼痛,称为紫杉醇诱导的周围神经病变(PIPN)。然而,改变紫杉醇的剂量或治疗方案并不能消除 PIPN,尽管有许多研究试图揭示这种疾病发展/维持的机制,但仍没有针对 PIPN 的治疗方法。因此,我们旨在揭示 PIPN 发病机制的新机制。临床研究表明,原发性感觉神经元的急性过度兴奋与 PIPN 的发病机制有关。我们发现,紫杉醇诱导的原发性感觉神经元的急性过度兴奋是由于紫杉醇抑制了大量存在于感觉神经元和轴突中的 KCNQ 钾通道(主要是 KCNQ2)。我们发现,重复应用特异性 KCNQ 通道阻断剂 XE-991 会在大鼠中诱导出类似于 PIPN 的改变,包括机械性感觉过敏和周围神经变性,这可以通过形态学和行为学检测来证实。相比之下,从小鼠的外周感觉神经元中基因敲除 KCNQ2 可显著减轻紫杉醇诱导的周围感觉纤维变性和慢性疼痛的发展。这些发现可能有助于更好地理解 PIPN 的原因,并为开发新型 KCNQ 激活剂用于其治疗提供动力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc5d/9776748/63ac818a08c3/cells-11-04067-g001.jpg

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