Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, CA, USA.
Department of Radiation Oncology, School of Medicine, University of California, Irvine, CA, USA.
Neurotherapeutics. 2023 Apr;20(3):838-852. doi: 10.1007/s13311-022-01339-z. Epub 2023 Jan 31.
Cancer-related cognitive impairment (CRCI) considerably affects the quality of life of millions of cancer survivors. Brain-derived neurotrophic factor (BDNF) has been shown to promote survival, differentiation, and maintenance of in vivo dentate neurogenesis, and chemotherapy induces a plethora of physiological and cellular alterations, including a decline in neurogenesis and increased neuroinflammation linked with cognitive impairments. In our clinical studies, breast cancer patients treated with doxorubicin (Adriamycin, ADR) experienced a significant reduction in the blood levels of BDNF that was associated with a higher risk of CRCI. Our past rodent studies in CRCI have also shown a significant reduction in dentate neurogenesis accompanied by cognitive impairment. In this study, using a female mouse model of ADR-induced cognitive decline, we tested the impact of riluzole (RZ), an orally active BDNF-enhancing medication that is FDA-approved for amyotrophic lateral sclerosis. ADR-treated mice receiving RZ in the drinking water for 1 month showed significant improvements in hippocampal-dependent learning and memory function (spatial recognition), fear extinction memory consolidation, and reduced anxiety-like behavior. RZ prevented chemotherapy-induced reductions of BDNF levels in the hippocampus. Importantly, RZ mitigated chemotherapy-induced loss of newly born, immature neurons, dentate neurogenesis, and neuroinflammation. In conclusion, this data provides pre-clinical evidence for a translationally feasible approach to enhance the neuroprotective effects of RZ treatment to prevent CRCI.
癌症相关认知障碍 (CRCI) 极大地影响了数以百万计癌症幸存者的生活质量。脑源性神经营养因子 (BDNF) 已被证明可促进体内齿状突神经发生的存活、分化和维持,而化疗会引起大量的生理和细胞改变,包括神经发生减少和与认知障碍相关的神经炎症增加。在我们的临床研究中,接受多柔比星(阿霉素,ADR)治疗的乳腺癌患者血液中的 BDNF 水平显著降低,与 CRCI 的风险增加相关。我们过去在 CRCI 中的啮齿动物研究也表明,齿状突神经发生显著减少伴随着认知障碍。在这项研究中,我们使用 ADR 诱导认知下降的雌性小鼠模型,测试了利鲁唑 (RZ) 的影响,利鲁唑是一种具有口服活性的 BDNF 增强药物,已获得美国食品和药物管理局批准用于肌萎缩侧索硬化症。在饮用水中接受 RZ 治疗 1 个月的 ADR 处理小鼠表现出海马依赖性学习和记忆功能(空间识别)、恐惧消退记忆巩固以及焦虑样行为减少的显著改善。RZ 预防了化疗引起的海马 BDNF 水平降低。重要的是,RZ 减轻了化疗引起的新产生的不成熟神经元、齿状突神经发生和神经炎症的损失。总之,这些数据为增强 RZ 治疗的神经保护作用以预防 CRCI 的转化可行方法提供了临床前证据。