Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Campusvej 55, Building 45.3-45.4, 5230 Odense M, Denmark.
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik und Hochschulambulanz für Neurologie, Charitéplatz 1, 10117 Berlin, Germany; Berlin Institute of Health at Charité, Universitätsmedizin Berlin, Anna-Louisa-Karsch Straße 2, 10178 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, NeuroCure Cluster of Excellence, Charitéplatz 1, 10117 Berlin, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Germany.
Trends Pharmacol Sci. 2024 Oct;45(10):872-879. doi: 10.1016/j.tips.2024.08.001. Epub 2024 Sep 5.
Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy. The frequency of CIPN ranges from one in three to almost all patients depending on type of chemotherapy and dose. It causes symptoms that can range from sensitivity to touch and numbness to neuropathic pain in hands and feet. CIPN is notoriously difficult to grade objectively and has mostly relied on a clinician- or patient-based rating that is subjective and poorly reproducible. Thus, considerable effort has been aimed at identifying objective biomarkers of CIPN. Recent in vitro, animal, and clinical studies suggest that neurofilament light chain (NFL), a structural neuronal protein, may be an objective biomarker of CIPN. NFL released from cells to cell culture media reflects in vitro neurotoxicity, while NFL in serum reflects neuronal damage caused by chemotherapy in rodent models. Finally, NFL in serum may be a diagnostic biomarker of CIPN, but its prognostic ability to predict CIPN requires prospective evaluation. We discuss current limitations and future perspectives on the use of NFL as a preclinical and clinical biomarker of CIPN.
化疗引起的周围神经病（CIPN）是化疗的常见副作用。根据化疗类型和剂量的不同，CIPN 的发生率从三分之一到几乎所有患者不等。它会引起各种症状，从触觉敏感到手脚神经性疼痛。CIPN 很难客观分级，主要依赖于临床医生或患者的主观、重现性差的评分。因此，人们已经在努力寻找 CIPN 的客观生物标志物。最近的体外、动物和临床研究表明，神经丝轻链（NFL）作为一种结构性神经元蛋白，可能是 CIPN 的客观生物标志物。从细胞释放到细胞培养基中的 NFL 反映了体外神经毒性，而血清中的 NFL 反映了啮齿动物模型中化疗引起的神经元损伤。最后，血清中的 NFL 可能是 CIPN 的诊断生物标志物，但预测 CIPN 的预后能力需要前瞻性评估。我们讨论了目前在使用 NFL 作为 CIPN 的临床前和临床生物标志物方面的局限性和未来展望。
