Yu Jiaqi, Fu Yuanfeng, Xu Weifeng, Ding Ren-Bo, Bao Jiaolin
Key Laboratory of Tropical Biological Resources of Ministry of Education, One Health Collaborative Innovation Center, School of Pharmaceutical Sciences, Hainan University, Haikou, 570228, China.
State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, 999078, China.
Curr Rev Clin Exp Pharmacol. 2025;20(2):98-102. doi: 10.2174/0127724328314214240829181006.
Cancer is a high-morbidity disease prevalent worldwide. Chemotherapy is the primarily used regimen for cancer treatment; however, it also brings severe side effects. Chemotherapy-induced Peripheral Neuropathy (CIPN) and Chemotherapy-induced Cognitive Impairment (CICI) are two main complications occurring in chemotherapy. They are both associated with nervous system injury and are therefore collectively referred to as Chemotherapy-induced Neuropathy (CIN). CIPN induces neuralgia and numbness in limbs, while CICI causes amnesia and cognitive dysfunction. Currently, there are no effective therapeutics to prevent or cure CIN, so research into new drugs to alleviate CIN becomes urgent. Oxidative stress and neuroinflammation are the common pathogenic mechanisms of CIPN and CICI. Excessive Reactive Oxygen Species (ROS) and pro-inflammatory cytokines cause peripheral nervous system damage and hence CIPN. Peripheral ROS and cytokines also change the permeability of the blood-brain barrier, thereby increasing oxidative stress and neuroinflammation in the central nervous system, ultimately leading to CICI. Several antidepressants have been used to treat CIN and exhibited good clinical effects. Their potential pharmacological mechanism has been reported to ameliorate oxidative stress and neuroinflammation, guiding a new feasible way for effective therapeutic development against CIN. This mini-review has summarized the latest advances in the research on CIN with respect to clinical status, pathogenesis, and treatment. It has also discussed the potential of repurposing antidepressants for CIN treatment and prospected the strategy of developing therapeutics by targeting oxidative stress and neuroinflammation against CIN.
癌症是一种在全球范围内高发的疾病。化疗是癌症治疗中主要使用的方案;然而,它也会带来严重的副作用。化疗引起的周围神经病变(CIPN)和化疗引起的认知障碍(CICI)是化疗中出现的两种主要并发症。它们都与神经系统损伤有关,因此统称为化疗引起的神经病变(CIN)。CIPN会导致肢体神经痛和麻木,而CICI会导致失忆和认知功能障碍。目前,尚无有效的治疗方法来预防或治愈CIN,因此研发缓解CIN的新药变得迫在眉睫。氧化应激和神经炎症是CIPN和CICI的常见致病机制。过量的活性氧(ROS)和促炎细胞因子会导致周围神经系统损伤,进而引发CIPN。外周ROS和细胞因子还会改变血脑屏障的通透性,从而增加中枢神经系统的氧化应激和神经炎症,最终导致CICI。几种抗抑郁药已被用于治疗CIN,并显示出良好的临床效果。据报道,它们潜在的药理机制是改善氧化应激和神经炎症,为开发有效的CIN治疗方法指引了一条新的可行途径。这篇综述总结了CIN在临床状况、发病机制和治疗方面的最新研究进展。还讨论了将抗抑郁药重新用于治疗CIN的潜力,并展望了针对氧化应激和神经炎症开发CIN治疗药物的策略。