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Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity
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Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity

Published on: April 26, 2012

Toxic and drug-induced peripheral neuropathies: updates on causes, mechanisms and management

Manuel Diezi1, Thierry Buclin, Thierry Kuntzer

  • 1Division of Clinical Pharmacology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.

Current Opinion in Neurology
|September 3, 2013
PubMed
Abstract

Insights

This review covers chemotherapy-induced peripheral neuropathies (CIPNs) and drug-induced peripheral neuropathies (DIPNs). Research focuses on early detection, molecular mechanisms, and potential treatments like chemoprotectants for nerve damage.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Oncology

Background:

  • Peripheral neuropathies, including chemotherapy-induced (CIPN) and drug-induced (DIPN), are significant clinical challenges.
  • Current research investigates the molecular mechanisms underlying these conditions.

Purpose of the Study:

  • To review current research on toxic CIPNs and DIPNs.
  • To highlight advancements in early detection, molecular mechanisms, and therapeutic strategies.

Main Methods:

  • Review of recent publications on CIPN and DIPN.
  • Analysis of clinical studies focusing on detection and grading.
  • Examination of animal model studies for molecular insights.
  • Evaluation of pharmacogenetic approaches and chemoprotectant research.

Main Results:

  • Clinical studies emphasize early detection and grading of neuropathies.
  • Animal models reveal novel neuronal, axonal, and Schwann cell targets.
  • Inflammatory changes in peripheral nerves are observed with certain substances.
  • Pharmacogenetics aims to identify high-risk individuals for DIPNs.
  • Chemoprotectant trials have not yet proven effective.

Conclusions:

  • Peripheral neuropathies involve length-dependent, nonlength-dependent, and small-fiber types.
  • New diagnostic techniques (excitability studies, Doppler flowmetry, pharmacogenetics) aid early detection and mechanistic understanding.
  • Approaches to improve function and quality of life in CIPN patients are discussed.
  • Developing less neurotoxic therapies and identifying effective chemoprotective agents (e.g., erythropoietin, endocannabinoid system modulators) offer hope for preventing or correcting painful CIPNs.

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