摘要
奥沙利铂是一种广泛应用的抗癌药,其代表治疗结肠直肠癌的基石。 然而,也有许多的副作用限制了它的应用,其中包括奥沙利铂诱导的外周性神经毒性(OIPN), 其中,在临床应用奥沙利铂中,OIPN代表了一种剂量限制性副作用;更好的了解发病机理将会为提高癌症病人的“存活质量”提供很好的机会。 迄今为止,证实没有治疗能够预防或限制OIPN。这种未解决的临床需求的原因之一是由于药物介入的基本原理预防发展病理知识的不完备。 临床前和临床证据提出了细胞内钙离子相关事件也许在OIPN的发作中起到了非常重要的作用的一种假设。然而,机械的临床前研究结果表现出了不一致性,因此,他们在神经保护作用药物设计中的相关性仍旧不明确。的确,异常的钙离子信号是否为关键的发病时刻或者它是否仅构成临床显型调节物。 为了对现有证据提供更新总结并且突出设计有效神经保护药物的最有希望的方案,本文将对临床前结果总结,其中包括钙相关性事件和OIPN. 我们会特别关注临床前证据,其认为可能涉及TRPV1、TRPM8和TRPA1,因为这些特别显示出了对药理学调节的服从性。
关键词: 奥沙利铂,钙,神经毒性,发病机理,治疗,临床前,体外
Current Medicinal Chemistry
Title:Calcium-related Neurotoxicity of Oxaliplatin: Understanding the Mechanisms to Drive Therapy
Volume: 22 Issue: 32
Author(s): Paola Marmiroli, Guido Cavaletti, Valentina Carozzi, Beatrice Riva, Dmitry Lim and Armando A. Genazzani
Affiliation:
关键词: 奥沙利铂,钙,神经毒性,发病机理,治疗,临床前,体外
摘要: Oxaliplatin is one of the most widely used anticancer drugs representing the cornerstone of the treatment of colorectal cancer. Yet a number of side effects, including oxaliplatin- induced peripheral neurotoxicity (OIPN) which represents a dose-limiting side effect in the clinical use of oxaliplatin, limit its use and a better understanding of its pathogenesis would offer a great opportunity to improve the “quality of survival” of cancer patients. So far, no treatment able to prevent or limit OIPN has been approved, and one of the reasons for this unmet clinical need is the incomplete knowledge of its pathogenesis preventing the development of rationalebased pharmacological interventions.
Preclinical and clinical evidence raised the hypothesis that intracellular calcium-related events might play an important role in the onset of OIPN. Yet, the results of mechanistic pre-clinical studies appear inconsistent and, therefore, their relevance in neuroprotective drugs design is still uncertain. Indeed, it is at present unclear whether aberrant calcium signalling is the key pathogenetic moment or whether it just constitutes the mediator of the clinical phenotype.
This review will summarize the preclinical results involving calcium-related events and OIPN with the aim to provide an updated overview of the available evidence and highlight the most promising strategies to design effective neuroprotective drugs. In particular, we will focus on the pre-clinical evidence suggesting that TRPV1, TRPM8 or TRPA1 might be involved, as these appear particularly amenable to pharmacological modulation.
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Paola Marmiroli, Guido Cavaletti, Valentina Carozzi, Beatrice Riva, Dmitry Lim and Armando A. Genazzani , Calcium-related Neurotoxicity of Oxaliplatin: Understanding the Mechanisms to Drive Therapy, Current Medicinal Chemistry 2015; 22 (32) . https://dx.doi.org/10.2174/0929867322666151001121302
DOI https://dx.doi.org/10.2174/0929867322666151001121302 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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