化学疗法介导的神经异常。
Chemotherapy-Mediated Neuronal Aberration.
发表日期:2023 Aug 16
作者:
Pradip Kumar Jaiswara, Surendra Kumar Shukla
来源:
CYTOKINE & GROWTH FACTOR REVIEWS
摘要:
化疗是癌症患者维持生命的治疗选择之一。尽管出现了多种现代治疗方法,如免疫疗法、基因疗法等,但对于大多数癌症患者来说,化疗仍然是首选治疗。除了抗癌效果之外,化疗还会产生一系列不利后果,限制其疗效和长期使用。此外,化疗还会严重影响癌症患者的生活质量。接受化疗药物的癌症患者会遭受神经功能障碍,即所谓的化疗脑,其中包括认知和记忆功能障碍、学习、推理和注意力能力缺陷。化疗通过干扰DNA修复系统和抗氧化机制损害神经元的DNA,表现出神经毒性。此外,化疗还通过诱导多种促炎细胞因子的释放,如NF-kB、IL-1β、IL-6和TNF-α,引发炎症。化疗介导的炎症是导致癌症患者化疗脑的原因之一。这些炎症细胞因子调节多个生长信号通路和活性氧平衡,导致全身炎症反应。本综述旨在总结现有信息,讨论化疗引起的炎症对化疗脑的作用,以及它对治疗效果和患者整体生活质量的影响。此外,本文还讨论了基于草药的治疗方法在克服化疗介导的神经毒性以及改善癌症患者生活质量方面的潜力。
Chemotherapy is a life-sustaining therapeutic option for cancer patients. Despite the advancement of several modern therapies, such as immunotherapy, gene therapy, etc., chemotherapy remains the first-line therapy for most cancer patients. Along with its anti-cancerous effect, chemotherapy exhibits several detrimental consequences that restrict its efficacy and long-term utilization. Moreover, it effectively hampers the quality of life of cancer patients. Cancer patients receiving chemotherapeutic drugs suffer from neurological dysfunction, referred to as chemobrain, that includes cognitive and memory dysfunction and deficits in learning, reasoning, and concentration ability. Chemotherapy exhibits neurotoxicity by damaging the DNA in neurons by interfering with the DNA repair system and antioxidant machinery. In addition, chemotherapy also provokes inflammation by inducing the release of various pro-inflammatory cytokines, including NF-kB, IL-1β, IL-6, and TNF-α. The chemotherapy-mediated inflammation contributes to chemobrain in cancer patients. These inflammatory cytokines modulate several growth signaling pathways and reactive oxygen species homeostasis leading to systemic inflammation in the body. This review is an effort to summarize the available information which discusses the role of chemotherapy-induced inflammation in chemobrain and how it impacts different aspects of therapeutic outcome and the overall quality of life of the patient. Further, this article also discusses the potential of herbal-based remedies to overcome chemotherapy-mediated neuronal toxicity as well as to improve the quality of life of cancer patients.