Mechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy.
Mechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy.
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DOI：
10.3390/cancers14051224
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发表时间：
2022-02-26
期刊：
影响因子：
5.2
通讯作者：
Kleckner IR
中科院分区：
文献类型：
--
作者：
Chung KH;Park SB;Streckmann F;Wiskemann J;Mohile N;Kleckner AS;Colloca L;Dorsey SG;Kleckner IR
化疗引起的周围神经病变（CIPN）是癌症治疗的常见副作用。其表现为手和/或脚麻木、刺痛、疼痛和抽筋，并会干扰日常生活。运动是一种很有前途的 CIPN 治疗方法，但其潜在机制尚未得到充分研究。在此，我们讨论运动治疗 CIPN 的潜在机制（例如，抗炎细胞因子、自我效能和社会支持），以及哪些人口统计学（例如，年龄和性别）和临床特征（例如，体重指数）以及运动习惯（例如，运动时间、强度和类型）可能会调节运动对缓解 CIPN 的影响。这些详细信息可以帮助临床医生预测谁将获得 CIPN，使临床医生能够根据患者的具体特征定制运动计划，并为未来关于运动与 CIPN 之间关系的研究和生物标志物提供信息。化疗引起的周围神经病变（CIPN）是常用于治疗癌症的神经毒性抗肿瘤药物的不良反应。 CIPN 患者会出现使人衰弱的体征和症状，例如手脚刺痛、麻木、疼痛和抽筋，从而抑制其日常功能。在 CIPN 的有限预防和治疗选择中，运动已成为一种有前景的新干预措施，迄今为止已在大约两打临床试验中进行了研究。随着更多研究测试并表明运动在治疗 CIPN 中的功效，对运动效果的机制性理解变得越来越重要，以便调整运动以最好地治疗 CIPN 症状并确定谁将受益最多。为了解决目前运动对 CIPN 的影响缺乏明确性的问题，我们回顾了可能阐明运动与 CIPN 改善之间关系的关键潜在机制（例如，神经生理学和社会心理因素）、调节因素（例如，抗炎细胞因子、自我效能和社会支持）和调节因素（例如，年龄、性别、体重指数、身体素质、运动剂量、运动坚持性和运动时间）。我们的综述基于对 CIPN 患者、其他类型神经病患者和健康成年人进行运动测试的研究。本文提出的讨论可用于 (1) 指导肿瘤学家预测特定运动计划最适合哪些症状，(2) 使临床医生能够根据具体特征为患者量身定制运动处方，以及 (3) 为未来关于运动和 CIPN 之间关系的研究和生物标志物提供信息。
Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatment. It is experienced as numbness, tingling, pain, and cramping in the hands and/or feet and can interfere with daily living. Exercise is a promising treatment for CIPN but its underlying mechanisms are understudied. Herein, we discuss potential mechanisms underlying how exercise might treat CIPN (e.g., anti-inflammatory cytokines, self-efficacy, and social support) and what demographic (e.g., age and sex) and clinical characteristics (e.g., body mass index), and exercise routines (e.g., timing, intensity, and type of exercise) may moderate the effects of exercise on relieving CIPN. These details can help clinicians predict who will get CIPN, enable clinicians to tailor exercise programs to patients based on specific characteristics, and inform future research and biomarkers on the relationship between exercise and CIPN. Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of neurotoxic antineoplastic agents commonly used to treat cancer. Patients with CIPN experience debilitating signs and symptoms, such as combinations of tingling, numbness, pain, and cramping in the hands and feet that inhibit their daily function. Among the limited prevention and treatment options for CIPN, exercise has emerged as a promising new intervention that has been investigated in approximately two dozen clinical trials to date. As additional studies test and suggest the efficacy of exercise in treating CIPN, it is becoming more critical to develop mechanistic understanding of the effects of exercise in order to tailor it to best treat CIPN symptoms and identify who will benefit most. To address the current lack of clarity around the effect of exercise on CIPN, we reviewed the key potential mechanisms (e.g., neurophysiological and psychosocial factors), mediators (e.g., anti-inflammatory cytokines, self-efficacy, and social support), and moderators (e.g., age, sex, body mass index, physical fitness, exercise dose, exercise adherence, and timing of exercise) that may illuminate the relationship between exercise and CIPN improvement. Our review is based on the studies that tested the use of exercise for patients with CIPN, patients with other types of neuropathies, and healthy adults. The discussion presented herein may be used to (1) guide oncologists in predicting which symptoms are best targeted by specific exercise programs, (2) enable clinicians to tailor exercise prescriptions to patients based on specific characteristics, and (3) inform future research and biomarkers on the relationship between exercise and CIPN.
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