Persistent chemoneuropathy in patients receiving the plant alkaloids paclitaxel and vincristine.
Persistent chemoneuropathy in patients receiving the plant alkaloids paclitaxel and vincristine.
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DOI：
10.1007/s00280-012-2047-z
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发表时间：
2013-03
影响因子：
3
通讯作者：
Dougherty, Patrick M.
中科院分区：
文献类型：
--
作者：
Boyette-Davis, Jessica A.;Cata, Juan P.;Driver, Larry C.;Novy, Diane M.;Bruel, Brian M.;Mooring, Deidre L.;Wendelschafer-Crabb, Gwen;Kennedy, William R.;Dougherty, Patrick M.
对于接受一系列化疗药物的患者来说，化学神经病变仍然是癌症治疗中一种痛苦、负担沉重的并发症，但这种情况的原因和持久性还没有完全记录下来。这项研究旨在量化植物生物碱紫杉醇和长春新碱治疗神经病后的寿命和对神经病的贡献。对14名患者进行了大约18个月的定量感觉测试，其中7名患者接受了紫杉醇治疗，7名患者接受了长春新碱治疗，并与18名健康对照受试者的数据进行了比较。此外，还获得了皮肤活检，以研究触觉小体和表皮神经纤维(ENF)密度的变化，这些纤维的丢失被认为是多种形式的神经病的原因之一。通过一块有凹槽的钉板测量，发现了运动技能的损害。使用von Frey单丝可以观察到触摸检测的缺陷，使用加权针具检测清晰度的变化也是如此。使用帕尔蒂埃设备，温度和热量检测受到了损害。这些赤字在时间上是一致的。值得注意的是，患者报告疼痛神经病变的平均时间超过四年半。皮肤活检发现在迈斯纳小体和ENF中缺乏。接受紫杉醇或长春新碱治疗的癌症患者普遍存在感觉测试缺陷，皮肤神经支配减少，这两种情况相结合，证明了一种持续性的多发性神经病，严重影响了这些患者。迈斯纳小体和ENF的减少表明了神经病的可能机制。
Chemoneuropathy remains a painful, burdensome complication of cancer treatment for patients receiving a range of chemotherapeutics, yet the cause and persistence of this condition are not fully documented. This study was designed to quantify the longevity of and contributions to neuropathy following treatment with the plant alkaloids paclitaxel and vincristine. Quantitative sensory testing was conducted approximately 18 months apart on 14 patients, seven of which had been treated with paclitaxel and seven with vincristine and compared to data from 18 healthy control subjects. In addition, skin biopsies were obtained to investigate changes in the density of Meissner’s corpuscles and epidermal nerve fibers (ENFs), the loss of which is thought to contribute to multiple forms of neuropathy. Impairments in motor skills, as measured by a grooved peg-board, were found. Deficits in touch detection were observed using von Frey monofilaments, as were changes in sharpness detection using a weighted needle device. Using a Peltier device, warmth and heat detection were impaired. These deficits were consistent across time. Remarkably, the average length of time patients reported painful neuropathy was over four and a half years. Skin biopsies were found to be deficient in Meissner’s corpuscles and ENFs. The combination of widespread deficits in sensory testing and decreases in skin innervation for cancer patients receiving paclitaxel or vincristine document a persistent polyneuropathy which severely impacts these patients. Decreases in Meissner’s corpuscles and ENFs indicate a possible mechanism for the neuropathy.
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影响因子：
7.4
作者：
Oaklander, AL
通讯作者：
Oaklander, AL
影响因子：
7.4
作者：
Petersen, Karin Lottrup;Rice, Frank L.;Rowbotham, Michael C.
通讯作者：
Rowbotham, Michael C.
影响因子：
6.1
作者：
Rowbotham, MC;Yosipovitch, G;Fields, HL
通讯作者：
Fields, HL
影响因子：
9.9
作者：
Burakgazi, A. Z.;Messersmith, W.;Polydefkis, M.
通讯作者：
Polydefkis, M.
影响因子：
9.9
作者：
Chaudhry, V;Chaudhry, M;Griffin, JW
通讯作者：
Griffin, JW