The role of cell-specific TLR-4 signaling in oxaliplatin-induced peripheral neuropathy

奥沙利铂相关化疗诱导的周围神经病变（CIPN）是一种常见的，潜在的 严重和剂量限制性毒性的结直肠癌治疗。CIPN的总发病率估计为 在患者中大约有40%以上。CIPN可在化疗后持续数月至数年 完成，由于其对生活质量的负面影响，对癌症幸存者造成重大挑战 （QOL）。CIPN是一个重要的挑战，因为缺乏可以有效预防或治疗的治疗方法。 减轻药物的不良反应。我们已经确定了特定的受体介导的途径， 离子电流的增加作为治疗或预防CIPN的潜在治疗靶点。值得注意的是， 几种对CIPN治疗至关重要的离子通道调节剂是FDA批准的用于其它疾病的药物 条件这项建议强调了一个多学科的研究计划，建立在我们的初步数据， 探索CIPN的机制以及FDA批准的药物可以重新用于 治疗或预防的条件。在目标1中，我们将研究铂-DNA加合物的影响， 啮齿动物暴露于奥沙利铂后释放高迁移率族蛋白1（HMGB 1）。在目标2中，我们 研究受体Toll样受体（TLR 4）是否负责发展或维持 跨时间的CIPN最后，在目标3中，我们将对FDA批准的 抗癫痫药物对神经元离子电流和CIPN行为特征的影响。这些拟议的研究将提供新的治疗靶点，这可能会改变奥沙利铂对感觉神经元的不利影响。

Oxaliplatin-associated Chemotherapy-induced Peripheral Neuropathy (CIPN) is a frequent, potentially severe and dose-limiting toxicity of colorectal cancer treatment. The overall incidence of CIPN is estimated to be approximately upwards of 40% in patients. CIPN can persist for months to years beyond chemotherapy completion, causing significant challenges for cancer survivors due to its negative influence on quality of life (QOL). CIPN represents an important challenge because of the lack of treatment that can effectively prevent or mitigate this adverse drug effect. We have identified specific receptor-mediated pathways which contribute to increases in ion current as a potential therapeutic target for the treatment or prevention of CIPN. Noteworthy, several ion channel modulators central to CIPN treatment are FDA-approved drugs used for other disease conditions. This proposal highlights a multidisciplinary research plan that builds upon our preliminary data to explore both the mechanism of CIPN and the degree to which FDA-approved drugs can be repurposed for the treatment or prevention of the condition. In Aim 1, we will examine the influence of platinum-DNA adducts and release of high mobility group box-1 (HMGB1) in rodents following exposure to oxaliplatin. In Aim 2, we will investigate whether the receptor Toll-like receptor (TLR4) is responsible for the development or maintenance of CIPN across time. Finally, in Aim 3, we will conduct a proof of concept assessment of the efficacy of FDA-approved antiepileptic drugs on both neuronal ion currents and CIPN behavioral characteristics. These proposed studies will provide new therapeutic targets which will likely alter the detrimental effects of oxaliplatin on sensory neurons.