Mitochondrial trafficking as a protective mechanism against chemotherapy drug-induced peripheral neuropathy: Identifying the key site of action

Life Sci. 2023 Dec 1:334:122219. doi: 10.1016/j.lfs.2023.122219. Epub 2023 Oct 29.

Abstract

Aims: Chemotherapy induced peripheral neuropathy (CIPN) is a common side effect seen in patients who have undergone most chemotherapy treatments to which there are currently no treatment methods. CIPN has been shown to cause axonal degeneration leading to Peripheral Neuropathy (PN), which can lead to major dosage reduction and may prevent further chemotherapy treatment due to oftentimes debilitating pain. Previously, we have determined the site-specific action of Paclitaxel (PTX), a microtubule targeting agent, as well as the neuroprotective effect of Fluocinolone Acetonide (FA) against Paclitaxel Induced Peripheral Neuropathy (PIPN).

Main methods: Mitochondrial trafficking analysis was determined for all sample sets, wherein FA showed enhanced anterograde (axonal) mitochondrial trafficking leading to neuroprotective effects for all samples.

Key findings: Using this system, we demonstrate that PTX, Monomethyl auristatin E (MMAE), and Vincristine (VCR), are toxic at clinically prescribed levels when treated focally to axons. However, Cisplatin (CDDP) was determined to have a higher toxicity when treated to cell bodies. Although having different targeting mechanisms, the administration of FA was determined to have a significant neuroprotective effect for against all chemotherapy drugs tested.

Significance: This study identifies key insights regarding site of action and neuroprotective strategies to further development as potential therapeutics against CIPN. FA was treated alongside each chemotherapy drug to identify the neuroprotective effect against CIPN, where FA was found to be neuroprotective for all drugs tested. This study found that treatment with FA led to an enhancement in the anterograde movement of mitochondria based on fluorescent imaging.

Keywords: Axonal degeneration; Chemotherapy induced peripheral neuropathy; Cisplatin; Fluocinolone acetonide; Paclitaxel, monomethyl auristatin E; Vincristine.

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Cisplatin / adverse effects
  • Humans
  • Mitochondria
  • Neuroprotective Agents* / adverse effects
  • Paclitaxel / adverse effects
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / drug therapy
  • Peripheral Nervous System Diseases* / prevention & control
  • Pharmaceutical Preparations

Substances

  • Pharmaceutical Preparations
  • Neuroprotective Agents
  • Paclitaxel
  • Cisplatin
  • Antineoplastic Agents