Bortezomib-based regimen affects cognitive functions in multiple myeloma patients through the VEGF pathway – Hypothesis that connects different knowledge streams

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses Pub Date : 2024-11-02 DOI:10.1016/j.mehy.2024.111510

Marija Stanić Damić , Toni Valković , Duška Petranović , Andrej Belančić , Zinaida Perić

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Abstract

Multiple myeloma is a chronic hematological malignancy that usually affects older adults. Cancer-related cognitive impairment in multiple myeloma patients significantly impacts the everyday quality of life, however its pathophysiology remains poorly understood. Bortezomib is a commonly used drug in the treatment of multiple myeloma that does not pass the blood–brain barrier. Nevertheless, it can still affect central nervous system (CNS) through yet unknown mechanisms. This article discusses the potential effect of bortezomib-based treatment on cognitive functions in multiple myeloma patients. We hypothesize that bortezomib impairs cognition by decreasing the levels of a neuroprotective cytokine – vascular endothelial growth factor (VEGF). The generation of hypotheses about the pathophysiology of cognitive impairment paves the way for future basic and clinical studies to improve multiple myeloma management. VEGF could serve as a biomarker of cognitive dysfunction while systematic evaluation of cognition could enable early detection of cognitive impairment. Timely recognition of cognitive impairment might be crucial when selecting the most appropriate treatment. Furthermore, this could allow the implementation of preventive measures against further deterioration in cognitive function and quality of life for patients with multiple myeloma.

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硼替佐米疗法通过血管内皮生长因子途径影响多发性骨髓瘤患者的认知功能--连接不同知识流的假设

多发性骨髓瘤是一种慢性血液恶性肿瘤，通常影响老年人。多发性骨髓瘤患者与癌症相关的认知障碍严重影响了他们的日常生活质量，但人们对其病理生理学仍知之甚少。硼替佐米是治疗多发性骨髓瘤的常用药物，它不能通过血脑屏障。然而，它仍可通过未知的机制影响中枢神经系统（CNS）。本文讨论了硼替佐米治疗对多发性骨髓瘤患者认知功能的潜在影响。我们假设硼替佐米通过降低神经保护细胞因子--血管内皮生长因子（VEGF）的水平来损害认知功能。认知障碍病理生理学假设的提出为未来的基础和临床研究铺平了道路，从而改善多发性骨髓瘤的治疗。血管内皮生长因子可作为认知功能障碍的生物标志物，而对认知功能进行系统评估则可及早发现认知功能障碍。在选择最合适的治疗方法时，及时发现认知障碍可能至关重要。此外，这还有助于采取预防措施，防止多发性骨髓瘤患者的认知功能和生活质量进一步恶化。

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来源期刊

Medical hypotheses 医学-医学：研究与实验

CiteScore

10.60

自引率

2.10%

发文量

167

审稿时长

60 days

期刊介绍： Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.