Chemobrain: A review on mechanistic insight, targets and treatments.

2区 医学 Q1 Medicine
Advances in Cancer Research Pub Date : 2022-01-01 Epub Date: 2022-05-11 DOI:10.1016/bs.acr.2022.04.001
Vanishree Rao, Rashmi Bhushan, Priyanka Kumari, Sri Pragnya Cheruku, V Ravichandiran, Nitesh Kumar
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引用次数: 5

Abstract

Chemo-brain refers to the thinking and memory problems that occur in cancer patients during and after chemotherapy. It is also known as cognitive dysfunction or chemo-fog. Risk factors include brain malignancies, either primary or metastatic, radiotherapy and chemotherapy, either systemic or brain targeted. There are various mechanisms by which chemo-brain occurs in patients post-chemotherapy, including inflammation of neurons, stress due to free radical generation, and alterations in normal neuronal cell process due to biochemical changes. While chemotherapy drugs that are non-brain targeted, usually fail to cross the blood-brain barrier (BBB), this is not the case for inflammatory cytokines that are released, which easily cross the BBB. These inflammatory neurotoxic agents may represent the primary mediators of chemobrain and include the pro-inflammatory cytokines such as interleukins 1 and 6 and tumor necrosis factor. The pronounced rise in oxidative stress due to continuous chemotherapy also leads to a reduction in neurogenesis and gliogenesis, loss of spine and dendritic cells, and a reduction in neurotransmitter release. Based on recent research, potential agents to prevent and treat chemo brain have been identified, which include Lithium, Fluoxetine, Metformin, Rolipram, Astaxanthin, and microglial inhibitors. However, more defined animal models for cognitive dysfunction are required to study in detail the mechanisms involved in chemo-brain; furthermore, well-defined clinical trials are required to identify drug targets and their therapeutic significance. With these focused approaches, the future for improved therapies is promising.

化学脑:机制、靶点和治疗的综述。
化疗脑是指癌症患者在化疗期间和化疗后出现的思维和记忆问题。它也被称为认知功能障碍或化学雾。危险因素包括原发性或转移性脑恶性肿瘤,全身性或靶向性的放疗和化疗。化疗后患者发生化学脑的机制多种多样,包括神经元的炎症、自由基产生引起的应激以及生化变化引起的正常神经元细胞过程的改变。虽然非脑靶向化疗药物通常不能穿过血脑屏障(BBB),但释放的炎症细胞因子却不是这样,它们很容易穿过血脑屏障。这些炎症性神经毒性物质可能代表了化学脑的主要介质,包括促炎细胞因子,如白细胞介素1和6和肿瘤坏死因子。持续化疗引起的氧化应激的显著升高也导致神经发生和胶质发生的减少,脊柱和树突状细胞的损失,以及神经递质释放的减少。根据最近的研究,已经确定了预防和治疗化疗脑的潜在药物,包括锂、氟西汀、二甲双胍、罗利普兰、虾青素和小胶质细胞抑制剂。然而,需要更明确的认知功能障碍动物模型来详细研究化学脑机制;此外,需要明确的临床试验来确定药物靶点及其治疗意义。有了这些重点突出的方法,改进疗法的未来是有希望的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Advances in Cancer Research
Advances in Cancer Research 医学-肿瘤学
CiteScore
10.00
自引率
0.00%
发文量
52
期刊介绍: Advances in Cancer Research (ACR) has covered a remarkable period of discovery that encompasses the beginning of the revolution in biology. Advances in Cancer Research (ACR) has covered a remarkable period of discovery that encompasses the beginning of the revolution in biology. The first ACR volume came out in the year that Watson and Crick reported on the central dogma of biology, the DNA double helix. In the first 100 volumes are found many contributions by some of those who helped shape the revolution and who made many of the remarkable discoveries in cancer research that have developed from it.
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