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Achenbach P, Block F, Dafotakis M. Medikamentös-induzierte Polyneuropathien jenseits von
Chemotherapeutika und Antiinfektiva. KLIN NEUROPHYSIOL 2022. [DOI: 10.1055/a-1869-3563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Zahlreiche in der klinischen Routine eingesetzte Wirkstoffe jenseits von
Chemotherapeutika und Antiinfektiva können eine Polyneuropathie
verstärken oder hervorrufen. Kenntnis darüber, welche
Medikamente mit Polyneuropathien assoziiert sind sowie über
Risikofaktoren seitens der Patienten können die Häufigkeit
reduzieren. Bei entsprechendem Risiko sollten alternative Präparate
eingesetzt oder die Indikation zur Therapie generell überdacht
werden.
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Achenbach P, Block F, Dafotakis M. Medikamentös-induzierte Polyneuropathien durch
Chemotherapeutika und Antiinfektiva. KLIN NEUROPHYSIOL 2022. [DOI: 10.1055/a-1869-3577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Polyneuropathien können durch zahlreiche Wirkstoffe hervorgerufen oder
aggraviert werden. Insbesondere die Chemotherapeutika-induzierte Polyneuropathie
(CIPN) ist im Alltag von hoher Relevanz. Jedoch kann auch der Einsatz von
Antiinfektiva zu neuropathischen Beschwerden führen. Im Folgenden soll
ein Überblick über die wichtigsten mit Polyneuropathien
assoziierten Wirkstoffe der Substanzklassen sowie die klinischen Charakteristika
gegeben werden.
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Achenbach P, Block F, Dafotakis M. Grundlagen medikamentös-induzierter
Polyneuropathien. KLIN NEUROPHYSIOL 2022. [DOI: 10.1055/a-1886-2355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
ZusammenfassungZahlreiche Wirkstoffe können mit dem erstmaligen Auftreten oder dem
Fortschreiten neuropathischer Symptome in Verbindung gebracht werden.
Insbesondere im Kontext der modernen Polypharmazie kommt
medikamentös-induzierten Polyneuropathien eine besondere Bedeutung zu.
Die Schädigungsmechanismen und individuellen Risikofaktoren sind
vielfältig. In den meisten Fällen resultiert eine
längenabhängige, axonale Polyneuropathie mit vorwiegend
sensiblen Symptomen. Grundlegende Kenntnisse darüber, welche
Arzneimittel mit dem Auftreten einer Polyneuropathie assoziiert sind,
können dazu beitragen, das Auftreten dieser Nebenwirkung
frühzeitig zu erkennen. Die Verordnung entsprechender Medikamente sollte
vermieden werden, wenn das Risiko für den einzelnen Patienten als zu
hoch eingeschätzt wird. Unter Therapie sind regelmäßige
Kontrolluntersuchungen nötig, um bei neuauftretenden oder zunehmenden
Symptomen die Therapie so früh wie möglich anpassen oder
absetzen zu können. Die Prognose ist dann meist gut.
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Affiliation(s)
- Pascal Achenbach
- Neurologische Klinik, Universitätsklinik RWTH Aachen, Aachen,
Germany
| | - Frank Block
- Neurologische Klinik, Helios Klinik, Schwerin, Germany
| | - Manuel Dafotakis
- Neurologische Klinik, Universitätsklinik RWTH Aachen, Aachen,
Germany
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Old drugs for a new indication: a review of chloroquine and analogue in COVID-19 treatment. Porto Biomed J 2021; 6:e132. [PMID: 34136717 PMCID: PMC8202634 DOI: 10.1097/j.pbj.0000000000000132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/12/2021] [Accepted: 01/25/2021] [Indexed: 12/27/2022] Open
Abstract
As an innovative therapeutic strategy, drug repurposing affords old, approved, and already established drugs a chance at new indications. In the wake of the COVID-19 pandemic and the accompanied urgency for a lasting treatment, drug repurposing has come in handy to stem the debilitating effects of the disease. Among other therapeutic options currently in clinical trials, chloroquine (CQ) and the hydroxylated analogue, hydroxychloroquine (HCQ) have been frontline therapeutic options in most formal and informal clinical settings with varying degrees of efficacy against this life-threatening disease. Their status in randomized clinical trials is related to the biochemical and pharmacological profiles as validated by in vitro, in vivo and case studies. With the aim to bear a balance for their use in the long run, this review not only synopsizes findings from recent studies on the degrees of efficacy and roles of CQ/HCQ as potential anti-COVID-19 agents but also highlights our perspectives for their consideration in rational drug repositioning and use.
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Marmor M, Thawani S, Cotrina ML, Shao Y, Wong ES, Stecker MM, Wang B, Allen A, Wilkenfeld M, Vinik EJ, Vinik AI, Reibman J. Case-Control Study of Paresthesia Among World Trade Center-Exposed Community Members. J Occup Environ Med 2020; 62:307-316. [PMID: 32049876 PMCID: PMC7113112 DOI: 10.1097/jom.0000000000001828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To investigate whether paresthesia of the lower extremities following exposure to the World Trade Center (WTC) disaster was associated with signs of neuropathy, metabolic abnormalities, or neurotoxin exposures. METHODS Case-control study comparing WTC-exposed paresthesia cases with "clinic controls" (WTC-exposed subjects without paresthesias), and "community controls" (WTC-unexposed persons). RESULTS Neurological histories and examination findings were significantly worse in cases than controls. Intraepidermal nerve fiber densities were below normal in 47% of cases and sural to radial sensory nerve amplitude ratios were less than 0.4 in 29.4%. Neurologic abnormalities were uncommon among WTC-unexposed community controls. Metabolic conditions and neurotoxin exposures did not differ among groups. CONCLUSIONS Paresthesias among WTC-exposed individuals were associated with signs of neuropathy, small and large fiber disease. The data support WTC-related exposures as risk factors for neuropathy, and do not support non-WTC etiologies.
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Affiliation(s)
- Michael Marmor
- Department of Population Health, New York University School
of Medicine, USA
- Department of Environmental Medicine, New York University
School of Medicine, USA
- Department of Medicine, New York University School of
Medicine, USA
| | - Sujata Thawani
- Department of Neurology, New York University School of
Medicine, USA
| | | | - Yongzhao Shao
- Department of Population Health, New York University School
of Medicine, USA
- Department of Environmental Medicine, New York University
School of Medicine, USA
| | - Ericka S. Wong
- Department of Neurology, New York University School of
Medicine, USA
- Department of Neurology, Thomas Jefferson University
Hospital, Philadelphia, PA, USA
| | - Mark M. Stecker
- UCSF/Fresno and University Neurology Associates, Fresno,
CA, USA
| | - Bin Wang
- Department of Population Health, New York University School
of Medicine, USA
- Department of Environmental Medicine, New York University
School of Medicine, USA
| | | | - Marc Wilkenfeld
- Department of Medicine, New York University School of
Medicine, USA
- Division of Occupational and Environmental Medicine,
Department of Medicine, NYU Winthrop Hospital, Mineola, NY, USA
| | - Etta J. Vinik
- Department of Internal Medicine, Strelitz Diabetes Center,
Eastern Virginia Medical School, Norfolk, VA, USA
| | - Aaron I. Vinik
- Department of Internal Medicine, Strelitz Diabetes Center,
Eastern Virginia Medical School, Norfolk, VA, USA
| | - Joan Reibman
- Department of Environmental Medicine, New York University
School of Medicine, USA
- Department of Medicine, New York University School of
Medicine, USA
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Meier WA, Linn MJ, Davis WP, Sutherland JE, Sharma AK. Incidental Ultrastructural Findings in the Sural Nerve and Dorsal Root Ganglion of Aged Control Sprague Dawley Rats in a Nonclinical Carcinogenicity Study. Toxicol Pathol 2019; 48:132-143. [DOI: 10.1177/0192623319873319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Xenobiotic-induced peripheral nerve damage is a growing concern. Identifying relative risks that a new drug may cause peripheral nerve injury over long periods of administration is gathering importance in the evaluation of animal models. Separating out age-related changes in peripheral nerves of rats caused by compression injury from drug-induced effects has been difficult. Biopsy of the sural nerve is utilized in humans for investigations of peripheral neuropathy, because it is largely removed from the effects of nerve compression. This study used transmission electron microscopy to identify incidental findings in the sural nerves and dorsal root ganglia of aged control rats over time. The goal was to establish a baseline understanding of the range of possible changes that could be noted in controls compared to rats treated with any new investigative drug. In this evaluation, most sural nerve fibers from aged control rats had few ultrastructural abnormalities of pathologic significance. However, glycogenosomes, polyglucosan bodies, swollen mitochondria, autolysosomes, split myelin, Schwann cell processes, and endoneural macrophages with phagocytosed debris (considered an indication of ongoing degenerative changes) were occasionally noted.
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Bolon B, Krinke GJ, Pardo ID. Essential References for Structural Analysis of the Peripheral Nervous System for Pathologists and Toxicologists. Toxicol Pathol 2019; 48:87-95. [DOI: 10.1177/0192623319868160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Toxicologic neuropathology for the peripheral nervous system (PNS) is a vital but often underappreciated element of basic translational research and safety assessment. Evaluation of the PNS may be complicated by unfamiliarity with normal nerve and ganglion biology, which differs to some degree among species; the presence of confounding artifacts related to suboptimal sampling and processing; and limited experience with differentiating such artifacts from genuine disease manifestations and incidental background changes. This compilation of key PNS neurobiology, neuropathology, and neurotoxicology references is designed to allow pathologists and toxicologists to readily access essential information that is needed to enhance their proficiency in evaluating and interpreting toxic changes in PNS tissues from many species.
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Hydroxychloroquine-Induced Reversible Hypomnesis in Systemic Lupus Erythematosus. J Clin Rheumatol 2018; 24:291-293. [DOI: 10.1097/rhu.0000000000000655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Al-Bari MAA. Chloroquine analogues in drug discovery: new directions of uses, mechanisms of actions and toxic manifestations from malaria to multifarious diseases. J Antimicrob Chemother 2015; 70:1608-21. [PMID: 25693996 PMCID: PMC7537707 DOI: 10.1093/jac/dkv018] [Citation(s) in RCA: 287] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Antimalarial drugs (e.g. chloroquine and its close structural analogues) were developed primarily to treat malaria; however, they are beneficial for many dermatological, immunological, rheumatological and severe infectious diseases, for which they are used mostly today. Chloroquine and hydroxychloroquine, two of the most fascinating drugs developed in the last 50 years, are increasingly recognized for their effectiveness in myriad non-malarial diseases. In advanced research, chloroquine and hydroxychloroquine have been shown to have various immunomodulatory and immunosuppressive effects, and currently have established roles in the management of rheumatic diseases, lupus erythematosus (different forms) and skin diseases, and in the treatment of different forms of cancer. Recently, chloroquine analogues have also been found to have metabolic, cardiovascular, antithrombotic and antineoplastic effects. This review is concerned with the lysosomotropic, anti-inflammatory and immunomodulatory mechanisms of chloroquine, hydroxychloroquine, quinacrine and related analogues, and the current evidence for both their beneficial effects and potential adverse manifestations in various diseases.
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