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Housley SN, Nardelli P, Rotterman TM, Reed J, Cope TC. Mechanosensory encoding dysfunction emerges from cancer-chemotherapy interaction. Front Mol Biosci 2022; 9:1017427. [PMID: 36504708 PMCID: PMC9729348 DOI: 10.3389/fmolb.2022.1017427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/20/2022] [Indexed: 11/25/2022] Open
Abstract
Persistent sensory, motor and cognitive disabilities comprise chemotherapy-induced neural disorders (CIND) that limit quality of life with little therapeutic relief for cancer survivors. Our recent preclinical study provides new insight into a condition impacting the severity of chronic CIND. We find that sensorimotor disability observed following cancer treatment exceeds that attributable to chemotherapy alone. A possible explanation for intensified disability emerged from evidence that codependent effects of cancer and chemotherapy amplify defective firing in primary sensory neurons supplying one type of low threshold mechanosensory receptor (LTMR). Here we test whether cancer's modification of chemotherapy-induced sensory defects generalizes across eight LTMR submodalities that collectively generate the signals of origin for proprioceptive and tactile perception and guidance of body movement. Preclinical study enabled controlled comparison of the independent contributions of chemotherapy and cancer to their clinically relevant combined effects. We compared data sampled from rats that were otherwise healthy or bearing colon cancer and treated, or not, with human-scaled, standard-of-care chemotherapy with oxaliplatin. Action potential firing patterns encoding naturalistic mechanical perturbations of skeletal muscle and skin were measured electrophysiologically in vivo from multiple types of LTMR neurons. All expressed aberrant encoding of dynamic and/or static features of mechanical stimuli in healthy rats treated with chemotherapy, and surprisingly also by some LTMRs in cancer-bearing rats that were not treated. By comparison, chemotherapy and cancer in combination worsened encoding aberrations, especially in slowly adapting LTMRs supplying both muscle and glabrous skin. Probabilistic modeling best predicted observed encoding defects when incorporating interaction effects of cancer and chemotherapy. We conclude that for multiple mechanosensory submodalities, the severity of encoding defects is modulated by a codependence of chemotherapy side effects and cancer's systemic processes. We propose that the severity of CIND might be reduced by therapeutically targeting the mechanisms, yet to be determined, by which cancer magnifies chemotherapy's neural side effects as an alternative to reducing chemotherapy and its life-saving benefits.
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Affiliation(s)
- Stephen N. Housley
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States,Integrated Cancer Research Center, Georgia Institute of Technology, Atlanta, GA, United States,*Correspondence: Stephen N. Housley, ; Timothy C. Cope,
| | - Paul Nardelli
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Travis M. Rotterman
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - J’Ana Reed
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Timothy C. Cope
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States,Integrated Cancer Research Center, Georgia Institute of Technology, Atlanta, GA, United States,W. H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Georgia Institute of Technology, Atlanta, GA, United States,*Correspondence: Stephen N. Housley, ; Timothy C. Cope,
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Cauli O. Oxidative Stress and Cognitive Alterations Induced by Cancer Chemotherapy Drugs: A Scoping Review. Antioxidants (Basel) 2021; 10:1116. [PMID: 34356349 PMCID: PMC8301189 DOI: 10.3390/antiox10071116] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 02/06/2023] Open
Abstract
Cognitive impairment is one of the most deleterious effects of chemotherapy treatment in cancer patients, and this problem sometimes remains even after chemotherapy ends. Common classes of chemotherapy-based regimens such as anthracyclines, taxanes, and platinum derivatives can induce both oxidative stress in the blood and in the brain, and these effects can be reproduced in neuronal and glia cell cultures. In rodent models, both the acute and repeated administration of doxorubicin or adriamycin (anthracyclines) or cisplatin impairs cognitive functions, as shown by their diminished performance in different learning and memory behavioural tasks. Administration of compounds with strong antioxidant effects such as N-acetylcysteine, gamma-glutamyl cysteine ethyl ester, polydatin, caffeic acid phenethyl ester, and 2-mercaptoethane sulfonate sodium (MESNA) counteract both oxidative stress and cognitive alterations induced by chemotherapeutic drugs. These antioxidant molecules provide the scientific basis to design clinical trials in patients with the aim of reducing the oxidative stress and cognitive alterations, among other probable central nervous system changes, elicited by chemotherapy in cancer patients. In particular, N-acetylcysteine and MESNA are currently used in clinical settings and are therefore attracting scientific attention.
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Affiliation(s)
- Omar Cauli
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain; ; Tel.: +34-96-386-41-82; Fax: +34-96-398-30-35
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
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Emerging mechanistic underpinnings and therapeutic targets for chemotherapy-related cognitive impairment. Curr Opin Oncol 2020; 31:531-539. [PMID: 31449084 DOI: 10.1097/cco.0000000000000578] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW Modern innovations in cancer therapy have dramatically increased the number of cancer survivors. An unfortunately frequent side-effect of cancer treatment is enduring neurological impairment. Persistent deficits in attention, concentration, memory, and speed of information processing afflict a substantial fraction of cancer survivors following completion of these life-saving therapies. Here, we highlight chemotherapy-related cognitive impairment (CRCI) and discuss the current understanding of mechanisms underlying CRCI. RECENT FINDINGS New studies emphasize the deleterious impact of chemotherapeutic agents on glial-glial and neuron-glial interactions that shape the form, function and plasticity of the central nervous system. An emerging theme in cancer therapy-related cognitive impairment is therapy-induced microglial activation and consequent dysfunction of both neural precursor cells and mature neural cell types. Recent work has highlighted the complexity of dysregulated intercellular interactions involving oligodendrocyte lineage cells, microglia, astrocytes, and neurons following exposure to traditional cancer therapies such as methotrexate. This new understanding of the mechanistic underpinnings of CRCI has elucidated potential therapeutic interventions, including colony-stimulating factor 1 receptor inhibition, TrkB agonism, and aerobic exercise. SUMMARY Traditional cancer therapies induce lasting alterations to multiple neural cell types. Therapy-induced microglial activation is a critical component of the cause of CRCI, contributing to dysregulation of numerous processes of neural plasticity. Therapeutic targeting of microglial activation or the consequent dysregulation of neural plasticity mechanisms are emerging.
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An Evaluation of DNA Methyltransferase 1 (DNMT1) Single Nucleotide Polymorphisms and Chemotherapy-Associated Cognitive Impairment: A Prospective, Longitudinal Study. Sci Rep 2019; 9:14570. [PMID: 31601979 PMCID: PMC6787348 DOI: 10.1038/s41598-019-51203-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/26/2019] [Indexed: 01/31/2023] Open
Abstract
Strong evidence suggests that genetic variations in DNA methyltransferases (DNMTs) may alter the downstream expression and DNA methylation patterns of neuronal genes and influence cognition. This study investigates the association between a DNMT1 polymorphism, rs2162560, and chemotherapy-associated cognitive impairment (CACI) in a cohort of breast cancer patients. This is a prospective, longitudinal cohort study. From 2011 to 2017, 351 early-stage breast cancer patients receiving chemotherapy were assessed at baseline, the midpoint, and the end of chemotherapy. DNA was extracted from whole blood, and genotyping was performed using Sanger sequencing. Patients' self-perceived cognitive function and cognitive performance were assessed at three different time points using FACT-Cog (v.3) and a neuropsychological battery, respectively. The association between DNMT1 rs2162560 and cognitive function was evaluated using logistic regression analyses. Overall, 33.3% of the patients reported impairment relative to baseline in one or more cognitive domains. Cognitive impairment was observed in various objective cognitive domains, with incidences ranging from 7.2% to 36.9%. The DNMT1 rs2162560 A allele was observed in 21.8% of patients and this was associated with lower odds of self-reported cognitive decline in the concentration (OR = 0.45, 95% CI: 0.25-0.82, P = 0.01) and functional interference (OR = 0.48, 95% CI: 0.24-0.95, P = 0.03) domains. No significant association was observed between DNMT1 rs2162560 and objective cognitive impairment. This is the first study to show a significant association between the DNMT1 rs2162560 polymorphism and CACI. Our data suggest that epigenetic processes could contribute to CACI, and further studies are needed to validate these findings.
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Bellet M, Ahmad F, Villanueva R, Valdivia C, Palomino-Doza J, Ruiz A, Gonzàlez X, Adrover E, Azaro A, Valls-Margarit M, Parra JL, Aguilar J, Vidal M, Martín A, Gavilá J, Escrivá-de-Romaní S, Perelló A, Hernando C, Lahuerta A, Zamora P, Reyes V, Alcalde M, Masanas H, Céliz P, Ruíz I, Gil M, Seguí MÀ, de la Peña L. Palbociclib and ribociclib in breast cancer: consensus workshop on the management of concomitant medication. Ther Adv Med Oncol 2019; 11:1758835919833867. [PMID: 31205497 PMCID: PMC6535716 DOI: 10.1177/1758835919833867] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/23/2019] [Indexed: 12/11/2022] Open
Abstract
Drug–drug interactions are of significant concern in clinical practice in oncology, particularly in patients receiving Cyclin-dependent kinase (CDK) 4/6 inhibitors, which are typically exposed to long-term regimens. This article presents the highlights from the ‘First Workshop on Pharmacology and Management of CDK4/6 Inhibitors: Consensus about Concomitant Medications’. The article is structured into two modules. The educational module includes background information regarding drug metabolism, corrected QT (QTc) interval abnormalities, management of psychotropic drugs and a comprehensive review of selected adverse effects of palbociclib and ribociclib. The collaborative module presents the conclusions of the five working groups, each of which comprised five experts from different fields. From these conclusions positive lists of drugs for treating common comorbid conditions that can be safely administered concomitantly with palbociclib and/or ribociclib were developed.
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Affiliation(s)
- Meritxell Bellet
- Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - Faten Ahmad
- Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Rafael Villanueva
- Institut Català d'Oncologia, Hospital Moisès Broggi, Barcelona, Spain
| | | | - Julián Palomino-Doza
- Hereditary Cardiopathies Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ada Ruiz
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, and Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Xavier Gonzàlez
- Instituto Oncológico Dr Rosell, Hospital General De Catalunya, SOLTI, Barcelona, Spain
| | - Encarna Adrover
- Servicio de Oncología Médica, Complejo Hospital Universitario Albacete, Albacete, Spain
| | - Analía Azaro
- Medical Oncology Department, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology. Barcelona, Spain
| | | | | | - Juan Aguilar
- Medical Oncology Department and Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Maria Vidal
- Hospital Clínic Barcelona and Translational Genomics and Targeted Therapeutics in Solid Tumors Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Anastasi Martín
- Unitat de Cures Palliatives, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Joaquín Gavilá
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain
| | | | - Antonia Perelló
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Cristina Hernando
- Hospital Clínico Universitario de Valencia, INCLIVA Institut d'Investigació Sanitària and Centro de Investigación Biomédica en Red Cáncer, Valencia, Spain
| | | | - Pilar Zamora
- Servicio de Oncologia Médica, Hospital Universitario La Paz, Madrid, Spain
| | - Victoria Reyes
- Radiation Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - María Alcalde
- Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | - Isabel Ruíz
- Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Miguel Gil
- Institut Català d'Oncologia, IDIBELL Institut d'Investigació Biomédica de Bellvitge, L'Hospitalet, Barcelona, Spain
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Gan C, Lv Y, Zhao J, Chao HH, Li CSR, Zhang C, Yu F, Cheng H. Neural correlates of chemotherapy-induced emotion regulation impairment in breast cancer patients. Am J Cancer Res 2019; 9:171-179. [PMID: 30755820 PMCID: PMC6356929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 12/07/2018] [Indexed: 06/09/2023] Open
Abstract
To investigate the chemotherapy-induced emotion regulation impairment and its neural correlates in breast cancer (BC) patients by event-related potentials (ERP), seventeen BC patients were investigated on emotion regulation paradigms while undergoing the recording of an event-related potential (ERP) both before and after chemotherapy. The performance of behavioral and ERP was compared for the data collected before and after chemotherapy (BCB and BCA, respectively). The correlation of the difference between the peak and the latency of each component before and after chemotherapy were compared with the difference in behavior (RT and AR). BC patients showed a lower accuracy rate in both explicit and implicit emotion identification in BCA compared to that in BCB. Further, both the N1 and P2 components were significantly delayed. The peak values of the N1 and P2 in BCA were significantly higher than those in BCB, whereas the peak value of the N2 in BCA was significantly lower than that in BCB. There was a positive correlation between the difference in latency at the CZ (r=0.88), F3 (r=0.97) and FZ (r=0.85) points in the N1 component and the RT. The difference in latency at the FCZ point in the N2 (r=0.88) component is positively correlated with the AR. The difference in peak value at the CPZ (r=0.89) point in the N1 component is positively correlated with the RT. Both the implicit and explicit emotional processing was compromised in BC patients following chemotherapy. These emotional processing deficits may be related to the changes of the N1, N2 and P2 of the ERP.
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Affiliation(s)
- Chen Gan
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
| | - Yue Lv
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
| | - Jingjing Zhao
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
| | - Herta H Chao
- Cancer Center, VA Connecticut Healthcare SystemWest Haven, CT 06516, USA
- Department of Internal Medicine, Yale University School of MedicineNew Haven, CT 06520, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of MedicineNew Haven, CT 06520, USA
| | - Congjun Zhang
- Department of Oncology, The First Affiliated Hospital of Anhui Medical UniversityHefei 231200, Anhui, China
| | - Fengqiong Yu
- Laboratory of Cognitive Neuropsychology, Department of Medical Psychology, Anhui Medical UniversityHefei, China
- Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental HealthAnhui Province, China
| | - Huaidong Cheng
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
- Department of Psychiatry, Yale University School of MedicineNew Haven, CT 06520, USA
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van der Willik KD, Schagen SB, Ikram MA. Cancer and dementia: Two sides of the same coin? Eur J Clin Invest 2018; 48:e13019. [PMID: 30112764 PMCID: PMC6220770 DOI: 10.1111/eci.13019] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 08/13/2018] [Indexed: 12/12/2022]
Abstract
Noncentral nervous system cancer and the brain share an interesting and complex relation, with an emerging body of evidence showing that cancer patients are at an increased risk of developing cognitive problems. In contrast, population-based studies consistently find an inverse link between cancer and dementia, that is patients with dementia having a lower risk of subsequently developing cancer, and cancer patients being less often diagnosed with dementia. Different biological processes such as inversely activated cell proliferation and survival pathways have been suggested to have an important role underlying this inverse association. However, the effect of methodological biases including surveillance or survival bias has not been completely ruled out, calling into question the inverse direction of the association between cancer and dementia. In fact, emerging evidence now suggests that cancer and dementia might share a positive association. This narrative review summarises the current literature on cancer, cognitive problems and dementia. Moreover, different strategies will be discussed to reduce the impact of potential methodological biases on the association between cancer and dementia, trying to reveal the true direction of this link.
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Affiliation(s)
- Kimberly D. van der Willik
- Department of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamThe Netherlands
- Department of EpidemiologyErasmus Medical CenterRotterdamThe Netherlands
| | - Sanne B. Schagen
- Department of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamThe Netherlands
- Brain and CognitionDepartment of PsychologyUniversity of AmsterdamAmsterdamThe Netherlands
| | - M. Arfan Ikram
- Department of EpidemiologyErasmus Medical CenterRotterdamThe Netherlands
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