A Review on Cisplatin-Induced Peripheral Neuropathy: Pathophysiology, Molecular Mechanisms, Oxidative Stress, Biomarkers and Therapeutic Strategies

Author

Vimalya S, Abinaya G, Deepika V, Charumathi S, Sharmila S


Abstract

 Cisplatin is an important anticancer drug used for the treatment of several types of cancer. However, its clinical use is limited by adverse effects, particularly cisplatin-induced peripheral neuropathy (CIPN). CIPN mainly affects sensory nerves and can cause numbness, tingling, pain, burning sensation and reduced sensation in the hands and feet. The development of CIPN involves several mechanisms, including DNA damage, mitochondrial dysfunction, oxidative stress, calcium imbalance, axonal damage and neuroinflammation. Increased production of reactive oxygen species can further damage nerve cells and reduce the activity of antioxidant defenses. Biomarkers such as malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) are useful for studying oxidative stress associated with cisplatin-induced nerve injury. Animal models have helped in understanding the mechanisms and evaluating potential treatments for CIPN. Current management mainly includes dose modification and symptomatic treatment, while drugs such as duloxetine have shown clinical benefit for painful chemotherapy-induced neuropathy. Antioxidants, anti-inflammatory agents and natural products are also being investigated as potential neuroprotective approaches. This review summarizes the pathophysiology, molecular mechanisms, oxidative stress, biomarkers, experimental models and therapeutic strategies associated with cisplatin-induced peripheral neuropathy and highlights potential areas for future research.



Keywords

Cisplatin; Peripheral neuropathy; Chemotherapy-induced peripheral neuropathy; Oxidative stress; Reactive oxygen species; Mitochondrial dysfunction; Dorsal root ganglion; Biomarkers; Neuroinflammation; Natural products.



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References


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