Discovery of Peripheral Neuropathy Cause May Lead to Preventive Treatments
Researchers have found that taxane chemotherapies such as paclitaxel impede a protein called Bclw, which leads to the side effect of peripheral neuropathy. The study results were published in (http://www.cell.com/neuron/fulltext/S0896-6273(17)30903-0)Neuron (http://www.cell.com/neuron/fulltext/S0896-6273(17)30903-0).
Peripheral neuropathy affects about one-third of patients receiving chemotherapy. In some cases it resolves when treatment ends, but in others it is a long-term side effect. It results from the degeneration of the long, spindly nerve cell projections called axons, which transmit physical sensations to the brain.
The study authors found that Bclw protects nerves from degeneration, except in the cause of traumatic injury or exposure to chemotherapy drugs. They used paclitaxel on sensory nerve axons in the lab and discovered that messenger RNA caused too little of Bclw protein to be made, resulting in axon degeneration. However, they then found that adding a synthetic Bclw to the nerve axons before exposing them to paclitaxel prevented the nerves from dying off.
Although the researchers cautioned that a possible treatment based on their findings would be a long way off, they noted that the new information may help clinicians soon predict which patients would develop peripheral neuropathy based on high or low levels of Bclw in genetic testing.
ONS’s Putting Evidence Into Practice (PEP) resources provide evidence-based interventions for oncology nurses to use in managing peripheral neuropathy in their patients. For more information on the treatments deemed “likely to be effective,” visit ONS’s PEP resources (https://www.ons.org/practice-resources/pep/peripheral-neuropathy).