Author, as appears in the article.: Albayrak, Merve; Figueras, Carolina; Segui, Elia; Campolo, Michela; Gabarron, Eva; Moreno, Reinaldo; Maurel, Joan; Casanova-Molla, Jordi;
Department: Medicina i Cirurgia
URV's Author/s: Casanova Mollà, Jordi
Keywords: Small fiber neuropathy Skin biopsy Regeneration Re-innervation Predictors Pain Oxaliplatin-induced neuropathy Neurotoxicity Intra-epidermal nerve fiber density Induced peripheral neuropathy Gap-43 Colorectal-cancer Chemotherapy
Abstract: Background and purpose Oxaliplatin-induced neuropathy (OIN) implies axonal damage of both small and large sensory nerve fibers. We aimed at comparing the neurophysiological changes occurred after treatment and the capability to recovery based on histological marker of re-innervation GAP-43. Methods 48 patients with cancer were assessed before and after chemotherapy (at 3 months and 12 months if available). We recorded ulnar and sural sensory nerve action potentials (SNAP), determined quantitative sensory thresholds for warm and cold (WDT, CDT), pain thresholds and collected a distal biopsy of skin to assess the intra-epidermal nerve fiber density (IENFD) with PGP9.5 and GAP-43 markers (in a subgroup of 19 patients). Results Increased WDT and CDT as well as diminished IENFD at distal leg were already found in 30% of oncologic patients before treatment. After oxaliplatin, there was a significant increase in thermal thresholds in 52% of patients, and a decrease of SNAP amplitude in the sural nerve in 67% patients. IENFD was reduced in 47% and remained unchanged in 37% after oxiplatin. The density of GAP-43 + fibers and GAP-43/PGP 9.5 ratio was similar before and after treatment showing that cutaneous re-innervation is preserved despite no clinical recovery was observed after one year. Conclusion Non-selective axonal loss affects sensory fibers in OIN. However, the presence of intra-epidermal regenerative sprouts detected by GAP-43 may reduce the impact of neurotoxicity in the small fibers with long-term sequelae mostly on myelinated nerve endings. Pre-oxaliplatin GAP-43 failed to identify patients with higher risk of damage or worse recovery after treatment.
Thematic Areas: Saúde coletiva Psicología Odontología Neurology (clinical) Neurology Medicina veterinaria Medicina iii Medicina ii Medicina i Interdisciplinar General medicine Farmacia Educação física Clinical neurology Ciências biológicas ii Ciências biológicas i Astronomia / física
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: jordi.casanova@urv.cat
Author identifier: 0000-0003-0565-8015
Record's date: 2024-09-07
Papper version: info:eu-repo/semantics/publishedVersion
Link to the original source: https://link.springer.com/article/10.1007/s00415-022-11035-9
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Journal Of Neurology. 269 (8): 4174-4184
APA: Albayrak, Merve; Figueras, Carolina; Segui, Elia; Campolo, Michela; Gabarron, Eva; Moreno, Reinaldo; Maurel, Joan; Casanova-Molla, Jordi; (2022). Prognostic value of cutaneous reinnervation with GAP-43 in oxaliplatin-induced neuropathy. Journal Of Neurology, 269(8), 4174-4184. DOI: 10.1007/s00415-022-11035-9
Article's DOI: 10.1007/s00415-022-11035-9
Entity: Universitat Rovira i Virgili
Journal publication year: 2022
Publication Type: Journal Publications
Repositori URV