Abstract

BackgroundOxaliplatin has widely been used as a key drug in the treatment of colorectal cancer; however, it causes peripheral neuropathy. Exenatide, a glucagon-like peptide-1 (GLP-1) agonist, is an incretin mimetic secreted from ileal L cells, which is clinically used to treat type 2 diabetes mellitus. GLP-1 receptor agonists have been reported to exhibit neuroprotective effects on the central and peripheral nervous systems. In this study, we investigated the effects of exenatide on oxaliplatin-induced neuropathy in rats and cultured cells.MethodsOxaliplatin (4 mg/kg) was administered intravenously twice per week for 4 weeks, and mechanical allodynia was evaluated using the von Frey test in rats. Axonal degeneration was assessed by toluidine blue staining of sciatic nerves.ResultsRepeated administration of oxaliplatin caused mechanical allodynia from day 14 to 49. Although the co-administration of extended-release exenatide (100 μg/kg) could not inhibit the incidence of oxaliplatin-induced mechanical allodynia, it facilitated recovery from the oxaliplatin-induced neuropathy with reparation of axonal degeneration. Inhibition of neurite outgrowth was evaluated in cultured pheochromocytoma 12 (PC12) cells. Exenatide inhibited oxaliplatin-induced neurite degeneration, but did not affect oxaliplatin-induced cell injury in cultured PC12 cells. Additionally, extended-release exenatide had no effect on the anti-tumor activity of oxaliplatin in cultured murine colon adenocarcinoma 26 (C-26) cells or C-26 cell-implanted mice.ConclusionThese results suggest that exenatide may be useful for treating peripheral neuropathy induced by oxaliplatin in colorectal cancer patients with type 2 diabetes.

Highlights

  • Oxaliplatin, a platinum-based chemotherapeutic agent, is a key drug widely used for treating colorectal cancer; it causes severe acute and chronic peripheral neuropathies

  • Extended-release exenatide had no effect on the anti-tumor activity of oxaliplatin in cultured murine colon adenocarcinoma 26 (C-26) cells or C-26 cell-implanted mice

  • These results suggest that exenatide may be useful for treating peripheral neuropathy induced by oxaliplatin in colorectal cancer patients with type 2 diabetes

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Summary

Introduction

Oxaliplatin, a platinum-based chemotherapeutic agent, is a key drug widely used for treating colorectal cancer; it causes severe acute and chronic peripheral neuropathies. Transient receptor potential (TRP) melastatin (M) 8 and ankyrin (A) 1 channels have been reported to play an important role in the oxaliplatin-induced acute cold hypersensitivity in rodents [5, 6]. The voltage-gated Nav1.9 sodium channel has been reported to be associated with cold pain hypersensitivity induced by oxaliplatin [7]. Patients develop chronic neuropathy, which is characterized by sensory and motor dysfunction [8]. The chronic neuropathy takes at least 2 years after discontinuation of the drug to completely recover from the neuropathy in 10% of patients [10] These neuropathies are a major clinical problem in oxaliplatin chemotherapy. We investigated the effects of exenatide on oxaliplatin-induced neuropathy in rats and cultured cells

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