Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling side effect of various chemotherapeutic agents, including oxaliplatin. It is highly prevalent amongst cancer patients, causing sensory abnormalities and pain. Unfortunately, as the underlying mechanisms remain poorly understood, effective therapeutics are lacking. Neuro-immune interactions have been highlighted as potential contributors to the development and maintenance of CIPN, however, whether this is the case in oxaliplatin-induced peripheral neuropathy (OIPN) is yet to be fully established. Methods: In this study we used flow cytometry to examine the peripheral immune response of male C57BL/6 mice following both single and repeated oxaliplatin administration. In animals exposed to repeated dosing, we also undertook mechanical and thermal behavioural assays to investigate how oxaliplatin alters phenotype, and conducted RT-qPCR experiments on bone marrow derived macrophages in order to further inspect the effects of oxaliplatin on immune cells. Results: In contrast to other reports, we failed to observe substantial changes in overall leukocyte, lymphocyte or myeloid cell numbers in dorsal root ganglia, sciatic nerves or inguinal lymph nodes. We did however note subtle, tissue-dependant alterations in several myeloid subpopulations following repeated dosing. These included a significant reduction in MHCII antigen presenting cells in the sciatic nerve and an increase in infiltrating cell types into the inguinal lymph nodes. Though repeated oxaliplatin administration had a systemic effect, we were unable to detect a pain-like behavioural phenotype in response to either cold or mechanical stimuli. Consequently, we cannot comment on whether the observed myeloid changes are associated with OIPN. Conclusions: Our discussion puts these results into the wider context of the field, advocating for greater transparency in reporting, alignment in experimental design and the introduction of more clinically relevant models. Only through joint concerted effort can we hope to increase our understanding of the underlying mechanisms of CIPN, including any immune contributions.

Highlights

  • Chemotherapy induced peripheral neuropathy (CIPN) is an unpleasant and debilitating side-effect of numerous neurotoxic chemotherapeutics, including epothilones, proteasome inhibitors, taxanes, vinca alkaloids and platinum-based agents (Starobova & Vetter, 2017)

  • A single dose of 6mg/kg oxaliplatin resulted in shortterm weight loss which resolved within 2-days following injection In order to gain an indication of whether oxaliplatin was having a negative effect on the health of these mice - suggesting effective administration - the body weights of all animals were monitored prior to injection i.e. day 0, and for 2 days following injection i.e. day 1 and 2 (Figure 1 (Hore et al, 2021a))

  • No behavioural assays were conducted for this acute administration model, and flow cytometry was performed 4-days following injection i.e. once animals had returned to their pre-injection weights

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Summary

Introduction

Chemotherapy induced peripheral neuropathy (CIPN) is an unpleasant and debilitating side-effect of numerous neurotoxic chemotherapeutics, including epothilones, proteasome inhibitors, taxanes, vinca alkaloids and platinum-based agents (Starobova & Vetter, 2017). Prevalence of CIPN is markedly high, acutely affecting 60–70% of patients, with 30% continuing to suffer symptoms 6 months following cessation of chemotherapy (Seretny et al, 2014) One such agent with a high incidence of inducing long-lasting peripheral neuropathy is oxaliplatin, a platinum-based chemotherapeutic commonly used in the treatment of cancers of the digestive tract, including colorectal, oesophageal, stomach, liver and pancreatic (Zajączkowska et al, 2019). Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling side effect of various chemotherapeutic agents, including oxaliplatin It is highly prevalent amongst cancer patients, causing sensory abnormalities and pain. We did note subtle, tissue-dependant alterations in several myeloid subpopulations following repeated dosing These included a significant reduction in MHCII antigen presenting cells in the sciatic nerve and an increase in infiltrating cell types into the inguinal lymph nodes. We cannot comment on whether the observed myeloid changes are associated with OIPN

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