Abstract
The present study seeks to identify the nutritional risk factors involved in the development of neuropathies induced by chemotherapeutic treatments. Unlike the gastrointestinal or hematological adverse effects of chemotherapy there is no protective treatment strategy for polyneuropathy. The aim of this study was to find possible deficiencies in nutritional factors, which can be used for supplementation in the future for prevention of chemotherapy-induced neuropathy development. We analyzed 70 patients undergoing paclitaxel chemotherapy and evaluated the risk factors involved in chemotherapy-induced peripheral neuropathy (CIPN). Several risk factors were considered in the development of CIPN, including deficiency of vitamin B1, B6, and D and fatty acids. The occurrence of CIPN complication in 60% cases was observed. We found significant differences in vitamin D and saturated fatty acid concentration. Vitamin D levels in the group without CIPN were estimated to be 38.2 (24.95, 47.63) nmol/L, whereas in the group with CIPN it was determined to be 25.6 (19.7, 32.55) nmol/L, p = 0.008. The level of total saturated fatty acids in the group without CIPN was of 32.613 Area % (31.322; 36.262), whereas in the group with CIPN it was of 34.209 Area % (32.86; 39.386), p = 0.01. The obtained results suggest a diet lower in saturated fatty acid content during chemotherapy. The most significant finding was that supplementation of vitamin D before chemotherapy could be an efficient neuroprotective in CIPN prophylaxis, as significantly lower levels 25OH derivative of vitamin D were observed in the CIPN group throughout the study period.
Highlights
Chemotherapy-induced peripheral neuropathy (CIPN) is an undesirable side effect and a limiting factor of systemic chemotherapeutic treatments
Sensory fibers are more vulnerable to damage in comparison to motor nerves [1] due to the hematoencephalic barrier preventing the penetration of cytotoxic drugs into the central nervous system (CNS), where the body of Nutrients 2017, 9, 535; doi:10.3390/nu9060535
Our study suggests that monitoring these analytes in patients undergoing chemotherapy could establish a direct correlation with the appearance of polyneuropathy
Summary
Chemotherapy-induced peripheral neuropathy (CIPN) is an undesirable side effect and a limiting factor of systemic chemotherapeutic treatments. Sensory fibers are more vulnerable to damage in comparison to motor nerves [1] due to the hematoencephalic barrier preventing the penetration of cytotoxic drugs into the central nervous system (CNS), where the body of Nutrients 2017, 9, 535; doi:10.3390/nu9060535 www.mdpi.com/journal/nutrients. The primary sensory and autonomic neurons are located outside of the central nervous system, unprotected by the hematoencephalic barrier [1]. The capillaries of these neurons have fenestrated walls, enabling the relatively easy transfer of drug molecules between the blood capillaries and the extracellular space of ganglia. Microtubule damage by taxanes and vinca alkaloids in particular results in axoplasmic transport failure [1]
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