RESEARCH - Toxic neuropathy

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Curr Opin Neurol. 2005 Oct;18(5):574-80.

Toxic neuropathy.

Umapathi T, Chaudhry V.

Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock

Seng, Singapore. Umapathi_Thirugnanam@...

PURPOSE OF REVIEW: This paper examines recent research on toxic neuropathy

and potential therapeutic developments. It also summarizes reports of new

agents reported to cause peripheral neuropathy. RECENT FINDINGS: Gene

therapy with vasoactive endothelial growth factor, neurotrophic substances

such as nerve growth factor and neurotrophin-3 are reported to reverse or

protect against neurotoxicity in animal models. The neuroprotective effects

of more established therapeutic agents like vitamin E, tacrolimus (FK 506)

and erythropoietin hold promise for the immediate future. Cisplatin and

high-dose pyridoxine are used more frequently to produce robust models of

peripheral neuropathy in animals. Statins do appear to cause peripheral

neuropathy. The incidence is low, however, and compared to its benefits in

terms of cardiovascular protection, relatively innocuous. The profile of

thalidomide neuropathy is becoming clearer as the indications for this drug

increases. The incidence of thalidomide neuropathy is high, up to three

quarters in some series, and although the information on dose dependency is

variable, lower cumulative doses appear to be less toxic. Like thalidomide

bortezomib, a novel proteosome inhibitor, is reportedly effective in the

treatment of multiple myeloma and is associated with peripheral neuropathy.

Oxaliplatin and epothilone are emerging anticancer drugs with neurotoxic

potential. Similarly, leflunomide, a new disease modifying-agent approved

for the treatment of rheumatoid arthritis, is reported to cause neuropathy.

SUMMARY: The study of toxic neuropathy is not only enhancing our knowledge

of the mechanisms of neurotoxicity but also the neurobiology of peripheral

neuropathy in general; and is likely to reveal avenues for therapeutics.

PMID: 16155443

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=16155443 & itool=iconabstr & query_hl=29 & itool=pubmed_DocSum

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