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Li DJ, Zhong ZJ, Wang XL, Wei N, Zhao SJ, Shan TT, Liu YP, Yu YQ. Chemokine receptor CXCR2 in primary sensory neurons of trigeminal ganglion mediates orofacial itch. Front Mol Neurosci 2023; 16:1279237. [PMID: 37953876 PMCID: PMC10637378 DOI: 10.3389/fnmol.2023.1279237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Abstract
The CXCR2 chemokine receptor is known to have a significant impact on the initiation and control of inflammatory processes. However, its specific involvement in the sensation of itch is not yet fully understood. In this study, we aimed to elucidate the function of CXCR2 in the trigeminal ganglion (TG) by utilizing orofacial itch models induced by incision, chloroquine (CQ), and histamine. Our results revealed a significant up-regulation of CXCR2 mRNA and protein expressions in the primary sensory neurons of TG in response to itch stimuli. The CXCR2 inhibitor SB225002 resulted in notable decrease in CXCR2 protein expression and reduction in scratch behaviors. Distal infraorbital nerve (DION) microinjection of a specific shRNA virus inhibited CXCR2 expression in TG neurons and reversed itch behaviors. Additionally, the administration of the PI3K inhibitor LY294002 resulted in a decrease in the expressions of p-Akt, Akt, and CXCR2 in TG neurons, thereby mitigating pruritic behaviors. Collectively, we report that CXCR2 in the primary sensory neurons of trigeminal ganglion contributes to orofacial itch through the PI3K/Akt signaling pathway. These observations highlight the potential of molecules involved in the regulation of CXCR2 as viable therapeutic targets for the treatment of itch.
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Affiliation(s)
- Dong-Jin Li
- College of Life Sciences, Northwest University, Xi’an, China
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Zhen-Juan Zhong
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Xiao-Liang Wang
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Na Wei
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Si-Jia Zhao
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Ting-Ting Shan
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Ya-Ping Liu
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Yao-Qing Yu
- College of Life Sciences, Northwest University, Xi’an, China
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
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Lin MTY, Lee IXY, Chen WL, Chen MY, Mehta JS, Yam GHF, Peh GSL, Liu YC. Culture of Primary Neurons from Dissociated and Cryopreserved Mouse Trigeminal Ganglion. Tissue Eng Part C Methods 2023; 29:381-393. [PMID: 37212303 PMCID: PMC10442681 DOI: 10.1089/ten.tec.2023.0054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/16/2023] [Indexed: 05/23/2023] Open
Abstract
Corneal nerves originate from the ophthalmic branch of the trigeminal nerve, which enters the cornea at the limbus radially from all directions toward the central cornea. The cell bodies of the sensory neurons of trigeminal nerve are located in the trigeminal ganglion (TG), while the axons are extended into the three divisions, including ophthalmic branch that supplies corneal nerves. Study of primary neuronal cultures established from the TG fibers can therefore provide a knowledge basis for corneal nerve biology and potentially be developed as an in vitro platform for drug testing. However, setting up primary neuron cultures from animal TG has been dubious with inconsistency among laboratories due to a lack of efficient isolation protocol, resulting in low yield and heterogenous cultures. In this study, we used a combined enzymatic digestion with collagenase and TrypLE to dissociate mouse TG while preserving nerve cell viability. A subsequent discontinuous Percoll density gradient followed by mitotic inhibitor treatment effectively diminished the contamination of non-neuronal cells. Using this method, we reproducibly generated high yield and homogenous primary TG neuron cultures. Similar efficiency of nerve cell isolation and culture was further obtained for TG tissue cryopreserved for short (1 week) and long duration (3 months), compared to freshly isolated tissues. In conclusion, this optimized protocol shows a promising potential to standardize TG nerve culture and generate a high-quality corneal nerve model for drug testing and neurotoxicity studies.
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Affiliation(s)
- Molly Tzu-Yu Lin
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Isabelle Xin Yu Lee
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Wei-Li Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University, Taipei, Taiwan
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mei-Yun Chen
- Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University, Taipei, Taiwan
| | - Jodhbir S. Mehta
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore, Singapore
- Corneal and External Eye Disease Department, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Gary H. F. Yam
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gary S. L. Peh
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Yu-Chi Liu
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Corneal and External Eye Disease Department, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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Thammasart S, Namchaiw P, Pasuwat K, Tonsomboon K, Khantachawana A. Attenuation Aβ1-42-induced neurotoxicity in neuronal cell by 660nm and 810nm LED light irradiation. PLoS One 2023; 18:e0283976. [PMID: 37478089 PMCID: PMC10361470 DOI: 10.1371/journal.pone.0283976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/21/2023] [Indexed: 07/23/2023] Open
Abstract
Oligomeric amyloid-β 1-42 (Aβ1-42) has a close correlation with neurodegenerative disorder especially Alzheimer's disease (AD). It induces oxidative stress and mitochondrial damage in neurons. Therefore, it is used to generate AD-like in vitro model for studying neurotoxicity and neuroprotection against amyloid-β. A low-level light therapy (LLLT) is a non-invasive method that has been used to treat several neurodegenerative disorders. In this study, the red wavelength (660nm) and near infrared wavelength (810nm) at energy densities of 1, 3, and 5 J/cm2 were used to modulate biochemical processes in the neural cells. The exposure of Aβ1-42 resulted in cell death, increased intracellular reactive oxygen species (ROS), and retracted neurite outgrowth. We showed that both of LLLT wavelengths could protect neurons form Aβ1-42-induced neurotoxicity in a biphasic manner. The treatment of LLLT at 3 J/cm2 potentially alleviated cell death and recovered neurite outgrowth. In addition, the treatment of LLLT following Aβ1-42 exposure could attenuate the intracellular ROS generation and Ca2+ influx. Interestingly, both wavelengths could induce minimal level of ROS generation. However, they did not affect cell viability. In addition, LLLT also stimulated Ca2+ influx, but not altered mitochondrial membrane potential. This finding indicated LLLT may protect neurons through the stimulation of secondary signaling messengers such as ROS and Ca2+. The increase of these secondary messengers was in a functional level and did not harmful to the cells. These results suggested the use of LLLT as a tool to modulate the neuronal toxicity following Aβ1-42 accumulation in AD's brain.
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Affiliation(s)
- Siriluk Thammasart
- Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi (KMUTT), Thung Kru, Bangkok, Thailand
| | - Poommaree Namchaiw
- Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi (KMUTT), Thung Kru, Bangkok, Thailand
- Neuroscience Center for Research and Innovation, Learning Institute, King Mongkut's University of Technology Thonburi (KMUTT), Thung Kru, Bangkok, Thailand
| | - Kwanchanok Pasuwat
- Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi (KMUTT), Thung Kru, Bangkok, Thailand
- Department of Chemical Engineering, Faculty of Engineering, King Mongkut's University of Technology Thonburi (KMUTT), Thung Kru, Bangkok, Thailand
| | - Khaow Tonsomboon
- National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Anak Khantachawana
- Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi (KMUTT), Thung Kru, Bangkok, Thailand
- Department of Mechanical Engineering, Faculty of Engineering, King Mongkut's University of Technology Thonburi (KMUTT), Thung Kru, Bangkok, Thailand
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Li Y, Li J, Wei SS, Du J. Lipopolysaccharide-induced Trigeminal Ganglion Nerve Fiber Damage is Associated with Autophagy Inhibition. Curr Med Sci 2023:10.1007/s11596-023-2739-0. [PMID: 37278832 DOI: 10.1007/s11596-023-2739-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 02/20/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study aimed to determine whether lipopolysaccharide (LPS) induces the loss of corneal nerve fibers in cultured trigeminal ganglion (TG) cells, and the underlying mechanism of LPS-induced TG neurite damage. METHODS TG neurons were isolated from C57BL/6 mice, and the cell viability and purity were maintained for up to 7 days. Then, they were treated with LPS (1 µg/mL) or the autophagy regulator (autophibib and rapamycin) alone or in combination for 48 h, and the length of neurites in TG cells was examined by the immunofluorescence staining of the neuron-specific protein β3-tubulin. Afterwards, the molecular mechanisms by which LPS induces TG neuron damage were explored. RESULTS The immunofluorescence staining revealed that the average length of neurites in TG cells significantly decreased after LPS treatment. Importantly, LPS induced the impairment of autophagic flux in TG cells, which was evidenced by the increase in the accumulation of LC3 and p62 proteins. The pharmacological inhibition of autophagy by autophinib dramatically reduced the length of TG neurites. However, the rapamycin-induced activation of autophagy significantly lessened the effect of LPS on the degeneration of TG neurites. CONCLUSION LPS-induced autophagy inhibition contributes to the loss of TG neurites.
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Affiliation(s)
- Yong Li
- Refractive Surgery Center, Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Jing Li
- Refractive Surgery Center, Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Sheng-Sheng Wei
- Refractive Surgery Center, Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Jing Du
- Refractive Surgery Center, Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710004, China.
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Neurite growth induced by red light-caused intracellular reactive oxygen species production through cytochrome c oxidase activation. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2023; 241:112681. [PMID: 36870246 DOI: 10.1016/j.jphotobiol.2023.112681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/02/2023] [Accepted: 02/23/2023] [Indexed: 02/27/2023]
Abstract
The applications of red-light photobiomodulation (PBM) to enhance neurite growth have been proposed for many years. However, the detailed mechanisms require further studies. In the present work we used a focused red-light spot to illuminate the junction of the longest neurite and the soma of a neuroblastoma cell (N2a), and demonstrated enhanced neurite growth at 620 nm and 760 nm with adequate illumination energy fluences. In contrast, 680 nm light showed no effect on neurite growth. The neurite growth was accompanied with the increase of intracellular reactive oxygen species (ROS). Using Trolox to reduce the ROS level, this red light-induced neurite growth was hindered. Suppressing the activities of cytochrome c oxidase (CCO) by using either a small-molecule inhibitor or siRNA abrogated the red light-induced neurite growth. These results suggest that red light-induced ROS production through the activation of CCO could be beneficial for neurite growth.
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KC E, Islam J, Park YS. Trigeminal ganglion itself can be a viable target to manage trigeminal neuralgia. J Headache Pain 2022; 23:150. [PMID: 36424545 PMCID: PMC9686102 DOI: 10.1186/s10194-022-01512-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/26/2022] [Indexed: 11/25/2022] Open
Abstract
Excruciating trigeminal neuralgia (TN) management is very difficult and severely affects the patient's quality of life. Earlier studies have shown that the trigeminal ganglion (TG) comprises several receptors and signal molecules that are involved in the process of peripheral sensitization, which influences the development and persistence of neuropathic pain. Targeting TG can modulate this sensitization pathway and mediate the pain-relieving effect. So far,there are few studies in which modulation approaches to TG itself have been suggested so far. "Trigeminal ganglion modulation" and "trigeminal neuralgia" were used as search phrases in the Scopus Index and PubMed databases to discover articles that were pertinent to the topic. In this review, we address the role of the trigeminal ganglion in TN and underlying molecules and neuropeptides implicated in trigeminal pain pathways in processing pathological orofacial pain. We also reviewed different modulation approaches in TG for TN management. Furthermore, we discuss the prospect of targeting trigeminal ganglion to manage such intractable pain.
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Affiliation(s)
- Elina KC
- grid.254229.a0000 0000 9611 0917Program in Neuroscience, Department of Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jaisan Islam
- grid.254229.a0000 0000 9611 0917Program in Neuroscience, Department of Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Young Seok Park
- grid.254229.a0000 0000 9611 0917Program in Neuroscience, Department of Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea ,grid.411725.40000 0004 1794 4809Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
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Nakajima N, Ohnishi Y, Yamamoto M, Setoyama D, Imai H, Takenaka T, Matsumoto M, Hosomi K, Saitoh Y, Furue H, Kishima H. Excess intracellular ATP causes neuropathic pain following spinal cord injury. Cell Mol Life Sci 2022; 79:483. [PMID: 35972649 PMCID: PMC11072579 DOI: 10.1007/s00018-022-04510-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/16/2022] [Accepted: 08/01/2022] [Indexed: 11/03/2022]
Abstract
Intractable neuropathic pain following spinal cord injury (NP-SCI) reduces a patient's quality of life. Excessive release of ATP into the extracellular space evokes neuroinflammation via purinergic receptor. Neuroinflammation plays an important role in the initiation and maintenance of NP. However, little is known about whether or not extracellular ATP cause NP-SCI. We found in the present study that excess of intracellular ATP at the lesion site evokes at-level NP-SCI. No significant differences in the body weight, locomotor function, or motor behaviors were found in groups that were negative and positive for at-level allodynia. The intracellular ATP level at the lesion site was significantly higher in the allodynia-positive mice than in the allodynia-negative mice. A metabolome analysis revealed that there were no significant differences in the ATP production or degradation between allodynia-negative and allodynia-positive mice. Dorsal horn neurons in allodynia mice were found to be inactivated in the resting state, suggesting that decreased ATP consumption due to neural inactivity leads to a build-up of intracellular ATP. In contrast to the findings in the resting state, mechanical stimulation increased the neural activity of dorsal horn and extracellular ATP release at lesion site. The forced production of intracellular ATP at the lesion site in non-allodynia mice induced allodynia. The inhibition of P2X4 receptors in allodynia mice reduced allodynia. These results suggest that an excess buildup of intracellular ATP in the resting state causes at-level NP-SCI as a result of the extracellular release of ATP with mechanical stimulation.
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Affiliation(s)
- Nobuhiko Nakajima
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuichiro Ohnishi
- Department of Research Promotion and Management, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
- Department of Neurosurgery, Osaka Gyoumeikan Hospital, Osaka, Japan.
| | - Masamichi Yamamoto
- Department of Research Promotion and Management, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
| | - Daiki Setoyama
- Department of Clinical Chemistry and Laboratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirohiko Imai
- Department of Systems Science, Graduate School of Informatics, Kyoto University, Kyoto, Japan
| | - Tomofumi Takenaka
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mari Matsumoto
- Department of Research Promotion and Management, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Koichi Hosomi
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoichi Saitoh
- Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hidemasa Furue
- Department of Neurophysiology, Hyogo College of Medicine, Hyogo, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
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Joy L, Jolien R, Marithé C, Stijn E, Laura S, Hilde L, Sandra B, Wendy N, Ruth H, Liesbeth R, Sylvana S, Sylvia H, Jeroen M. The use of photobiomodulation therapy for the prevention of chemotherapy-induced peripheral neuropathy: a randomized, placebo-controlled pilot trial (NEUROLASER trial). Support Care Cancer 2022; 30:5509-5517. [PMID: 35312857 PMCID: PMC8935622 DOI: 10.1007/s00520-022-06975-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/10/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effectiveness of photobiomodulation (PBM) therapy for the prevention of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients. METHODS A prospective, randomized placebo-controlled pilot trial (NEUROLASER) was set up with 32 breast cancer patients who underwent chemotherapy (ClinicalTrials.gov; NCT03391271). Patients were randomized to receive PBM (n = 16) or placebo treatments (n = 16) (2 × /week) during their chemotherapy. The modified Total Neuropathy Score (mTNS), six-minute walk test (6MWT), Numeric pain Rating Scale (NRS), and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Taxane (FACT/GOG-Taxane) were used to evaluate the severity of CIPN and the patients' quality of life (QoL). Outcome measures were collected at the first chemotherapy session, 6 weeks after initiation of chemotherapy, at the final chemotherapy session, and 3 weeks after the end of chemotherapy (follow-up). RESULTS The mTNS score increased significantly over time in both the control and the PBM group. A significantly higher score for FACT/GOG-Taxane was observed in the PBM group during chemotherapy compared to the control group. Questions of the FACT/GOG-Taxane related to sensory peripheral neuropathy symptoms showed a significant increase in severeness over time in the control group, whereas they remained constant in the PBM group. At follow-up, a (borderline) significant difference was observed between both groups for the 6MWT and patients' pain level, in benefit of the PBM group. CONCLUSIONS This NEUROLASER trial shows promising results concerning the prevention of CIPN with PBM in breast cancer patients. Furthermore, a better QoL was observed when treated with PBM.
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Affiliation(s)
- Lodewijckx Joy
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
| | - Robijns Jolien
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
| | - Claes Marithé
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
| | - Evens Stijn
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
| | - Swinnen Laura
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
| | - Lenders Hilde
- Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Bortels Sandra
- Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Nassen Wendy
- Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Hilkens Ruth
- Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Raymakers Liesbeth
- Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Snoekx Sylvana
- Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Hermans Sylvia
- Department of Neurology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Mebis Jeroen
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium ,Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
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