Abstract: The boronic acid dipeptide bortezomib, able to induce tumor cell death by degradation of key proteins, is the first proteasome inhibitor drug to enter clinical practice. It is employed as first-line treatment in relapsed or resistant multiple myeloma (MM) patients. However, bortezomib often induces a dose-limiting toxicity in the form of painful sensory neuropathy, which can mainly be reduced by subcutaneous administration or dose modification. In this review we focus on the current understanding of the pathophysiological mechanisms of bortezomib-induced neuropathy to allow further studies in animal models and humans, including analysis of clinical and pharmacogenetic aspects, to optimize the treatment regimens.
Abstract: Cisplatin is a highly effective chemotherapeutic agent that is widely used to treat solid organ malignancies. However, serious side effects have been associated with its use, such as bilateral, progressive, irreversible, dose-dependent neurosensory hearing loss. Current evidence indicates that cisplatin triggers the production of reactive oxygen species in target tissues in the inner ear. A variety of agents that protect against cisplatin-induced ototoxicity have been successfully tested in cell culture and animal models. However, many of them interfere with the therapeutic effect of cisplatin, and therefore are not suitable for systemic administration in clinical practice. Consequently, local administration strategies, namely intratympanic administration, have been developed to achieve otoprotection, without reducing the antitumoral effect of cisplatin. While a considerable amount of pre-clinical information is available, clinical data on treatments to prevent cisplatin ototoxicity are only just beginning to appear. This review summarizes clinical and experimental studies of cisplatin ototoxicity, and focuses on understanding its toxicity mechanisms, clinical repercussions and prevention strategies.
Abstract: The capability to predict short-term maximum individual exposure is very important for several applications including, for example, deliberate/accidental release of hazardous substances, odour fluctuations or material flammability level exceedance. Recently, authors have proposed a simple approach relating maximum individual exposure to parameters such as the fluctuation intensity and the concentration integral time scale. In the first part of this study (Part I), the methodology was validated against field measurements, which are governed by the natural variability of atmospheric boundary conditions. In Part II of this study, an in-depth validation of the approach is performed using reference data recorded under truly stationary and well documented flow conditions. For this reason, a boundary-layer wind-tunnel experiment was used. The experimental dataset includes 196 time-resolved concentration measurements which detect the dispersion from a continuous point source within an urban model of semi-idealized complexity. The data analysis allowed the improvement of an important model parameter. The model performed very well in predicting the maximum individual exposure, presenting a factor of two of observations equal to 95%. For large time intervals, an exponential correction term has been introduced in the model based on the experimental observations. The new model is capable of predicting all time intervals giving an overall factor of two of observations equal to 100%.
Abstract: The release of airborne hazardous substances in the atmosphere has a direct effect on human health as, during the inhalation, an amount of concentration is inserted through the respiratory system into the human body, which can cause serious or even irreparable damage in health. One of the key problems in such cases is the prediction of the maximum individual exposure. Current state of the art methods, which are based on the concentration cumulative distribution function and require the knowledge of the concentration variance and the intermittency factor, have limitations. Recently, authors proposed a deterministic approach relating maximum individual exposure to parameters such as the fluctuation intensity and the concentration integral time scale. The purpose of the first part of this study is to validate the deterministic approach with the extensive dataset of the MUST (Mock Urban Setting Test) field experiment. This dataset includes 81 trials, which practically cover various atmospheric conditions and stability classes and contains in total 4004 non-zero concentration sensor data with time resolutions of 0.01–0.02 s. The results strengthen the usefulness of the deterministic model in predicting short-term maximum individual exposure. Another important output is the estimation of the methodology uncertainty involved.
Abstract: Platinum compounds cause significant clinical neurotoxicity. Several studies highlight neurological complications especially in paediatric oncology patients with Central Nervous System (CNS) and non-CNS malignancies. To understand the toxicity mechanisms of platinum drugs at cellular and molecular levels in the immature brain, which appears more vulnerable to injury than in the adult one, we compared the effects in vivo of the most used platinum compounds, i.e., cisdichlorodiammineplatinum (cisplatin, cisPt), and the new [Pt(O,O′-acac)(γ-acac)(DMS)] (PtAcacDMS). As models of developing brain areas, we have chosen the cerebellum and hippocampus dentate gyrus. Both areas show the neurogenesis events, from proliferation to differentiation and synaptogenesis, and therefore allow comparing the action of platinum compounds with DNA and non-DNA targets. Here, we focused on the changes in the intracellular calcium homeostasis within CNS architecture, using two immunohistochemical markers, the calcium buffer protein Calbindin and Plasma Membrane Calcium ATPase. From the comparison of the cisPt and PtAcacDMS effects, it emerges how essential the equilibrium and synergy between CB and PMCA1 is or how important the presence of at least one of them is to warrant the morphology and function of nervous tissue and limit neuroarchitecture damages, depending on the peculiar and intrinsic properties of the developing CNS areas.
Abstract: The mitochondrial dysfunction has a critical role in several disorders including chemotherapy-induced peripheral neuropathies (CIPN). This is due to a related dysregulation of pathways involving calcium signalling, reactive oxygen species and apoptosis. Vincristine is able to affect calcium movement through the Dorsal Root Ganglia (DRG) neuronal mitochondrial membrane, altering its homeostasis and leading to abnormal neuronal excitability. Paclitaxel induces the opening of the mitochondrial permeability transition pore in axons followed by mitochondrial membrane potential loss, increased reactive oxygen species generation, ATP level reduction, calcium release and mitochondrial swelling. Cisplatin and oxaliplatin form adducts with mitochondrial DNA producing inhibition of replication, disruption of transcription and morphological abnormalities within mitochondria in DRG neurons, leading to a gradual energy failure. Bortezomib is able to modify mitochondrial calcium homeostasis and mitochondrial respiratory chain. Moreover, the expression of a certain number of genes, including those controlling mitochondrial functions, was altered in patients with bortezomib-induced peripheral neuropathy.