Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC200710.15690/vramn2007NEUROLOGY AND NEUROSURGERY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ НЕВРОЛОГИИ И НЕЙРОХИРУРГИИReview ArticleРotential Laboratory Markers of Vincristine-Induced Peripheral NeuropathyПотенциальные лабораторные маркеры винкристин-индуцированной периферической невропатииhttps://orcid.org/0000-0002-5250-73519919-9048KovtunOlga P.КовтунОльга Петровна
Russian Federation

MD, PhD, Professor, Academician of the RAS

д.м.н., профессор, академик РАН

usma@usma.ruhttps://orcid.org/0000-0003-0966-95714813-8710BazarnyiVladimir V.БазарныйВладимир Викторович
Russian Federation

MD, PhD, Professor

д.м.н., профессор

vlad-bazarny@yandex.ruhttps://orcid.org/0000-0002-4595-10244880-6913KoryakinaOksana V.КорякинаОксана Валерьевна
Russian Federation

MD, PhD, Associate Professor

к.м.н., доцент

koryakina09@mail.ruUral State Medical UniversityУральский государственный медицинский университет310720227732082132501202221062022Copyright ©; 2022, "Paediatrician" Publishers LLCCopyright ©; 2022, Издательство "Педиатръ"2022"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/2007

New chemotherapy agents of haematological malignancies in children often lead to adverse drug reactions, including vincristine-induced peripheral neuropathy (VIPN). The incidence of this pathology ranges from 22 to 72%. The clinic and instrumental evaluation of children with VPN, including questionaries, scales, electrodiagnostic examinations, do not provide an opportunity for prognosis and early detection of chemotherapy-related neurologic complications. Consequently, identifying biomarkers associated with VIPN is urgently warranted that discussed in this review. PubMed and Scopus were browsed based on the keywords that allowed us to select 55 articles (4 systemic reviews, 14 scientific reviews, 37 original articles) between 2017 and 2021. Reports from the included studies clearly emphasize that vincristine-induced peripheral neuropathy is associated with changes in plasma and cerebrospinal fluid (CSF) levels of the nerve growth factor (NGF) light chains of neurofilaments (NfL) and brain derived neurotrophic factor (BDNF) that are biomarkers of axonal damage. However, none of them do have criterion validity — sensitivity and specificity. One of the most promising prognostic biomarkers is CХCL10 and CXCL12 that detect children with or without VIPN (sensitivity — 79%, specificity — 78%). The next task is finding an optimal profile of these cytokines. These cytokines together with axonal biomarkers can be used for the diagnosis and prevention of chemotherapy-induced neurotoxicity in children.

Современная химиотерапия гемобластозов у детей нередко сопровождается медикаментозными осложнениями, в том числе винкристин-индуцированной периферической невропатией (vincristin-induced peripheral neuropathy, VIPN). Она встречается, как минимум, у 22–72% пациентов. Используемые в диагностике VIPN клинико-инструментальные тесты не дают возможности прогнозирования неврологических осложнений. Это делает актуальным поиск лабораторных биомаркеров повреждения нервной ткани при VIPN, что явилось предметом данного обзора. Источником первичной информации служили медицинские библиографические базы данных PubMed и Scopus, из которых по ключевым словам было отобрано 55 полнотекстовых статей, в том числе 4 систематических обзора, 14 научных обзоров, 37 оригинальных статей за 2017–2021 гг. Несмотря на отсутствие общепринятых высокоинформативных лабораторных методов оценки нейротоксичности, имеются данные о том, что поражение периферической нервной системы винкристином сопровождается изменением уровня в крови и ликворе маркеров аксонального повреждения — основного мозгового нейротрофического фактора (BDNF), легких цепей нейрофиламентов (NfL) и фактора роста нервов (NGF). Однако ни в одной из проанализированных работ не представлены критерии клинической ценности — чувствительность и специфичность этих показателей. Вместе с тем полученные данные об уровне плазменных хемокинов CХCL10 и CXCL12 позволяют с определенной уверенностью выявлять среди больных группу высокого риска по формированию периферической полиневропатии (диагностическая чувствительность — 79%, диагностическая специфичность — 78%). Следующей задачей становится поиск оптимального профиля этих цитокинов. Они вместе с аксональными маркерами могут стать инструментом для диагностических и профилактических методов нейротоксических осложнений, индуцированных химиотерапевтическими препаратами у детей.

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