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Crit Rev Microbiol. 2019 Aug;45(4):369-393. doi: 10.1080/1040841X.2019.1608905. Epub 2019 May 18.

Targeting strategies for chemotherapy-induced peripheral neuropathy: does gut microbiota play a role?

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Department of Neurology and Stroke Center, The First Hospital of China Medical University , Shenyang , PR China.
Department of Geriatrics, The First Hospital of China Medical University , Shenyang , PR China.
Department of Biochemistry and Molecular Cell Biology, Shanghai Jiao Tong University , Shenyang , PR China.
Department of Cardiology, Shengjing Hospital of China Medical University , Shenyang , PR China.


Chemotherapy-induced peripheral neuropathy (CIPN) is a progressive, often irreversible condition that produces severe neurological deficits. Emerging data suggest that chemotherapy also exerts detrimental effects on gut microbiota composition and intestinal permeability, contributing to dysbiosis and inflammation. Compared with other complications associated with chemotherapy, such as diarrhoea and mucositis, CIPN is of particular concern because it is the most common reason for terminating or suspending treatment. However, specific and effective curative treatment strategies are lacking. In this review, we provide an update on current preclinical and clinical understandings about the role of gut microbiota in CIPN. The gut microbiota serves as an intersection between the microbiome-gut-brain and the neuroimmune-endocrine axis, forming a complex network that can directly or indirectly affect key components involved in the manifestations of CIPN. Herein, we discuss several potential mechanisms within the context of the networks and summarize alterations in gut microbiome induced by chemotherapeutic drugs, providing great potential for researchers to target pathways associated with the gut microbiome and overcome CIPN.


Chemotherapy-induced peripheral neuropathy; gut microbiota; immune system; nervous system; neuropathic pain

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