Page 47 - ATHM26_4

Table 1. Reports in Animal and Clinical Studies Revealing the Neuroprotective Properties of Nutrients for CIPN

Mechanism Efficacy
Vitamin E  Antioxidant, neuroprotective for neuron cells 14 c19,20
Vitamin B complex  Coenzymes within nervous system for neurotransmitter 21,22 c,23
 Neuronal membrane synthesis 21
 Formation of new cells, DNA, RNA and myelin 22
Glutamine  Nerve growth factor 24 a Paclitaxel-induced PN 28
a Oxaliplatin-induced PN 30
a Children with vincristine-induced PN 31
Acetyl-L-carnitine  Neuroprotection: TNF-α, interleukins 34 a Paclitaxel- or cisplatin-IPN 37,38
 Against oxidative stress: protein carbonyl groups b Taxane-induced PN 39,40
35
c Bortezomib 41
Alpha-Lipoic acid  Glutathione peroxidase activity 42 c Cisplatin/carboplatin-induced PN with oral form 44
 Oxidative stress 42,44 a IV form 47
 Inflammatory-related pathways 45,46 ✳Inconclusive
Glutathione  Detoxification of xenobiotics 48 a Platinum-based neurotoxicity 48
 Maintenance of the redox state 48 c Paclitaxel + carboplatin 55
 Preventing platinum from accumulating in the DRG 49,50
Omega-3 fatty acids  Stability of cell membrane 57 a Paclitaxel-induced peripheral neuropathy 59,60
 Regulated ion channels and receptors 58
 Attenuate pro-inflammatory cytokines 57,58
Ca Mg 2+  Reconfiguration of sodium channel in the cell membrane 63,65 Oral form:
2+/
a Mg intake group 67
2+
2+
c Ca intake group 67
IV form: ✳Inconclusive
Abbreviations: CIPN, chemotherapy-induced peripheral neuropathy; IV, intravenous; TNF-α, tumor necrosis factor-alpha;

a CIPN symptoms improved.
b CIPN symptoms worsened.
c Symptoms not significantly changed.

RESULTS OF NUTRIENT-BASED COMPLEMENTARY Vitamin B
THERAPIES FOR CIPN B vitamins are a class of water-soluble vitamins that play
Our search reviewed 58 studies. A total of 19 preclinical important roles in cell metabolism. Vitamin B (thiamine),
1
studies reported mechanisms of effects and 31 clinical studies vitamin B (pyridoxine), and vitamin B (cyanocobalamin)
6
12
corroborated preclinical findings, including 22 randomized are 3 major B complex vitamins. They act mainly as coenzymes
controlled trials (RCTs) and 3085 patients with CIPN. Table of different reactions, participating in the metabolism of
1 summarizes the evidence gathered regarding the efficacy of carbohydrates, proteins, and lipids. They are involved in
different nutrient options for CIPN in animal and clinical RNA, DNA, and myelin production, as well as neuronal
studies. membrane synthesis, and neurotransmitter synthesis. 21,22
Schloss et al completed a literature review and found that
21
Vitamin E vitamin B has protective and treatment effects for
3
Vitamin E, an essential nutrient that functions as a lipid hypersensitivity (sensory neuropathy) and escape-avoidance
soluble antioxidant, is found in vegetable oils, nuts, and green behavior (motor) from the administration of paclitaxel in
leafy vegetables. Vitamin E supplementation is well known as animal studies. However, a recent RCT compared the efficacy
an antioxidant, has shown neuroprotective effects, and is of B vitamins and placebo for CIPN. The results showed that
believed to play a role in protecting neuron cells. Several B vitamins did not significantly reduce the incidence of
14
clinical trials have shown that vitamin E decreases the CIPN. Currently, vitamins B , B , B , or B complex are most
23
12
1
6
incidence and severity of CIPN. 15-18 However, other studies often used to examine either protective or treatment options
have produced the opposite results. Two recent meta-analysis in human studies. These studies to date have still produced
studies have reported that vitamin E does not decrease the inconsistent conclusions.
incidence of CIPN. 19,20 Possible reasons are differences in the
study designs and evaluation scales and in the various Glutamine
chemotherapeutic drugs received by the patients. Glutamine is an α-amino acid used in the biosynthesis of
proteins. It is thought to have a neuroprotective role, possibly

Liu—Complementary Nutritional Supplements and Chemotherapy-induced ALTERNATIVE THERAPIES, JUL/AUG 2020 VOL. 26 NO. 4 45