Estimulação do nervo vago no tratamento de dor neuropática induzida por quimioterápicos
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Data
2023-12
Tipo de documento
Artigo Científico
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Modalidade de acesso
Acesso aberto
Editora
Autores
REIS, Ana Kéren Gomes
SANTOS, Bianca Castro dos
Orientador
PAGANO, Rosana de Lima
Coorientador
Resumo
A dor neuropática induzida por quimioterápico (chemotherapy-induced neuropathic pain, CINP), é uma complicação frequentemente encontrada no tratamento de pacientes com câncer, representando um sério problema de saúde pública. Este fenômeno é motivo de preocupação na comunidade científica devido à sua alta incidência entre os pacientes oncológicos, resultando em uma significativa redução na qualidade de vida e, em alguns casos, na interrupção do tratamento. Entretanto, os tratamentos preventivos ou sintomáticos da CINP são na sua grande maioria ineficazes, fazendo-se necessária a busca por novas abordagens terapêuticas que evitem ou melhorem esses sintomas. Neste cenário, o nervo vago possui grande relevância terapêutica em razão da sua ação anti-inflamatória, que ocorre principalmente devido a liberação de acetilcolina pelo próprio nervo vago ou indiretamente pelo baço, que agindo no receptor colinérgicos nicotínicos α7 (α7nAChR), inibem a liberação de citocinas pró-inflamatórias por células imunes. Por isso, a estimulação invasiva e não invasiva do nervo vago tem sido alvo de novas abordagens terapêuticas devido a sua capacidade de tratar diversas doenças de caráter inflamatório. Sendo assim, essa revisão visou aprofundar a compreensão da interação entre a CINP e o nervo vago, especialmente em relação aos efeitos da quimioterapia. Esse estudo abordou os avanços recentes no entendimento dos mecanismos fisiológicos e bioquímicos dessa relação, destacando sua relevância no manejo da dor em pacientes submetidos a tratamentos de quimioterapia.
Chemotherapy-induced neuropathic pain (CINP) is a complication frequently encountered in the treatment of cancer patients, representing a serious public health problem. This phenomenon is a cause for concern in the scientific community due to its high incidence among cancer patients, resulting in a significant reduction in quality of life and, in some cases, treatment interruption. However, preventive or symptomatic treatments for CINP are ineffective, making it necessary to search for new therapeutic approaches that prevent or improve these symptoms. In this scenario, the vagus nerve has great therapeutic relevance due to its anti-inflammatory action, which occurs mainly due to the release of acetylcholine by the vagus nerve itself or indirectly by the spleen, which, by acting on the α7 nicotinic acetylcholine receptor (α7nACh), inhibits the release of pro-inflammatory cytokines by immune cells. For this reason, invasive and non-invasive stimulation of the vagus nerve has been the target of new therapeutic approaches due to its ability to treat various inflammatory diseases. Therefore, this review aimed to deepen our understanding of the interaction between the CINP and the vagus nerve, especially in relation to the effects of chemotherapy. This study addressed recent advances in the understanding of the physiological and biochemical mechanisms of this relationship, highlighting its relevance of pain in patients undergoing chemotherapy treatments.
Chemotherapy-induced neuropathic pain (CINP) is a complication frequently encountered in the treatment of cancer patients, representing a serious public health problem. This phenomenon is a cause for concern in the scientific community due to its high incidence among cancer patients, resulting in a significant reduction in quality of life and, in some cases, treatment interruption. However, preventive or symptomatic treatments for CINP are ineffective, making it necessary to search for new therapeutic approaches that prevent or improve these symptoms. In this scenario, the vagus nerve has great therapeutic relevance due to its anti-inflammatory action, which occurs mainly due to the release of acetylcholine by the vagus nerve itself or indirectly by the spleen, which, by acting on the α7 nicotinic acetylcholine receptor (α7nACh), inhibits the release of pro-inflammatory cytokines by immune cells. For this reason, invasive and non-invasive stimulation of the vagus nerve has been the target of new therapeutic approaches due to its ability to treat various inflammatory diseases. Therefore, this review aimed to deepen our understanding of the interaction between the CINP and the vagus nerve, especially in relation to the effects of chemotherapy. This study addressed recent advances in the understanding of the physiological and biochemical mechanisms of this relationship, highlighting its relevance of pain in patients undergoing chemotherapy treatments.
Palavras-chave
dor neuropática induzida por quimioterápicos, nervo vago, tratamentos de quimioterapia, dor neuropática, estimulação do nervo vago