The Mechanisms Of Nerve Growth Factor Reduction On The Pathogenesis Of Bortezomib-induced Peripheral Neuropathy

Objective To explore the mechanisms of reduction of nerve growth factor (NGF) in the Bortezomib-induced peripheral neuropathy (BIPN) and detect the electromyography features of the patients with BIPN.Methods10multiple myeloma (MM) patients treating with bortezomib,10MM patients treating with conventional treatment(VAD) and10healthy controls were enrolled in this study. The serum level of NGF was detected through enzyme-linked immunosorbent assay(ELISA). The motor nerve conduction velocity(MCV) and sensory nerve conduction velocity(SCV) were recorded by electroneuromyogram(EMG) at the same time.Results There was no significant difference in the serum levels of NGF between the healthy controls(56.828±1.670ng/L) and MM patients(bortezomib group:55.885±2.825ng/L, VAD group:56.694±2.399ng/L) before the treatment (P>0.05). However, the serum level of NGF was significantly lower in the MM patients (the first course, bortezomib group:54.548±2.666ng/L, VAD group:56.710±2.537ng/L; the second one, bortezomib group:51.837±2.678ng/L, VAD group:54.446±2.293ng/L; the third one, bortezomib group:49.788±2.918ng/L, VAD group:53.078±1.990ng/L; the fourth one, bortezomib group:48.324±3.480ng/L, VAD group:51.377±2.654ng/L; the last one, bortezomib group:47.144±3.952ng/L, VAD group:50.843±3.227ng/L)after the treatment(P<0.05), especially in the patients treating with bortezomib(P<0.05). The reduction of the serum level of NGF was positively correlated with BIPN(r=0.727, P<0.05) and therapeutic effect of bortezomib(r=0.681, P<0.05). However, no obviously relativity was found between serum level of NGF and the MCV and SCV of their EMG (P>0.05). Neither were the MCV and SCV between the first and last course in the MM patients who use bortezomib (P>0.05) in EMG.Conclusion The reduction of the serum level of nerve growth factor may have a contribution to the pathogenesis of BIPN.