Naringenin relieves Paclitaxel-induced pain via inhibiting CGRP
production and DRG neuron sensitization and enhances Paclitaxel's
anti-tumor action
Abstract
Background and Purposes: Chemotherapy-induced peripheral neuropathy
commonly causes neuropathic pain. The pathogenesis of CIPN is unclear,
and effective therapies are also lacking. Naringenin, a dihydroflavonoid
compound in Rutaceae plants and citrus fruits, has anti-inflammatory,
antioxidant, and anti-tumor activities. However, its effect on
chemotherapy-induced pain has not been investigated. Experimental
Approach: We used Paclitaxel (PTX) to establish a mouse model of
chemotherapy-induced pain. Mechanical and thermal pain thresholds, glial
activation, calcitonin gene-related peptide (CGRP) expression, c-fos
expression, phosphorylation of nuclear factor κB (NF-κB), dorsal root
ganglion (DRG) neuron excitability, and cell survival of pancreatic,
colorectal, and gastric cancer cell lines were measured. Key Results:
Systemic application of Naringenin reduced the mechanical and thermal
pain hypersensitivity induced by PTX. Naringenin reduced the activation
of glial cells in both DRGs and the spinal dorsal horn of PTX-treated
mice. Naringenin decreased the PTX-enhanced CGRP expression in DRG and
spinal neurons. Naringenin reversed the PTX-enhanced c-fos expression
and excitability of DRG neurons. Naringenin downregulated PTX-elevated
NF-κB phosphorylation in the spinal cord. Additionally,
co-administration of Naringenin with PTX enhanced the inhibitory effect
of PTX on pancreatic and colorectal cancer cell growth, whereas the
application of Naringenin alone inhibited the survival of pancreatic
cancer cells. Conclusion and Implications: Naringenin alleviates
PTX-induced pain and may facilitate PTX’s anti-tumor effect. The
mechanism involves the inhibition of glial activation, CGRP production,
and neuronal sensitization in PTX-treated mice. Our study suggests the
multiple beneficial actions of Naringenin in chemotherapy by mitigating
side effects and inhibiting tumor growth.