Differential methylation and expression of genes in the hypoxia-inducible factor 1 signaling pathway are associated with paclitaxel-induced peripheral neuropathy in breast cancer survivors and with preclinical models of chemotherapy-induced neuropathic pain
- PMID: 32586194
- PMCID: PMC7322824
- DOI: 10.1177/1744806920936502
Differential methylation and expression of genes in the hypoxia-inducible factor 1 signaling pathway are associated with paclitaxel-induced peripheral neuropathy in breast cancer survivors and with preclinical models of chemotherapy-induced neuropathic pain
Abstract
Background: Paclitaxel is an important chemotherapeutic agent for the treatment of breast cancer. Paclitaxel-induced peripheral neuropathy (PIPN) is a major dose-limiting toxicity that can persist into survivorship. While not all survivors develop PIPN, for those who do, it has a substantial negative impact on their functional status and quality of life. No interventions are available to treat PIPN. In our previous studies, we identified that the HIF-1 signaling pathway (H1SP) was perturbed between breast cancer survivors with and without PIPN. Preclinical studies suggest that the H1SP is involved in the development of bortezomib-induced and diabetic peripheral neuropathy, and sciatic nerve injury. The purpose of this study was to identify H1SP genes that have both differential methylation and differential gene expression between breast cancer survivors with and without PIPN.
Methods: A multi-staged integrated analysis was performed. In peripheral blood, methylation was assayed using microarray and gene expression was assayed using RNA-seq. Candidate genes in the H1SP having both differentially methylation and differential expression were identified between survivors who received paclitaxel and did (n = 25) and did not (n = 25) develop PIPN. Then, candidate genes were evaluated for differential methylation and differential expression in public data sets of preclinical models of PIPN and sciatic nerve injury.
Results: Eight candidate genes were identified as both differential methylation and differential expression in survivors. Of the eight homologs identified, one was found to be differential expression in both PIPN and "normal" mice dorsal root ganglia; three were differential methylation in sciatic nerve injury versus sham rats in both pre-frontal cortex and T-cells; and two were differential methylation in sciatic nerve injury versus sham rats in the pre-frontal cortex.
Conclusions: This study is the first to evaluate for methylation in cancer survivors with chronic PIPN. The findings provide evidence that the expression of H1SP genes associated with chronic PIPN in cancer survivors may be regulated by epigenetic mechanisms and suggests genes for validation as potential therapeutic targets.
Keywords: Paclitaxel-induced peripheral neuropathy; breast cancer; chemotherapy; gene expression; hypoxia-inducible factor; integrated genomic analysis; methylation; survivor.
Figures

Similar articles
-
Expression of mitochondrial dysfunction-related genes and pathways in paclitaxel-induced peripheral neuropathy in breast cancer survivors.Mol Pain. 2018 Jan-Dec;14:1744806918816462. doi: 10.1177/1744806918816462. Epub 2018 Nov 14. Mol Pain. 2018. PMID: 30426838 Free PMC article.
-
Estrogen decline is a risk factor for paclitaxel-induced peripheral neuropathy: Clinical evidence supported by a preclinical study.J Pharmacol Sci. 2021 May;146(1):49-57. doi: 10.1016/j.jphs.2021.03.001. Epub 2021 Mar 10. J Pharmacol Sci. 2021. PMID: 33858655
-
Perturbations in neuroinflammatory pathways are associated with paclitaxel-induced peripheral neuropathy in breast cancer survivors.J Neuroimmunol. 2019 Oct 15;335:577019. doi: 10.1016/j.jneuroim.2019.577019. Epub 2019 Aug 2. J Neuroimmunol. 2019. PMID: 31401418 Free PMC article.
-
Preclinical and Clinical Evidence of Therapeutic Agents for Paclitaxel-Induced Peripheral Neuropathy.Int J Mol Sci. 2021 Aug 13;22(16):8733. doi: 10.3390/ijms22168733. Int J Mol Sci. 2021. PMID: 34445439 Free PMC article. Review.
-
Genetic determinants of paclitaxel-induced peripheral neuropathy: a review of current literature.Drug Metab Rev. 2025 May;57(2):190-207. doi: 10.1080/03602532.2025.2485055. Epub 2025 Mar 31. Drug Metab Rev. 2025. PMID: 40162869 Review.
Cited by
-
A Multimodal Approach to Discover Biomarkers for Taxane-Induced Peripheral Neuropathy (TIPN): A Study Protocol.Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221127169. doi: 10.1177/15330338221127169. Technol Cancer Res Treat. 2022. PMID: 36172750 Free PMC article.
-
An Investigation of the Molecular Mechanisms Underlying the Analgesic Effect of Jakyak-Gamcho Decoction: A Network Pharmacology Study.Evid Based Complement Alternat Med. 2020 Dec 1;2020:6628641. doi: 10.1155/2020/6628641. eCollection 2020. Evid Based Complement Alternat Med. 2020. PMID: 33343676 Free PMC article.
-
Ganglioside Monosialic Acid Alleviates Peripheral Neuropathy Induced by Utidelone Plus Capecitabine in Metastatic Breast Cancer From a Phase III Clinical Trial.Front Oncol. 2020 Oct 9;10:524223. doi: 10.3389/fonc.2020.524223. eCollection 2020. Front Oncol. 2020. PMID: 33163394 Free PMC article.
-
A prediction model for moderate to severe pain in primary hepatic carcinoma after chemotherapy: a multi-center prospective case‒control study.Sci Rep. 2025 Apr 25;15(1):14415. doi: 10.1038/s41598-025-90814-6. Sci Rep. 2025. PMID: 40280983 Free PMC article.
-
Pharmacologic Management of Persistent Pain in Cancer Survivors.Drugs. 2022 Feb;82(3):275-291. doi: 10.1007/s40265-022-01675-6. Epub 2022 Feb 17. Drugs. 2022. PMID: 35175587 Free PMC article. Review.
References
-
- Kudlowitz D, Muggia F. Defining risks of taxane neuropathy: insights from randomized clinical trials. Clin Cancer Res 2013; 19: 4570–4577. - PubMed
-
- Sarosy G, Kohn E, Stone DA, Rothenberg M, Jacob J, Adamo DO, Ognibene FP, Cunnion RE, Reed E, Cunnion RE, Reed E. Phase I study of taxol and granulocyte colony-stimulating factor in patients with refractory ovarian cancer. J Clin Oncol 1992; 10: 1165–1170. - PubMed
-
- Jones SE, Erban J, Overmoyer B, Budd GT, Hutchins L, Lower E, Laufman L, Sundaram S, Urba WJ, Pritchard KI, Mennel R, Richards D, Olsen S, Meyers ML, Ravdin PM. Randomized phase III study of docetaxel compared with paclitaxel in metastatic breast cancer. JCO 2005; 23: 5542–5551. - PubMed
-
- Beijers AJ, Mols F, Tjan-Heijnen VC, Faber CG, van de Poll-Franse LV, Vreugdenhil G. Peripheral neuropathy in colorectal cancer survivors: the influence of oxaliplatin administration. Results from the population-based PROFILES registry. Acta Oncol 2015; 54: 463–469. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical