Oxaliplatin is a key drug in the treatment of advanced metastatic
colorectal cancer. Despite its beneficial effects in
tumor reduction, the most prevalent side-effect of
oxaliplatin treatment is a
chemotherapy-induced neuropathy that frequently forces to discontinue the
therapy. Indeed, along with direct damage to peripheral nerves, the
chemotherapy-related neurotoxicity involves also the central nervous system (CNS) as demonstrated by
pain chronicity and
cognitive impairment (also known as
chemobrain), a newly described pharmacological side effect. The presence of the blood brain barrier (BBB) is instrumental in preventing the entry of the drug into the CNS; here we tested the hypothesis that
oxaliplatin might enter the endothelial cells of the BBB vessels and trigger a signaling pathway that induce the disassembly of the tight junctions, the critical components of the BBB integrity. By using a rat brain endothelial cell line (RBE4) we investigated the signaling pathway that ensued the entry of
oxaliplatin within the cell. We found that the administration of 10 μM
oxaliplatin for 8 and 16 h induced alterations of the tight junction (TJs)
proteins zonula occludens-1 (ZO-1) and of
F-actin, thus highlighting BBB alteration. Furthermore, we reported that intracellular
oxaliplatin rapidly induced increased levels of
reactive oxygen species and endoplasmic reticulum stress, assessed by the evaluation of
glucose-regulated
protein GRP78 expression levels. These events were accompanied by activation of
caspase-3 that led to extracellular
ATP release. These findings suggested a possible novel mechanism of action for
oxaliplatin toxicity that could explain, at least in part, the
chemotherapy-related central effects.