Fig. 2.

Susceptibility of peripheral nervous system (PNS) to chemotherapeutic insult and oxidative stress: structural architecture of peripheral sensory and motor neurons makes them more susceptible to drug induced nervous damage [5]. Dorsal root ganglion lacks an efficient vascular barrier and hence, drugs like chemotherapeutics and other neurotoxins can gain easy access to cell bodies of the sensory neurons. Unlike the central nervous system, the PNS doesn't have an analogy of blood brain barrier, and hence allows contact with some dangerous drug molecules, toxins and other blood proteins. Further, the absence of lymphatic system and cerebrospinal fluid around the peripheral nerves makes the potential dangerous substances to accumulate in the extracellular matrix around nervous tissue, which exacerbates the neuropathic damage [37]. Chemotherapeutics accumulate in this manner can cause oxidative stress in the neurons directly by forming DNA adducts or indirectly by mitochondrial impairment of electron transport chain [24]. Oxidative stress generated can cause nerve damage through microtubular disruption and or demyelination [14].