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. 2017 Jun 8;1:19. doi: 10.1038/s41698-017-0023-0

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 5 — Chemotherapy-induced peripheral neuropathy (CIPN) produces significant DNA damage acted upon by Ref-1/APE1. Agents inducing oxidative DNA damage, such as cisplatin, oxaliplatin, ionizing radiation as well as other drugs are acted upon by the DNA BER pathway and specifically Ref-1/APE1. ROS reactive oxygen species, RNS reactive nitrogen species. DNA damage can occur on both nuclear and mitochondrial DNA in the dorsal root ganglion (DRG). Additional sites of action for some of the chemo-agents occurs in the axons. Inflammation has also been attributed to inducing oxidative DNA damage in DRGs. Patients report side effects, such as severe burning in fingertips, like putting fingers on hot stove, fingernails on a chalkboard, pain like needle stuck in toes, walking on hot coals, sandpaper at the bottom of feet, something crawling, blob of numbness, and feet are asleep. Parts of this figure are used by permission from previous figures after revision (see refs. 252, 278)