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. 2022 Mar 28;13:750507. doi: 10.3389/fphar.2022.750507

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Copyright © 2022 Was, Borkowska, Bagues, Tu, Liu, Lu, Rudd, Nurgali and Abalo.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Peripheral and central neurotoxicity - a wheel of bad fortune. In Roman mythology, Fortuna is the goddess, who directs human fate as the deity of both happiness and misfortune. In the art, Fortuna was depicted sitting or standing with a cornucopia and often blindfolded. On the reverse of Roman coins, she is usually shown with a wheel at her side. We propose to consider chemotherapy-induced neurotoxicity (peripheral neuropathy, chemobrain) as a wheel of bad fortune. No matter what chemotherapeutics drugs are used: alkylating agents, platinum-based drugs, antimetabolites, microtubule modulators or antibiotics and what biological mechanisms they trigger: 1. downregulated neurotransmitters’ secretion, 2. overproduction of reactive oxygen species, 3. genetic alterations, 4. neuro-inflammation and breakdown of the blood-brain barrier, 5. reduced gliogenesis and hyperactivation of microglia and astrocytes, 6. impairment in neurogenesis and neural network dynamics, this will lead to the development of nervous dysfunctions (neuropathic pain, cognitive deficits) in the majority of cancer patients.