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Event: 1583

Key Event Title

The KE title should describe a discrete biological change that can be measured. It should generally define the biological object or process being measured and whether it is increased, decreased, or otherwise definably altered relative to a control state. For example “enzyme activity, decreased”, “hormone concentration, increased”, or “growth rate, decreased”, where the specific enzyme or hormone being measured is defined. More help

Sensory axonal peripheral neuropathy

Short name
The KE short name should be a reasonable abbreviation of the KE title and is used in labelling this object throughout the AOP-Wiki. The short name should be less than 80 characters in length. More help
Sensory axonal peripheral neuropathy

Biological Context

Structured terms, selected from a drop-down menu, are used to identify the level of biological organization for each KE. Note, KEs should be defined within a particular level of biological organization. Only KERs should be used to transition from one level of organization to another. Selection of the level of biological organization defines which structured terms will be available to select when defining the Event Components (below). More help
Level of Biological Organization

Key Event Components

Further information on Event Components and Biological Context may be viewed on the attached pdf.Because one of the aims of the AOP-KB is to facilitate de facto construction of AOP networks through the use of shared KE and KER elements, authors are also asked to define their KEs using a set of structured ontology terms (Event Components). In the absence of structured terms, the same KE can readily be defined using a number of synonymous titles (read by a computer as character strings). In order to make these synonymous KEs more machine-readable, KEs should also be defined by one or more “event components” consisting of a biological process, object, and action with each term originating from one of 22 biological ontologies (Ives, et al., 2017; See List). Biological process describes dynamics of the underlying biological system (e.g., receptor signalling). The biological object is the subject of the perturbation (e.g., a specific biological receptor that is activated or inhibited). Action represents the direction of perturbation of this system (generally increased or decreased; e.g., ‘decreased’ in the case of a receptor that is inhibited to indicate a decrease in the signalling by that receptor).Note that when editing Event Components, clicking an existing Event Component from the Suggestions menu will autopopulate these fields, along with their source ID and description. To clear any fields before submitting the event component, use the 'Clear process,' 'Clear object,' or 'Clear action' buttons. If a desired term does not exist, a new term request may be made via Term Requests. Event components may not be edited; to edit an event component, remove the existing event component and create a new one using the terms that you wish to add. More help

Key Event Overview

AOPs Including This Key Event

All of the AOPs that are linked to this KE will automatically be listed in this subsection. This table can be particularly useful for derivation of AOP networks including the KE. Clicking on the name of the AOP will bring you to the individual page for that AOP. More help
AOP Name Role of event in AOP Point of Contact Author Status OECD Status
Microtubule interacting drugs lead to peripheral neuropathy AdverseOutcome Arthur Author (send email) Under development: Not open for comment. Do not cite


This is a structured field used to identify specific agents (generally chemicals) that can trigger the KE. Stressors identified in this field will be linked to the KE in a machine-readable manner, such that, for example, a stressor search would identify this as an event the stressor can trigger. NOTE: intermediate or downstream KEs in one AOP may function as MIEs in other AOPs, meaning that stressor information may be added to the KE description, even if it is a downstream KE in the pathway currently under development.Information concerning the stressors that may trigger an MIE can be defined using a combination of structured and unstructured (free-text) fields. For example, structured fields may be used to indicate specific chemicals for which there is evidence of an interaction relevant to this MIE. By linking the KE description to a structured chemical name, it will be increasingly possible to link the MIE to other sources of chemical data and information, enhancing searchability and inter-operability among different data-sources and knowledgebases. The free-text section “Evidence for perturbation of this MIE by stressor” can be used both to identify the supporting evidence for specific stressors triggering the MIE as well as to define broad chemical categories or other properties that classify the stressors able to trigger the MIE for which specific structured terms may not exist. More help

Taxonomic Applicability

Latin or common names of a species or broader taxonomic grouping (e.g., class, order, family) can be selected from an ontology. In many cases, individual species identified in these structured fields will be those for which the strongest evidence used in constructing the AOP was available in relation to this KE. More help

Life Stages

The structured ontology terms for life-stage are more comprehensive than those for taxa, but may still require further description/development and explanation in the free text section. More help

Sex Applicability

The authors must select from one of the following: Male, female, mixed, asexual, third gender, hermaphrodite, or unspecific. More help

Key Event Description

A description of the biological state being observed or measured, the biological compartment in which it is measured, and its general role in the biology should be provided. For example, the biological state being measured could be the activity of an enzyme, the expression of a gene or abundance of an mRNA transcript, the concentration of a hormone or protein, neuronal activity, heart rate, etc. The biological compartment may be a particular cell type, tissue, organ, fluid (e.g., plasma, cerebrospinal fluid), etc. The role in the biology could describe the reaction that an enzyme catalyses and the role of that reaction within a given metabolic pathway; the protein that a gene or mRNA transcript codes for and the function of that protein; the function of a hormone in a given target tissue, physiological function of an organ, etc. Careful attention should be taken to avoid reference to other KEs, KERs or AOPs. Only describe this KE as a single isolated measurable event/state. This will ensure that the KE is modular and can be used by other AOPs, thereby facilitating construction of AOP networks. More help

The peripheral nervous system (PNS) connects the central nervous system with peripheral tissues and can be divided into the visceral and the somatic nervous system.The somatic nervous system consists of sensory and motor neurons. While the motor neurons control the contraction of skeletal muscles, the sensory neurons receive information from joints, muscles and skin and send it to the CNS. Motor neuron cell bodies lie in the spinal cord but cell bodies of the sensory neurons are located in the dorsal root ganglia (DRG). In contrast to the central nervous system (CNS), the PNS is not protected by the blood-brain-barrier, the skull or the spinal column and is therefore highly vulnerable to toxicants and mechanical damage. [1] However, the PNS neurons exhibits a greater ability of regeneration compared to neurons of the CNS. [2]

Peripheral neuropathies mostly affect sensory neurons in a length-dependent manner and therefore are characterized by a stocking-and-glove distribution of the symptoms. Sensory symptoms occurring upon taxol treatment are for example numbness and paresthesia. [3-6] Reversibility of neuropathy upon discontinuation of treatment is reported. [7]

How It Is Measured or Detected

One of the primary considerations in evaluating AOPs is the relevance and reliability of the methods with which the KEs can be measured. The aim of this section of the KE description is not to provide detailed protocols, but rather to capture, in a sentence or two, per method, the type(s) of measurements that can be employed to evaluate the KE and the relative level of scientific confidence in those measurements. Methods that can be used to detect or measure the biological state represented in the KE should be briefly described and/or cited. These can range from citation of specific validated test guidelines, citation of specific methods published in the peer reviewed literature, or outlines of a general protocol or approach (e.g., a protein may be measured by ELISA).Key considerations regarding scientific confidence in the measurement approach include whether the assay is fit for purpose, whether it provides a direct or indirect measure of the biological state in question, whether it is repeatable and reproducible, and the extent to which it is accepted in the scientific and/or regulatory community. Information can be obtained from the OECD Test Guidelines website and the EURL ECVAM Database Service on Alternative Methods to Animal Experimentation (DB-ALM). ?

- Retrospective study: Patients are interviewed after chemotherapy treatment and symptoms are assessed. [8, 9]

- Abnormal pin perception: Measurement of the distance in centimeters from the tip of the great toe or index finger to a level where normal pin sensation was sensed.

- Abnormalities in vibration and position sensation: Measurement at distal phalanx of the great toe or index finger. [9, 10]

- Reductions in strength of toe extensors, index finger abductors, arm abductors, hip flexors, foot dorsiflexors: Measurement by using the MRC scale and dynamometer [9, 10]

- Nerve conduction studies: Electrophysiological measurement of nerve conduction amplitudes and velocities in sensory neurons [9, 10]

- Quantitative sensory testing of vibratory threshold: Measurement of vibratory latency in seconds between the patient and the examiner in toes and fingers. [9, 10] Automated measurement using e.g. ‘Vibration 2’ (Physitemp Instruments Inc., Clifton NJ) which can be adjusted to different vibration amplitudes and records vibration units. [6]

- Quantitative sensory testing of thermal threshold: Using the Thermal Sensitivity Tester or NTE-2 (Physitemp Instruments Inc., Clifton NJ), the ability to discriminate small temperature differences at the index finger or the great toe can be quantified. [6, 11, 12]

- Sural nerve biopsy: A part of the sural nerve (some millimetres) is removed, fixed and investigated via light or electron microscopy. [13]

Domain of Applicability

This free text section should be used to elaborate on the scientific basis for the indicated domains of applicability and the WoE calls (if provided). While structured terms may be selected to define the taxonomic, life stage and sex applicability (see structured applicability terms, above) of the KE, the structured terms may not adequately reflect or capture the overall biological applicability domain (particularly with regard to taxa). Likewise, the structured terms do not provide an explanation or rationale for the selection. The free-text section on evidence for taxonomic, life stage, and sex applicability can be used to elaborate on why the specific structured terms were selected, and provide supporting references and background information.  More help

Regulatory Significance of the Adverse Outcome

An AO is a specialised KE that represents the end (an adverse outcome of regulatory significance) of an AOP. For KEs that are designated as an AO, one additional field of information (regulatory significance of the AO) should be completed, to the extent feasible. If the KE is being described is not an AO, simply indicate “not an AO” in this section.A key criterion for defining an AO is its relevance for regulatory decision-making (i.e., it corresponds to an accepted protection goal or common apical endpoint in an established regulatory guideline study). For example, in humans this may constitute increased risk of disease-related pathology in a particular organ or organ system in an individual or in either the entire or a specified subset of the population. In wildlife, this will most often be an outcome of demographic significance that has meaning in terms of estimates of population sustainability. Given this consideration, in addition to describing the biological state associated with the AO, how it can be measured, and its taxonomic, life stage, and sex applicability, it is useful to describe regulatory examples using this AO. More help


List of the literature that was cited for this KE description. Ideally, the list of references, should conform, to the extent possible, with the OECD Style Guide ( (OECD, 2015). More help

1. Benoy V. , d.Y.C., Van Den Bosch L. , Charcot-Marie-Tooth Disease and other peripheral neuropathies, in Young Perspectives for Old Diseases, M.H. G., Editor. 2015, Bentham Science Publishers. p. pp. 269-325.

2. Yiu, G. and Z. He, Glial inhibition of CNS axon regeneration. Nature Reviews Neuroscience, 2006. 7: p. 617.

3. Rowinsky, E.K., et al., Neurotoxicity of Taxol. J Natl Cancer Inst Monogr, 1993(15): p. 107-15.

4. Rowinsky , E.K. and R.C. Donehower Paclitaxel (Taxol). New England Journal of Medicine, 1995. 332(15): p. 1004-1014.

5. Donehower, R.C., et al., Phase I trial of taxol in patients with advanced cancer. Cancer treatment reports, 1987. 71(12): p. 1171-1177.

6. Forsyth, P.a., et al., Prospective study of paclitaxel-induced peripheral neuropathy with quantitative sensory testing. Journal of Neuro-Oncology, 1997. 35(1): p. 47-53.

7. Brown, T., et al., A phase I trial of taxol given by a 6-hour intravenous infusion. Journal of Clinical Oncology, 1991. 9(7): p. 1261-1267.

8. Pignata, S., et al., Residual neurotoxicity in ovarian cancer patients in clinical remission after first-line chemotherapy with carboplatin and paclitaxel: The Multicenter Italian Trial in Ovarian cancer (MITO-4) retrospective study. BMC Cancer, 2006. 6(1): p. 5.

9. Rowinsky, E.K., et al., Sequences of taxol and cisplatin: a phase I and pharmacologic study. Journal of Clinical Oncology, 1991. 9(9): p. 1692-1703.

10. Chaudhry, V., et al., Peripheral neuropathy from taxol and cisplatin combination chemotherapy: Clinical and electrophysiological studies. Annals of Neurology, 1994. 35(3): p. 304-311.

11. Arezzo, J.C., H.H. Schaumburg, and C. Laudadio, Thermal Sensitivity Tester: Device for Quantitative Assessment of Thermal Sense in Diabetic Neuropathy. Diabetes, 1986. 35(5): p. 590-592.

12. Wiernik, P.H., et al., Phase I Clinical and Pharmacokinetic Study of Taxol. Cancer Research, 1987. 47(9): p. 2486-2493.

13. Behse, F., F. Buchthal, and F. Carlsen, Nerve biopsy and conduction studies in diabetic neuropathy. Journal of Neurology, Neurosurgery, and Psychiatry, 1977. 40(11): p. 1072-1082.