摘要Paclitaxel(PTX)serves as a primary chemotherapy agent against diverse solid tumors including breast cancer,lung cancer,head and neck cancer and ovarian cancer,having severe adverse effects including PTX-induced peripheral neuropathy(PIPN)and hypersensitivity reactions(HSR).A recommended anti-allergic agent diphenhydramine(DIP)has been used to alleviate PTX-induced HSR.Desloratadine(DLT)is a third generation of histamine H1 receptor antagonist,but also acted as a selective antagonist of 5HTR2A.In this study we investigated whether DLT ameliorated PIPN-like symptoms in mice and the underlying mechanisms.PIPN was induced in male mice by injection of PTX(4 mg/kg,i.p.)every other day for 4 times.The mice exhibited 50％reduction in mechanical threshold,paw thermal response latency and paw cold response latency compared with control mice.PIPN mice were treated with DLT(10,20 mg/kg,i.p.)30 min before each PTX administration in the phase of establishing PIPN mice model and then administered daily for 4 weeks after the model was established.We showed that DLT administration dose-dependently elevated the mechanical,thermal and cold pain thresholds in PIPN mice,whereas administration of DIP(10 mg/kg,i.p.)had no ameliorative effects on PIPN-like symptoms.We found that the expression of 5HTR2A was selectively elevated in the activated spinal astrocytes of PIPN mice.Spinal cord-specific 5HTR2A knockdown by intrathecal injection of AAV9-5Htr2a-shRNA significantly alleviated the mechanical hyperalgesia,thermal and cold hypersensitivity in PIPN mice,while administration of DLT(20 mg/kg)did not further ameliorate PIPN-like symptoms.We demonstrated that DLT administration alleviated dorsal root ganglion neuronal damage and suppressed sciatic nerve destruction,spinal neuron apoptosis and neuroinflammation in the spinal cord of PIPN mice.Furthermore,we revealed that DLT administration suppressed astrocytic neuroinflammation via the 5HTR2A/c-Fos/NLRP3 pathway and blocked astrocyte-neuron crosstalk by targeting 5HTR2A.We conclude that spinal 5HTR2A inhibition holds promise as a therapeutic approach for PIPN and we emphasize the potential of DLT as a dual-functional agent in ameliorating PTX-induced both PIPN and HSR in chemotherapy.