Effects of mitochondrial poisons on the neuropathic pain produced by the chemotherapeutic agents, paclitaxel and oxaliplatin

Pain. 2012 Mar;153(3):704-709. doi: 10.1016/j.pain.2011.12.011. Epub 2012 Jan 13.


The dose-limiting side effect of taxane, platinum-complex, and other kinds of anticancer drugs is a chronic, distal, bilaterally symmetrical, sensory peripheral neuropathy that is often accompanied by neuropathic pain. Work with animal models of these conditions suggests that the neuropathy is a consequence of toxic effects on mitochondria in primary afferent sensory neurons. If this is true, then additional mitochondrial insult ought to make the neuropathic pain worse. This prediction was tested in rats with painful peripheral neuropathy due to the taxane agent, paclitaxel, and the platinum-complex agent, oxaliplatin. Rats with established neuropathy were given 1 of 3 mitochondrial poisons: rotenone (an inhibitor of respiratory Complex I), oligomycin (an inhibitor of adenosine triphosphate synthase), and auranofin (an inhibitor of the thioredoxin-thioredoxin reductase mitochondrial antioxidant defense system). All 3 toxins significantly increased the severity of paclitaxel-evoked and oxaliplatin-evoked mechano-allodynia and mechano-hyperalgesia while having no effect on the mechano-sensitivity of chemotherapy-naïve rats. Chemotherapy-evoked painful peripheral neuropathy is associated with an abnormal spontaneous discharge in primary afferent A fibers and C fibers. Oligomycin, at the same dose that exacerbated allodynia and hyperalgesia, significantly increased the discharge frequency of spontaneously discharging A fibers and C fibers in both paclitaxel-treated and oxaliplatin-treated rats, but did not evoke any discharge in naïve control rats. These results implicate mitochondrial dysfunction in the production of chemotherapy-evoked neuropathic pain and suggest that drugs that have positive effects on mitochondrial function may be of use in its treatment and prevention.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents / adverse effects*
  • Antirheumatic Agents / therapeutic use
  • Auranofin / therapeutic use
  • Behavior, Animal / drug effects
  • Drug Interactions
  • Hyperalgesia / chemically induced
  • Male
  • Mitochondria / drug effects*
  • Mitochondria / pathology
  • Nerve Fibers / drug effects
  • Neuralgia / chemically induced*
  • Oligomycins / adverse effects
  • Organoplatinum Compounds / adverse effects*
  • Oxaliplatin
  • Paclitaxel / adverse effects*
  • Pain Measurement
  • Pain Threshold / drug effects
  • Rats
  • Rats, Sprague-Dawley
  • Rotenone / adverse effects
  • Time Factors
  • Uncoupling Agents / administration & dosage


  • Antineoplastic Agents
  • Antirheumatic Agents
  • Oligomycins
  • Organoplatinum Compounds
  • Uncoupling Agents
  • Rotenone
  • Oxaliplatin
  • Auranofin
  • Paclitaxel