Pioglitazone, a PPARγ agonist, reduces cisplatin-evoked neuropathic pain by protecting against oxidative stress

Iryna A. Khasabova, Sergey G. Khasabov, Julie K. Olson, Megan L. Uhelski, Amy H. Kim, Alejandra M. Albino-Ramírez, Chad L. Wagner, Virginia S. Seybold, Donald A. Simone

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Painful peripheral neuropathy is a dose-limiting side effect of cisplatin treatment. Using a murine model of cisplatin-induced hyperalgesia, we determined whether a PPARγ synthetic agonist, pioglitazone, attenuated the development of neuropathic pain and identified underlying mechanisms. Cisplatin produced mechanical and cold hyperalgesia and decreased electrical thresholds of Aδ and C fibers, which were attenuated by coadministration of pioglitazone (10 mg/kg, intraperitoneally [i.p.]) with cisplatin. Antihyperalgesic effects of pioglitazone were blocked by the PPARγ antagonist T0070907 (10 mg/kg, i.p.). We hypothesized that the ability of pioglitazone to reduce the accumulation of reactive oxygen species (ROS) in dorsal root ganglion (DRG) neurons contributed to its antihyperalgesic activity. Effects of cisplatin and pioglitazone on somatosensory neurons were studied on dissociated mouse DRG neurons after 24 hours in vitro. Incubation of DRG neurons with cisplatin (13 µM) for 24 hours increased the occurrence of depolarization-evoked calcium transients, and these were normalized by coincubation with pioglitazone (10 µM). Oxidative stress in DRG neurons was considered a significant contributor to cisplatin-evoked hyperalgesia because a ROS scavenger attenuated hyperalgesia and normalized the evoked calcium responses when cotreated with cisplatin. Pioglitazone increased the expression and activity of ROS-reducing enzymes in DRG and normalized cisplatin-evoked changes in oxidative stress and labeling of mitochondria with the dye MitoTracker Deep Red, indicating that the antihyperalgesic effects of pioglitazone were attributed to its antioxidant properties in DRG neurons. These data demonstrate clear benefits of broadening the use of the antidiabetic drug pioglitazone, or other PPARγ agonists, to minimize the development of cisplatin-induced painful neuropathy.

Original languageEnglish (US)
Pages (from-to)688-701
Number of pages14
Issue number3
StatePublished - Mar 1 2019

Bibliographical note

Funding Information:
The authors thank Catherine Harding-Rose and Matthew Tracy for technical assistance, and they are especially grateful to Dr Tamila Bulat for valued discussions related to clinical relevance. They thank Dr James Hodges, University of Minnesota, for consultation and performing some of the statistical analyses. This work was supported by NIH grant 9R01 HL135895.

Publisher Copyright:
© 2018 International Association for the Study of Pain.


  • Chemotherapy
  • DRG neurons
  • Dorsal root ganglion
  • PPARγ
  • Pioglitazone
  • Reactive oxygen species
  • Superoxide Dismutase/genetics
  • Male
  • Neurons/drug effects
  • Oxidative Stress/drug effects
  • Ganglia, Spinal/cytology
  • Pain Threshold/drug effects
  • Mitochondria/drug effects
  • Female
  • Disease Models, Animal
  • Pioglitazone/therapeutic use
  • PPAR gamma/metabolism
  • Cells, Cultured
  • Neuralgia/chemically induced
  • Animals
  • Hyperalgesia/drug therapy
  • Hypoglycemic Agents/therapeutic use
  • Mice
  • Cisplatin/toxicity
  • Antineoplastic Agents/toxicity
  • Superoxide Dismutase-1/genetics

PubMed: MeSH publication types

  • Journal Article


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