, 2000 and Varbiro et al., 2001). The paclitaxel-evoked opening of the mPTP in-turn causes the calcium release from the mitochondria (Kidd et al., 2002) and calcium chelating agents reverse paclitaxel-evoked pain (Siau and

Bennett, 2006). Furthermore, acetyl-l-carnitine (naturally occurring amino acid derivative that plays an essential role in transporting Navitoclax in vitro long-chain free fatty acids into mitochondria) prevent mPTP opening (Pastorino et al., 1993), normalizes mitochondrial function and attenuate development of paclitaxel-induced neuropathic pain (Jin et al., 2008). Administration of bortezomib leads to the intracytoplasmic vacuolation in dorsal root ganglia (DRG) satellite cells which is ascribed to mitochondrial and endoplasmic reticulum enlargement (Cavaletti et al., 2007). These changes are related to bortezomib’s ability to induce the activation of the mitochondrial-based check details apoptotic pathway including activation of caspases (Broyl et al., 2010) and dysregulation of calcium homeostasis (Landowski et al., 2005). The inhibitors of mitochondrial electron transport chain (mETC), which mediates electron transport and ATP synthesis, produce antinociception in chemotherapeutic agents induced painful peripheral neuropathy and also attenuate TNF-α induced mechanical hyperalgesia (Joseph and Levine,

2004). Furthermore in the same study, inhibitors of ATP synthesis such as pentachlorophenol (ATP analog and potent uncoupler of mitochondrial phosphorylation) and Ap4A were also shown to attenuate neuropathic pain supporting the critical role of mETC in peripheral

pain mechanisms. Using in vitro model of chemotherapy induced peripheral neuropathy that closely mimic the in vivo condition by exposing primary cultures of DRG sensory neurons to paclitaxel and cisplatin, it has been demonstrated that alpha-lipoic acid exerts neuroprotective effects against chemotherapy induced neurotoxicity in sensory neurons. It rescues the mitochondrial impairment by inducing the expression of frataxin, an essential mitochondrial Glycogen branching enzyme protein with anti-oxidant and chaperone properties ( Melli et al., 2008). Recently, clinical study has demonstrated significant changes in expression of number of gene including that controlling the mitochondrial dysfunction due to vincristine and bortezomib associated peripheral neuropathy ( Broyl et al., 2010). Calcium plays a major role in the pathogenesis of different forms of neuropathic pain including cancer chemotherapeutic drugs-induced pain. Suramin, a synthetic symmetrical polysulfonated naphthylamine derivative, exhibits significant in vivo and in vitro activities against a variety of solid tumor cells including breast cancer and prostate cancer. Sun and Windeback demonstrated the important role of intracellular calcium in mediating suramin-induced cell damage using DRG culture.