title: Overcoming PGP-related multidrug resistance. The cyclosporine derivative SDZ PSC 833 can abolish the resistance to methoxy-morpholynil-doxorubicin.
abstract: BACKGROUND
  The results obtained so far in studies designed to neutralize P glycoprotein (PGP)-related multidrug resistance (MDR) by using MDR reversal agents, have not yet fulfilled the promise of the experiments which were performed in vitro. In order to improve PGP-related MDR neutralization, we tested in vitro the activity of the cyclosporine derivative SDZ PSC 833 (PSC) together with doxorubicin (DOX) and with two new DOX derivatives named 4' iodo 4' deoxy-doxorubicin (IODODOX) and methoxy-morpholynil-doxorubicin (MMDOX, FCE 23762) using four different human cell lines and their multi-drug resistant variants.
  
  
  METHODS
  Anthracycline toxicity was evaluated by using the MTT method after a 7-day culture with continuous exposure to the antitumor drugs with or without the addition of PSC.
  
  
  RESULTS
  PSC significantly downmodulated the toxicity of all three anthracyclines in all the four cell systems. However, despite the great increase caused by PSC in the toxicity of DOX and a more modest effect on the toxicity of the two DOX derivatives, this MDR reversal agent could only completely block the PGP mediated MMDOX resistance whereas DOX refractoriness was only decreased.
  
  
  CONCLUSIONS
  The combination of MMDOX or IODODOX with PSC 1.6 microM is more efficient than the combination of DOX plus PSC for the full reversion of PGP-mediated drug resistance. Careful clinical studies are required to evaluate if these associations can also effectively and safely neutralize MDR in vivo.
authors.affiliation: Department of Clinical and Morphological Research, University Hospital, Udine, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Michieli
authors.forename: D
authors.initials: D
authors.lastname: Damiani
authors.forename: A
authors.initials: A
authors.lastname: Michelutti
authors.forename: C
authors.initials: C
authors.lastname: Melli
authors.forename: A
authors.initials: A
authors.lastname: Ermacora
authors.forename: A
authors.initials: A
authors.lastname: Geromin
authors.forename: R
authors.initials: R
authors.lastname: Fanin
authors.forename: D
authors.initials: D
authors.lastname: Russo
authors.forename: M
authors.initials: M
authors.lastname: Baccarani
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000903:Antibiotics, Antineoplastic / Q000494:pharmacology*; D002460:Cell Line; D003524:Cyclosporins / Q000494:pharmacology*; D004317:Doxorubicin / Q000031:analogs & derivatives* / Q000494:pharmacology*; D018432:Drug Resistance, Multiple; D006801:Humans
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000903:Antibiotics, Antineoplastic; D003524:Cyclosporins; C066998:methoxy-morpholinyl-doxorubicin; D004317:Doxorubicin; C070272:valspodar