title: The role of glucuronidation in drug resistance.
abstract: The final therapeutic effect of a drug candidate, which is directed to a specific molecular target strongly depends on its absorption, distribution, metabolism and excretion (ADME). The disruption of at least one element of ADME may result in serious drug resistance. In this work we described the role of one element of this resistance: phase II metabolism with UDP-glucuronosyltransferases (UGTs). UGT function is the transformation of their substrates into more polar metabolites, which are better substrates for the ABC transporters, MDR1, MRP and BCRP, than the native drug. UGT-mediated drug resistance can be associated with (i) inherent overexpression of the enzyme, named intrinsic drug resistance or (ii) induced expression of the enzyme, named acquired drug resistance observed when enzyme expression is induced by the drug or other factors, as food-derived compounds. Very often this induction occurs via ligand binding receptors including AhR (aryl hydrocarbon receptor) PXR (pregnane X receptor), or other transcription factors. The effect of UGT dependent resistance is strengthened by coordinate action and also a coordinate regulation of the expression of UGTs and ABC transporters. This coupling of UGT and multidrug resistance proteins has been intensively studied, particularly in the case of antitumor treatment, when this resistance is "improved" by differences in UGT expression between tumor and healthy tissue. Multidrug resistance coordinated with glucuronidation has also been described here for drugs used in the management of epilepsy, psychiatric diseases, HIV infections, hypertension and hypercholesterolemia. Proposals to reverse UGT-mediated drug resistance should consider the endogenous functions of UGT.
authors.affiliation: Gdańsk University of Technology, Chemical Faculty, Department of Pharmaceutical Technology and Biochemistry, 80-233 Gdańsk, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Mazerska
authors.affiliation: Gdańsk University of Technology, Chemical Faculty, Department of Pharmaceutical Technology and Biochemistry, 80-233 Gdańsk, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Mróz
authors.affiliation: Gdańsk University of Technology, Chemical Faculty, Department of Pharmaceutical Technology and Biochemistry, 80-233 Gdańsk, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Pawłowska
authors.affiliation: Gdańsk University of Technology, Chemical Faculty, Department of Pharmaceutical Technology and Biochemistry, 80-233 Gdańsk, Poland. Electronic address: ewa.augustin@pg.gda.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Augustin
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004351:Drug Resistance / Q000502:physiology*; D004827:Epilepsy / Q000188:drug therapy / Q000378:metabolism; D014453:Glucuronosyltransferase / Q000378:metabolism*; D015658:HIV Infections / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000378:metabolism; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D001523:Mental Disorders / Q000188:drug therapy / Q000378:metabolism; D009369:Neoplasms / Q000188:drug therapy / Q000378:metabolism; D010024:Osteoporosis / Q000188:drug therapy / Q000378:metabolism
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D007166:Immunosuppressive Agents; D014453:Glucuronosyltransferase
keywords: ABC transporters; Antitumor drug resistance; Glucuronidation; UGT-dependent resistance; UGT-modulated pharmacokinetics