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Dual Inhibition of P-gp and BCRP Improves Oral Topotecan Bioavailability in Rodents.

ABSTRACT: P-glycoprotein (P-gp) inhibition has been studied to overcome multidrug resistance in cancer chemotherapy but failed in clinical trials due to low/toxic effects. Recently, a dual modulation of transporters and natural derivatives have been examined to surmount this limitation. We examined breast cancer resistance protein (BCRP) inhibition in vitro and in vivo by P-gp inhibitors derived from natural compounds in previous studies. P-gp inhibitors increased the accumulation of the anticancer drug, topotecan (TPT)-a substrate of P-gp and BCRP, albeit with higher affinity for BCRP-in BCRP-overexpressing cells, resulting in cell death. These dual inhibitors, when orally co-administered with TPT, enhanced TPT bioavailability with slightly reduced total oral clearance (Clt/F) in rats. In xenograft mice, they strengthened oral TPT-induced tumor reduction with no alterations in body weight. Moreover, we investigated the effects of an oral drug formulation (Cremophor^® EL, Tween^® 80, and polyethylene glycol 400) on the transporters function. The excipients increased TPT accumulation in P-gp- or BCRP-overexpressing cells. Oral TPT bioavailability was higher with the formulation than with a control, as shown by the increases in the maximum plasma concentration (C_max) and the area under the plasma concentration-time curve from zero to infinity (AUC_INF) (p< 0.01). Therefore, oral TPT bioavailability was enhanced by P-gp/BCRP dual inhibition, which resulted in a formulation-mediated increase in absorption and decrease in elimination, and a dual inhibitor-mediated decrease in elimination. These results suggest that the combination of dual inhibition by a natural derivative and the drug formulation can be a useful clinical approach.

SUBMITTER: Lee J

PROVIDER: S-EPMC8071537 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:The human ATP binding cassette transporters Breast Cancer Resistance Protein (BCRP) and Multidrug Resistance Protein 1 (P-gp) are co-expressed in many tissues and barriers, especially at the blood-brain barrier and at the hepatocyte canalicular membrane. Understanding their interplay in affecting the pharmacokinetics of drugs is of prime interest. In silico tools to predict inhibition and substrate profiles towards BCRP and P-gp might serve as early filters in the drug discovery and development process. However, to build such models, pharmacological data must be collected for both targets, which is a tedious task, often involving manual and poorly reproducible steps. RESULTS:Compounds with inhibitory activity measured against BCRP and/or P-gp were retrieved by combining Open Data and manually curated data from literature using a KNIME workflow. After determination of compound overlap, machine learning approaches were used to establish multi-label classification models for BCRP/P-gp. Different ways of addressing multi-label problems are explored and compared: label-powerset, binary relevance and classifiers chain. Label-powerset revealed important molecular features for selective or polyspecific inhibitory activity. In our dataset, only two descriptors (the numbers of hydrophobic and aromatic atoms) were sufficient to separate selective BCRP inhibitors from selective P-gp inhibitors. Also, dual inhibitors share properties with both groups of selective inhibitors. Binary relevance and classifiers chain allow improving the predictivity of the models. CONCLUSIONS:The KNIME workflow proved a useful tool to merge data from diverse sources. It could be used for building multi-label datasets of any set of pharmacological targets for which there is data available either in the open domain or in-house. By applying various multi-label learning algorithms, important molecular features driving transporter selectivity could be retrieved. Finally, using the dataset with missing annotations, predictive models can be derived in cases where no accurate dense dataset is available (not enough data overlap or no well balanced class distribution).Graphical abstract.

Project description:Multidrug resistance (MDR) in tumors and pathogens remains a major problem in the efficacious treatment of patients by reduction of therapy options and subsequent treatment failure. Various mechanisms are described to be involved in the development of MDR with overexpression of ATP-binding cassette (ABC) transporters reflecting the most extensively studied. These membrane transporters translocate a wide variety of substrates utilizing energy from ATP hydrolysis leading to decreased intracellular drug accumulation and impaired drug efficacy. One treatment strategy might be inhibition of transporter-mediated efflux by small molecules. Isocoumarins and 3,4-dihydroisocoumarins are a large group of natural products derived from various sources with great structural and functional variety, but have so far not been in the focus as potential MDR reversing agents. Thus, three natural products and nine novel 3,4-dihydroisocoumarins were designed and analyzed regarding cytotoxicity induction and inhibition of human ABC transporters P-glycoprotein (P-gp), multidrug resistance-associated protein 1 (MRP1) and breast cancer resistance protein (BCRP) in a variety of human cancer cell lines as well as the yeast ABC transporter Pdr5 in Saccharomyces cerevisiae. Dual inhibitors of P-gp and BCRP and inhibitors of Pdr5 were identified, and distinct structure-activity relationships for transporter inhibition were revealed. The strongest inhibitor of P-gp and BCRP, which inhibited the transporters up to 80 to 90% compared to the respective positive controls, demonstrated the ability to reverse chemotherapy resistance in resistant cancer cell lines up to 5.6-fold. In the case of Pdr5, inhibitors were identified that prevented substrate transport and/or ATPase activity with IC50 values in the low micromolar range. However, cell toxicity was not observed. Molecular docking of the test compounds to P-gp revealed that differences in inhibition capacity were based on different binding affinities to the transporter. Thus, these small molecules provide novel lead structures for further optimization.

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Dual Inhibition of P-gp and BCRP Improves Oral Topotecan Bioavailability in Rodents.

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