Partial circumvention of P-glycoprotein-mediated multidrug resistance by doxorubicin-14-O-hemiadipate.

Previously, we have reported partial circumvention of P-glycoprotein (Pgp)-associated resistance to doxorubicin (Dox) in MCF7/R human breast carcinoma and P388/R murine leukemia cell lines by doxorubicin-14-O-hemiadipate (H-Dox) [Povarov L.S. et al. (1995) Russian J. Bioorganic Chemistry 21: 797-803]. We felt that these changes were due to alterations in the cellular pharmacokinetics of the analog in multidrug (MDR) resistant cells, as compared to that of Dox. To address this hypothesis, we performed comparative studies of the accumulation, retention and intracellular localization of H-Dox and Dox in Dox-sensitive murine leukemia cell line P388/S and its Dox-selected. Pgp-positive drug resistant P388/R subline. These studies were performed in the presence or absence of cyclosporin A (CsA), a competitive inhibitor of Pgp. Flow cytometric analysis revealed significant differences in Dox and H-Dox accumulation in P388/R cells when compared to P388/S cells. In P388/R versus P388/S cells, there was a 38-fold decrease in Dox accumulation, but only a 5-fold decrease in H-Dox accumulation, indicating over a 7-fold increase in H-Dox buildup in resistant cells. CsA did not affect uptake or retention of either drug by sensitive cells. However, coincubation with CsA resulted in a 54-fold increase in Dox accumulation and only a 5-fold increase in H-Dox uptake in P388/R cells, restoring anthracycline levels in P388/R to 100% of that found in P388/S cells. Once internalized by the resistant cells, H-Dox was retained better than Dox regardless of presence or absence of CsA. Confocal microscopic analysis revealed the presence of H-Dox but no Dox in cellular nuclei of P388/R cells. Thus, increased activity of H-Dox toward P388/R cells was correlated with its enhanced ability to enter and be retained in these cells, and also with redistribution of H-Dox into the nuclei of the resistant cells as compared to Dox. Overall, our findings support our initial hypothesis and provide evidence that H-Dox, a 14-O-hemiadipate of doxorubicin, is affected by Pgp-mediated MDR to a lesser extent than parental Dox due to changes iin the cellular pharmacokinetics of the analog.