Multidrug transporter P-glycoprotein 170 as a differentiation antigen on normal human lymphocytes and thymocytes: modulation with differentiation stage and during aging.

P-glycoprotein 170 (P-gp), the multidrug transport pump, excludes drugs from the interior of cells and is inhibited by agents such as cyclosporin A (CsA), verapamil, and FK-506, which are also substrates for the P-gp pump. This work documents the age- and differentiation-related changes in P-gp on T and B lymphocytes from human blood or spleen, and its absence on most thymus and bone marrow cells. Analysis of rhodamine 123 (Rh123) dye efflux, and its inhibition by cyclosporin A, was used as a quantitative measure of functional P-gp, and reactivity with MRK-16 was used as a measure of P-gp surface expression. The dye efflux and phenotypic expression of P-gp+ PBMC appeared equivalent to that of a moderately drug-resistant cell line, although efflux is prolonged. The sensitivity to inhibition by CsA, cyclosporin G (CsG), and PSC833 of P-gp on PBMC, thymocytes, or T-cell lines varied with apparent cell-type specificity. Normal blood and splenic T- or B-cells included 50-80% of cells with surface P-gp (MRK-16+), which mediated CsA-sensitive dye export. The proportion of P-gp+ T- and B-cells was lowest among children under age 10 years, increased in adulthood, and decreased after age 60. Thymus included 30% of P-gp+ cells mediating CsA-sensitive dye export, including CD3-4-8- progenitors and mature CD3hi CD4+8- or CD4-8+ thymocytes. Mature T-cells in cord or adult blood, spleen, and bone marrow included a large proportion (50-60%) with efficient CsA-sensitive dye export, preferentially among the CD45RA+ subset. Monocytes from all tissue sources, and most bone marrow cells, expressed surface P-gp but retained Rh123, suggesting the absence of a functional dye export mechanism. In vitro mitogen-stimulated PBMC T and B lymphocytes lost P-gp function within 4-24 hr, consistent with the observation that P-gp was reduced on antigen-experienced CD45R0+ T-cells in vivo. Drug export by P-gp may protect lymphocytes from toxic effects of CsA, and may contribute to the immunosuppressive effects of such drugs. The developmentally regulated expression of P-gp function on lymphocytes, and its modulation on activated T- or B-cells, suggest an important role in normal immune development.