Emerging Significance of Flavonoids as P-Glycoprotein Inhibitors in Cancer Chemotherapy

Chemotherapy forms the mainstay of cancer treatment particularly for patients who do not respond to local excision or radiation treatment. However, cancer treatment by drugs is seriously limited by P-glycoprotein (P-gp) associated multi-drug resistance (MDR) in various tumor cells. On the other hand...

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Main Authors: Tripta Bansal, Manu Jaggi, Roop Khar, Sushama Talegaonkar
Format: Article
Language:English
Published: Frontiers Media S.A. 2009-04-01
Series:Journal of Pharmacy & Pharmaceutical Sciences
Online Access:https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/4376
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author Tripta Bansal
Manu Jaggi
Roop Khar
Sushama Talegaonkar
author_facet Tripta Bansal
Manu Jaggi
Roop Khar
Sushama Talegaonkar
author_sort Tripta Bansal
collection DOAJ
description Chemotherapy forms the mainstay of cancer treatment particularly for patients who do not respond to local excision or radiation treatment. However, cancer treatment by drugs is seriously limited by P-glycoprotein (P-gp) associated multi-drug resistance (MDR) in various tumor cells. On the other hand, it is now widely recognized that P-gp also influences drug transport across various biological membranes. P-gp transporter is widely present in the luminal surface of enterocytes, biliary canalicular surface of hepatocytes, apical surface of proximal tubular cells of kidney, endothelial cells of blood brain barrier, etc. thus affecting absorption, distribution, metabolism and excretion of xenobiotics. Clinical significance of above mentioned carrier is appreciated from the fact that more than fifty percent of existing anti-cancer drugs undergo inhibitable and saturable P-gp mediated efflux. Consequently, there is an increasing trend to optimize pharmacokinetics, enhance antitumour activity and reduce systemic toxicity of existing anti-cancer drugs by inhibiting P-gp mediated transport. Although a wide variety of P-gp inhibitors have been discovered, research efforts are underway to identify the most appropriate one. Flavonoids (polyphenolic herbal constituents) form the third generation, non-pharmaceutical category of P-gp inhibitors. The effects produced by some of these components are found to be comparable to those of well-known P-gp inhibitors verapamil and cyclosporine. Identification of effective P-gp modulator among herbal compounds have an added advantage of being safe, thereby making them ideal candidates for bioavailability enhancement, tissue-penetration (e.g. blood brain barrier (BBB)), decreasing biliary excretion and multi-drug resistance modulating agents. The dual effects, i.e. P-gp modulation and antitumor activity, of these herbal derivatives may synergistically act in cancer chemotherapy. This paper presents an overview of the investigations on the feasibility and application of flavonoids as P-gp modulators for improved efficacy of anti-cancer drugs like taxanes, anthracyclines, epipodophyllotoxins, camptothecins and vinca alkaloids. The review also focuses on flavonoid-drug interactions as well as the reversal activity of flavonoids useful against MDR. In addition, the experimental models which could be used for investigation on P-gp mediated efflux are also discussed.
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spelling doaj.art-a4e54ecb48044bee81ba71e6f2f554f22023-09-02T14:25:56ZengFrontiers Media S.A.Journal of Pharmacy & Pharmaceutical Sciences1482-18262009-04-0112110.18433/J3RC77Emerging Significance of Flavonoids as P-Glycoprotein Inhibitors in Cancer ChemotherapyTripta BansalManu JaggiRoop KharSushama TalegaonkarChemotherapy forms the mainstay of cancer treatment particularly for patients who do not respond to local excision or radiation treatment. However, cancer treatment by drugs is seriously limited by P-glycoprotein (P-gp) associated multi-drug resistance (MDR) in various tumor cells. On the other hand, it is now widely recognized that P-gp also influences drug transport across various biological membranes. P-gp transporter is widely present in the luminal surface of enterocytes, biliary canalicular surface of hepatocytes, apical surface of proximal tubular cells of kidney, endothelial cells of blood brain barrier, etc. thus affecting absorption, distribution, metabolism and excretion of xenobiotics. Clinical significance of above mentioned carrier is appreciated from the fact that more than fifty percent of existing anti-cancer drugs undergo inhibitable and saturable P-gp mediated efflux. Consequently, there is an increasing trend to optimize pharmacokinetics, enhance antitumour activity and reduce systemic toxicity of existing anti-cancer drugs by inhibiting P-gp mediated transport. Although a wide variety of P-gp inhibitors have been discovered, research efforts are underway to identify the most appropriate one. Flavonoids (polyphenolic herbal constituents) form the third generation, non-pharmaceutical category of P-gp inhibitors. The effects produced by some of these components are found to be comparable to those of well-known P-gp inhibitors verapamil and cyclosporine. Identification of effective P-gp modulator among herbal compounds have an added advantage of being safe, thereby making them ideal candidates for bioavailability enhancement, tissue-penetration (e.g. blood brain barrier (BBB)), decreasing biliary excretion and multi-drug resistance modulating agents. The dual effects, i.e. P-gp modulation and antitumor activity, of these herbal derivatives may synergistically act in cancer chemotherapy. This paper presents an overview of the investigations on the feasibility and application of flavonoids as P-gp modulators for improved efficacy of anti-cancer drugs like taxanes, anthracyclines, epipodophyllotoxins, camptothecins and vinca alkaloids. The review also focuses on flavonoid-drug interactions as well as the reversal activity of flavonoids useful against MDR. In addition, the experimental models which could be used for investigation on P-gp mediated efflux are also discussed.https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/4376
spellingShingle Tripta Bansal
Manu Jaggi
Roop Khar
Sushama Talegaonkar
Emerging Significance of Flavonoids as P-Glycoprotein Inhibitors in Cancer Chemotherapy
Journal of Pharmacy & Pharmaceutical Sciences
title Emerging Significance of Flavonoids as P-Glycoprotein Inhibitors in Cancer Chemotherapy
title_full Emerging Significance of Flavonoids as P-Glycoprotein Inhibitors in Cancer Chemotherapy
title_fullStr Emerging Significance of Flavonoids as P-Glycoprotein Inhibitors in Cancer Chemotherapy
title_full_unstemmed Emerging Significance of Flavonoids as P-Glycoprotein Inhibitors in Cancer Chemotherapy
title_short Emerging Significance of Flavonoids as P-Glycoprotein Inhibitors in Cancer Chemotherapy
title_sort emerging significance of flavonoids as p glycoprotein inhibitors in cancer chemotherapy
url https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/4376
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AT sushamatalegaonkar emergingsignificanceofflavonoidsaspglycoproteininhibitorsincancerchemotherapy