ABSTRACT
Overexpression of multidrug resistance (MDR) protein, P-glycoprotein (P-gp), on lymphocytes has been suggested to be implicated in the failure of glucocorticoid (GC) therapy in patients with ulcerative colitis (UC). However, whether the overexpression of P-gp in a class of patients with inflammatory bowel disease (IBD) is intrinsic or related to the administration of GC is unknown. Relative amounts of MDR1 mRNA expressed in peripheral blood mononuclear cells (PBMCs) were measured using the reverse-transcriptase polymerase chain reaction (RT-PCR) technique in 25 UC patients having no history of GC administration, 25 UC patients having experienced GC therapy, 19 patients with Crohn's disease (CD) with no history of GC therapy, and 27 healthy subjects. Relative amounts of MDR1 mRNA expressed in PBMCs were compared among the groups. The relationship between the amounts of MDR1 mRNA expressed, as well as the total dose of GC administered or the period of GC therapy in UC patients, was examined. The relative amounts of MDR1 mRNA expressed in PBMCs were not significantly different between the healthy subjects and CD patients or UC patients having no history of GC therapy. However, the mean MDR1 mRNA amount in PBMCs of UC patients having experienced GC therapy was significantly greater than that in PBMCs of UC patients with no history of GC administration (p = 0.0375). The amounts of MDR1 mRNA in PBMCs of UC patients having experienced GC therapy significantly correlated with the total dose of GCs administered (p = 0.0175). Overexpression of MDR1 mRNA in PBMCs of IBD patients is not intrinsic. However, high-dose administration of GCs for the treatment of UC may result in an increased expression of MDR1 mRNA, which may impair successful GC therapy in these patients.
Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics , Colitis, Ulcerative/drug therapy , Glucocorticoids/administration & dosage , Colitis, Ulcerative/blood , Colitis, Ulcerative/genetics , Glucocorticoids/pharmacokinetics , Glucocorticoids/therapeutic use , Humans , Inflammatory Bowel Diseases/drug therapy , Inflammatory Bowel Diseases/genetics , Inflammatory Bowel Diseases/prevention & control , Leukocytes, Mononuclear/drug effects , Leukocytes, Mononuclear/physiology , RNA, Messenger/genetics , Reverse Transcriptase Polymerase Chain Reaction/methodsABSTRACT
PURPOSE: The aim of this study was to investigate the multidrug resistance (MDR) pattern, MDR gene and P-glycoprotein (P-gp) expression, and P-gp function in drug-induced human T-lymphoblastoid leukemia MOLT-4 sublines. METHODS: The MDR sublines were developed by exposing the parental MOLT-4 cells to stepwise increasing concentrations of anticancer drugs daunorubicin (DNR), vinblastine (VBL) and doxorubicin (DOX). Degrees of resistance were assessed in terms of IC(50) values in an MTT assay and the P-gp function was evaluated in terms of rhodamine 123 (Rh123) accumulation and efflux. The percentage of cells undergoing apoptosis was determined by flow cytometry after staining with annexin V-FITC and propidium iodide. The levels of P-gp and MDR mRNA expression were estimated using the PE-conjugated anti-P-gp monoclonal antibody 17F9 and quantitative real-time reverse transcription-polymerase chain reaction. RESULTS: Three MOLT-4 sublines were established and revealed a 2- to 115-fold resistance to the anticancer reagents DNR, VBL and DOX as compared to the parental cell line. The highest MDR was expressed in MOLT-4/DNR cells, which was overcome by the P-gp modulator, cyclosporin A (CsA). The resistant sublines showed a decreased accumulation and an increased efflux of Rh123 in proportion to the degree of resistance, and these were completely reversed in the presence of 8 microM CsA. The decreased apoptotic response in these cell lines was clearly associated with the degree of drug resistance. P-gp antigen and MDR1 mRNA were highly expressed in both the MOLT-4/DNR and MOLT-4/DOX sublines. Less-resistant MOLT-4/VBL cells expressed lower levels of MDR1 mRNA and P-gp, even though the cell line was established by exposing the parental MOLT-4 cells to VBL for longer (5 months) than to the other two reagents (3 months). CONCLUSIONS: MOLT-4 cells were able to acquire a high level of drug resistance by culturing the cells in the presence of certain anticancer drugs, and acquisition of the resistance was relatively reagent-specific. The degrees of resistance to the anticancer drugs were well correlated with the expressions of MDR1 mRNA and functional P-gp, and were also associated with a decreased response to apoptosis.
