MDM2 antagonist nutlin-3a reverses mitoxantrone resistance by inhibiting breast cancer resistance protein mediated drug transport.

Breast cancer resistance protein (BCRP; ABCG2), a clinical marker for identifying the side population (SP) cancer stem cell subgroup, affects intestinal absorption, brain penetration, hepatobiliary excretion, and multidrug resistance of many anti-cancer drugs. Nutlin-3a is currently under pre-clinical investigation in a variety of solid tumor and leukemia models as a p53 reactivation agent, and has been recently demonstrated to also have p53 independent actions in cancer cells. In the present study, we first report that nutlin-3a can inhibit the efflux function of BCRP. We observed that although the nutlin-3a IC(50) did not differ between BCRP over-expressing and vector control cells, nutlin-3a treatment significantly potentiated the cells to treatment with the BCRP substrate mitoxantrone. Combination index calculations suggested synergism between nutlin-3a and mitoxantrone in cell lines over-expressing BCRP. Upon further investigation, it was confirmed that nutlin-3a increased the intracellular accumulation of BCRP substrates such as mitoxantrone and Hoechst 33342 in cells expressing functional BCRP without altering the expression level or localization of BCRP. Interestingly, nutlin-3b, considered virtually "inactive" in disrupting the MDM2/p53 interaction, reversed Hoechst 33342 efflux with the same potency as nutlin-3a. Intracellular accumulation and bi-directional transport studies using MDCKII cells suggested that nutlin-3a is not a substrate of BCRP. Additionally, an ATPase assay using Sf9 insect cell membranes over-expressing wild-type BCRP indicated that nutlin-3a inhibits BCRP ATPase activity in a dose-dependent fashion. In conclusion, our studies demonstrate that nutlin-3a inhibits BCRP efflux function, which consequently reverses BCRP-related drug resistance.

Studies of the mitogen-activated protein kinases and phosphatidylinositol-3 kinase in the lens. 2. The intercommunications.

The lens possesses comprehensive mitogen-activated signal transduction pathways (MAPK), which include the mitogen response pathway (Raf-MEK-ERK cascade), the stress-response pathways (p38 and SAPK/JNK cascades) and also the survival pathway (PI-3K-Akt). To understand the cross-cascade intercommunication among signal transduction pathways in the lens, we used specific protein kinase inhibitors and cultured the lenses under unstimulated, basic fibroblast growth factor (bFGF)- or galactose-treated conditions. Inhibitors included genistein (tyrosine kinases inhibitor), U0126 (MEK inhibitor), SB203580 or SB202190 (p38 inhibitor), FTS (Ras inhibitor), wortmannin (PI-3K inhibitor) or phorbol ester (protein kinase C down-regulator following long-term exposure). The results showed that genistein inhibited the activations of the members of the MAPK superfamily and the activation of PI-3K. FTS suppressed the activation of Raf and PI-3K but stimulated the other members of MAPKs. MEK inhibitor restrained the activations of ERK, SAPK/JNK (under bFGF-stimulated condition) and p38 (under galactose-stimulated condition) while p38 inhibitor suppressed ERK but stimulated SAPK/JNK. Both MEK and p38 inhibitors stimulated PI-3K. Wortmannin had a strong inhibitory effect on Raf but little effect on its downstream target proteins. Down-regulating PKC suppressed Raf and PI-3K but stimulated ERK. Taken together, these data suggest that all the stimuli responses are mediated through phosphorylation and that the signaling among the mitogenic and stress response pathways is integrated through 'cross-talk' to process the most appropriate response. The survival signaling pathway appears to communicate well with the mitogenic and stress response pathways. In addition to Ras, both Raf and MEK emerge to be the diverging or regulatory points for signal integration, amplification, suppression or compensatory action in the lens.