Can flavonoids from honey alter multidrug resistance?

Cancer is one of the deadly diseases that burdens the society since long-time. Although design of chemotherapy is well-advanced, still it could not prevent the cancer death by hundred percent. One of the major stumbling blocks for cancer chemotherapy is multidrug resistance (MDR) developed by cancer cells. Role of ABC family of transporter proteins is well recognized in MDR. P-glycoprotein (P-gp), member of ABC transporter family, has been described for drug resistance and a low bioavailability of drugs by pumping structurally unrelated drugs out of the cells at the cost of ATP hydrolysis. Recently various P-gp inhibitors (chemosensitizers) are studied extensively to reverse MDR. In this scenario, we propose honey with multitude of polyphenolic flavonoids as a plausible candidate for inhibiting the P-gp proteins. Common flavonoids of honey like chrysin, genistein, biochanin, quercetin, kaempferol, and naringenin have found to interact with P-gp transporters. Generally chemosensitizers bind with transmembrane domain (TMD) in the P-gp transporter but flavonoids are bi-functional in reversing the MDR. Flavonoids can inhibit the ATPases activity involved in drug efflux and also it may serve as substrates for P-gp transporters, thereby causing competitive inhibition towards other substrates. This dual-mode of flavonoids interaction with P-gp transporter enhances the therapeutic index. Hence we promulgate honey with rich flavonoid content as a potential candidate for reversing MDR. If our hypothesis is true, honey a novel chemosensitizer will reduce the huge amount invested in developing new chemosensitizers to overcome the burden of chemo-resistance.