Redox Control of Multidrug Resistance and Its Possible Modulation by Antioxidants
Aysegul Cort1, Tomris Ozben2, Luciano Saso3
1Department of Nutrition and Dietetics, Faculty of Health Sciences, Sanko University, İncili Pınar, Gazi Muhtar Paşa Bulvarı, Sehitkamil, 27090 Gaziantep, Turkey.
Abstract:
Clinical efficacy of anticancer chemotherapies is dramatically hampered by multidrug resistance (MDR) dependent on inherited traits, acquired defence against toxins, and adaptive mechanisms mounting in tumours. There is overwhelming evidence that molecular events leading to MDR are regulated by redox mechanisms. For example, chemotherapeutics which overrun the first obstacle of redox-regulated cellular uptake channels (MDR1, MDR2, and MDR3) induce a concerted action of phase I/II metabolic enzymes with a temporal redox-regulated axis. This results in rapid metabolic transformation and elimination of a toxin. This metabolic axis is tightly interconnected with the inducible Nrf2-linked pathway, a key switch-on mechanism for upregulation of endogenous antioxidant enzymes and detoxifying systems. As a result, chemotherapeutics and cytotoxic by-products of their metabolism (ROS, hydroperoxides, and aldehydes) are inactivated and MDR occurs. On the other hand, tumour cells are capable of mounting an adaptive antioxidant response against ROS produced by chemotherapeutics and host immune cells. The multiple redox-dependent mechanisms involved in MDR prompted suggesting redox-active drugs (antioxidants and prooxidants) or inhibitors of inducible antioxidant defence as a novel approach to diminish MDR. Pitfalls and progress in this direction are discussed.
Insights
Multidrug resistance (MDR) in cancer chemotherapy is driven by redox mechanisms. Targeting these redox pathways with novel drugs offers a promising strategy to overcome MDR and improve treatment efficacy.
Area of Science:
- Biochemistry
- Molecular Biology
- Cancer Research
Background:
- Multidrug resistance (MDR) significantly limits the clinical effectiveness of anticancer chemotherapies.
- Redox mechanisms are critically involved in the molecular regulation of MDR.
- Tumor cells develop adaptive antioxidant responses to counteract chemotherapy-induced oxidative stress.
Purpose of the Study:
- To elucidate the role of redox mechanisms in MDR.
- To explore novel therapeutic strategies targeting redox pathways to overcome MDR.
Main Methods:
- Analysis of molecular events regulating MDR, focusing on redox-dependent pathways.
- Investigation of the interplay between chemotherapeutic metabolism, Nrf2 pathway, and antioxidant systems.
- Review of therapeutic approaches involving redox-active drugs and inhibitors of antioxidant defense.
Main Results:
- Chemotherapeutics are subject to redox-regulated cellular uptake and rapid metabolic inactivation.
- The Nrf2 pathway upregulates antioxidant and detoxifying systems, contributing to MDR.
- Tumor cells mount adaptive antioxidant defenses against reactive oxygen species (ROS).
Conclusions:
- Redox-dependent mechanisms are central to MDR in cancer.
- Targeting redox pathways, including the use of antioxidants, prooxidants, or inhibitors of antioxidant defense, presents a novel strategy to combat MDR.
- Further research into these redox-active drugs is warranted to improve chemotherapy outcomes.
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