1. Natural alkaloids as P-gp inhibitors for multidrug resistance reversal in cancer.
- Author
-
Joshi P, Vishwakarma RA, and Bharate SB
- Subjects
- Alkaloids chemistry, Antineoplastic Agents, Phytogenic chemical synthesis, Antineoplastic Agents, Phytogenic chemistry, Biological Products chemical synthesis, Biological Products chemistry, Dose-Response Relationship, Drug, Humans, Molecular Structure, Structure-Activity Relationship, ATP Binding Cassette Transporter, Subfamily B, Member 1 antagonists & inhibitors, Alkaloids pharmacology, Antineoplastic Agents, Phytogenic pharmacology, Biological Products pharmacology, Drug Resistance, Multiple drug effects, Drug Resistance, Neoplasm drug effects, Neoplasms drug therapy
- Abstract
The biggest challenge associated with cancer chemotherapy is the development of cross multi-drug resistance to almost all anti-cancer agents upon chronic treatment. The major contributing factor for this resistance is efflux of the drugs by the p-glycoprotein pump. Over the years, inhibitors of this pump have been discovered to administer them in combination with chemotherapeutic agents. The clinical failure of first and second generation P-gp inhibitors (such as verapamil and cyclosporine analogs) has led to the discovery of third generation potent P-gp inhibitors (tariquidar, zosuquidar, laniquidar). Most of these inhibitors are nitrogenous compounds and recently a natural alkaloid CBT-01
® (tetrandrine) has advanced to the clinical phase. CBT-01 demonstrated positive results in Phase-I study in combination with paclitaxel, which warranted conducting it's Phase II/III trial. Apart from this, there exist a large number of natural alkaloids possessing potent inhibition of P-gp efflux pump and other related pumps responsible for the development of resistance. Despite the extensive contribution of alkaloids in this area, has never been reviewed. The present review provides a comprehensive account on natural alkaloids possessing P-gp inhibition activity and their potential for multidrug resistance reversal in cancer., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)- Published
- 2017
- Full Text
- View/download PDF