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Clinical Cancer Research Vol. 11, 2320-2326, March 2005
© 2005 American Association for Cancer Research


Cancer Therapy: Preclinical

Cyclosporin A Is a Broad-Spectrum Multidrug Resistance Modulator

Misbah Qadir1, Kieran L. O'Loughlin1, Stacy M. Fricke1,2, Nicole A. Williamson1, William R. Greco3, Hans Minderman1 and Maria R. Baer1,2

1 Leukemia Section, Department of Medicine, 2 Program of Molecular Pharmacology and Cancer Therapeutics, and 3 Cancer Prevention & Population Sciences, Roswell Park Cancer Institute, Buffalo, New York

Requests for reprints: Maria R. Baer, Department of Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263. Phone: 716-845-5975; Fax: 716-845-8446; E-mail: maria.baer{at}roswellpark.org.

Purpose: Overexpression of the multidrug resistance proteins P-glycoprotein (Pgp), multidrug resistance protein (MRP-1), breast cancer resistance protein (BCRP), and lung resistance protein (LRP) is associated with treatment failure in acute myeloid leukemia (AML) and other malignancies. The Pgp modulator cyclosporin A has shown clinical efficacy in AML, whereas its analogue PSC-833 has not. Cyclosporin A is known to also modulate MRP-1, and we hypothesized that broad-spectrum multidrug resistance modulation might contribute to its clinical efficacy.

Experimental Design: We studied the effects of cyclosporin A and PSC-833 on in vitro drug retention and cytotoxicity in resistant cell lines overexpressing Pgp, MRP-1, and BCRP and on nuclear-cytoplasmic drug distribution and cytotoxicity in cells overexpressing LRP. Cellular drug content was assessed by flow cytometry and nuclear-cytoplasmic drug distribution by confocal microscopy.

Results: Cyclosporin A enhanced retention of the substrate drug mitoxantrone in cells overexpressing Pgp (HL60/VCR), MRP-1 (HL60/ADR), and BCRP (8226/MR20, HEK-293 482R) and increased cytotoxicity 6-, 4-, 4-, and 3-fold, respectively. Moreover, cyclosporin A enhanced nuclear distribution of doxorubicin in 8226/MR20 cells, which also express LRP, and increased doxorubicin cytotoxicity 12-fold without an effect on cellular doxorubicin content, consistent with expression of wild-type BCRP, which does not efflux doxorubicin. Cyclosporin A also enhanced nuclear doxorubicin distribution in a second cell line with LRP overexpression, HT1080/DR4. PSC-833 enhanced mitoxantrone retention and cytotoxicity in cells overexpressing Pgp, but had no effect in cells overexpressing MRP-1, BCRP, or LRP.

Conclusions: Cyclosporin A modulates Pgp, MRP-1, BCRP, and LRP, and this broad-spectrum activity may contribute to its clinical efficacy.

Key Words: P glycoprotein • multidrug resistance protein • breast cancer resistance protein • lung resistance protein • PSC-833




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