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Critical Reviews™ in Therapeutic Drug Carrier Systems
インパクトファクター: 2.9 5年インパクトファクター: 3.72 SJR: 0.736 SNIP: 0.818 CiteScore™: 4.6

ISSN 印刷: 0743-4863
ISSN オンライン: 2162-660X

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Critical Reviews™ in Therapeutic Drug Carrier Systems

DOI: 10.1615/CritRevTherDrugCarrierSyst.2020025052
pages 473-509

Insight on Multidrug Resistance and Nanomedicine Approaches to Overcome MDR

Imran Shair Mohammad
Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 211198, P.R. China; School of Pharmaceutical Sciences, Sun Yat-sen University, University Town, Guangzhou 510006, P.R. China
Wei He
Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 211198, P.R. China
Lifang Yin
Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing 211198, P.R. China; Key Laboratory of Druggability of Biopharmaceutics, China Pharmaceutical University, Nanjing, 211198, P.R. China

要約

Multidrug resistance (MDR) remains a major obstacle to ensure effective chemotherapy in cancer patients. Several factors could be associated with cancer cells' drug resistance such as overexpression of P-glycoprotein (P-gp), cancer stem cells (CSCs), defect in apoptosis, mutation and alteration in DNA repair pathways, angiogenesis, autophagy, and modulation in metabolic enzymes. Until now, drug efflux by ABC transporters has been a univocal and well-established mechanism of chemotherapeutic associated drug resistance. To explore the mechanics involved in ABC transporter associated drug resistance, many crucial studies have been conducted from identification of drug binding sites to elucidation of their structure. Due to our continuous battle with drug resistance, several strategies have been employed to combat MDR, including P-gp modulators, siRNAs, antibodies, as well as peptides. Furthermore, various nanoparticle and different effective combination nanomedicine strategies also suggest some exciting results. Thus, to improve nanomedicine approaches to overcome MDR, in this evolutionary review, we have focused on fundamentals of possible strategies as well as the latest accomplishments to reverse MDR.

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