[Role of Scaffold Proteins in Functional Alteration of Small Intestinal P-glycoprotein by Anti-cancer Drugs]

Yakugaku Zasshi. 2015;135(5):687-95. doi: 10.1248/yakushi.14-00234-1.
[Article in Japanese]

Abstract

Since there is accumulating evidence to indicate that introduction of early palliative care for cancer patients may improved their quality of life or survival rates, the number of patients receiving pain relief by narcotic analgesics in conjunction with chemotherapy is predicted to increase. Therefore to provide effective combination treatments it is important to evaluate basic evidence regarding drug-drug interactions between anti-cancer drugs and narcotics. We have focused on P-glycoprotein (P-gp), a drug efflux transporter, in small intestine where the absorption process of drugs administered via oral route is greatly limited. Then, we revealed that repeated oral treatment with etoposide (ETP) increases P-gp levels in the small intestinal membrane via RhoA/ROCK activation, leading to decrease in analgesia of morphine, a P-gp substrate drug, with alteration of its disposition after oral administration. Furthermore, we found that activation of ezrin/radixin/moesin (ERM), scaffold proteins that regulate plasma membrane localization or function of certain plasma membrane proteins such as P-gp, are involved in this mechanism. Of particular interest is that among ERM proteins, radixin may contribute, at least in part, to increased expression of P-gp in the small intestine under repeated oral treatment with ETP.

Publication types

  • Review

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / metabolism*
  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / physiology
  • Administration, Oral
  • Animals
  • Antineoplastic Agents, Phytogenic / administration & dosage*
  • Antineoplastic Agents, Phytogenic / pharmacology
  • Cytoskeletal Proteins / metabolism
  • Drug Interactions
  • Etoposide / administration & dosage*
  • Etoposide / pharmacology
  • Humans
  • Intestine, Small / metabolism*
  • Male
  • Membrane Proteins / metabolism
  • Mice, Inbred Strains
  • Morphine / administration & dosage
  • Morphine / pharmacokinetics
  • Morphine / pharmacology*
  • Pain / drug therapy
  • rhoA GTP-Binding Protein / metabolism
  • rhoA GTP-Binding Protein / physiology

Substances

  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • Antineoplastic Agents, Phytogenic
  • Cytoskeletal Proteins
  • Membrane Proteins
  • radixin
  • Etoposide
  • Morphine
  • rhoA GTP-Binding Protein