Frances J. Sharom

ABC multidrug transporters: structure, function and role in chemoresistance

Three ATP-binding cassette (ABC)-superfamily multidrug efflux pumps are known to be responsible for chemoresistance; P-glycoprotein (ABCB1), MRP1 (ABCC1) and ABCG2 (BCRP). These transporters play an important role in normal physiology by protecting tissues from toxic xenobiotics and endogenous metabolites. Hydrophobic amphipathic compounds, including many clinically used drugs, interact with the substrate-binding pocket of these proteins via flexible hydrophobic and H-bonding interactions. These efflux pumps are expressed in many human tumors, where they likely contribute to resistance to chemotherapy treatment. However, the use of efflux-pump modulators in clinical cancer treatment has proved disappointing. Single nucleotide polymorphisms in ABC drug-efflux pumps may play a role in responses to drug therapy and disease susceptibility. The effect of various genotypes and haplotypes on the expression and function of these proteins is not yet clear, and their true impact remains controversial.

The P-Glycoprotein Efflux Pump: How Does it Transport Drugs?

Pgp is an atypical translocating ATPase, with low affinity for ATP and high constitutive ATPase activity. Pgp also has an unusually broad specificity for hydrophobic substrates, including many chemotherapeutic drugs. Transport studies in reconstituted systems indicate that drug transport requires ATP hydrolysis and is active, generating a drug concentration gradient. Binding of drugs and ATP to Pgp induces conformational changes in the protein, and the drug binding site is conformationally coupled to the NBDs. Evidence accumulated to date suggests that the transporter interacts directly with nonpolar substrates within the membrane environment, and may act as a drug flippase, moving drugs from the inner to the outer leaflet of the bilayer. Chemosensitizers that block the action of Pgp are proposed to act as alternative substrates, but their high rate of spontaneous flip-flop across the membrane results in futile cycling of the transporter.

ABC Efflux Pump-Based Resistance to Chemotherapy Drugs

3.2. Other Potential in vivo Functions of Pgp 2992 3.3. Physiological Role of ABCG2 2992 3.4. Physiological Role of MRP1 2992 4. Structure of ABC Superfamily Drug Efflux Pumps 2992 4.1. Domain Structure of ABC Proteins 2992 4.2. Structure of Entire Bacterial ABC Proteins 2993 4.3. Structure of Pgp, MRP1, and ABCG2 2994 5. Substrate Specificity of ABC Drug Efflux Pumps 2995 5.1. MDR Spectrum Substrates 2995 5.2. Binding and Transport of Drugs 2998 5.3. Multidrug-Binding Pockets 2998 6. Catalytic Cycle of ABC Drug Efflux Pumps 3000 6.1. ATP Binding and Hydrolysis 3000 6.2. Occluded Nucleotide Conformation of Pgp 3000 6.3. Role of NBD Dimerization and the Occluded Conformation in the Catalytic Cycle of Pgp 3000

β-Amyloid efflux mediated by p-glycoprotein

A large body of evidence suggests that an increase in the brain β‐amyloid (Aβ) burden contributes to the etiology of Alzheimers disease (AD). Much is now known about the intracellular processes regulating the production of Aβ, however, less is known regarding its secretion from cells. We now report that p‐glycoprotein (p‐gp), an ATP‐binding cassette (ABC) transporter, is an Aβ efflux pump. Pharmacological blockade of p‐gp rapidly decrease extracellular levels of Aβ secretion. In vitro binding studies showed that addition of synthetic human Aβ1–40 and Aβ1–42 peptides to hamster mdr1‐enriched vesicles labeled with the fluorophore MIANS resulted in saturable quenching, suggesting that both peptides interact directly with the transporter. Finally, we were able to directly measure transport of Aβ peptides across the plasma membranes of p‐gp enriched vesicles, and showed that this phenomenon was both ATP‐ and p‐gp‐dependent. Taken together, our study suggests a novel mechanism of Aβ detachment from cellular membranes, and represents an obvious route towards identification of such a mechanism in the brain.

The effects of lipids and detergents on ATPase-active P-glycoprotein

We previously isolated and characterized a partially purified preparation of ATPase-active P-glycoprotein, the multidrug transporter (Doige, C.A., Yu, X. and Sharom, F.J. (1992) Biochim. Biophys. Acta 1109, 149-160). The effect of various detergents and membrane phospholipids on the ATPase activity of P-glycoprotein has now been investigated. P-Glycoprotein ATPase activity was most stable in CHAPS, with over 50% of the activity retained at a concentration of 8 mM. Octyl glucoside in the low mM range also supported the ATPase, while deoxycholate destroyed all activity at 1 mM. Digitonin and SDS inhibited ATPase activity at very low concentrations. Triton X-100 at 2-10 microM stimulated the ATPase almost 2-fold, while higher levels inhibited activity. Although P-glycoprotein ATPase was sensitive to thermal inactivation, full activity was preserved in the presence of asolectin, but not phosphatidylcholine species. Further studies revealed that asolectin, both saturated and unsaturated phosphatidylethanolamines, and phosphatidylserine, were best able to maintain ATPase activity at 23 degrees C. Saturated phosphatidylethanolamine species activated P-glycoprotein ATPase up to 40% at 23 degrees C, and 80% at 4 degrees C. Following detergent delipidation, various lipids were able to restore P-glycoprotein ATPase activity. Unsaturated phosphatidylcholine and phosphatidylserine were most effective, while saturated species were not able to restore catalytic activity. These results indicate that membrane lipids are necessary for catalytic activity of the ATPase domains of P-glycoprotein. P-Glycoprotein has well-defined lipid preferences, with saturated phosphatidylethanolamines both activating the ATPase and providing protection from thermal inactivation, while fluid lipid mixtures are able to restore activity following delipidation.

ATPase activity of partially purified P-glycoprotein from multidrug-resistant Chinese hamster ovary cells

In vitro studies of multidrug-resistant cell lines have shown that a membrane protein, the P-glycoprotein, is responsible for resistance to a wide range of structurally and functionally dissimilar anti-cancer drugs. The amino-acid sequence of P-glycoprotein (Pgp) indicates two consensus sequences for ATP binding and the purified protein has been reported to possess a low level of ATPase activity. As part of our goal to further characterize the ATPase activity of P-glycoprotein, we have developed a procedure for rapid partial purification of the protein in a highly active form. Plasma membrane vesicles from multidrug-resistant CHRC5 Chinese hamster ovary cells were subjected to a two-step procedure involving selective extraction with different concentrations of the zwitterionic detergent CHAPS. The resulting extract was enriched in P-glycoprotein (around 30% pure) and displayed an ATPase activity (specific activity 543 nmol mg-1 min-1) that was not found in a similar preparation from drug-sensitive cells. The ATPase specific activity was over 10-fold higher than that previously reported for immunoprecipitated Pgp and 280-fold higher than that of immunoaffinity-purified Pgp. This ATPase activity could be distinguished from that of other ion-motive ATPases and membrane-associated phosphatases and is, thus, proposed to be directly attributable to P-glycoprotein. Optimal P-glycoprotein ATPase activity required Mg2+ at an ATP: Mg2+ molar ratio of 0.75:1 and the apparent Km for ATP was 0.88 mM. P-Glycoprotein ATPase could be completely inhibited by vanadate and by the sulfhydryl-modifying reagents N-ethylmaleimide, HgCl2 and p-chloromercuribenzenesulfonate. Certain drugs and chemosensitizers, including colchicine, progesterone, nifedipine, verapamil and trifluoperazine, produced up to 50% activation of P-glycoprotein ATPase activity.

Multidrug Resistance and Chemosensitization: Therapeutic Implications for Cancer Chemotherapy

Publisher Summary This chapter discusses the multidrug resistance (MDR) and chemosensitization. A major impetus for research into the mechanism of P-glycoprotein-mediated MDR is the possibility that MDR tumor cells can arise during tumor progression in human malignancies, and that the outgrowth of MDR tumor cells could eventually limit a patients response to anticancer drugs. This hypothesis has been strengthened by recent reports demonstrating that relatively high levels of P-glycoprotein are observed in different cancers. Although further studies will be required to determine if the presence of P-glycoprotein-containing tumor cells is prognostic of response to chemotherapy, there is nonetheless optimism that this line of investigation will ultimately lead to a more rational approach to the development and use of anticancer drugs. A particularly exciting finding is that a group of structurally diverse compounds is able to reverse the P-glycoprotein-mediated MDR phenotype.

Interaction of the P-glycoprotein multidrug transporter (MDR1) with high affinity peptide chemosensitizers in isolated membranes, reconstituted systems, and intact cells.

P-glycoprotein-mediated multidrug resistance can be reversed by the action of a group of compounds known as chemosensitizers. The interactions with P-glycoprotein of two novel hydrophobic peptide chemosensitizers (reversins 121 and 205) have been studied in model systems in vitro, and in a variety of MDR1-expressing intact tumor cells. The reversins bound to purified P-glycoprotein with high affinity (77-154 nM), as assessed by a quenching assay using fluorescently labeled purified protein. The peptides modulated P-glycoprotein ATPase activity in Sf9 insect cell membranes expressing human MDR1, plasma membrane vesicles from multidrug-resistant cells, and reconstituted proteoliposomes. Both peptides induced a large stimulation of ATPase activity; however, higher concentrations, especially of reversin 205, led to inhibition. This pattern was different from that of simple linear peptides, and resembled that of chemosensitizers such as verapamil. In both membrane vesicles and reconstituted proteoliposomes, 1-2 microM reversins were more effective than cyclosporin A at blocking colchicine transport. Reversin 121 and reversin 205 restored the uptake of [3H]daunorubicin and rhodamine 123 in MDR1-expressing cells to the level observed in the drug-sensitive parent cell lines, and also effectively inhibited the extrusion of calcein acetoxymethyl ester from intact cells. In cytotoxicity assays, reversin 121 and reversin 205 eliminated the resistance of MDR1-expressing tumor cells against MDR1-substrate anticancer drugs, and they had no toxic effects in MDR1-negative control cells. We suggest that peptides of the reversin type interact with the MDR1 protein with high affinity and specificity, and thus they may be good candidates for the development of MDR1-modulating agents to sensitize drug resistance in cancer.

Transport properties of P-glycoprotein in plasma membrane vesicles from multidrug-resistant Chinese hamster ovary cells.

Multidrug resistant (MDR) cells overexpress a 170-180 kDa membrane glycoprotein, the P-glycoprotein, which is believed to export drugs in an ATP-dependent manner. Plasma membrane vesicles from the MDR CHRC5 cell line, but not the AuxB1 drug-sensitive parent, showed uptake of [3H]colchicine and [3H]vinblastine that was stimulated by the presence of ATP and an ATP-regenerating system. Steady-state uptake of drugs was achieved by 10 min and was stable for greater than 30 min. Non-hydrolysable ATP analogues were unable to support drug uptake, indicating that ATP hydrolysis is essential for transport. ATP-stimulated drug uptake appeared to result from drug transport into inside-out vesicles, since uptake was osmotically sensitive and could be prevented by detergent permeabilization. Steady-state uptake was half-maximal at 100 microM colchicine and 200 nM vinblastine and was inhibited by a 10-100-fold excess of MDR drugs and chemosensitizers, in the order vinblastine greater than verapamil greater than daunomycin greater than colchicine. In addition to being vanadate-sensitive, drug uptake was inhibited by 10-200 microM concentrations of several sulfhydryl-modifying reagents, suggesting that cysteine residues play an important role in drug transport. Vesicular colchicine was rapidly exchanged by an excess of unlabelled drug, demonstrating that drug association is the net result of opposing colchicine fluxes across the membrane.

Complex Interplay between the P-Glycoprotein Multidrug Efflux Pump and the Membrane: Its Role in Modulating Protein Function

Multidrug resistance in cancer is linked to expression of the P-glycoprotein multidrug transporter (Pgp, ABCB1), which exports many structurally diverse compounds from cells. Substrates first partition into the bilayer and then interact with a large flexible binding pocket within the transporter’s transmembrane regions. Pgp has been described as a hydrophobic vacuum cleaner or an outwardly directed drug/lipid flippase. Recent X-ray crystal structures have shed some light on the nature of the drug-binding pocket and suggested routes by which substrates can enter it from the membrane. Detergents have profound effects on Pgp function, and several appear to be substrates. Biochemical and biophysical studies in vitro, some using purified reconstituted protein, have explored the effects of the membrane environment. They have demonstrated that Pgp is involved in a complex relationship with its lipid environment, which modulates the behavior of its substrates, as well as various functions of the protein, including ATP hydrolysis, drug binding, and drug transport. Membrane lipid composition and fluidity, phospholipid headgroup and acyl chain length all influence Pgp function. Recent studies focusing on thermodynamics and kinetics have revealed some important principles governing Pgp–lipid and substrate–lipid interactions, and how these affect drug-binding and transport. In some cells, Pgp is associated with cholesterol-rich microdomains, which may modulate its functions. The relationship between Pgp and cholesterol remains an open question; however, it clearly affects several aspects of its function in addition to substrate–membrane partitioning. The action of Pgp modulators appears to depend on their membrane permeability, and membrane fluidizers and surfactants reverse drug resistance, likely via an indirect mechanism. A detailed understanding of how the membrane affects Pgp substrates and Pgp’s catalytic cycle may lead to new strategies to combat clinical drug resistance.