Abstract
Drug resistance as a remarkable issue in cancer treatment is associated with inflammation which occurs through complex chemical reactions in the tumor microenvironment. Recent studies have implicated that glucocorticoids and NSAIDs are mainly useful combinations for inflammatory response modulation in chemotherapeutic protocols for cancer treatment. Immunosuppressive actions of glucocorticoids and NSAIDs are mainly mediated by the transrepression or activation regulation of inflammatory genes with different DNA-bound transcription factors including AP-1, NFAT, NF-κB, STAT and also, varying functions of COX enzymes in cancer cells. Interestingly, many investigations have proved the benefits of these anti-inflammatory agents in the quenching of multidrug resistance pathways. Numerous analyses on the ABC transporter promoters showed conserved nucleotide sequences with several DNA response elements that participate in transcriptional regulation. Furthermore, genetic variations in nucleotide sequences of membrane transporters were strongly associated with changes in these transporters' expression or function and a substantial impact on systemic drug exposure and toxicity. It appeared that several polymorphisms in MDR transporter genes especially MDR1 have influenced the regulatory mechanisms and explained differences in glucocorticoid responses.
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Abbreviations
- ABC transporters:
-
ATP-binding cassette transporters
- ABCC:
-
ATP-binding cassette transporters sub-family C
- ABCA:
-
ATP-binding cassette transporters sub-family A
- ABCG:
-
ATP-binding cassette transporters sub-family G
- AC:
-
Adenylyl cyclase
- AP-1,2:
-
Activating protein-1 and 2
- BCRP:
-
Breast cancer resistance protein
- C/EBP:
-
CCAAT-enhancer-binding proteins
- COX:
-
Cyclooxygenase
- CRE:
-
CAMP response element
- CYP3A4:
-
Cytochrome P450 3A4
- ERE:
-
Estrogen response element
- FKBP51:
-
FK506 binding protein
- 5-FU:
-
5-Fluorouracil
- γ-GCSh:
-
γ-Glutamylcystein synthetase heavy subunit
- G-protein:
-
Guanosine triphosphate-binding proteins
- GRE:
-
Glucocorticoid response elements
- 11b-HSD1:
-
11B-hydroxysteroid dehydrogenase type 1
- HSE:
-
Heat shock element
- HSP:
-
Heat shock protein
- JAK:
-
Janus kinase
- JNK:
-
C-Jun N-terminal Kinase
- LOX:
-
Lipoxygenase
- MAPK:
-
Mitogen-activated protein kinase
- MDR:
-
Multi drug resistance
- MRP:
-
Multidrug-resistance-related protein
- nGRE:
-
Negative GRE
- NF-κB:
-
Nuclear factor-κB
- NSAIDs:
-
Nonsteroidal anti-inflammatory drugs
- P-gp:
-
P-glycoprotein
- PKC:
-
Protein kinase C
- PXR:
-
Pregnane X receptor
- PRE:
-
Progesterone response element
- ROS:
-
Reactive oxygen species
- RXR:
-
Retinoid X receptor
- SNP:
-
Single nucleotide polymorphism
- SP-1:
-
Specificity protein 1
- SP/KLF:
-
Specificity protein/Kruppel-like factor
- SRE:
-
Sterol regulatory element
- STAT:
-
Signal transducers and activators of transcription
- TdT:
-
Terminal deoxynucleotidyl transferase
- TNF-α:
-
Tumor necrosis factor-α
- TPA:
-
12-O-Tetradecanoylphorbol-13-acetate
- TSS:
-
Transcription start sites
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Acknowledgements
We would like to thank Professor M. Hashemzadeh (Department of Medical Genetics), Professor M. Ghatrehsamani (Department of Medical Immunology), and Bita Jafari (the graphic designer) for their valuable feedback and suggestions. We thank the anonymous reviewers for their thoughtful comments, which have helped improving the quality of the article.
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This work was supported by the Shahrekord University of Medical Sciences under Grant SKUMS-5204.
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Gholamian Dehkordi, N., Mirzaei, S.A. & Elahian, F. Pharmacodynamic mechanisms of anti-inflammatory drugs on the chemosensitization of multidrug-resistant cancers and the pharmacogenetics effectiveness. Inflammopharmacol 29, 49–74 (2021). https://doi.org/10.1007/s10787-020-00765-9
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DOI: https://doi.org/10.1007/s10787-020-00765-9