The role of glucuronidation in drug resistance

The final therapeutic effect of a drug candidate, which is directed to a specific molecular target strongly depends on its absorption, distribution, metabolism and excretion (ADME). The disruption of at least one element of ADME may result in serious drug resistance. In this work we described the ro...

Full description

Saved in:
Bibliographic Details
Published in:Pharmacology & therapeutics (Oxford) 2016-03, Vol.159, p.35-55
Main Authors: Mazerska, Zofia, Mróz, Anna, Pawłowska, Monika, Augustin, Ewa
Format: Article
Language:English
Subjects:
Anticholesteremic Agents - therapeutic use
Antihypertensive Agents - therapeutic use
Drug Resistance - physiology
Epilepsy - drug therapy
Epilepsy - metabolism
Glucuronosyltransferase - metabolism
HIV Infections - drug therapy
HIV Infections - metabolism
Humans
Hypertension - drug therapy
Hypertension - metabolism
Immunosuppressive Agents - therapeutic use
Mental Disorders - drug therapy
Mental Disorders - metabolism
Neoplasms - drug therapy
Neoplasms - metabolism
Osteoporosis - drug therapy
Osteoporosis - metabolism
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The final therapeutic effect of a drug candidate, which is directed to a specific molecular target strongly depends on its absorption, distribution, metabolism and excretion (ADME). The disruption of at least one element of ADME may result in serious drug resistance. In this work we described the role of one element of this resistance: phase II metabolism with UDP-glucuronosyltransferases (UGTs). UGT function is the transformation of their substrates into more polar metabolites, which are better substrates for the ABC transporters, MDR1, MRP and BCRP, than the native drug. UGT-mediated drug resistance can be associated with (i) inherent overexpression of the enzyme, named intrinsic drug resistance or (ii) induced expression of the enzyme, named acquired drug resistance observed when enzyme expression is induced by the drug or other factors, as food-derived compounds. Very often this induction occurs via ligand binding receptors including AhR (aryl hydrocarbon receptor) PXR (pregnane X receptor), or other transcription factors. The effect of UGT dependent resistance is strengthened by coordinate action and also a coordinate regulation of the expression of UGTs and ABC transporters. This coupling of UGT and multidrug resistance proteins has been intensively studied, particularly in the case of antitumor treatment, when this resistance is "improved" by differences in UGT expression between tumor and healthy tissue. Multidrug resistance coordinated with glucuronidation has also been described here for drugs used in the management of epilepsy, psychiatric diseases, HIV infections, hypertension and hypercholesterolemia. Proposals to reverse UGT-mediated drug resistance should consider the endogenous functions of UGT.
ISSN:0163-7258
1879-016X
DOI:10.1016/j.pharmthera.2016.01.009