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Review
. 2017 Jun 24;36(1):52.
doi: 10.1186/s40880-017-0219-2.

Autophagy and multidrug resistance in cancer

Ying-Jie Li  1 , Yu-He Lei  1 , Nan Yao  1 , Chen-Ran Wang  1 , Nan Hu  1 , Wen-Cai Ye  1 , Dong-Mei Zhang  2 , Zhe-Sheng Chen  3   4
Affiliations
Review

Autophagy and multidrug resistance in cancer

Ying-Jie Li et al. Chin J Cancer. .

Abstract

Multidrug resistance (MDR) occurs frequently after long-term chemotherapy, resulting in refractory cancer and tumor recurrence. Therefore, combatting MDR is an important issue. Autophagy, a self-degradative system, universally arises during the treatment of sensitive and MDR cancer. Autophagy can be a double-edged sword for MDR tumors: it participates in the development of MDR and protects cancer cells from chemotherapeutics but can also kill MDR cancer cells in which apoptosis pathways are inactive. Autophagy induced by anticancer drugs could also activate apoptosis signaling pathways in MDR cells, facilitating MDR reversal. Therefore, research on the regulation of autophagy to combat MDR is expanding and is becoming increasingly important. We summarize advanced studies of autophagy in MDR tumors, including the variable role of autophagy in MDR cancer cells.

Keywords: Autophagy; Cell death; Cell survival; Drug resistance; Neoplasms.

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Figures

Fig. 1
Fig. 1
Complicated mechanisms of multidrug resistance (MDR) in tumor. The main mechanism of MDR is overexpressing ATP-binding cassette (ABC) transporters to increase drug efflux, resulting in a decrease in intracellular drug concentration. Other mechanisms of MDR are reducing drug uptake by influx transporters, boosting drug metabolism, blocking apoptotic signaling pathways, elevating adaptability by epigenetic regulation and microRNA regulation, mutation in drug targets or feedback activation of other targets and signaling pathways, and change of tumor microenvironment. ABCB1, ATP-binding cassette subfamily B member 1; ABCG2, ATP-binding cassette subfamily G member 2; ABCC1, ATP-binding cassette subfamily C member 1; CYP450, cytochrome P450
Fig. 2
Fig. 2
Autophagy chemosensitizes MDR cancer cells to chemotherapeutics. A novel role of autophagy induced by certain autophagy inducers such as cysteamine, the nanocrystal of underivatized fullerene C60 (nano-C60) and its derivative was confirmed. Autophagy triggered by those inducers could sensitive MDR cancer cells to chemotherapeutics. PAS, pre-autophagosomal structure
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