Previously, we reported that repeated oral administration of etoposide (ETP) increases P-glycoprotein (P-gp) expression in association with activation of ezrin/radixin/moesin (ERM) via Ras homolog gene family member A (RhoA)/Rho-associated coiled-coil containing protein kinase (ROCK) signaling in the small intestine. However, the detailed mechanisms of this pathway have yet to be fully elucidated. Recently, phosphatidylinositol 4,5-bisphosphate [PtdIns(4,5)P2], one of the most abundant phosphoinositides in the plasma membrane, has attracted attention regarding its involvement in the plasma membrane localization of various membrane proteins. PtdIns(4,5)P2 is an essential factor in the dissociation and subsequent membrane translocation (activation) of ERM, and its synthetic pathway is known to be highly regulated by RhoA/ROCK signaling. Here, we examined the involvement of PtdIns(4,5)P2 in the mechanism by which ETP treatment increases small intestinal P-gp levels, and we determined which protein within ERM contributes to this phenomenon. Key words P-glycoprotein; radixin; phosphatidylinositol 4,5-bisphosphate (PtdIns(4,5)P2); Ras homolog gene family member A (RhoA); Rho-associated coiled-coil containing protein kinase (ROCK); small intestine We previously reported that repeated oral treatment with etoposide (ETP), an anticancer drug that is a substrate for Pglycoprotein (P-gp), 1) activates ezrin/radixin/moesin (ERM), which are scaffold proteins for P-gp in the small intestine.
2,3)Activated ERM may in turn increase P-gp expression in the plasma membrane of the small intestine under ETP treatment.2,3) ERM activation is regulated by Ras homolog gene family member A (RhoA) and Rho-associated coiled-coil containing protein kinase (ROCK) signaling, as demonstrated in our previous studies 2,3) and others. 4,5) In our reports we proposed the possibility that of the ERM proteins, radixin may contribute to the above phenomena more than ezrin or moesin 6)