Abstract. Multidrug resistance (MDR) to chemotherapy presents a major obstacle in the treatment of cancer patients, which directly affects the clinical success rate of cancer therapy. Current research aims to improve the efficiency of chemotherapy, whilst reducing toxicity to prolong the lives of cancer patients. As with good biocompatibility, high stability and drug release targeting properties, nanodrug delivery systems alter the mechanism by which drugs function to reverse MDR, via passive or active targeting, increasing drug accumulation in the tumor tissue or reducing drug elimination. Given the potential role of nanodrug delivery systems used in multidrug resistance, the present study summarizes the current knowledge on the properties of liposomes, lipid nanoparticles, polymeric micelles and mesoporous silica nanoparticles, together with their underlying mechanisms. The current review aims to provide a reliable basis and useful information for the development of new treatment strategies of multidrug resistance reversal using nanodrug delivery systems.
IntroductionAt present, chemotherapy remains the optimal choice for cancer therapy, and tumor multidrug resistance (MDR) is a major factor that reduces the efficacy of chemotherapy (1). MDR is a phenotype that tumor cells acquire, which confers resistance to certain chemotherapy drugs, as well as concurrent cross-resistance to additional antitumor drugs that have different structures or mechanisms of action (2,3). The complexity of MDR has impeded the study of reversal agents (3-5). In recent years, the application of nanotechnology for drug carrier design has resulted in the development of novel nanoparticle drug delivery systems that aim to reverse MDR (6-8). Inorganic nanodrug delivery systems, lipid-based systems and polymer nanodrug delivery systems are the most common nanodrug delivery systems, which exhibit non-toxic, biocompatible and highly stable properties (8,9). The application of nanoparticle drug delivery systems is increasing due to their advantage of controlled and targeted drug release (9,10). Studies have demonstrated that entrapped small molecule drugs (10-200 nm in diameter) are more conducive to drug uptake and efflux; these nanodrug particles function via passive and active mechanisms, whereas in the systemic blood circulation they exhibit sustained release that subsequently enhances intracellular drug accumulation in tumor cells, yielding an improved effect (1,(11)(12)(13)(14). In the present review, the application of nanoparticle drug delivery systems in reversing the MDR of tumors is reviewed, which may provide an improved understanding of novel strategies for cancer therapy.
Applications of nanoparticle drug delivery systems for the reversal of multidrug resistance in cancer (Review)YINGHONG HUANG 1 , SUSAN P.C. COLE 2 , TIANGE CAI 3 , and YU CAI