Inhibition of Pgp activity and cell cycle-dependent chemosensitivity to doxorubicin in the multidrug-resistant LoVo human colon cancer cell line

To determine whether the cell cycle affects multidrug resistance (MDR) and its reversal, doxorubicin (DOX) cytotoxicity and the effect of inhibition of P-glycoprotein (Pgp) activity by verapamil (VER) were investigated in MDR LoVo cell lines (LoVo-R) in different phases of the cell cycle. Synchronised cells were obtained by exposing cells for 24 h to non-toxic concentrations (40 nmol/1) of methotrexate (MTX), which induced a reversible blockade in the S phase. DOX cytotoxicity was higher if cells were exposed to DOX shortly after the pretreatment with MTX, when most cells were in the S phase of the cell cycle. At that tune, the DOX concentration inhibiting cell growth by 50% (icso) was decreased by approximately 4-fold compared to non-synchronised cycling cells. DOX cytotoxicity remained high during the transition from the S to the G2M phase, but was reduced when the cells had shifted to the G2M phase. Inhibition of Pgp activity by VER (6 umolA) enhanced DOX uptake and resulted in an intracellular nuclear compartmentalisation of DOX in LoVo-R cells. These effects were not significantly different (P = NS) in the different phases of the cell cycle. However, similar increases in intracellular DOX uptake due to the inhibitory effect of VER on Pgp greatly potentiated DOX cytotoxicity in LoVo-R cells synchronised in the S or G2M phase compared with non-synchronised cycling cells. The ratio between DOX ics in the absence and presence of VER in LoVo-R cells synchronised in the S phase and in cycling cells was 11.1 and 4.1, respectively (P<0.01). This greater potentiation could be explained by the increased chemosensitivity of the S- and G2M-phase cells to intracellular DOX concentration compared with the non-synchronised cells. Finally, the combination of synchronisation by MTX and of inhibition of Pgp activity by VER produced a considerable reduction in DOX icso (approximately 50-fold) in LoVo-R cells compared with the cells not treated with MTX and VER. In conclusion, this study demonstrates that, in LoVo-R cells, the effect of Pgp inhibition on DOX cytotoxicity is dependent on cell cycle phase. DOX cytotoxicity is maximal when inhibition of Pgp activity occurs during the S/G2M phases.