Effect of S9788, cyclosporin A and verapamil on intracellular distribution of THP-doxorubicin in multidrug-resistant K562 tumor cells, as studied by laser confocal microspectrofluorometry.

S9788 modulating resistance effect has been investigated on the activity of THP-DOX against multidrug-resistant K562R cells and compared to that of cyclosporin A and verapamil. Intracellular THP-DOX distribution and particulary its intranuclear concentration, with or without modulators, has been measured using confocal laser microspectrofluorometry. The kinetics of intranuclear accumulation of THP-DOX (1 microM in the medium), as a function of time, were rapid in K562S and K562R cells. Maximum accumulation of THP-DOX is reached in a few minutes (K562S, 400 microM; K562R, 40 microM). The addition of S9788, cyclosporin A and verapamil (5 microM) after one hour THP-DOX incubation, led to respectively 290, 250 and 114 microM. Uptake of THP-DOX was increased in K562R cells by a factor of 7 when S9788 was added. Results obtained on THP-DOX efflux from nuclei of K562S and K562R cells, after 3 hours of incubation without drug, showed a very short T1/2 (time corresponding to 50% decrease of intranuclear concentration of THP-DOX) in K562R cells (12 min) compared to that in K562S cells (150 min). The addition of S9788, cyclosporin A and verapamil (5 microM) led to a T1/2 of 90, 30 and 20 min respectively. The T1/2 of THP-DOX was increased in K562R cells by a factor of 7.5 when S9788 was added. We tried to correlate these results with those obtained in growth inhibition study. The IC50 (concentration which induces 50% growth inhibition) of THP-DOX, corresponding to one hour THP-DOX treatment and 3 days culture of K562S and K562R cells were respectively 230 and 7000 nM, and the RI (resistance index) value is 30. The addition of S9788, cyclosporin A and verapamil (5 microM), during the one hour treatment, led to an IC50 value of 350, 2000 and 5000 nM respectively. S9788 induced an IC50 value 20 times lower than without the modulator. Our study suggests that the higher activity of THP-DOX against K562R cells in the presence of S9788, compared to cyclosporin A and verapamil, is due to a higher intranuclear THP-DOX accumulation and to a strong decrease of drug efflux from K562R nuclei. This could be explained by a higher affinity of S9788 for membrane P-glycoprotein of K562R cells and/or an additional mechanism of action.