Gambogenic acid reverses P-glycoprotein mediated multidrug resistance in HepG2/Adr cells and its underlying mechanism

Gambogenic acid (GNA), an active ingredient isolated from Gamboge, which possesses diverse antitumor effects in vivo and vitro. Here we were mainly designed to understand the role of GNA in drug resistance in HepG2/Adr cells. The alteration of cytotoxic drugs IC50 was examined using the MTT method. Cell apoptosis and uptake of P-glycoprotein (P-gp) substrates were measured under a flow cytometry and fluorescence microscope, respectively. Moreover, the ATPase activity, the expression of P-gp and P-gp-related proteins were also investigated. Results of the MTT method indicated that GNA increased the chemosensitivity of doxorubicin (DOX) and paclitaxel (PTX) in the HepG2/Adr cells and promoted the cell apoptosis in the presence of DOX. Meanwhile, it was also increased the retention of P-gp substrates DOX and Rhodamine 123 (Rho-123) while did not affect the ATPase activity. Furthermore, the down-regulation of P-gp expression could be contributed to multidrug resistance (MDR) upon a reversal concentration of 0.8 μg/mL GNA. Mechanistically, the expression of P-gp was reduced by GNA may result from the inhibition of the NF-kB and MAPK pathway. Collectively, GNA could be a potential inhibitor to reverse P-gp-mediated MDR in liver cancer therapy.