Multi-drug resistance associated

Huai-Yun H, Secrest DT, Mark KS, Carney D, Elmquist WF, Miller W. Expression of multi-drug resistance-associated protein (MRP) in brain microvessel endothelial cells. Biochem Biophys Res Commun 1998 243 816-820. 

Figure 2.1 Hepatocyte basolateral bile acid transporters. Protein-bound bile acids returning in portal blood are taken up by the hepatocyte via the sodium taurocholate co-transporting polypeptide (NTCP) and organic-anion-transporting polypeptide (OATP). In cholestasis bile acids may be returned to blood by the multi-drug-resistance-associated protein 3 (MRP3).

Figure 2.3 Absorption of bile acids by the cholangiocyte in the cholehepatic shunt. Bile acids are absorbed at the apical membrane of the cholangioc5de by the apical sodium-dependent bile-acid transporter (ASBT) that causes cholehepatic shunting of bile acids back to the hepatocyte. Absorbed bile adds are exported across the basolateral membrane by multi-drug-resistance-associated protein 3 (MRP3), a truncated form of ASBT or by the het-eromeric organic solute (OST) a and p forms. Bile adds cause choleresis that is rich in bicarbonate ions secreted by the chloride/bicarbonate ion exchanger.

MRP s multi-drug resistance associated proteins family... 

Diestra JE, Scheffer GL, Catala II, Maliepaard M, Schellens JH, Scheper RJ, Germa-Lluch JR, Izquierdo MA. Frequent expression of the multi-drug resistance-associated protein BCRP/MXR/ABCP/ABCG2 in human tumours detected by the BXP-21 monoclonal antibody in paraffin-embedded material. J Pathol 2002 198 213-219. 

Multi-drug resistance associated protein (MRP), member of the ATP binding Cassette transporter proteins, is particularly involved in glutathione-conjugates detoxification. In human bronchial ciliated ceUs MRP mRNA immunostaining was observed at the basolateral plasma membrane (Br6-CHOT et al. 1997). 

Li Y, Revalde JL, Reid G, Paxton JW (2011) Modulatory effects of curcumin on multi-drug resistance-associated protein 5 in pancreatic cancer cells. Cancer Chemother Pharmacol 68 603-610... 

Kaufmann, A. M. Toro-Ramos, A. J. Krise, J. P. Assessment of Golgi apparatus versus plasma membrane-localized multi-drug resistance-associated protein 1. Mol Pharm. 2008, 5, 787-794. 

Treatment for septic patients with hospital-acquired, ventilator-acquired, and health care-associated pneumonia is dependent on risk factors for multi-drug resistant (MDR) organisms (Fig. 79-2). Recommended treatment for patients with no MDR risk factors are third-generation cephalosporins, fluoroquinolones, ampicillin-sulbactam, or ertapenem (see Table 79-3).35 Recommended treatment for patients with MDR risk factors are P-lactam/p-lactamase inhibitors (piperacillin-tazobactam), antipseudomonal cephalosporin, or carbapenem, plus an aminoglycoside, plus vancomycin or linezolid (see Table 79-3).35 If an aminoglycoside is undesirable, a antipseudomonal fluoroquinolone may be utilized with a P-lactam/p-lactamase inhibitor. 

This is known to be mediated in some instances by the multi-drug resistant gene (MDRl) producing the /J-glycoprotein, where /(-glycoprotein expression was associated with a decrease in intracellular IM levels and development of resistance (37). 

P-glycoprotein (P-gp) is an ATP-dependent drug efflux pump. In humans, P-gp is encoded by the multi-drug resistance gene (MDR-1) that is located on the long arm of chromosome 7. Overexpression of P-gp in neoplastic cells is associated with the phenomenon of multidrug resistance to chemotherapeutic agents... 

Papastavros T, Dolovich LR, Holbrook A, Whitehead L, Loeb M. Adverse events associated with Pyrazinamide and levofloxacin in the treatment of latent multi-drug resistant tuberculosis. CMAJ2002 167(2) 131-6. 

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