Reduced
drug accumulation is the most common functional change accompanying development of
P-glycoprotein-associated multidrug resistance. One of our laboratories showed earlier that the
anthracycline analogue
4'-deoxy-4'-iododoxorubicin (
DIDOX) was accumulated to identical levels in
Ehrlich ascites tumor (EHR2) and
daunorubicin (DNR)-resistant EHR2/DNR+ cells (E. Friche, P. B. Jensen, T. Skovsgaard, and N. I. Nissen, J. Cell. Pharmacol., 1:57-65, 1990). In this communication, we show that weekly treatment of EHR2-bearing mice with 4, 8, or 12 mg of
DIDOX/kg/week led to the development of three
DIDOX-resistant cell lines, EHR2/
DIDOX-1, EHR2/
DIDOX-2, and EHR2/
DIDOX-3. The levels of
DIDOX accumulation and retention and its outward transport were similar in the
drug-sensitive and three
drug-resistant cell lines. By contrast, the accumulation of the active
DIDOX metabolite, 13-dihydro-DIDOX (13-OH-DIDOX), the parent compound
doxorubicin, and
daunorubicin were all decreased in proportion to the resistance of the cells. In EHR2/
DIDOX-3 cells, the reduction in
daunorubicin accumulation coincided with the development of
P-glycoprotein as demonstrated by Western blot and flow cytometry with C219 antibody.
DIDOX had no effect on the photolabeling of
P-glycoprotein by [3H]
azidopine, whereas 13-OH-DIDOX inhibited this labeling in a concentration-dependent manner. Subsequent analysis of
topoisomerase II activities and amounts in EHR2/
DIDOX-3 cells revealed decreased
DNA topoisomerase II catalytic activity. The amounts of immunoreactive
DNA topoisomerase II from EHR2/
DIDOX-1, EHR2/
DIDOX-2, and EHR2/
DIDOX-3 cells were about 89%, 73%, and 52%, respectively, of that seen in the
drug-sensitive cells. We also found that
teniposide stabilized
DNA-
protein complexes in EHR2/
DIDOX-3 but they never reached the level seen in EHR2 cells. Because it has been reported that
DIDOX is rapidly metabolized to 13-OH-DIDOX, we postulate that the development of resistance to
DIDOX in vivo is due in part to its metabolite, 13-OH-DIDOX, which is a substrate for plasma membrane
glycoprotein, and in part to
DIDOX, which is an inhibitor of
topoisomerase II.