Multidrug resistance (MDR) remains the primary issue in
cancer therapy, which is characterized by the overexpressed
P-glycoprotein (P-gp)-included efflux pump or the upregulated
anti-apoptotic proteins. In this study, a D-alpha-
tocopheryl poly (ethylene glycol 1000) succinate (
TPGS) and
hyaluronic acid (HA) dual-functionalized cationic
liposome containing a synthetic cationic
lipid, 1,5-dioctadecyl-N-histidyl-L-glutamate (HG2C18) was developed for co-delivery of a small-molecule chemotherapeutic
drug,
paclitaxel (PTX) with a chemosensitizing agent,
lonidamine (LND) to treat the MDR
cancer. It was demonstrated that the HG2C18
lipid contributes to the endo-lysosomal escape of the
liposome following internalization for efficient intracellular delivery. The
TPGS component was confirmed able to elevate the intracellular accumulation of PTX by inhibiting the P-gp efflux, and to facilitate the mitochondrial-targeting of the
liposome. The intracellularly released LND suppressed the intracellular
ATP production by interfering with the mitochondrial function for enhanced P-gp inhibition, and additionally, sensitized the MDR
breast cancer (MCF-7/MDR) cells to PTX for promoted induction of apoptosis through a synergistic effect. Functionalized with the outer HA shell, the
liposome preferentially accumulated at the
tumor site and showed a superior antitumor efficacy in the xenograft MCF-7/MDR
tumor mice models. These findings suggest that this dual-functional
liposome for co-delivery of a cytotoxic
drug and an MDR modulator provides a promising strategy for reversal of MDR in
cancer treatment.