Acquisition of multidrug resistance by L1210 leukemia cells decreases their tumorigenicity and enhances their susceptibility to the host immune response
It was the aim of this study to compare drug-resistant sublines of the murine P388 in relation to resistance markers, the resistant phenotype and immunogenicity. Resistance to drugs either belonging to the MDR type (Doxorubicin, Vincristine, Mitoxantrone) or to the non-MDR type (Methotrexate) was generated in vivo in order to mimic the clinical situation. All resistant sublines expressed the mdr1 gene and the p-glycoprotein determined on m-RNA level or immunohistochemically, while no expression was registered in the parent P388. The rhodamine 123 fluorescence as marker for the energy dependent drug efflux pump was decreased only in the MDR-sublines, while the parent P388 and the Methotrexate-resistant line retained 100% or 90% of the dye, respectively. This indicates that the rhodamine efflux is a more function-related marker for MDR than the mdr1 gene and the pgp. The in vivo characterization of the sublines as regards their sensitivity to cytostatics revealed a clear-cut cross-resistance to MDR drugs in the MDR-lines, while the Methotrexate resistant subline was only cross-resistant to Cytarabine. In each resistant subline collateral sensitivity to certain but different cytostatics was observed. Experiments to overcome resistance by concomitant treatment with the modulators Nifedipine, Verapamil, Cyclosporin A and Chloroquin led to only limited success. The sublines P388/Mitox, P388/Vinc and P388/MTX developed immunogenicity which was never registered in the original P388. Vaccination with lethally irradiated drug-resistant cells resulted in a substantial rejection of viable tumor cells of the same line. With the P388/Mitox and P388/Vinc also an over-cross immunization was possible. This generation of immunogenicity as a concomitant characteristic of resistance should be considered as therapeutic potential also in the treatment of clinical cancer.