Multidrug resistance is a crucial factor contributing to the failure of cancer treatment. Multidrug resistance protein 1 (MDR1) is the most relevant efflux transporter associated with multidrug resistance. The objective of this study was to identify potent MDR1 inhibitors from flavonols. Fifteen flavonols were identified as inhibitors of MDR1 in vitro, with four compounds exhibiting strong inhibitory activity, having IC50 values below 5 μM. These potent MDR1 inhibitors were found to enhance chemosensitivity to doxorubicin in MDR1-overexpressing cells. The results of the multiple-factor analysis indicated that the 3, 5, and 6-methoxy groups were crucial for enhancing the inhibitory effects on MDR1. Furthermore, the total number of methoxy groups in the flavonol backbone was found to be a significant factor in determining the potency of MDR1 inhibition. These observations provide fundamental insights into the structure-activity relationship between flavonol derivatives and MDR1 inhibition, potentially aiding in overcoming drug resistance in cancer.
Keywords: Multidrug resistance protein 1; doxorubicin; flavonols; multidrug resistance; multiple-factor analysis.