Multiple molecular mechanisms for multidrug resistance transporters

Multidrug resistance Most multidrug resistance mechanisms, for agents as diverse as antibiotics, antifungals, antimalarials, herbicides, and also for cancer chemotherapeutics in man, involve a transporter that pumps the drugs out of the cell. The archetypal such transporter, mammalian P-glycoprotein, has been subjected to extensive study for decades but it is only in the past few years that sufficient structural and biochemical data have emerged to give us a mechanistic understanding. Chris Higgins reviews current knowledge on the four major classes of multidrug transporter. Differences and similarities between the four are providing new insights into how multidrug resistance is achieved. This work has not yet solved pressing clinical problems, but may pave the way to strategies to beat or avoid multidrug resistance.