Active ingredients in Overcoming Multi-Drug Resistance
Pseudolaric acid B, a major active component of Pseudolarix kaempferi (Jinqiansong), reversed MDR in vitro and in vivo and induced apoptosis via cell cycle arrest at G2/M phase. In either resistant cell line or nude mice model, pseudolaric acid B circumvented MDR associated with Pgp over-expression (1). Salvinal, isolated from Salvia miltiorrhizae (Danshen), induced apoptosis and inhibited tubulin polymerization in various cancer cell lines, including the Pgp and MRP overexpressing MDR cells (2). A study on 22 compounds from CM herbs found that homoharringtonine, artesunate and bufalin from Cephalotaxus hainanensis (Hainancufei), Artemisia annua (Qinghao) and Bufo marinus, B. viridis (Chanchu) respectively exhibited active MDR modulation (3). Moreover, other compounds such as jatrorrhizine, indirubin, rhynchophylline (4), arsenic trioxide (5,6), psoralen (7,8), oridonin (9,10), b-elemene (11,12) also showed MDR reversal effects.

1. Wong VK, Chiu P, Chung SS, Chow LM, Zhao YZ, Yang BB, Ko BC: Pseudolaric acid B, a novel microtubule-destabilizing agent that circumvents multidrug resistance phenotype and exhibits antitumor activity in vivo. Clin Cancer Res 2005, 11(16):6002-6011.
2. Chang JY, Chang CY, Kuo CC, Chen LT, Wein YS, Kuo YH: Salvinal, a novel microtubule inhibitor isolated from Salvia miltiorrhizae bunge (Danshen), with antimitotic activity in multidrug-sensitive and -resistant human tumor cells. Mol Pharmacol 2004, 65(1):77-84.
3. Efferth T, Davey M, Olbrich A, Rücker G, Gebhart E, Davey R: Activity of drugs from traditional Chinese medicine toward sensitive and MDR1-or
MRP1-overexpressing multidrug-resistant human CCRF-CEM leukemia cells. Blood Cells Mol Dis 2002, 28(2):160-168.
4. Zhang HZ, Yang L, Ren LM, Liu SM: Drug screening for reversal of multidrug resistance in tumor cell from Chinese drug active compounds in vitro. J North China Coal Med Coll 2003, 5(3):265-267.
5. Li JW: Study progress in TCM for the multidrug-resistant reversing effect. Hebei J TCM 2007, 29(6):557-560. Chai et al. Chinese Medicine 2010, 5:26 http://www.cmjournal.org/content/5/1/26 Page 8 of 9
6. Yang SL, Pang J, Chen HP: Research progress in reversing MDR by Chinese medicine. J Hepatobiliary Surg 2008, 16(6):477-479.
7. Chang XH, Xiang Y, Huang SL: Review on revering multidrug resistance with Chinese herbs leukemia. J Bran Camp First Mil Med Univ 2004, 27(2):200-203.
8. Bao WL: Study progress in MDR reversal effect in Chinese medicine. Lishizhen Med Mater Med Res 2008, 19(12):2905-2907.
9. Song XR, Hou SX: Research progress in reversing multi-drug resistant in TCM. Zhongguo Zhong Yao Za Zhi 2005, 30(16):1300-1304.
10. Suen JL, Li CJ, Liang F, Liu JX: Thoughts in using TCM to reverse multidrug resistance. Chin Arch Trad Chin Med 2006, 24(4):736-737.
11. Liu LS, Tien JH, Shi ZM: Advances in research on reversing multidrug resistance of tumour. Trad Chin Med Res 2003, 16(1):43-45.
12. Ma Q, Zhang ZS: Research review in reversing MDR by TCM. J Hunan Coll TCM 2002, 22(4):70-72.

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