“…Pgp inhibitory agents (in literature often termed overcoming agents or chemosensitizers) are a group of diverse, yet well characterized substances including calcium and sodium channel blockers, calmodulin antagonists, local anaesthetics, steroidal and structurally related compounds, immunosupressive agents, protein kinase inhibitors, flavonoids, detergents, indole alkaloids, macrolide compounds, methylxanthines derived from pentoxifylline, etc. [12,19,20,46,63,119,121,[146][147][148][149][150][151][152][153]. As reversers of P-gp-mediated MDR, these substances may act by different mechanisms: (i) direct interaction with the P-gp molecule at its ATP-binding site, drug binding sites or other loci that are critical for its transport function; (ii) modulation of expression of mdr genes encoding P-gp; (iii) modulation of P-gp activity by inhibition of its post-translational modifications (phosphorylation or glycosylation); (iv) indirect modulation of P-gp transport activities by other systems.…”