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. Author manuscript; available in PMC: 2014 Jun 1.
Published in final edited form as: Nano Today. 2013 Jun 10;8(3):313–331. doi: 10.1016/j.nantod.2013.04.006

Figure 2. Summary of the Proposed Cellular Mechanisms of Anthracycline NPs to Overcome MDR.

Figure 2

(1) NPs interact with or modify plasma membrane and therefore change the membrane structure and induce membrane permeability; (2) NPs do not enter cells; instead free drugs are released to plasma membrane and then diffuse into cells; (3) NPs directly interact with and inhibit P-gp; (4) NPs bypass, but do not inhibit P-gp; (5) NPs enter into cells via receptor-mediated endocytosis; (6) NPs enter into cells via endocytosis, phagocytosis, or micropinocytosis; (7) NPs down-regulate P-gp, MRP, BCL-2, and HSP-70; (8) NPs up-regulate BAX, p53, and caspase-3; (9) NPs generate ROS; (10) NPs deplete ATP; (11) Very small NPs enter into the nucleus; (12) NPs dysregulate mitochondrial function or activate mitochondrial independent apoptotic pathways.