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. 2018 May 1;9:218. doi: 10.3389/fendo.2018.00218

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Copyright © 2018 Farrell and Reagan.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Proteasome inhibition resistance mechanisms. This mini-review discusses the many factors that contribute to proteasome inhibitor (PI) resistance in the bone marrow (BM). For example, there are genetic mutations that can lead to drug resistance, as well as soluble factors and cell–cell contact-mediated signals from an array of BM stromal cells that can cause PI resistance. Cells that can cause drug resistance include mesenchymal stem cells (MSCs), osteoblasts, osteocytes, cancer-associated fibroblasts (CAFs), and potentially BM adipocytes. Stress-mediated responses can also cause PI resistance.