Bypassing P-Glycoprotein Drug Efflux Mechanisms: Possible Applications in Pharmacoresistant Schizophrenia Therapy

Table 3

Summarized list of polymer & surfactant P-gp inhibitors and their mechanism of action.

Polymer and surfactant based P-gp efflux inhibitors	Applications	References
Natural polymers:
Xanthan gum; Gellan gum; Alginates	Inhibition of the P-gp efflux transporter by the presence of polysaccharide d-mannose monomers, increasing concentration of substrates, for example, vinblastine and doxorubicin.	[65]
Synthetic polymers:
PEG 400; PEG-PEI; PEG 300	Changes the microenvironment of Caco-2 cell membranes, leading to modifications in membrane fluidity.	[65, 66]
Pluronic P85	Results in ATPase inhibition and ATPase reduction, as well as membrane fluidization.	[66, 68, 69]
Thiomers	Thiol groups interact with cysteine in the P-gp transmembrane channel, forming disulfide bonds. Thus the allosteric change blocks efflux.	[71]