A newly synthesized 1,4-benzothiazipine derivate, 4-[3-(4-benzylpiperidin-1-yl)propionyl]-7-methoxy-2,3,4,5-tetrahydro-1, 4-benzothiazepine monohydrochloride (JTV-519) was examined for its ability to reverse P-glycoprotein (P-gp) and multidrug resistance protein 1 (MRP1) mediated multidrug resistance (MDR) in K562/MDR and KB/MRP cells, respectively. JTV-519 at 3 muM reversed the resistance of K562/MDR cells to vincristine (VCR), taxol, etoposide (VP16), adriamycin (ADM) and actimomycin D and at 0.5 or 1muM reversed their resistance to ST1571. JTV-519 at 10 muM enhanced the accumulation of ADM in K562/MDR cells to the level in parental K562 cells and inhibited the efflux of ADM from K562/MDR cells. Photoaffinity labeling of P-gp with H-3-azidopine was almost completely inhibited by 500 muM JTV-519. JTV-519 at 3 muM also partially reversed the resistance of KB/MRP cells to VCR and at 500 muM partially inhibited the photoaffinity labeling of MRPI with I-125-II-azidophenyl agosterol A (I-125-azidoAG-A). These results suggest that JTV-519 reversed the resistance to the anti-cancer agents in P-gp and MRP1 overexpressing multidrug-resistant cells by directly binding to P-gp and MRP1, and competitively inhibiting transport of the anti-cancer agents. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.