The expression of P-gp is regulated by various genetic and epigenetic mechanisms. The MDR1 gene, which encodes P-gp, can be upregulated through amplification, mutations, or transcriptional activation by various signaling pathways, including NF-κB and PI3K/AKT. Epigenetic modifications like DNA methylation and histone acetylation also play a role in modulating P-gp levels.
