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Cardiac glycoside

About: Cardiac glycoside is a research topic. Over the lifetime, 933 publications have been published within this topic receiving 20204 citations. The topic is also known as: cardiac glycosides.


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Journal Article
TL;DR: It is difficult to summarise when so much that has been said is tentative but it is probably fair to state that it is doubtful whether therapeutic doses of cardiac glycosides cause appreciable lowering of the internal potassium concentration.
Abstract: It is difficult to summarise when so much that has been said is tentative but it is probably fair to state that: 1) The cardiotonic effect is not primarily on the action potential mechanism or on the contractile mechanism but is on "excitation-contraction coupling." 2) The sensitivity to cardiac glycosides of the sodium and potassium transport mnechanism in the muscle membrane is sufficient for sodium and potassium transport to be affected by cardiac glycoskies in therapeutic concentrations. Nevertheless 3) it is doubtful whether therapeutic doses of cardiac glycosides cause appreciable lowering of the internal potassium concentration. A gain in sodiumn may occur. 4) A positive inotropic action is probably associated with increased uptake of calcium. 5) It is possible that the cardiotonic action of the cardiac glycosides is caused by interference with the removal or inactivation of the calcium that enters the muscle at each contraction. Such interference might be a primary effect of the cardiac glycoside or it might be secondary to a rise in the intracellular sodium concentration.

441 citations

Journal ArticleDOI
TL;DR: It is indicated that oatp2 may play an especially important role in the brain accumulation and toxicity of digoxin and in the hepatobiliary and renal excretion of cardiac glycosides from the body.
Abstract: A novel multispecific organic anion transporting polypeptide (oatp2) has been isolated from rat brain. The cloned cDNA contains 3,640 bp. The coding region extends over 1,983 nucleotides, thus encoding a polypeptide of 661 amino acids. Oatp2 is homologous to other members of the oatp gene family of membrane transporters with 12 predicted transmembrane domains, five potential glycosylation, and six potential protein kinase C phosphorylation sites. In functional expression studies in Xenopus laevis oocytes, oatp2 mediated uptake of the bile acids taurocholate (Km ≈ 35 μM) and cholate (Km ≈ 46 μM), the estrogen conjugates 17β-estradiol-glucuronide (Km ≈ 3 μM) and estrone-3-sulfate (Km ≈ 11 μM), and the cardiac gylcosides ouabain (Km ≈ 470 μM) and digoxin (Km ≈ 0.24 μM). Although most of the tested compounds are common substrates of several oatp-related transporters, high-affinity uptake of digoxin is a unique feature of the newly cloned oatp2. On the basis of Northern blot analysis under high-stringency conditions, oatp2 is highly expressed in brain, liver, and kidney but not in heart, spleen, lung, skeletal muscle, and testes. These results provide further support for the overall significance of oatps as a new family of multispecific organic anion transporters. They indicate that oatp2 may play an especially important role in the brain accumulation and toxicity of digoxin and in the hepatobiliary and renal excretion of cardiac glycosides from the body.

402 citations

Journal ArticleDOI
TL;DR: The discovery of ouabain as a new adrenal hormone affecting Na(+) metabolism and the development of the new ouABain antagonist PST 2238 allows for new possibilities for the therapy of hypertension and congestive heart failure.
Abstract: The search for endogenous digitalis has led to the isolation of ouabain as well as several additional cardiotonic steroids of the cardenolide and bufadienolide type from blood, adrenals, and hypothalamus. The concentration of endogenous ouabain is elevated in blood upon increased Na(+) uptake, hypoxia, and physical exercise. Changes in blood levels of ouabain upon physical exercise occur rapidly. Adrenal cortical cells in tissue culture release ouabain upon addition of angiotensin II and epinephrine, and it is thought that ouabain is released from adrenal cortex in vivo. Ouabain levels in blood are elevated in 50% of Caucasians with low-renin hypertension. Infusion over several weeks of low concentrations of ouabain, but not of digoxin, induces hypertension in rats. A digoxin-like compound, which has been isolated from human urine and adrenals, as well various other endogenous cardiac glycosides may counterbalance their actions within a regulatory framework of water and salt metabolism. Marinobufagenin, for instance, whose concentration is increased after cardiac infarction, may show natriuretic properties because it inhibits the alpha1 isoform of Na(+)/K(+)-ATPase, the main sodium pump isoform of the kidney, much better than other sodium pump isoforms. In analogy to other steroid hormones, cardiotonic steroid hormones in blood are bound to a specific cardiac glycoside binding globulin. The discovery of ouabain as a new adrenal hormone affecting Na(+) metabolism and the development of the new ouabain antagonist PST 2238 allows for new possibilities for the therapy of hypertension and congestive heart failure. This will lead in turn to a better understanding of the disease on a physiological and endocrinological level and of the action of ouabain on the cellular level as a signal that is transduced to the plasma membrane as well as to the cell nucleus.

378 citations

Journal ArticleDOI
TL;DR: A crystal structure of Na+,K+-ATPase with bound ouabain, a representative cardiac glycoside, at 2.8 Å resolution in a state analogous to E2·2K+·Pi is described, indicating that the binding site for ouABain is essentially the same.
Abstract: The sodium-potassium pump (Na(+),K(+)-ATPase) is responsible for establishing Na(+) and K(+) concentration gradients across the plasma membrane and therefore plays an essential role in, for instance, generating action potentials. Cardiac glycosides, prescribed for congestive heart failure for more than 2 centuries, are efficient inhibitors of this ATPase. Here we describe a crystal structure of Na(+),K(+)-ATPase with bound ouabain, a representative cardiac glycoside, at 2.8 A resolution in a state analogous to E2.2K(+).Pi. Ouabain is deeply inserted into the transmembrane domain with the lactone ring very close to the bound K(+), in marked contrast to previous models. Due to antagonism between ouabain and K(+), the structure represents a low-affinity ouabain-bound state. Yet, most of the mutagenesis data obtained with the high-affinity state are readily explained by the present crystal structure, indicating that the binding site for ouabain is essentially the same. According to a homology model for the high affinity state, it is a closure of the binding cavity that confers a high affinity.

307 citations

Journal ArticleDOI
TL;DR: Results suggest that digoxin binds with the phosphorylated conformation of the enzyme, and the mechanism of digoxin inhibition of the ATPase is explained by the stability of the digoxin-intermediate complex.

276 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20237
20227
202115
202017
201917
201812