Endogenous digitalis: pathophysiologic roles and therapeutic applications.
Endogenous digitalis-like factors, also called cardiotonic steroids, have been thought for nearly half a century to have important roles in health and disease. The endogenous cardiotonic steroids ouabain and marinobufagenin have been identified in humans, and an effector mechanism has been delineated by which these hormones signal through the sodium/potassium-transporting ATPase. These findings have increased interest in this field substantially. Although cardiotonic steroids were first considered important in the regulation of renal sodium transport and arterial pressure, subsequent work has implicated these hormones in the control of cell growth, apoptosis and fibrosis, among other processes. This Review focuses on the role of endogenous cardiotonic steroids in the pathophysiology of essential hypertension, congestive heart failure, end-stage renal disease and pre-eclampsia. We also discuss potential therapeutic strategies that have emerged as a result of the increased understanding of the regulation and actions of cardiotonic steroids.
Bagrov
Alexei Y
AY
Hypertension Unit at Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, NIH, Baltimore 21224, MD, USA. bagrova@mail.nih.gov
Shapiro
Joseph I
JI
D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D004071:Digitalis Glycosides / Q000378:metabolism* / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000378:metabolism* / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000378:metabolism; D007674:Kidney Diseases / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D000254:Sodium-Potassium-Exchanging ATPase / Q000037:antagonists & inhibitors / Q000378:metabolism; D016896:Treatment Outcome
D004071:Digitalis Glycosides; D004791:Enzyme Inhibitors; D000254:Sodium-Potassium-Exchanging ATPase