title: Ouabain attenuates cardiotoxicity induced by other cardiac steroids.
abstract: OBJECTIVE
  All cardiac steroids have a similar structure, bind to and inhibit the ubiquitous transmembrane protein Na(+), K(+)-ATPase and increase the force of contraction of heart muscle. However, there are diverse biological responses to different cardiac steroids both at the cellular and at the molecular level. Moreover, we have recently shown that ouabain inhibits digoxin- and bufalin-induced changes in membrane traffic. The present study was designed to test the hypothesis that ouabain also has an inhibitory effect on cardiotoxicity induced by other cardiac steroids.
  
  
  METHODS
  The hypothesis was tested in isolated heart muscle preparations and in an in vivo model of cardiotoxicity in guinea pigs.
  
  
  RESULTS
  Ouabain at a low dose attenuated the toxicity induced by bufalin and digoxin in heart muscle preparations. In addition, ouabain at the low dose (91 ng.kg(-1).h(-1)), but not at a higher dose (182 ng.kg(-1).h(-1)), delayed the development of digoxin-induced (500 microg.kg(-1).h(-1)) cardiotoxicity in anaesthetized guinea pigs, as manifested by delayed arrhythmia and terminal ventricular fibrillation, as well as a reduced heart rate. In addition, as observed with ouabain, the phosphoinositide 3-kinase inhibitor wortmannin (100 microg.kg(-1).h(-1)) delayed the digoxin-induced arrhythmia in anaesthetized guinea pigs.
  
  
  CONCLUSIONS
  The present study demonstrates the inhibitory effect, probably through signal transduction pathways, of ouabain on digoxin- and bufalin-induced cardiotoxicity in guinea pigs. Further understanding of this phenomenon could be beneficial for increasing the therapeutic window for cardiac steroids in the treatment of chronic heart failure.
authors.affiliation: Department of Medical Neurobiology, Institute for Medical Research Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Nesher
authors.forename: U
authors.initials: U
authors.lastname: Shpolansky
authors.forename: N
authors.initials: N
authors.lastname: Viola
authors.forename: M
authors.initials: M
authors.lastname: Dvela
authors.forename: N
authors.initials: N
authors.lastname: Buzaglo
authors.forename: H
authors.initials: H
authors.lastname: Cohen Ben-Ami
authors.forename: H
authors.initials: H
authors.lastname: Rosen
authors.forename: D
authors.initials: D
authors.lastname: Lichtstein
mesh_terms: D000730:Androstadienes / Q000494:pharmacology; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000517:prevention & control; D002018:Bufanolides / Q000633:toxicity*; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000633:toxicity; D004077:Digoxin / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D006168:Guinea Pigs; D006339:Heart Rate / Q000187:drug effects; D008297:Male; D009206:Myocardium / Q000378:metabolism; D010042:Ouabain / Q000008:administration & dosage / Q000494:pharmacology*; D019869:Phosphatidylinositol 3-Kinases / Q000378:metabolism; D000081082:Phosphoinositide-3 Kinase Inhibitors; D015398:Signal Transduction / Q000187:drug effects; D000254:Sodium-Potassium-Exchanging ATPase; D014693:Ventricular Fibrillation / Q000139:chemically induced / Q000517:prevention & control; D000077191:Wortmannin
chemical_list: D000730:Androstadienes; D002018:Bufanolides; D002316:Cardiotonic Agents; D004077:Digoxin; D010042:Ouabain; D019869:Phosphatidylinositol 3-Kinases; D000081082:Phosphoinositide-3 Kinase Inhibitors; D000254:Sodium-Potassium-Exchanging ATPase; D000077191:Wortmannin; C022777:bufalin