Cardenolides: Insights from chemical structure and pharmacological utility

Pharmacol Res. 2019 Mar:141:123-175. doi: 10.1016/j.phrs.2018.12.015. Epub 2018 Dec 21.

Abstract

Cardiac glycosides (CGs) are a class of naturally occurring steroid-like compounds, and members of this class have been in clinical use for more than 1500 years. They have been used in folk medicine as arrow poisons, abortifacients, heart tonics, emetics, and diuretics as well as in other applications. The major use of CGs today is based on their ability to inhibit the membrane-bound Na+/K+-ATPase enzyme, and they are regarded as an effective treatment for congestive heart failure (CHF), cardiac arrhythmia and atrial fibrillation. Furthermore, increasing evidence has indicated the potential cytotoxic effects of CGs against various types of cancer. In this review, we highlight some of the structural features of this class of natural products that are crucial for their efficacy, some methods of isolating these compounds from natural resources, and the structural elucidation tools that have been used. We also describe their physicochemical properties and several modern biotechnological approaches for preparing CGs that do not require plant sources.

Keywords: Cardiac glycosides; Chemical property space; Heart failure; Isolation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / chemistry
  • Antineoplastic Agents / pharmacology
  • Cardenolides / chemistry*
  • Cardenolides / pharmacology*
  • Cardiovascular Agents / chemistry
  • Cardiovascular Agents / pharmacology
  • Diuretics / chemistry
  • Diuretics / pharmacology
  • Humans

Substances

  • Antineoplastic Agents
  • Cardenolides
  • Cardiovascular Agents
  • Diuretics