Plant-derived cardiac glycosides: Role in heart ailments and cancer management

Biomed Pharmacother. 2016 Dec:84:1036-1041. doi: 10.1016/j.biopha.2016.10.030. Epub 2016 Oct 22.

Abstract

Cardiac glycosides, the cardiotonic steroids such as digitalis have been in use as heart ailment remedy since ages. They manipulate the renin-angiotensin axis to improve cardiac output. However; their safety and efficacy have come under scrutiny in recent times, as poisoning and accidental mortalities have been observed. In order to better understand and exploit them as cardiac ionotropes, studies are being pursued using different cardiac glycosides such as digitoxin, digoxin, ouabain, oleandrin etc. Several cardiac glycosides as peruvoside have shown promise in cancer control, especially ovary cancer and leukemia. Functional variability of these glycosides has revealed that not all cardiac glycosides are alike. Apart from their specific affinity to sodium-potassium ATPase, their therapeutic dosage and behavior in poly-morbidity conditions needs to be considered. This review presents a concise account of the key findings in recent years with adequate elaboration of the mechanisms. This compilation is expected to contribute towards management of cardiac, cancer, even viral ailments.

Keywords: Anticancer; Cardiac glycosides; Cardiovascular effect; Efficacy; Na-K-ATPase; Safety.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents, Phytogenic / adverse effects
  • Antineoplastic Agents, Phytogenic / therapeutic use*
  • Cardenolides / metabolism
  • Cardiac Glycosides / adverse effects
  • Cardiac Glycosides / therapeutic use*
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Enzyme Inhibitors / adverse effects
  • Enzyme Inhibitors / therapeutic use*
  • Heart Diseases / drug therapy*
  • Heart Diseases / enzymology
  • Heart Diseases / physiopathology
  • Humans
  • Neoplasms / drug therapy*
  • Neoplasms / enzymology
  • Neoplasms / pathology
  • Renin-Angiotensin System / drug effects
  • Saponins / metabolism
  • Sodium-Potassium-Exchanging ATPase / antagonists & inhibitors*
  • Sodium-Potassium-Exchanging ATPase / metabolism

Substances

  • Antineoplastic Agents, Phytogenic
  • Cardenolides
  • Cardiac Glycosides
  • Cardiovascular Agents
  • Enzyme Inhibitors
  • Saponins
  • digoxin-like factors
  • Sodium-Potassium-Exchanging ATPase