digoxin and convallatoxin

Lily of the valley is a poisonous plant due to the presence of the cardiac glycoside convallatoxin which is known to interfere with serum digoxin measurement using the LOCI digoxin assay and other digoxin assays. We evaluated potential interference of convallatoxin as well as extract of lily of the valley with the ADVIA Centaur digoxin assay by comparing results obtained using the LOCI digoxin assay.. Aliquots of a drug-free serum pool and a digoxin serum pool were supplemented with nanograms to 1 μg quantities of convallatoxin or 1.0 and 2.5 μL of lily of the valley extract per milliliter of serum followed by measurement of digoxin concentrations using the LOCI and ADVIA Centaur digoxin assays.. Apparent digoxin concentrations were minimal using the ADVIA Centaur digoxin assay when aliquots of drug-free serum were supplemented with convallatoxin or extract of lily of the valley but apparent digoxin levels were very high using the LOCI digoxin assay. Moreover, minimal interference in serum digoxin measurement using the ADVIA Centaur digoxin assay was observed when aliquots of serum digoxin pool were further supplemented with lily of the valley extract. As expected, the LOCI digoxin assay showed significant interference of convallatoxin in serum digoxin measurement.. Significant interference of convallatoxin in serum digoxin measurement using the LOCI digoxin assay could be minimized using the ADVIA Centaur digoxin assay.

Topics: Convallaria; Digoxin; Drug Monitoring; Humans; Immunoassay; Plant Extracts; Reproducibility of Results; Strophanthins

Lily of the valley is a poisonous plant due to the presence of the cardiac glycoside convallatoxin. We compared two immunoassays (LOCI digoxin assay and iDigoxin assay) for rapid detection of convallatoxin if present in human serum.. Aliquots of a drug free serum pool and a digoxin serum pool were supplemented with microliter amounts of lily of the valley extract or nanogram to microgram quantities of convallatoxin, followed by measurement of apparent digoxin concentrations using the LOCI and iDigxoin assays.. Apparent digoxin concentrations were observed when aliquots of a drug free serum pool were supplemented with convallatoxin or lily of the valley extract using both assays but apparent digoxin concentrations were significantly higher using the iDigoxin assay. In addition, the interference of convallatoxin in serum digoxin measurement was also significantly higher using iDigxoin assay compared to the LOCI digoxin assay.. The iDigxoin assay is more sensitive in detecting convallatoxin in human serum.

Topics: Biological Assay; Cardiac Glycosides; Digoxin; Humans; Lilium; Sensitivity and Specificity; Strophanthins

Sodium taurocholate cotransporting polypeptide (NTCP) has been reported as a functional receptor for hepatitis B virus (HBV) infection. However, HBV could not efficiently infect HepG2 cells expressing NTCP (NTCP-HepG2 cells) under adherent monolayer-cell conditions. In this study, NTCP was mainly detected in the basolateral membrane region, but not the apical site, of monolayer NTCP-HepG2 cells. We hypothesized that non-adherent cell conditions of infection would enhance HBV infectivity. Non-adherent NTCP-HepG2 cells were prepared by treatment with trypsin and EDTA, which did not degrade NTCP in the membrane fraction. HBV successfully infected NTCP-HepG2 cells at a viral dose 10 times lower in non-adherent phase than in adherent phase. Efficient infection of non-adherent NTCP-HepG2 cells with blood-borne or cell-culture-derived HBV was observed and was remarkably impaired in the presence of the myristoylated preS1 peptide. HBV could also efficiently infect HepaRG cells under non-adherent cell conditions. We screened several compounds using our culture system and identified proscillaridin A as a potent anti-HBV agent with an IC50 value of 7.2 nM. In conclusion, non-adherent host cell conditions of infection augmented HBV infectivity in an NTCP-dependent manner, thus providing a novel strategy to identify anti-HBV drugs and investigate the mechanism of HBV infection.

Topics: Antiviral Agents; Bufanolides; Cell Adhesion; Digitoxin; Digoxin; Gene Expression; Hep G2 Cells; Hepatitis B virus; High-Throughput Screening Assays; Humans; Organic Anion Transporters, Sodium-Dependent; Phthalazines; Proscillaridin; Receptors, Virus; Simvastatin; Strophanthins; Symporters; Transgenes; Viral Envelope Proteins; Virus Internalization

Cardiac glycosides of plant origin are implicated in toxic ingestions that may result in hospitalization and are potentially lethal. The utility of commonly available digoxin serum assays for detecting foxglove and oleander ingestion has been demonstrated, but no studies have evaluated the structurally similar convallatoxin found in Convallaria majalis (lily of the valley) for rapid laboratory screening, nor has digoxin immune Fab been tested as an antidote for this ingestion.. We aimed to (1) evaluate multiple digoxin assays for cross-reactivity to convallatoxin, (2) identify whether convallatoxin could be detected in vivo at clinically significant doses, and (3) determine whether digoxin immune Fab could be an effective antidote to convallatoxin.. Cross-reactivities of purified convallatoxin and oleandrin with five common digoxin immunoassays were determined. Serum from mice challenged with convallatoxin was tested for apparent digoxin levels. Binding of convallatoxin to digoxin immune Fab was determined in vitro.. Both convallatoxin and oleandrin were detectable by a panel of commonly used digoxin immunoassays, but cross-reactivity was variable between individual assays. We observed measurable apparent digoxin levels in serum of convallatoxin intoxicated mice at sublethal doses. Convallatoxin demonstrated no binding by digoxin immune Fab.. Multiple digoxin immunoassays detect botanical cardiac glycosides including convallatoxin and thus may be useful for rapid determination of severe exposures, but neutralization of convallatoxin by digoxin immune Fab is unlikely to provide therapeutic benefit.

Topics: Animals; Animals, Outbred Strains; Cardenolides; Cardiotonic Agents; Convallaria; Cross Reactions; Digoxin; Dose-Response Relationship, Drug; Female; Immunoassay; Immunoglobulin Fab Fragments; Lethal Dose 50; Mice; Plant Poisoning; Poisoning; Strophanthins; Vasodilator Agents

Digitalis-like compounds (DLCs), such as digoxin and digitoxin that are derived from digitalis species, are currently used to treat heart failure and atrial fibrillation, but have a narrow therapeutic index. Drug-drug interactions at the transporter level are frequent causes of DLCs toxicity. P-glycoprotein (P-gp, ABCB1) is the primary transporter of digoxin and its inhibitors influence pharmacokinetics and disposition of digoxin in the human body; however, the involvement of P-gp in the disposition of other DLCs is currently unknown. In present study, the transport of fourteen DLCs by human P-gp was studied using membrane vesicles originating from human embryonic kidney (HEK293) cells overexpressing P-gp. DLCs were quantified by liquid chromatography-mass spectrometry (LC-MS). The Lily of the Valley toxin, convallatoxin, was identified as a P-gp substrate (Km: 1.1±0.2 mM) in the vesicular assay. Transport of convallatoxin by P-gp was confirmed in rat in vivo, in which co-administration with the P-gp inhibitor elacridar, resulted in increased concentrations in brain and kidney cortex. To address the interaction of convallatoxin with P-gp on a molecular level, the effect of nine alanine mutations was compared with the substrate N-methyl quinidine (NMQ). Phe343 appeared to be more important for transport of NMQ than convallatoxin, while Val982 was particularly relevant for convallatoxin transport. We identified convallatoxin as a new P-gp substrate and recognized Val982 as an important amino acid involved in its transport. These results contribute to a better understanding of the interaction of DLCs with P-gp.

Topics: Animals; ATP Binding Cassette Transporter, Subfamily B; Biological Transport; Brain; Cell Line; Digoxin; HEK293 Cells; Humans; Kidney Cortex; Male; Membrane Transport Proteins; Rats; Rats, Wistar; Strophanthins

Cardiac glycosides have been reported to exhibit cytotoxic activity against several different cancer types, but studies against colorectal cancer are lacking. In a screening procedure aimed at identifying natural products with activity against colon cancer, several cardiac glycosides were shown to be of interest, and five of these were further evaluated in different colorectal cancer cell lines and primary cells from patients. Convallatoxin (1), oleandrin (4), and proscillaridin A (5) were identified as the most potent compounds (submicromolar IC50 values), and digitoxin (2) and digoxin (3), which are used in cardiac disease, exhibited somewhat lower activity (IC50 values 0.27-4.1 microM). Selected cardiac glycosides were tested in combination with four clinically relevant cytotoxic drugs (5-fluorouracil, oxaliplatin, cisplatin, irinotecan). The combination of 2 and oxaliplatin exhibited synergism including the otherwise highly drug-resistant HT29 cell line. A ChemGPS-NP application comparing modes of action of anticancer drugs identified cardiac glycosides as a separate cluster. These findings demonstrate that such substances may exhibit significant activity against colorectal cancer cell lines, by mechanisms disparate from currently used anticancer drugs, but at concentrations generally considered not achievable in patient plasma.

Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Cardenolides; Colonic Neoplasms; Digitoxin; Digoxin; Drug Screening Assays, Antitumor; HT29 Cells; Humans; Irinotecan; NF-kappa B; Proscillaridin; Strophanthins

The investigation of active Na-K transport inhibition by mercury is difficult to perform in a cell because of the presence of numerous other membrane and intracellular proteins modifiable by mercury. Thus purified Na-K-adenosinetriphosphatase (ATPase) molecules performing active transport in an artificial membrane are required to demonstrate unequivocally the inhibition of active transport by mercury. We made use of a single population of Na-K-ATPase liposomes filled with ATP and Na to show mercury inhibition of active 86Rb transport mediated by both the inside-out and right-side-out pumps in the same liposome. The effect of HgCl2 on the Na-K-ATPase in cell-like and reversed orientation was measured in comparison with convallatoxin. A dilution series showed that 10 microM externally added HgCl2 inhibited the active 86Rb transport at the cytoplasmic side first; at 50 microM both pump populations were blocked, indicating either membrane permeation by HgCl2 and inhibition at the internal intracellular domains or onset of extracellular action at higher HgCl2 concentration. The results show that the metal-binding interface of Na-K-ATPase molecule is profoundly implicated in active ion transport and that the intracellular part of the Na-K-ATPase molecule presents the primary target for mercury action.

Topics: Biological Transport, Active; Calibration; Cell Membrane; Cytoplasm; Digoxin; Indicator Dilution Techniques; Intracellular Membranes; Liposomes; Mercury; Rubidium; Sodium-Potassium-Exchanging ATPase; Strophanthins

The authors estimated the influence of corglycon, strophanthin and digoxin on the central hemodynamics indices. Corglycon is recommended for use in urgent situations, while digoxin should be used for prophylactics of cardiac insufficiency.

Topics: Abdomen, Acute; Cardiac Glycosides; Digoxin; Heart Failure; Hemodynamics; Humans; Postoperative Care; Postoperative Complications; Strophanthins; Time Factors