The positive inotropic effect of
cardiac glycosides lies in their reversible inhibition on the membrane-bound Na(+)/K(+)-
ATPase in human myocardium.
Steroid-like compounds containing a core structure similar to
cardiac glycosides are found in many Chinese medicines conventionally used for promoting blood circulation. Some of them are demonstrated to be Na(+)/K(+)-
ATPase inhibitors and thus putatively responsible for their
therapeutic effects via the same molecular mechanism as
cardiac glycosides. On the other hand,
magnesium lithospermate B of danshen is also proposed to exert its cardiac
therapeutic effect by effectively inhibiting Na(+)/K(+)-
ATPase. Theoretical modeling suggests that the number of hydrogen bonds and the strength of hydrophobic interaction between the effective ingredients of various medicines and residues around the binding pocket of Na(+)/K(+)-
ATPase are crucial for the inhibitory potency of these active ingredients.
Ginsenosides, the active ingredients in ginseng and
sanqi, substantially inhibit Na(+)/K(+)-
ATPase when
sugar moieties are attached only to the C-3 position of their
steroid-like structure, equivalent to the
sugar position in
cardiac glycosides. Their inhibitory potency is abolished, however, when
sugar moieties are linked to C-6 or C-20 position of the
steroid nucleus; presumably, these
sugar attachments lead to steric hindrance for the entrance of
ginsenosides into the binding pocket of Na(+)/K(+)-
ATPase.
Neuroprotective effects of
cardiac glycosides, several
steroid-like compounds, and
magnesium lithospermate B against
ischemic stroke have been accordingly observed in a cortical brain slice-based assay model, and cumulative data support that effective inhibitors of Na(+)/K(+)-
ATPase in the brain could be potential drugs for the treatment of
ischemic stroke.