Endogenous cardiotonic steroids (CTS), also called digitalis-like factors, have been postulated to play important roles in health and disease for nearly half a century. Recent discoveries, which include the specific identification of endogenous cardenolide (endogenous ouabain) and bufadienolide (marinobufagenin) CTS in humans along with the delineation of an alternative mechanism by which CTS can signal through the Na(+)/K(+)-ATPase, have increased the interest in this field substantially. Although CTS were first considered important in the regulation of renal sodium transport and arterial pressure, more recent work implicates these hormones in the regulation of cell growth, differentiation, apoptosis, and fibrosis, the modulation of immunity and of carbohydrate metabolism, and the control of various central nervous functions and even behavior. This review focuses on the physiological interactions between CTS and other regulatory systems that may be important in the pathophysiology of essential hypertension, preeclampsia, end-stage renal disease, congestive heart failure, and diabetes mellitus. Based on our increasing understanding of the regulation of CTS as well as the molecular mechanisms of these hormone increases, we also discuss potential therapeutic strategies.

中文翻译：

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内源性强心类固醇：生理学、药理学和新的治疗靶点。


内源性强心类固醇（CTS），也称为洋地黄样因子，近半个世纪以来一直被认为在健康和疾病中发挥着重要作用。最近的发现包括对人类内源性卡烯内酯（内源性哇巴因）和蟾蜍二烯内酯（marinobufagenin）CTS的特异性鉴定，以及CTS可以通过Na（+）/K（+）-ATP酶发出信号的替代机制的描述，大大增加了人们对该领域的兴趣。尽管 CTS 最初被认为在调节肾钠转运和动脉压方面很重要，但最近的研究表明这些激素参与细胞生长、分化、凋亡和纤维化的调节，免疫和碳水化合物代谢的调节，以及各种中枢神经功能甚至行为。本综述重点关注 CTS 与其他调节系统之间的生理相互作用，这些调节系统在原发性高血压、先兆子痫、终末期肾病、充血性心力衰竭和糖尿病的病理生理学中可能很重要。基于我们对 CTS 调节以及这些激素增加的分子机制的日益了解，我们还讨论了潜在的治疗策略。