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On the Many Actions of Ouabain: Pro-Cystogenic Effects in Autosomal Dominant Polycystic Kidney Disease

Department of Molecular and Integrative Physiology, and The Kidney Institute, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA
Author to whom correspondence should be addressed.
Academic Editor: Robert Kiss
Molecules 2017, 22(5), 729;
Received: 15 March 2017 / Revised: 19 April 2017 / Accepted: 30 April 2017 / Published: 3 May 2017
(This article belongs to the Special Issue Cardiotonic Steroids)
PDF [1133 KB, uploaded 3 May 2017]


Ouabain and other cardenolides are steroidal compounds originally discovered in plants. Cardenolides were first used as poisons, but after finding their beneficial cardiotonic effects, they were rapidly included in the medical pharmacopeia. The use of cardenolides to treat congestive heart failure remained empirical for centuries and only relatively recently, their mechanisms of action became better understood. A breakthrough came with the discovery that ouabain and other cardenolides exist as endogenous compounds that circulate in the bloodstream of mammals. This elevated these compounds to the category of hormones and opened new lines of investigation directed to further study their biological role. Another important discovery was the finding that the effect of ouabain was mediated not only by inhibition of the activity of the Na,K-ATPase (NKA), but by the unexpected role of NKA as a receptor and a signal transducer, which activates a complex cascade of intracellular second messengers in the cell. This broadened the interest for ouabain and showed that it exerts actions that go beyond its cardiotonic effect. It is now clear that ouabain regulates multiple cell functions, including cell proliferation and hypertrophy, apoptosis, cell adhesion, cell migration, and cell metabolism in a cell and tissue type specific manner. This review article focuses on the cardenolide ouabain and discusses its various in vitro and in vivo effects, its role as an endogenous compound, its mechanisms of action, and its potential use as a therapeutic agent; placing especial emphasis on our findings of ouabain as a pro-cystogenic agent in autosomal dominant polycystic kidney disease (ADPKD). View Full-Text
Keywords: cardenolides; Na,K-ATPase; endogenous ouabain; polycystic kidney disease cardenolides; Na,K-ATPase; endogenous ouabain; polycystic kidney disease

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Venugopal, J.; Blanco, G. On the Many Actions of Ouabain: Pro-Cystogenic Effects in Autosomal Dominant Polycystic Kidney Disease. Molecules 2017, 22, 729.

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