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Cerberin

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Cerberin
Chemical structure of cerberin
Names
IUPAC name
(3β,5β)-3-[(2-O-acetyl-6-deoxy-3-O-methyl-α-L-glucopyranosyl)oxy]-14-hydroxycard-20(22)-enolide
Other names
2'-Acetylneriifolin
Identifiers
3D model (JSmol)
ChEBI
ChemSpider
  • InChI=1S/C32H48O9/c1-17-26(35)27(37-5)28(40-18(2)33)29(39-17)41-21-8-11-30(3)20(15-21)6-7-24-23(30)9-12-31(4)22(10-13-32(24,31)36)19-14-25(34)38-16-19/h14,17,20-24,26-29,35-36H,6-13,15-16H2,1-5H3/t17-,20+,21-,22+,23-,24+,26-,27+,28-,29-,30-,31+,32-/m0/s1
    Key: UYQMTWMXBKEHJQ-IVHDSYOHSA-N
  • CC1C(C(C(C(O1)OC2CCC3(C(C2)CCC4C3CCC5(C4(CCC5C6=CC(=O)OC6)O)C)C)OC(=O)C)OC)O
Properties
C32H48O9
Molar mass 576.727 g·mol−1
Melting point 191 °C (376 °F)[1][needs update][better source needed]
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).

Cerberin is a type of cardiac glycoside, a steroidal class found in the seeds of the dicotyledonous angiosperm genus Cerbera; including the suicide tree (Cerbera odollam) and the sea mango (Cerbera manghas). This class includes digitalis-like agents, channel-blockers that as a group have found historic uses as cardiac treatments, but which at higher doses are extremely toxic; in the case of cerberin, consumption of the C. odollam results in poisoning with presenting nausea, vomiting, and abdominal pain, often leading to death. The natural product has been structurally characterized, its toxicity is clear—it is often used as an intentional human poison in third-world countries, and accidental poisonings with fatalities have resulted from individuals even indirectly consuming the agent—but its potentially therapeutic pharmacologic properties are very poorly described.

Structure and synonyms

Digitoxigenin, the cardenolide substructure of cerberin, with the tetracyclic array of all-carbon steroid rings at its core, to which is attached the butenolide-type, oxygen-containing lactone substituent.

Cerberin, like all cardiac glycosides, has as its core a steroid-type set of four carbocycles (all-carbon rings). In cerberin, this steroid core is connected, first, to a separate oxygen-containing lactone ring (shown here, upper right of box), and second, to a sugar substituent (shown in infobox structure, left of image).[2][subscription required]

There are two types of cardiac glycosides depending on the characteristics of the lactone moiety. Cerberin, with its five-membered ring, belongs to the cardenolide class;[2][subscription required] cardenolides are 23-carbon steroids with methyl groups at positions 10 and 13 of the steroid ring system, and the appended five-membered butenolide-type of lactone at C-17.[citation needed]

Many types of sugars can be attached to cardiac glycosides; in the case of cerberin, it is an O-acetylated derivative of α-L-thevetose, which is itself a derivative of L-glucose (6-deoxy-3-O-methyl-α-L-glucopyranose).[citation needed] The cardenolide substructure to which the sugar is attached has also been independently characterised, and can be referred to as digitoxigenin (see image), hence, cerberin is, synonymously, (L-2'-O-acetylthevetosyl)digitoxigenin. As well, the non-acetylated structure was independently discovered and named neriifolin, and so cerberin is, synonymously, 2'-acetylneriifolin.[citation needed]

Physical properties

Cerberin is soluble in chloroform, acetone, and, moderately, in water.[1][needs update][better source needed]

Toxicity

The literature on cerberin toxicity, per se, remains sparse; unless otherwise specifically indicated, the following is general information regarding cardiac glycoside toxicity, with an emphasis on information from cardenolides (i.e., steroid natural products bearing the same digitoxigenin substructure).

In poisoning situations, those who are poisoned by ingesting cardiac glycosides experience, within an hour, a variety of gastrointestinal and cardiac symptoms.[citation needed] For cerberin, these have been noted to include nausea, vomiting, and abdominal pain.[3][non-primary source needed] Forensic sources indicate presentations for cardiac toxin poisonings that additionally include burning sensations in the mouth, diarrhea, headache, dilated pupils, irregular beating of the heart, and drowsiness; coma and death most often eventually follow.[4][verification needed][better source needed] [5][verification needed][better source needed] There is no clear, reported correlation between the dose and mortality (see below); death often occurs after 3–6 hours.[3][non-primary source needed]

An historic, reported lethal dose of cerberin in dog is 1.8 mg/kg, and in cat 3.1 mg/kg; that is, it is very low.[1][needs update][better source needed] Hence, eating the core of a fruit from the tree is sufficient for a human to receive a lethal dose,[citation needed] and consumption of the raw leaves of related oleander species by vegans has resulted in death (see below).

There is significant evidence both from Cerbera and from related species, with regard to lethal poisonings;[3][non-primary source needed] tragic individual cases of Cerbera, Nerium (oleander), and related species[6] poisonings include direct and indirect, and intentional and unintentional cases.[3] In a recent tragic case of accidental poisoning, two vegans in Europe that were foraging for and ingesting wild plants died after consuming wild oleander.[7] In indirect cases, human consumption of crab, where the crustacean had earlier consumed plants producing cerberin or related cardenolides, fatalities are also known.[8][9]

The response of humans to cardiac glycosides in general often depends on the tissue, exposure time and the dose.[citation needed] These toxins act mainly on the heart, either directly or through the nerves. Because cerberin is structurally similar to other cardiac glycosides, its half-life may be of the same magnitude.[dubious – discuss][citation needed] Ouabain and digoxin have half-lives of ≈20 and ≈40 hours, respectively,[citation needed] hence, for these agents, a few days with constant dosing are required before a steady state concentration is reached in tissues.[dubious – discuss][citation needed] The concentration of a cardioactive agent at steady state is called the therapeutic plasma concentration; for digoxin this value, in ng/mL, lies in the low single digits.[citation needed]. When this value is exceeded, the dose can be toxic. even life-threatening.[citation needed] Because of the long half-lives of cardiac glycosides, days might pass before plasma concentrations decrease to safe levels.[citation needed] The therapeutic index of cardiac glycosides is ≈2;[citation needed] this is quite narrow, indicating that only a small dose is needed for the compound to be toxic.[10][better source needed]

There are reports that treatment with potassium ion can be used to counter the toxic effects of cerberin,[citation needed] and gastric lavage may also be applied.[citation needed] Even so, cases of direct and indirect poisoning often are fatal, even when the nature and source of the toxin are rapidly identified.[8][9][better source needed]

Metabolism

Very little is known about the metabolism of cerberin. For the related digoxin, another cardiac glycoside, it is in largest part excreted unchanged by the kidneys (60-80%), with the remaining mostly metabolised by the liver.[citation needed] The half-life for digoxin is 36–48 hours for people with a normal renal function and up to 6 days for people with a compromised renal function.[citation needed] This makes the renal function an important factor in the toxicity of digoxin and perhaps for cerberin as well.[11][full citation needed][page needed]

Mechanism of action

There is very little formal, modern published information on the mechanism of action of cerberin.

Cerberin, as a cardiac glycoside, is seen as binding to and inhibiting the cellular Na+/K+ -ATPase, because it binds to the alpha-subunit of the enzyme. This is the catalytic moiety. There are also a beta- and FXYD subunits. These two subunits influence the affinity of cerberin to Na+/K+ -ATPase. The expression of the beta- and FXYD-subunit is tissue-specific. Because of this, cerberin will have different effects in different tissues. When cerberin binds to the Na+/K+-ATPase the conformation of the enzyme changes. This will lead to the activation of signal transduction pathways in the cell.[2][subscription required] A detailed description of the effects of cerberin in the cell is given below.

Na+/K+-ATPase pump

Na+/K+-ATPase is an ion transport system of sodium and potassium ions and requires energy. It is often used in many types of cellular systems. Sodium ions move out of the cell and potassium ions enter the cell (3:2) with the aid of this pump. During the transport of these ions, the enzyme undergoes several changes in conformation. Including a phosphorylation and dephosphorylation step.[12][needs update][better source needed]

The transport of Na+ and K+ is important for cell survival. Cardiac glycosides, such as cerberin, alter the transport of ions against their gradient. Cerberin is able to bind to the extracellular part of the Na+/K+-ATPase pump and can block the dephosphorylation step. Due to this inhibition it is impossible to transport sodium and potassium across the membrane and results in raising intracellular concentration of Na+.

Na+/Ca2+-exchanger

Accumulation of intracellular sodium ions cause an increase of intracellular calcium. This is because the calcium-sodium exchange pump’s activity decreases. The calcium-sodium exchange pump exchanges Ca2+ and Na+ without the use of energy.[13][needs update][better source needed] This exchanger is essential for maintaining sodium and calcium homeostasis. The exact mechanism by which this exchanger works is unclear. It is known that calcium and sodium can move in either direction across the membrane of muscle cells. It is also known that three sodium ions are exchanged for each calcium and that an increase in intracellular sodium concentration through this exchange mechanism leads to an increase in intracellular calcium concentration. As intracellular sodium increases, the concentration gradient driving sodium into the cell across the exchanger is reduced. As a result, the activity of the exchanger is reduced, which decreases the movement of calcium out of the cell.[citation needed]

Thus by inhibiting the Na+/K+-ATPase, cardiac glycosides cause intracellular sodium concentration to increase. This leads to an accumulation of intracellular calcium via the Na+/Ca2+-exchange system with the following effects:

  • In the heart, increased intracellular calcium causes more calcium to be released, thereby making more calcium available to bind to troponin-C, which increases contractility (inotropy).
  • Inhibition of the Na+/K+-ATPase in vascular smooth muscle causes depolarization, which causes smooth muscle contraction.[citation needed]

The conformational change of Na+/K+-ATPase plays not only a role in the contraction of muscles, but also in cell growth, cell motility and apoptosis. Due to de binding of cerberin, specific second messengers can be activated. After a cascade of cellular interactions nuclear transcription factors binds to the DNA and new enzymes will be made. This enzymes can for example play a role in cell proliferation.[2][subscription required]

Efficacy

There is very little formal, modern published information on the pharmacological actions of cerberin. One primary source reports that its ingestion results in electrocardiogram (ECG) changes, such as various types of bradycardia (e.g., sinus bradycardia), AV dissociation, and junctional rhythms; second-degree sinoatrial block and nodal rhythm are also described.[3][non-primary source needed]

In the case of digitalis administration, ST depression or T wave inversion may occur without indicating toxicity; however, PR interval prolongation indicate toxicity.[14][non-primary source needed]

Therapeutic uses

Main article: Digitalis § Cardiac

There are no clearly established therapeutic uses of the title compound, cerberin. Digitalis compounds, related cardiac glycosides, function through the inhibition of the Na+/K+-ATPase-pump,[2][subscription required] and have been widely used for in the treatment of chronic heart failure and arrhythmias; although newer and more efficacious treatments for heart failure are available, digitalis compounds are still used.[citation needed] Some cardiac glycosides have been shown to have antiproliferative and apoptotic effects, and are therefore of interest as potential agents in cancer chemotherapy;[2][subscription required] there is a single report to date of possible antiproliferative activity of cerberin.[15][16]

Further reading

  • Carlier J., Guitton J., Bévalot F., Fanton L. & Gaillard Y., 2014, "The principal toxic glycosidic steroids in Cerbera manghas L. seeds: identification of cerberin, neriifolin, tanghinin and deacetyltanghinin by UHPLC-HRMS/MS, quantification by UHPLC-PDA-MS," J. Chromatogr. B Analyt. Technol. Biomed. Life Sci. 962:1-8, PMID 24878878, see [6], accessed 18 June 2015.
  • Cheenpracha S., Karalai C., Rat-A-Pa Y., Ponglimanont C. & Chantrapromma K., 2004, "New cytotoxic cardenolide glycoside from the seeds of Cerbera manghas," Chem. Pharm. Bull. (Tokyo) 52(8):1023-1025, PMID 15305009, see [7], accessed 18 June 2015.

References

  1. ^ a b c Chopra R.N. & I.C. Chopra, 1933 [Third reprint, 2006], "Indigenous Drugs Of India," pp. 316-318, Kolkata, India:Academic Publishers, ISBN 818508680X, see [1], accessed 18 June 2015.[needs update][better source needed]
  2. ^ a b c d e f Prassas, I.; Diamandis, E. P. (2008). "Novel of therapeutic applications of cardiac glycosides". Nature reviews. 7 (11): 926–930. doi:10.1038/nrd2682. PMID 18948999.[subscription required]
  3. ^ a b c d e Gaillarda, Y.; Krishnamoorthyb, A.; Bevalot, F. (12 August 2004). "Cerbera odollam: a 'suicide tree' and cause of death in the state of Kerala, India". Journal of Ethnopharmacology. 95 (2–3): 123–126. doi:10.1016/j.jep.2004.08.004. PMID 15507323.[non-primary source needed]
  4. ^ Nageshkumar G. Rao, 1999, Textbook of Forensic Medicine and Toxicology, pp. 425-434, New Delhi, DL, IND:Jaypee Brothers Medical Publishers, ISBN 8171797350, see [2], accessed 22 June 2015. [Note, relevant content not available online.][verification needed][better source needed]
  5. ^ Krishan Vij, 1999, "Cardiac Poisons (Ch. 42)," in Textbook of Forensic Medicine and Toxicology: Principles and Practice, 5th Edn., pp. 529-530, Gurgaon, HR, IND:Elsevier India, ISBN 8131226840, see [3], accessed 22 June 2015. [Note, relevant content not available online.][verification needed][better source needed]
  6. ^ Members of family Apocynaceae that contain cardiac glycosides include the genera Acokanthera, Apocynum, Cerbera, Nerium, Thevetia, and Strophanthus.[citation needed]
  7. ^ Papi L., Luciani A.B., Forni D. & Giusiani M., 2012, "Unexpected double lethal oleander poisoning," Am. J. Forensic Med. Pathol. 33(1):93-7, DOI 10.1097/PAF.0b013e31822d33d4, see [4], accessed 22 June 2015.
  8. ^ a b Maillaud, C., S. Lefebvre, C. Sebat, Y. Barguil, P. Cabalion, M. Cheze, E. Hnawia, M. Nour, and F. Durand. “Double Lethal Coconut Crab (Birgus Latro L.) Poisoning.” Toxicon 55.1 (2010): 81-86.
  9. ^ a b Maillaud, C., Y. Barguil, M. Mikulski, M. Cheze, C. Pivert, M. Deveaux, and F. Lapostolle. “First Successful Curative Use of Digoxin-specific Fab Antibody Fragments in a Life-threatening Coconut Crab (Birgus Latro L.) Poisoning.” Toxicon 60.6 (2012): 1013-017.
  10. ^ Becker, D.E. (2007). "Drug therapy in dental practice: general principles. Part 2 - pharmacodynamic considerations". Anesthesia Progress. 54 (1): 19–24. doi:10.2344/0003-3006(2007)54[19:DTIDPG]2.0.CO;2. PMC 1821133. PMID 17352523.[better source needed]
  11. ^ Timbrell, J. A. (2009). Principles of biochemical toxicology.[full citation needed][page needed]
  12. ^ Godfraind, T. (1984). "Mechanism of action of cardiac glycosides". European heart Journal. 5 Suppl F: 303–308. doi:10.1093/eurheartj/5.suppl_f.303. PMID 6099806.[needs update][better source needed]
  13. ^ Fozzard, H. A.; Sheets, M. F. (1985). "Cellular mechanism of action of cardiac glycosides". Journal of the American College of Cardiology. 5 (5 Suppl A): 10A–15A. doi:10.1016/s0735-1097(85)80458-7. PMID 2580874.[needs update][better source needed]
  14. ^ Doering W, König E, Sturm W (1977). "Digitalisintoxikation: Wertigkeit klinischer und electrokardiographischer Befunde im Vergleich zur Digoxinkonzentration im Serum. 1. Teil: Patienten mit Digitalisinduzierten Rhythmusstörungen". Zeitschrift für Kardiologie (in German). 66 (3): 121–128. PMID 857452. {{cite journal}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)[non-primary source needed]
  15. ^ Laphookhieo, S., Cheenpracha, S., Karalai, C., Chantrapromma, S., Rat-a-Pa, T., Ponglimanont, C. & Chantrapromma, K., 2004, Cytotoxic cardenolide glycoside from the seeds of Cerbera odollam. Phytochemistry 65, 507–510.
  16. ^ Robert A. Newman, Peiying Yang, Alison D. Pawlus & Keith I. Block, 2008, "Cardiac Glycosides as Novel Cancer Therapeutic Agents," Mol. Interv. 8:36-49; DOI 10.1124/mi.8.1.8, see [5], accessed 18 June 2015.
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