Cerberin

Last updated
Cerberin
Cerberin structure.svg
Names
IUPAC name
14-Hydroxy-5β-card-20(22)-enolid-3β-yl α-D-quinovopyranoside 2-acetate
Systematic IUPAC name
(2R,3S,4R,5S,6S)-5-Hydroxy-2-[(1R,3aS,3bR,5aR,7S,9aS,9bS,11aR)-3a-hydroxy-9a,11a-dimethyl-1-(5-oxo-2,5-dihydrofuran-3-yl)hexadecahydro-1H-cyclopenta[a]phenanthren-7-yl]-4-methoxy-6-methyloxan-3-yl acetate
Other names
2′-Acetylneriifolin
(3β,5β)-3-[(2-O-Acetyl-6-deoxy-3-O-methyl-α-L-glucopyranosyl)oxy]-14-hydroxycard-20(22)-enolide
Identifiers
3D model (JSmol)
ChEBI
ChemSpider
PubChem CID
UNII
  • 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 212 °C (414 °F) [1]
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 ). As a cardiac glycoside, cerberin disrupts the function of the heart by blocking its sodium and potassium ATPase. [2] Cerberin can be used as a treatment for heart failure and arrhythmia. [3]

Contents

Overconsumption of cerberin results in poisoning. Symptoms include nausea, vomiting, and bradycardia, often leading to death. [4] Cerberin containing plants such as Cerbera odollam have historically been used for suicide and homicide in their growth regions due to their high toxicity.

Structure and properties

Structure

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. DigitoxigeninInt.svg
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). [5]

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; [5] 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 slightly soluble in chloroform and methanol. It is white to pale yellow in color. [6]

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).

A 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. [7] However, toxicity in humans is variable. One study showed that with treatment, humans could survive dosages of 1/2 kernel 94% of the time, 1 kernel 92% of the time, 2 kernels 71% of the time, and 4 kernels 67% of the time. [8] Deaths were also variable when cerberin was used for trials by ordeal.

Symptoms

Those who ingest cerberin experience, within an hour, a variety of gastrointestinal and cardiac symptoms, particularly nausea, vomiting, abdominal pain, and bradycardia. [9] 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. [10] [11] There is no clear, reported correlation between the dose and mortality (see above); death often occurs after 3–6 hours. [9]

Poisonings

There is significant evidence from Cerbera with regard to lethal poisonings. [9] Individual cases of poisoning from Cerbera are documented including direct and indirect, and intentional and unintentional ingestion. [9] Cases of human fatalities from consumption of crab where the crustacean had earlier consumed plants producing cerberin or related cardenolides are known. [12] [13]

Aside from accidental poisoning, cerberin has also been used for suicide and homicide. For example, a 2004 study found that Cerbera odollam was responsible for an average of one suicide death per week between 1989 and 1999 in Kerala, India. It was also the cause of 50% of plant poisoning cases and 10% of all poisonings in that region. [14]

Cerberin is ideal for use as a poison because it is fast acting, its flavor is easy to mask when added to food, [15] and it is relatively undetectable because there is only one analytical test to determine its presence in tissues after death. [16]

Mechanism of action

The mechanism of action of cerberin from current understanding, based on the MOA of general cardiac glycosides. Cerberin mechanism of action.png
The mechanism of action of cerberin from current understanding, based on the MOA of general cardiac glycosides.

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. [5] 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. [17]

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. [18] 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:

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. [5] [subscription required]

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. [19]

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. [9]

In the case of digitalis administration, ST depression or T wave inversion may occur without indicating toxicity; however, PR interval prolongation indicate toxicity. [20]

Therapeutic uses

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, [5] 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; [5] there is a single report to date of possible antiproliferative activity of cerberin. [21] [22]

Further reading

Related Research Articles

<span class="mw-page-title-main">Cardiac glycoside</span> Class of organic compounds

Cardiac glycosides are a class of organic compounds that increase the output force of the heart and decrease its rate of contractions by inhibiting the cellular sodium-potassium ATPase pump. Their beneficial medical uses include treatments for congestive heart failure and cardiac arrhythmias; however, their relative toxicity prevents them from being widely used. Most commonly found as secondary metabolites in several plants such as foxglove plants and milkweed plants, these compounds nevertheless have a diverse range of biochemical effects regarding cardiac cell function and have also been suggested for use in cancer treatment.

<i>Digitalis</i> Genus of flowering plants in the family Plantaginaceae

Digitalis is a genus of about 20 species of herbaceous perennial plants, shrubs, and biennials, commonly called foxgloves.

<span class="mw-page-title-main">Sodium–potassium pump</span> Enzyme found in the membrane of all animal cells

The sodium–potassium pump is an enzyme found in the membrane of all animal cells. It performs several functions in cell physiology.

<span class="mw-page-title-main">Digoxin</span> Plant-derived medication

Digoxin, sold under the brand name Lanoxin among others, is a medication used to treat various heart conditions. Most frequently it is used for atrial fibrillation, atrial flutter, and heart failure. Digoxin is one of the oldest medications used in the field of cardiology. It works by increasing myocardial contractility, increasing stroke volume and blood pressure, reducing heart rate, and somewhat extending the time frame of the contraction. Digoxin is taken by mouth or by injection into a vein. Digoxin has a half life of approximately 36 hours given at average doses in patients with normal renal function. It is excreted mostly unchanged in the urine.

<span class="mw-page-title-main">Digitoxin</span> Chemical compound

Digitoxin is a cardiac glycoside used for the treatment of heart failure and certain kinds of heart arrhythmia. It is a phytosteroid and is similar in structure and effects to digoxin, though the effects are longer-lasting. Unlike digoxin, which is eliminated from the body via the kidneys, it is eliminated via the liver, and so can be used in patients with poor or erratic kidney function. While several controlled trials have shown digoxin to be effective in a proportion of patients treated for heart failure, the evidence base for digitoxin is not as strong, although it is presumed to be similarly effective.

<span class="mw-page-title-main">Hyperkalemia</span> Medical condition with excess potassium

Hyperkalemia is an elevated level of potassium (K+) in the blood. Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5 mmol/L defined as hyperkalemia. Typically hyperkalemia does not cause symptoms. Occasionally when severe it can cause palpitations, muscle pain, muscle weakness, or numbness. Hyperkalemia can cause an abnormal heart rhythm which can result in cardiac arrest and death.

<span class="mw-page-title-main">Ouabain</span> Chemical substance

Ouabain or also known as g-strophanthin, is a plant derived toxic substance that was traditionally used as an arrow poison in eastern Africa for both hunting and warfare. Ouabain is a cardiac glycoside and in lower doses, can be used medically to treat hypotension and some arrhythmias. It acts by inhibiting the Na/K-ATPase, also known as the sodium–potassium ion pump. However, adaptations to the alpha-subunit of the Na+/K+-ATPase via amino acid substitutions, have been observed in certain species, namely some herbivore- insect species, that have resulted in toxin resistance.

<i>Cerbera odollam</i> Species of tree

Cerbera odollam is a tree species in the family Apocynaceae commonly known as the suicide tree or pong-pong. It bears a fruit known as othalanga whose seeds yield a potent poison called cerberin that has been used for trials by ordeal, suicide, and poisonings.

The sodium-calcium exchanger (often denoted Na+/Ca2+ exchanger, exchange protein, or NCX) is an antiporter membrane protein that removes calcium from cells. It uses the energy that is stored in the electrochemical gradient of sodium (Na+) by allowing Na+ to flow down its gradient across the plasma membrane in exchange for the countertransport of calcium ions (Ca2+). A single calcium ion is exported for the import of three sodium ions. The exchanger exists in many different cell types and animal species. The NCX is considered one of the most important cellular mechanisms for removing Ca2+.

<i>Cerbera manghas</i> Species of plant

Cerbera manghas, commonly known as the sea mango, tangena or bintaro is a small evergreen coastal tree growing up to 12 metres (39 ft) tall. It is native to coastal areas in Africa, Asia, Australasia, and the Pacific islands. It is classified as one of the three species in the genus Cerbera that constitute mangroves.

<span class="mw-page-title-main">Cardenolide</span> Chemical compound

A cardenolide is a type of steroid. Many plants contain derivatives, collectively known as cardenolides, including many in the form of cardenolide glycosides (cardenolides that contain structural groups derived from sugars). Cardenolide glycosides are often toxic; specifically, they are heart-arresting. Cardenolides are toxic to animals through inhibition of the enzyme Na+/K+‐ATPase, which is responsible for maintaining the sodium and potassium ion gradients across the cell membranes.

k-Strophanthidin Chemical compound

k-Strophanthidin is a cardenolide found in species of the genus Strophanthus. It is the aglycone of k-strophanthin, an analogue of ouabain. k-strophanthin is found in the ripe seeds of Strophanthus kombé and in the lily Convallaria.

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<span class="mw-page-title-main">Oleandrin</span> Chemical compound

Oleandrin is a cardiac glycoside found in the poisonous plant oleander. As a main phytochemical of oleander, oleandrin is associated with the toxicity of oleander sap, and has similar properties to digoxin.

<span class="mw-page-title-main">Antiarin</span> Chemical compound

Antiarins are cardiac glycoside poisons produced by the upas tree. There are two closely related forms, α-antiarin and β-antiarin. The two share the same aglycone, antiarigenin, but differ in the sugar group that is attached to it.

<span class="mw-page-title-main">Convallatoxin</span> Chemical compound

Convallatoxin is a glycoside extracted from Convallaria majalis.

<span class="mw-page-title-main">Tangena</span> Madagascan tree species whose toxic nuts were used for trials by ordeal

The tangena ordeal was a form of trial by ordeal practiced in Madagascar to determine the guilt or innocence of an accused party. The trial utilized seeds of the tree species Cerbera manghas, which produces seeds that contain highly toxic cardiac glycosides including cerberin and tanghinin.

<span class="mw-page-title-main">Istaroxime</span> Chemical compound

Istaroxime is an investigational drug under development for treatment of acute decompensated heart failure

<span class="mw-page-title-main">Erythrophleine</span> Chemical compound

Erythrophleine is a complex alkaloid and ester of tricyclic diterpene acids derived from many of the plants in the genus erythrophleum. A highly toxic compound, it is most commonly known for its use in West African trials by ordeal. Exposure to erythrophleine can quickly lead to ataxia, dyspnea, heart paralysis, and sudden death. Visible effects of erythrophleine poisoning include induced terror, labored and irregular breathing, convulsions, urination, and vomiting.

<span class="mw-page-title-main">Calotropin</span> Chemical compound

Calotropin is a toxic cardenolide found in plants in the family Asclepiadoideae. In extreme cases, calotropin poisoning can cause respiratory and cardiac failure. Accidental poisoning is common in livestock who have ingested milkweed. Calotropin is commonly stored as a defense mechanism by insects that eat milkweeds as their main food source.

References

  1. ↑ "cerberin | 25633-33-4". ChemicalBook. Retrieved 5 May 2024.
  2. ↑ Botelho, Ana Flávia M.; Pierezan, Felipe; Soto-Blanco, Benito; Melo, Marília Martins (February 2019). "A review of cardiac glycosides: Structure, toxicokinetics, clinical signs, diagnosis and antineoplastic potential". Toxicon. 158: 63–68. doi:10.1016/j.toxicon.2018.11.429. PMID   30529380.
  3. ↑ "Cardiac glycoside overdose: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 5 May 2024.
  4. ↑ Gaillard, Yvan; Krishnamoorthy, Ananthasankaran; Bevalot, Fabien (December 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.
  5. 1 2 3 4 5 6 Prassas, I.; Diamandis, E. P. (2008). "Novel of therapeutic applications of cardiac glycosides". Nature Reviews Drug Discovery. 7 (11): 926–930. doi:10.1038/nrd2682. PMID   18948999. S2CID   14459328.
  6. ↑ "cerberin | 25633-33-4". ChemicalBook. Retrieved 5 May 2024.
  7. ↑ Chopra R.N. & I.C. Chopra, 1933 [Third reprint, 2006], "Indigenous Drugs Of India," pp. 316–318, Kolkata, India:Academic Publishers, ISBN   818508680X, see , accessed 18 June 2015.
  8. ↑ Menon, MSuraj; Kumar, Prasantha; Jayachandran, Ci (2016). "Clinical profile and management of poisoning with suicide tree: An observational study". Heart Views. 17 (4): 136–139. doi: 10.4103/1995-705X.201783 . PMC   5363088 . PMID   28400936.
  9. 1 2 3 4 5 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.
  10. ↑ Nageshkumar G. Rao, 1999, Textbook of Forensic Medicine and Toxicology, pp. 425-434, New Delhi, DL, IND:Jaypee Brothers Medical Publishers, ISBN   8171797350, see , accessed 22 June 2015.
  11. ↑ 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 , accessed 22 June 2015.
  12. ↑ Maillaud, C.; Lefebvre, S.; Sebat, C.; Barguil, Y.; Cabalion, P.; Cheze, M.; Hnawia, E.; Nour, M.; Durand, F. (2010). "Double Lethal Coconut Crab (Birgus Latro L.) Poisoning". Toxicon. 55 (1): 81–86. doi:10.1016/j.toxicon.2009.06.034. PMID   19591858.
  13. ↑ Maillaud, C.; Barguil, Y.; Mikulski, M.; Cheze, M.; Pivert, C.; Deveaux, M.; Lapostolle, F. (2012). "First Successful Curative Use of Digoxin-specific Fab Antibody Fragments in a Life-threatening Coconut Crab (Birgus Latro L.) Poisoning". Toxicon. 60 (6): 1013–017. doi:10.1016/j.toxicon.2012.06.017. PMID   22824321.
  14. ↑ Gaillard, Yvan; Krishnamoorthy, Ananthasankaran; Bevalot, Fabien (December 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.
  15. ↑ "'Suicide tree' toxin is 'perfect' murder weapon". New Scientist. Retrieved 5 May 2024.
  16. ↑ Gaillard, Yvan; Krishnamoorthy, Ananthasankaran; Bevalot, Fabien (December 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.
  17. ↑ 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.
  18. ↑ 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.
  19. ↑ Timbrell, J. A. (2009). Principles of biochemical toxicology.[ page needed ]
  20. ↑ 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" [Digitalis intoxication: specificity and significance of cardiac and extracardiac symptoms. part I: Patients with digitalis-induced arrhythmias (author's transl.)]. Zeitschrift für Kardiologie (in German). 66 (3): 121–128. PMID   857452.
  21. ↑ 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 (4): 507–510. Bibcode:2004PChem..65..507L. doi:10.1016/j.phytochem.2003.10.019. PMID   14759549.
  22. ↑ Newman, R. A.; Yang, P.; Pawlus, A. D.; Block, K. I. (2008). "Cardiac Glycosides as Novel Cancer Therapeutic Agents". Molecular Interventions. 8 (1): 36–49. doi:10.1124/mi.8.1.8. PMID   18332483.
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