microcirculationРегионарное кровообращение и микроциркуляцияRegional blood circulation and microcirculation1682-66552712-9756Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1682-6655-2016-15-1-11-26microcirculation-54Research ArticleОБЗОРЫREVIEWSКардиотонические стероиды: основные эффекты, терапевтические подходыCardiotonic steroids: main effects, therapeutic applicationsГригороваЮ. Н.GrigorovaYu. N.grigorovay@mail.nih.govБагровА. Я.BagrovA. Ya.bagrova@grc.nia.nih.govФедороваО. В.FedorovaO. V.fedorovo@mail.nih.govСеверо-Западный федеральный медицинский исследовательский центрРоссияFederal Almazov North-West Medical Research CentreRussian FederationNational Institute on Aging, National Institutes of Health, Baltimore, MD; Институт эволюционной физиологии и биохимии им. И.М. СеченоваРоссияNational Institute on Aging, National Institutes of Health, Baltimore, MD; Sechenov Institute of Evolutionary Physiology and Biochemistry of Russian Academy of SciencesRussian FederationNational Institute on Aging, National Institutes of Health, Baltimore, MDРоссияNational Institute on Aging, National Institutes of Health, Baltimore, MDRussian Federation2016300320161511126Copyright © Григорова Ю.Н., Багров А.Я., Федорова О.В., 20162016Григорова Ю.Н., Багров А.Я., Федорова О.В.Grigorova Y.N., Bagrov A.Y., Fedorova O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.microcirc.ru/jour/article/view/54

На протяжении последних 50 лет многочисленные исследования были направлены на поиски предполагемого натрийуретического гормона, обладающего свойствами дигиталисподобных веществ. К сегодняшнему дню эндогенные кардиотонические стероиды идентифицированы в плазме человека, грызунов и амфибий, а несомненность роли в регуляуции водно-электролитного баланса доказана. Обнаружение повышенного уровня МБГ в плазме при различных патологических состояниях, таких как артериальная гипертензия, хроническая почечная недостаточность, преэклампсия и хроническая сердечная недостаточность, поспособствовало продвижению исследований в направлении изучения вовлечения МБГ в патогенез вышеперечисленных заболеваний, а также биосинтеза МБГ. Было продемонстрировано, что, помимо основного натрийуретического эффекта, МБГ обладает вазоконстрикторными и профибротическими свойствами. Изучение патофизиологической роли МБГ в развитии сердечно-сосудистых заболеваний подтолкнуло исследователей к рассмотрению МБГ в качестве терапевтической мишени. В качестве основных подходов к терапии рассмотрены иммунонейтрализация МБГ моноклональными антителами, а также антагонистическое взаимодействие антагонистов альдостерона и МБГ. Дальнейшее изучение и идентификация механизмов действия и синтеза КТС позволяет расширить горизонты современной терапии.

For last few decades 'putative natriuretic hormone' have been considered as very important therapeutic target for developing novel therapies for cardiovascular diseases. The present review discusses the pathophysiological role of endogenous cardiotonic steroids with main focus on marinobufagenin (MBG). Recent studies has established that MBG plays a vital role in regulation of electrolyte homeostasis in humans and rodents. Additionally, it has been reported that elevated MBG plasma levels are associated with number of pathological states such as arterial hypertension, chronic kidney disease, preeclampsia and heart failure. It has been demonstrated that MBG-Na/K-ATPase interaction in kidneys regulates renal sodium excretion inducing natriuresis. Further, it has been reported that MBG-Na/K-ATPase interaction in vascular smooth muscle cells could induce vasoconstriction and cardiovascular fibrosis. Thus these facts have established MBG as a potential therapeutic target. Several therapies such as immunoneutralization of MBG with specific monoclonal antibodies and antagonism with aldosterone antagonists have already been proposed. Further studies providing understanding of pathophysiological implications of MBG and signaling pathways could contribute in establishing new therapies for cardiovascular diseases.

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The authors declare that there are no conflicts of interest present.