Influence of quinidine on the binding of [³H]-ouabain and [³H]-digoxin by human lymphocytes

Summary

To explore the molecular basis of the glycoside-quinidine interaction, the in vitro effect of quinidine on the binding of [³H]-ouabain and [³H]-digoxin to Na⁺ K⁺ ATPase receptors on human mononuclear cells was investigated. The maximum [³H]-ouabain binding capacity was 45.7±9.4×10³ molecules/cell in pure lymphocyte preparations (n=8) and 75.5±7.3×10³ molecules/cell in mixtures of mononuclear cells (n=8). These parameters were not influenced by 10⁻⁵ M quinidine. In eight equilibrium experiments with pure lymphocytes, the dissociation constant of [³H]-ouabain increased from 0.79±0.26×10⁻⁸ M in the absence of 10⁻⁵ M quinidine to 1.56±0.74×10⁻⁸ M in its presence (p<0.01), indicating that the affinity of the drug was decreased. Similar findings were observed using mixed mononuclear cells. In five uptake and release experiments, quinidine decreased the association rate constant of [³H]-ouabain from 3.15±0.36×10⁴ M⁻¹×s⁻¹ to 2.01±0.37×10⁴ M⁻¹ s⁻¹ (p<0.01), whereas the dissociation rate constant was not affected. A therapeutic concentration of quinidine does not affect the number of glycoside receptors on lymphocytes, but it does appear to reduce fractional receptor occupancy by both [³H]-ouabain and [³H]-digoxin at lower tracer concentrations. This finding is compatible with the clinical observation that quinidine reduces the distribution volume of digoxin.