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Wirkungsmechanismus der Herzglykoside

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Book cover Therapie mit Herzglykosiden

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Zusammenfassung

Der genaue Mechanismus der positiv inotropen Herzglykosidwirkung ist trotz intensiver Forschung in seinen Einzelheiten noch weitgehend unaufgeklärt. Auf der Suche nach den spezifischen Angriffspunkten der kardioaktiven Glykoside wurden Einflüsse vermutet bzw. nachgewiesen auf die Polymerisation des Aktins der Herzmuskelzelle [34], auf die physikochemischen Eigenschaften des Myosins [52], auf die Myosin-ATPase-Aktivität [35], auf die kontraktilen Eigenschaften von Aktomyosinpräparationen [70] oder auf das sarkoplasmatisch-retikuläre System der Herzmuskelzelle [14, 27]. Diese Untersuchungen waren aber entweder mit extrem hohen Herzglykosidkonzentrationen (> 10−5 mol/l) durchgeführt worden, oder sie ließen sich an entsprechenden Präparationen mit höherer Reinheit nicht reproduzieren (Übersichten s. [9, 41, 62, 69]). Tatsächlich sind im Laufe der Bemühungen, den primären Wirkort der Herzglykoside zu sichern, wohl alle subzellulären Systeme schon einmal mit diesen in geringsten Dosen wirksamen Pharmaka letztlich erfolglos in Verbindung gebracht worden. Als einziger, sicher reproduzierbarer primärer Angriffspunkt der kardioaktiven Steroide an der Zelle hat sich dabei das (Na+ + K+)-ATPase-System der Zellmembran erwiesen [1, 56]. Dieses von Skou [63] nachgewiesene, membrangebundene Enzymsystem stellt die biochemische Basis für den aktiven, gekoppelten transmembranären Na+ /K+ -Transport der Zellmembran dar [64].

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  1. Klinikum Großhadern, Medizinische Klinik I, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 8000, München 70, Deutschland

    Erland Erdmann

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Erdmann, E. (1983). Wirkungsmechanismus der Herzglykoside. In: Erdmann, E. (eds) Therapie mit Herzglykosiden. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69046-4_1

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  • DOI: https://doi.org/10.1007/978-3-642-69046-4_1

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