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Science 15 April 1983:
Vol. 220. no. 4594, pp. 325 - 327
DOI: 10.1126/science.6836275
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Articles

Science, Vol 220, Issue 4594, 325-327
Copyright © 1983 by American Association for the Advancement of Science

articles

Digoxin-inactivating bacteria: identification in human gut flora

Saha JR, VP Butler Jr, HC Neu, and J Lindenbaum

Digoxin, the most widely used cardiac glycoside, undergoes significant metabolic conversion in many patients to cardioinactive metabolites in which the lactone ring is reduced. This appears to occur within the gastrointestinal tract. An attempt was made to isolate and identify the organisms capable of reducing digoxin from stool cultures obtained from human volunteers. Of hundreds of isolates studied, only Eubacterium lentum, a common anaerobe of the human colonic flora, converted digoxin to reduced derivatives. Such organisms were also isolated in high concentrations from the stools of individuals who did not excrete these metabolites when given digoxin in vivo. When the growth of E. lentum was stimulated by arginine, inactivation of digoxin was inhibited. Neither the presence of these organisms alone nor their concentration within the gut flora appeared to determine whether digoxin would be inactivated by this pathway in vivo.


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Secretion of a Lactone-Hydrogenated Ouabain-Like Effector of Sodium, Potassium-Adenosine Triphosphatase Activity by Adrenal Cells.
H. M. A. M. Qazzaz, M. A. El-Masri, and R. Valdes Jr. (2000)
Endocrinology 141, 3200-3209
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Deglycosylated Products of Endogenous Digoxin-like Immunoreactive Factor in Mammalian Tissue.
H. M. A. M. Qazzaz, S. L. Goudy, and R. Valdes Jr. (1996)
J. Biol. Chem. 271, 8731-8737
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Lack of Acipimox-Digoxin Interaction in Patient Volunteers.
C. P. Chijioke, R. M. Pearson, and S. Benedetti (1992)
Human and Experimental Toxicology 11, 357-359
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