2.1. Cardiac Glycosides and Their Activity
Cardiotoxins such as strophoside, cymarin and ouabain (
Figure 1) have been isolated from
S. kombe,
S. hispidus and
S. gratus, respectively [
3]. Many more of these so-called cardenolides are known; for introductory reading on their structures, biochemistry and pharmacology, see “Cardiac Glycosides 1785-1985” [
20] and review (with
S. kombe) [
21].
Cardenolides consist of steroid and sugar; only steroids containing 23 or 24 carbon atoms have cardiac activity [
3].
Figure 1 shows the prominent representative ouabain, which can be isolated from
S. gratus seeds. Like several members of this substance class, it is toxic when injected into the bloodstream, but not when given orally [
3] as a result of low absorption [
22]. Cardenolides can bind to and inhibit Na+/K+-ATPase causing the cardiotonic activity [
23]. For the aglykon of ouabain, ouabagenin (
Figure 1), it has also been shown that the oxysterol is a liver X receptor ligand [
24].
Glycoside composition in
Strophantus seeds is genetically determined as proven for four geographically separate chemical forms of
S. sarmentosus [
1,
25]. Exemplarily, sarmutoside and musaroside (from aglykon sarmutogenin) were isolated from two rare single plants in Senegal, which differed slightly in composition from the typical native
Strophantus representatives in that region [
26]. Differences in the cardenolide contents of
S. kombe seeds from Zimbabwe and Malawi were also reported [
27].
Analyses in
S. divaricus proved that cardenolides occur in different parts of the plant and that their concentrations there vary; most glycosides were isolated from the leaves in that study [
28]. Based on their seed glycosides,
Strophantus species were assigned to four groups [
1]:
ouabain group: S. gardeniiflorus, S. gratus, S. thollonii
sarmentogenin/sarverogenin group: S. welwitschii, S. amboensis, S. gerrardii, S. congoensis, S. petersianus, S. courmontii, S. sarmentosus
strophanthidin/strophanthidol/periplogenin group: S. arnoldianus, S. hispidus, S. mirabilis, S. barteri, S. hypoleucos, S. mortehanii, S. eminii, S. kombe, S. nicholsonii, S. gracilis, S. ledienii, S. preussii
divaricoside/caudoside group: S. caudatus, S. divaricatus, S. wightianus
S. kombe and
S. hispidus dried ripe seeds are rich in cardiac glycosides (8–10%) [
12] and were an early and important commercial source for these molecules; the purified total mixture of these substances was widely used as an injectable solution (strophantin K) for treatment of cardiac deficiencies [
29,
30]. Research has been ongoing for more than 100 years, but new cardenolides are still being isolated such as glycosides of 17α-strophadogenin in
S. kombe [
29,
30]. A dedicated electrospray mass spectrometry (MS)-method characterized strophantidin and six different glycosides including cymarin, helveticoside, erysimoside and neoglucoerysimoside in strophantin K [
31].
Strophanthidin glycosides of
S. kombe seed extracts changed upon storage over 12 months [
27]. Cardenolides exhibiting two or three saccharide moieties were degraded presumably by β-glucosidase activities, originating from the plant material or lactobacilli, releasing the corresponding monoglycosides. They were further degraded into the corresponding aglycons probably by acid hydrolysis as a result of lactic acid accumulation [
27].
For
S. sarmentosus [
32], the Reichstein group contributed many structural investigations in the 1950s and 1960s, identifying 20 glycosides including bipindogenin, lokundjosid and thollosid in a sarmentoside mixture of water-soluble glycosides (see [
18,
33] and references therein). The cardioactivity of s
armentoside extracted from the seeds was tested on rabbit heart preparations [
34]; i
t compared favorably with digoxin increasing the force and rate of heart contractions. These effects were antagonized by potassium chloride solution.
The cardioactivity of the bark extract of
S. cumingii and its sub-fractions was determined on isolated frog hearts [
35]. The hexane fraction was the most cardioactive with a maximum of 31% increase in the force of contraction and 38% increase in the frequency of contraction. The non-polar fraction of the crude extract from the bark elicited a positive inotropic and negative chronotropic effect on the hearts.
S. hispidus is used in treatment of myocardial infarction in Nigerian ethnomedicine. A study of the hearts from male Wistar rats daily pretreated with
S. hispidus extract for 14 days before isoprenaline hydrochloride injection (ISO) demonstrated that the pretreatment not only protected against excessive release of cytochrome c but also resulted in decreased caspase 3 activation, which prompted the decrease in excessive apoptosis [
36]. The reduction in lipid peroxidation levels in ISO-induced myocardial infarction in rats correlated with the decrease in creatine kinase and aspartate aminotransferase levels.
In another study, the use of
S. hispidus against ischemia-reperfusion myocardial infarction and renal artery occluded hypertension in rats suggested significant cardiac protective and anti-hypertensive activity for the ethanolic extract [
37]. Infarction size, blood pressure and heart rate were reduced.
Modern analytical technologies such as high-resolution MS and nuclear magnetic resonance spectroscopy accelerated the identification process of natural substances in recent years and led, e.g., to the description of six new cytotoxic cardenolide glycosides from
S. boivinii (boivinides), which, on a side note, exhibited antiproliferative activity in a human ovarian cancer cell line [
38]. In fact, several cardiac glycosides were found to exert potent antitumor activity; ouabain, e.g., showed antiproliferative effects on SW13, H295R and five primary adrenocortical tumor cells [
39]. Of 109 isolated and identified Apocynaceae cardenolides, about a quarter had the capability to regulate cancer cell survival (for review with limited information about
Strophantus, see [
40]).
S. gratus and S. caudatus extracts, e.g., showed no anticancer and antifungal activity in a study of 23 Indonesian plant families [
41]
. The choice of the sugar moieties at position C-3 is fundamental for a high growth inhibition against cancer cells, and the cytotoxic effects are decreased with the length of the sugar chain [
40].
Divaricoside from
S. divaricatus inhibited cell growth in a dose- and time-dependent manner in SCC2095 and oral squamous cell carcinoma OECM-1 OSCC cells [
42]. It induced autophagy, S and G2/M phase arrest accompanied by downregulation of phosphorylated CDC25C, CDC25C, and CDC2 in SCC2095 cells, and apoptosis by activating caspase 3 and downregulating the expression of Mcl-1. These findings suggest a translational potential as a therapeutic agent for OSCC treatment [
42].
Testing the hypothesis that they may provide patients with baseline protection to cancers and/or adjuvant treatment of chemotherapy-resistant cancers, 27 popular herbal infusions widely used in Nigeria for diabetes were studied on a panel of liver (HepG2), colon (Caco2), and skin (B16-F10) cancer cells [
43]. The results showed that
S. hispidus stem extract was preferentially toxic against the human colon carcinoma Caco2 cell line. It was concluded that its regular intake by diabetic patients may provide a baseline protection against colon cancer.
Not only the cardenolides exhibit bioactivity, but also the steroid core structures. For example, from twigs, stem and leaves of
S. divaricus, cytotoxic steroids were described [
44,
45].
Interestingly, on a side note, Apocynaceae cardenolides have been detected in monarch butterflies [
46]. These insects sequester cardiac glycosides from milkweed plants as part of their adaptive strategy. The substances elicit vomiting in birds, who learn to avoid this prey.
2.2. Triterpene Glycosides and Other Substances
In contrast to cardiac glycosides, triterpene glycosides were not as extensively investigated although
Strophantus extracts have been used as emetic and for treatment of respiratory diseases by native Africans for long [
2]. Saponins (water-soluble foam-forming plant components) are credited with emetic, secretolytic and expectorant activity. For a recent review on
Strophantus saponins and triterpene glycosides in
S. gratus, see [
2].
In
S. sarmentosus and other
Strophantus species, echinocystic acid (
Figure 2) was isolated from fermented seed extract as a core structure, e.g., of bidesmoside in
S. gratus [
2]. Echinocystic acid as a natural extract is widely used in the treatment of inflammatory diseases and reported to alleviate ischemia/reperfusion injury via inhibiting the JNK signaling pathway in mice [
47].
Phytochemical screening for the various substance groups in
Strophantus plant extracts is typically performed with specific assays [
48,
49]. Different plant parts vary in their composition;
S. sarmentosus stem methanol extract, for instance, tested positive for flavomoids, saponins, phenolics, tannins, carbohydrates, glycosides, alkaloids, steroids and terpenoids, while leave extract only showed five of these substance classes [
50,
51].
Gas chromatography (GC)-MS of the seed oils of
S. kombe characterized mainly fatty acids, especially oleic acid and linoleic acid, as well as phytosterols, the latter representing intermediates of cardenolide biosynthesis [
30]. In seed oil of
S. sarmentosus, major component acids were palmitic (12%), oleic (38%), and linoleic (30%) acids; the minor components included stearic acid (9%), some saturated acids (4%) higher than stearic, and an unsaturated hydroxy-acid (7%) not previously reported [
52]. In addition, triglycerides and 2-monoglycerides have been investigated in that species [
53]. Another GC-MS study of methanol extracts suggested the presence of six more compounds such as octadecyl vinyl ether and hexadecanal diisopentyl acetal without validation [
51]. The compound 2-hydroxy-4-methoxy-benzaldehyde has been described in the methanolic extract of
S. wallichii [
54].
From
S. gratus stem bark, lignans (pinoresinol; olivil,
Figure 3) [
55] and from the leaves, cyclitols (bornesitol, dambonitol, generally found in Apocynaceae) [
56,
57] have been structurally analysed. From stem and roots of
S. divaricatus, sesquiterpenoids (
Figure 3) were characterized, one of which (neridienone A) exhibited significant cytotoxicity against human cancer cell lines [
58,
59].
Seeds of
S. kombe and
S. hispidus contain, besides the cardioglycosides, about 30% of oil and other constituents such as kombic acid, the alkaloids, choline and trigonelline, resin, mucilage, and calcium oxalate [
12]. In
S. hispidus, chromatographic finger-printing of a methanol stem bark extract detected seven major compounds including ascorbic acid, quercetin, resorcinol and gallic acid represented in large amounts [
60,
61].
S. hispidus stem ethanolic extract contained polyphenol, flavonoids, tannins, alkaloids, terpenoids and saponines [
62]. In a study of plants used against diabetes mellitus [
63],
S. hispidus exhibited much less compared to the other plants of several phenolic compounds such as rutin, gallic acid, and ellagic acid.