Digitalis Research in Berlin–Buch—Retrospective and Perspective Views

TLDR

Digitalis research, originating with William Withering’s 1785 use of foxglove for dropsy, has faced political and scientific obstacles, prompting the senior author to pursue a lifelong investigation despite institutional bans. This review aims to promote straightforward research toward developing steroidal drugs that prevent and cure cardiac failure. The author circumvented restrictions by repurposing digitalis‑like steroids as probes for the Na⁺/K⁺‑ATPase, the enzyme identified as the digitalis target. The review compiles, for the first time, the author’s various ventures into digitalis research and related steroid studies.

Abstract

Abstract “The following remarks consist partially of matter of fact, and partially of opinion. The former will be permanent; the latter must vary with the detection of error, or the improvement of knowledge. I hazard them with diffidence, and hope they will be examined with candour.” These declarations, which stem from the famous book “An Account of the Foxglove and some of its Medical Uses” by physician William Withering in 1785 in which he introduced preparations from digitalis leaves in the therapy of dropsy (cardiac failure), are cited here by the senior author because of his awareness of the difficulties in presenting a balanced report on his life‐long research project on the further development of digitalis. His decision to devote himself to digitalis research originated at the bedside, when as a physician he experienced the grim final stages of cardiac failure in which no real help for the patients is possible. Unfortunately, his research project did not fit into the research program decreed by the Ministry of Science of the German Democratic Republic, so that he was ordered to stop the digitalis project in favor of biomembrane studies. Fortunately, he got round the ban simply by labeling the digitalis‐like acting steroids as probes for the cell membrane‐located Na + /K + ‐transporting ATPase which he had just recognized as the digitalis target (receptor) enzyme. These and other ventures by the authors are collated here for the first time. The aim of this review is to foster straightforward research for solving a major challenge: the development of steroidal drugs for the prevention and cure of cardiac failure.