Cardenolides from the Apocynaceae family and their anticancer activity.

Cardenolides, as a group of natural products that can bind to Na(+)/K(+)-ATPase with an inhibiting activity, are traditionally used to treat congestive heart failure. Recent studies have demonstrated that the strong tumor cytotoxicities of cardenolides are mainly due to inducing the tumor cells apoptosis through different expression and cellular location of Na(+)/K(+)-ATPase α-subunits. The leaves, flesh, seeds and juices of numerous plants from the genera of Nerium, Thevetia, Cerbera, Apocynum and Strophanthus in Apocynaceae family, are the major sources of natural cardenolides. So far, 109 cardenolides have been isolated and identified from this family, and about a quarter of them are reported to exhibit the capability to regulate cancer cell survival and death through multiple signaling pathways. In this review, we compile the phytochemical characteristics and anticancer activity of the cardenolides from this family.