Human liver alcohol dehydrogenase an enzyme essential to the metabolism of digitalis

Human liver alcohol dehydrogenase oxidizes the 3β OH group of digitoxigenin, digoxigenin and gitoxigenin, the pharmacologically active principles of the corresponding cardiac glycosides. The oxidation products were identified by high performance liquid chromatography analysis. Ethanol and digitoxigenin are competitive, and the efficiency of their oxidation is virtually the same. Thus, liver alcohol dehydrogenase is a hitherto unknown NAD(H) dependent enzyme that performs the first and major step in the inactivation of these genins of the cardiac glycosides in the human. This could bear importantly both on the pharmacology and toxicology of digitalis therapy.