Further studies on the mechanism of the mineralocorticoid action of licorice in humans.
The pathogenesis of pseudohyperaldosteronism from licorice has been evaluated in 6 male volunteers taking daily 7 g of a commercial preparation of licorice for 7 days, corresponding to an intake of 500 mg/day of glycyrrhizic acid. Pseudohyperaldosteronism was evident during the treatment (increase of body weight, suppression of plasma renin activity and plasma aldosterone, reduction of serum potassium). The ratio (tetrahydrocortisol + allo tetrahydrocortisol)/tetrahydrocortisone in urine increased in 5 cases after 3 days of treatment, without an increase of plasma mineralocorticoid activity (PMA). In the 6th case the urinary ratio was unchanged and PMA increased from the pretreatment value. After 7 days of therapy the ratio remained high and PMA was not measurable in 3 cases, while in the other 3 cases the ratio returned to pretreatment and PMA was higher than pretreatment value. We conclude that the pseudohyperaldosteronism from licorice is initially related to decreased activity of 11 beta-hydroxysteroid-dehydrogenase and afterwards also a direct effect of licorice derivatives on mineralocorticoid receptors becomes evident in some cases. In other cases however the effect on the enzyme is prevailing probably due to individual factors.
Armanini
D
D
Istituto Semeiotica Medica, University of Padova, Italy.
Lewicka
S
S
Pratesi
C
C
Scali
M
M
Zennaro
M C
MC
Zovato
S
S
Gottardo
C
C
Simoncini
M
M
Spigariol
A
A
Zampollo
V
V
D042842:11-beta-Hydroxysteroid Dehydrogenases; D000328:Adult; D000450:Aldosterone / Q000031:analogs & derivatives / Q000097:blood / Q000652:urine; D006034:Glycyrrhetinic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006035:Glycyrrhiza; D019695:Glycyrrhizic Acid; D006801:Humans; D006913:Hydroxysteroid Dehydrogenases / Q000378:metabolism; D006929:Hyperaldosteronism / Q000139:chemically induced*; D008297:Male; D008901:Mineralocorticoids / Q000097:blood*; D010946:Plants, Medicinal; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood; D013760:Tetrahydrocortisol / Q000652:urine; D013761:Tetrahydrocortisone / Q000652:urine
D008901:Mineralocorticoids; C013282:tetrahydroaldosterone; D000450:Aldosterone; D013761:Tetrahydrocortisone; D019695:Glycyrrhizic Acid; D013760:Tetrahydrocortisol; D006913:Hydroxysteroid Dehydrogenases; D042842:11-beta-Hydroxysteroid Dehydrogenases; D012083:Renin; D006034:Glycyrrhetinic Acid; D011188:Potassium