Review article: glycyrrhizin as a potential treatment for chronic hepatitis C.
Chronic hepatitis C is a slowly progressive liver disease that may evolve into cirrhosis with its potential complications of liver failure or hepatocellular carcinoma. Current therapy with alpha-interferon is directed at viral clearance, but sustained response is only achieved in 20-40% of patients without cirrhosis, and less than 20% in patients with cirrhosis who have the greatest need for therapy. Treatment for those who do not respond to anti-viral therapy is highly desirable. In Japan glycyrrhizin has been used for more than 20 years as treatment for chronic hepatitis. In randomized controlled trials, glycyrrhizin induced a significant reduction of serum aminotransferases and an improvement in liver histology compared to placebo. Recently, these short-term effects have been amplified by a well-conducted retrospective study suggesting that long-term usage of glycyrrhizin prevents development of hepatocellular carcinoma in chronic hepatitis C. The mechanism by which glycyrrhizin improves liver biochemistry and histology are undefined. Metabolism, pharmacokinetics, side-effects, and anti-viral and hepatoprotective effects of glycyrrhizin are discussed.
van Rossum
T G
TG
Department of Hepatogastroenterology, Erasmus University Hospital, Rotterdam, The Netherlands.
Vulto
A G
AG
de Man
R A
RA
Brouwer
J T
JT
Schalm
S W
SW
D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019695:Glycyrrhizic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D016174:Hepacivirus / Q000187:drug effects; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans
D000998:Antiviral Agents; D019695:Glycyrrhizic Acid