A Long-Term Glycyrrhizin Injection Therapy Reduces Hepatocellular Carcinogenesis Rate in Patients with Interferon-Resistant Active Chronic Hepatitis C: A Cohort Study of 1249 Patients

Abstract

To elucidate the influence of a glycyrrhizin therapy on hepatocarcinogenesis rate in interferon (IFN)-resistant hepatitis C, we retrospectively analyzed 1249 patients with chronic hepatitis with or without cirrhosis. Among 346 patients with high alanine transaminase value (twice or more of upper limit of normal), 244 patients received intravenous glycyrrhizin injection and 102 patients did not, after judgment of IFN resistance. Crude carcinogenesis rates in the treated and untreated group were 13.3%, 26.0% at the 5th year, and 21.5% and 35.5% at the 10th year, respectively (P = .0210). Proportional hazard analysis using time-dependent covariates disclosed that glycyrrhizin treatment significantly decreased the hepatocarcinogenesis rate (hazard ratio 0.49, 95% confidence interval 0.27-0.86, P = .014) after adjusting the background features with significant covariates. Glycyrrhizin injection therapy significantly decreased the incidence of hepatocellular carcinoma in patients with IFN-resistant active chronic hepatitis C, whose average aminotransferase value was twice or more of upper limit of normal after interferon.

Efficacy and safety of addition of minor bloodletting (petit phlebotomy) in hepatitis C virus-infected patients receiving regular glycyrrhizin injections

“…12 The same results have been found for long-term iron reduction therapy. 13,14 Based on these findings, it is plausible that the combination of GI and PP can reduce the risk of HCC development more than GI alone.…”

Hepatoprotective and Anti-Hepatitis C Viral Activity of Platycodon grandiflorum Extract on Carbon Tetrachloride-Induced Acute Hepatic Injury in Mice

“…Numerous studies recently showed that plant extracts exhibit an inhibitory effect on HCV enzyme and replication (4,(16)(17)(18)26). They have demonstrated their utility in eradicating chronic hepatitis C through a multitude of hepatoprotective functions in initial trials.…”

“…Current treatment is based on a combination of pegylated interferon (IFN)-␣ and ribavirin, which directly inhibits HCV replication and causes progressive infected cell clearance through intricate and only partly understood mechanisms (13)(14)(15). Among natural antiviral agents, recent investigations have reconsidered the interest of phyto-polysaccharides, which act as potent inhibitors of different viruses (16)(17)(18).…”

Glycyrrhizin and glycyrrhetic acid: scaffolds to promising new pharmacologically active compounds

“…In the period covered by this review, some new pharmacological activities were reported for GL (1), such as: antiviral (against flavivirus3 6 , HIV 37 and SARScoronavirus 38 ) antiallergic, 39 antithrombotic in experimental models in rats, 40,41 capable of lowering hepatocellular carcinogenesis rates in patients with interferon-resistant active chronic hepatitis C, 42 presenting a protective in vitro effect in gastric epithelial cells against H 2 O 2 -induced cell death 43 and as an inhibitor of influenza A virus uptake into human lung cells. 44 GL and GLA (2) were also reported as possessing a protective effect on acute cholestasis induced by α-naphtyl isocyanate in rats 45 and GLA was reported as an apoptosis inductor in human hepatoma, promyelotic leukemia and stomach cancer cells, 46 as an antihyperglycemic agent in rats with streptozocin-induced diabetes, 47 and as presenting antiviral activity against herpes simpex virus 1 (HSV-1).…”