Review article: management of chronic hepatitis C in patients with contraindications to anti‐viral therapy

Carréño, Vicente

doi:10.1111/apt.12562

Cited by 13 publications

(7 citation statements)

References 160 publications

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“…GLY acts as an anti-inflammatory, anti-oxidant and immune-regulator and can protect hepatocytes. As a chronic hepatitis drug, GLY has been used in clinical practice for many years with good therapeutic effects (12,48). Previous studies have shown that GLY could exert a good effect on alcoholic liver disease (49), non-alcoholic fatty liver disease (50), intrahepatic cholestasis (51), metabolic syndrome-induced liver damage (52), acute liver injury (53), liver fibrosis (11) and hepatocellular carcinoma (54).…”

Section: Discussionmentioning

confidence: 99%

Mechanism of glycyrrhizin on ferroptosis during acute liver failure by inhibiting oxidative stress

et al. 2019

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The present study aimed to investigate the anti-ferroptosis effects of the HMGB1 inhibitor glycyrrhizin (GLY). The present study used a cell and animal model of acute liver failure (ALF), induced using tumor necrosis factor-α, lipopolysaccharide and D-galactosamine, to investigate the effects of GLY. The expression of glutathione peroxidase 4 (GPX4) and high mobility group protein B1 (HMGB1), heme oxygenase-1 (HO-1) and nuclear factor erythroid 2-related factor 2 (Nrf2) were detected were detected by western blotting in L02 hepatocytes and mouse liver. The expression of GPX4 and HMGB1 in L02 hepatocytes and mouse liver was detected by immunofluorescence. The pathological changes to liver tissues were determined by hematoxylin and eosin staining. The levels of lactate dehydrogenase (LDH), Fe2+, reactive oxygen species (ROS) and glutathione (GSH) were tested using kits. Compared with the normal group, the degree of liver damage and liver function in the model animal group was severe. The protein levels of HMGB1 in L02 cells and liver tissues were significantly increased. The expression of NRF2, HO-1 and GPX4 was significantly decreased. The levels of LDH, Fe2+, malondialdehyde (MDA) and ROS were increased, whereas the level of GSH was decreased. Treatment with GLY reduced the degree of liver damage, the expression of HMGB1 was decreased, and the levels of Nrf2, HO-1 and GPX4 were increased. The levels of LDH, Fe2+, MDA, ROS were decreased, while the level of GSH was increased by GLY treatment. The results of the present study indicated that HMGB1 is involved in the process of ferroptosis. The HMGB1 inhibitor GLY significantly reduced the degree of ferroptosis during ALF by inhibiting oxidative stress.

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Section: Discussionmentioning

confidence: 99%

Mechanism of glycyrrhizin on ferroptosis during acute liver failure by inhibiting oxidative stress

et al. 2019

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“…Glycyrrhizin (GL) is a major component of licorice root. GL‐containing medications are used as complementary medicines to manage hepatic dysfunction in patients with chronic hepatitis; however, GL has notable side effects. Pseudoaldosteronism is the side effect most frequently associated with GL, which was first described by Conn et al Pseudoaldosteronism is characterized by hypertension, oedema of the extremities and serum hypokalaemia, which are all caused by excessive levels of mineralocorticoid receptor activity …”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with pseudoaldosteronism in patients with chronic hepatitis: A retrospective cohort study

Komatsu

Yoshino

Suzuki

et al. 2018

Basic Clin Pharma Tox

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Glycyrrhizin is used to treat chronic hepatitis, but it also plays an important role in pseudoaldosteronism. Multidrug resistance-associated protein 2 is important for glycyrrhizin excretion. Dysfunction of this transporter increases the serum levels of direct bilirubin, glycyrrhizin and its metabolites. Hence, elevated direct-bilirubin levels could predict the risk of pseudoaldosteronism. This study aimed to evaluate the relationship between elevated direct-bilirubin levels and hypokalaemia, which is the most sensitive marker of pseudoaldosteronism. This retrospective cohort study was conducted in a Japanese university hospital. The occurrence of hypokalaemia is defined as a serum potassium level of ≤3.5 mEq/L after the administration of a glycyrrhizin-containing medication, and a further decline of ≥0.5 mEq/L or an increase of ≥0.5 mEq/L after discontinuing the glycyrrhizincontaining medication was examined in patients with chronic hepatitis between January 2009 and December 2015. This analysis involved 1392 patients, including 596 women. Hepatitis C virus infections were the most common cause of chronic hepatitis in this study. Seventy-nine patients received glycyrrhizin (exposed group; mean age: 60.5 ± 14.2) and 1313 did not receive glycyrrhizin (control group; mean age: 58.3 ± 15.8 years). Synergistic effects of glycyrrhizin-containing medications and elevated direct-bilirubin levels were associated with hypokalaemia.Elevated direct-bilirubin levels and hypoalbuminaemia were associated with hypokalaemia in the exposed group. Older age, female sex, high daily glycyrrhizin dosage, longer duration of glycyrrhizin intake, and potassium-lowering medications were not associated with hypokalaemia after the model adjustment. Elevated direct-bilirubin levels and hypoalbuminaemia may predict pseudoaldosteronism caused by glycyrrhizin. K E Y W O R D S chronic hepatitis, glycyrrhetinic acid, glycyrrhizin, hypokalaemia, multidrug resistance-associated protein 2, pseudoaldosteronism

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“…We found a higher prevalence of anti‐HBc in patients with advanced disease but the difference was statistically significant only in the Chinese cohort. Coffee consumption had been demonstrated to have a protective effect against liver disease including HCC . US patients were more likely to drink coffee and regular coffee consumption was associated with less advanced liver disease in the US cohort.…”

Section: Discussionmentioning

confidence: 90%

The higher prevalence of truncal obesity and diabetes in American than Chinese patients with chronic hepatitis C might contribute to more rapid progression to advanced liver disease

Rao

et al. 2017

Aliment Pharmacol Ther

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Review article: management of chronic hepatitis C in patients with contraindications to anti‐viral therapy

Abstract: SUMMARY BackgroundThere are patients with chronic hepatitis C who are not eligible for the current interferon-based therapies or refuse to be treated due to secondary effects.

Cited by 13 publications

References 160 publications

Mechanism of glycyrrhizin on ferroptosis during acute liver failure by inhibiting oxidative stress

Mechanism of glycyrrhizin on ferroptosis during acute liver failure by inhibiting oxidative stress

Risk factors associated with pseudoaldosteronism in patients with chronic hepatitis: A retrospective cohort study

The higher prevalence of truncal obesity and diabetes in American than Chinese patients with chronic hepatitis C might contribute to more rapid progression to advanced liver disease

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