G. glabra is a shrub 1.5 m long, contains a variety of compounds, including triterpenoids, polyphenols and polysaccharides (starches, mannose and sucrose). Polyphenols include phenolic acids such as licitritine, flavons and flavans, coppers and isoflavonoids{ galbrianidine} vegetable gums, resins and essential oils. However, the root is grown for the main active glycyrizine{ 7% to 10% or more depending on the growth conditions}.Glycyrizine, glycyrizoric acid and glycyrizine amounts to 10% to 25% of root extract. Glycyrizine ammonium is prepared according to the specifications from licorice extract and is used as an aromatic agent. Carbenoxone, a synthetic analogue to glycyriradical acid, has been used as a healing digestive ulcer.
Properties
1}Anti-inflammatory
Glycriretic acid has shown anti-inflammatory activity due to prostaglandin E 2 inhibitory grades demonstrated with various glykirrizine analogues;
2}Anti-Ikes
Licorice and its extracts have been used in China and Japan to treat chronic viral hepatitis. In in vitro experiments, glycyrizine inhibited certain pathogenic viruses by preventing the binding of the virus into host cell membranes, its copying, and interference with signal switching. Animal and human studies indicate a more complex mechanism involving interferon production induction through effects of T-cell function.
Although the mechanism is unclear, glycyrrhic acid inhibited the reactivation of the latent herpes virus associated with Kaposi sarcoma and showed efficacy against SARS-associated CORONAVIRUS.
Glycyrizine noted an increased survival time in mice when a influenza A 2 virus and herpes simplex were administered.
In clinical trials in chronic hepatitis, Stronger Neo-Minophagen C (an intravenous glycyrizine solution produced in Japan) normalizes serum transaminases levels and improves liver function without affecting levels RNA hepatitis C.
3}Cancer
Chemical compounds including glamidine, glycyrizine, glycyrizolic acid and carbenoxone have been studied for their effects on cell cell cells{ prostate, breast, colus, liver and pulmonary cancer}of mice, rats and people with most studies indicating dose-dependent action on cell/tumor proliferation and apoptosis.
Various mechanisms of action have been proposed for licorice compounds, including antioxidant activity, dsedative protection, suppressive action, inhibition of cyclooxygenase and potency antagonist phytoestrogen and progesterone. In one experiment, gallabidine demonstrated activity promoting growth at low concentrations but inhibiting activity at higher concentrations. In a major retrospective study in Japan (N = 1,249), a difference in progression in hepatocellular carcinoma was found in patients with chronic hepatitis C who do not respond to interferon therapy. After adjusting for many variables, those who received IV glycirizine 4 mg showed a decrease in the rate of progression of liver cancer, probably regardless of the duration of treatment. The same authors had previously demonstrated protective effect of long-term administration of glycyrizine in hepatocellular cancer.
4}Cardiovascular
Carbenexolone slows myocardial therapy. An open, randomized, controlled study (n = 50) evaluated the hemodynamic effects of licorice (glycyrizine 290 to 370 mg / day) in nortaise volunteers. After 2 weeks, extracellular volume as well as systolic and diastolic blood pressure (peripheral and central) increased significantly in the licorice group compared to the control group.
Ingestion of licorice also significantly reduced plasma concentrations of aldosterone and potassium. A systematic review and meta-analysis of 26 clinical trials (N = 985), {published 2002-2017} found an overall statistically significant increase in diastolic blood pressure {in short-term use of licorice} compared to the control group.It was attributed to significant hypernatremia caused by licorice. Subgroup analysis revealed a significant increase in systolic blood pressure (SBP) when the duration of intervention was 2 and 8 weeks and a significant increase in both SBP and DBP in healthy patients, women with polycystic ovary syndrome and for each dose of licorice/day but without a significant effect on the overall parameters of lipids (HDL, LDL, total cholesterol, triglycerides).
5}Gastro-protection
A significant increase in negative seroconversions was observed in a more recent randomized controlled study conducted with 120 patients positive in Helicobacter pylori. weeks) as a triple therapy supplement (83%) compared only to triple therapy.
6}Hepatoprotective
Experiments on experimental animals and studies on liver cancer suggest a protective role for licorice in hepatotoxicity. A small (n = 66), randomized, double-blind, 2-month study in adults with non-alcoholic fatty liver disease found that 2 g of the root licorice per day aqueous extract produced a significant decrease from the baseline value at ALT and AST levels without however, histological evaluation. This
7}Hormonal
Serum testosterone reductions have been demonstrated in several studies in healthy men who consume glycyrizin0 0.5 g / day for 7 days. Another test found no reduction. However, the methodology between the two studies differed.
In women, licorice has been used in combination with sironolactone to treat polycystic ovary syndrome. The estrogenic activity of licorice, as it has been documented.
8}Metabolites
A systematic review and meta-analysis of 26 clinical trials (N = 985), published 2002-2017 found an overall statistically significant reduction in body weight with short-term use of licorice compared to controls. Significant effects included reductions in certain liver enzymes (e.g. ALP, c-GTP) and BUN. Overall, lipid parameters did not significantly alter.
Dosage
Licorice has poor oral bioavailability, taking 10 hours to achieve maximum glycyrrhic acid concentrations and 12 hours for licorice extract. The lipophilic components of licorice extract have been shown to reduce the rate of gastric discharge and absorption of glycyrrhic acid, and neither glycyrizine nor acid accumulate in tissues.There is extensive binding with albumin in humans.Licorice root has been used at daily doses from 760 mg to 15 g for ulcer, gastritis and non-alcoholic fatty liver disease. Higher doses administered for prolonged periods of time may pose a risk of hyperkalaemia. A level of “adverse effects” has been proposed as purified glycyrizine 2 mg / kg / day and is recommended at 0.2 mg / kg / day.
Interactions
A} With antiplatelet drugs. .
B}Anti-coffs.
may enhance their toxic effect and bleed
C}With antihypertensives: the antihypertensive effect of antihypertensive agents may be reduced.
D}With cardiac glycosides:Licorice can enhance the negative/toxic effect of cardiac glycosides.
E}With cortisone: Licorice can increase serum cortisol levels.
The licorice can enhance the hypocaemic effect of diuretics.
Z}With non-steroidal anti-inflammatory/see agents, salicylates:It can enhance their toxic effect
The thiazidic diuretics: It can enhance the hypocaimic effect of thiazide and diuretics that resemble thiazide.
Side effects
In “normal” doses or normal consumption levels, there are few side effects. Reports of adverse reactions in the literature are generally due to licorice poisoning or chronic over-intake, and these effects are described in the following toxicology.
The eye effects have been described and may be due to the inhibitory effect of cyclooxygenase. However, large amounts of licorice are required for this result. The vasculus of the blood vessels of the optic nerve that results in visual disturbances that mimic the eye migraine (but without headache) has been reported. In addition, a case of hypertensive retinopathy resulting in acute vision in the presence of pseudohyperaldosterism in a 57-year-old person was identified as a result of consumption of at least 900 g / licorice week in the last 3 to 4 months. He had a remarkable medical history and showed blood pressure of 250/110 mm Hg and severe hypokalaemia. Hypersensitivity reactions have also been observed in glycorice-containing products.
In the American Heart Association’s 2016 scientific statement on drugs that may cause or exacerbate heart failure, licorice has been identified as a product with antiplatelet and anticoatic effects, which can be increase the risk of bleeding when used with anticoacontics. In addition, it has potentially harmful cardiovascular effects, such as hypertension and fluid retention (pseudohyperaldosteronism), which may be harmful in patients with heart failure. The guidelines noted that naturoceuticals are not recommended for the management of heart failure symptoms or for secondary prevention of cardiovascular events and that dietary supplements are not recommended for the treatment of heart failure
Toxicology
Many reports of cases of hypocaemic paralysis, psedualaldosteronism and cardiac myopathy due to hypokalaemia are found in the literature. Symptoms such as severe hypokalaemia, metalcorticoid hypertension, cardiac arrhythmias, limb paralysis, metabolic alkalosis, hypoxaemia and hypertobaccohave been reported. Several authors suggest that licorice poisoning may be a more common cause for these states, taking into account the widespread availability of traditional and herbal medicines containing licorice. A rare case of thyrotoxic periodic paralysis caused by licorice was reported in a 43-year-old man who was recently diagnosed with Graves disease, who experienced hypokalaemia, hyperthyroid condition and paralysis. His symptoms were suspected to have been caused secondaryly to excessive consumption of licorice (licorice tea 400 ml / day for the previous 12 days). Symptoms of paralysis were fully resolved after stabilization of potassium levels.
The mechanism by which glyciresines exert their effect on the renin-angiotensin-aldosterone system has been clarified. Competitive (and reversible) inhibition of enzyme 11-beta-hydroxysteroid dehydrogenase effects on suppression of cortisol conversion to inactive cortisone. The subsequent suppression of plasma renin activity and aldosterone levels is evident. Interchangeable sodium levels increase and cortisol consolidate of metalcorticoid receptors in remote kidney tubes is enhanced. The condition responds to the administration of spinonoflactone, potassium supplementation and discontinuation of licorice.
SOURCE: https://www.medicalnewstoday.com/articles/323761
