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This study aimed to explore the liver protective effects of a fourth-generation glycyrrhizic acid product (magnesium isoglycyrrhizinate injection, MII) in the treatment of mice with drug-induced liver injury-specifically, to determine its effects on plasma metabolites. Moreover, the possible mechanism of its intervention in lipid metabolism and amino acid metabolism through the liver protective effect was preliminarily explored, combined with network pharmacology. The liver injury model of mice was established using acetaminophen (APAP). The protective effect of MII on the mice model was evaluated using pathological tissue sections and biochemical indices such as alanine transaminase (ALT), aspartate aminotransferase (AST), and superoxide dismutase (SOD). Metabolomics analysis of plasma was performed using the UHPLC-QTOF/MS technique to screen for potential biomarkers and enriched metabolic pathways. The potential targets and pathways of MII were predicted by network pharmacology, and the mechanism was verified by Western blot analysis. MII significantly improved the pathological liver changes in mice with liver injury. The content of ALT and AST was decreased, and the activity of SOD was increased significantly (p < 0.05, 0.01). A total of 29 potential biomarkers were identified in the metabolomics analysis, mainly involving seven pathways, such as lipid metabolism and amino acid metabolism. A total of 44 intersection targets of MII in the treatment of liver injury were obtained by network pharmacology, involving lipid metabolism and other related pathways. Western blot analysis results showed that MII could significantly reduce the expression of JAK2 and STAT3. MII can effectively ameliorate liver injury in modeled mice through related pathways such as lipid metabolism and amino acid metabolism. This study could provide not only a scientific basis for the elucidation of the mechanism of action of MII in exerting a hepatoprotective effect, but also a reference for its rational clinical application.
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OBJECTIVE:To observe the preventive effects and safety of 3 kinds of drugs on chemotherapy-induced liver dam-age in patients with gastrointestinal tumors,and to evaluate economics. METHODS:A total of 128 patients with gastrointestinal malignant tumor and systemic chemotherapy indication selected from our hospital during 2014-2015 were divided into group A(42 cases),B(46 cases)and C(40 cases)according to random number table. Since the first day of chemotherapy,group A,B and C were given Reduced glutathione for injection(1.2 g),Magnesium isoglycyrrhizinate injection(100 mg)and Polyene phosphati-dylcholine injection(465 mg)for preventing chemotherapy-induced liver damage respectively,for 7 d. The preventive effects and ADR occurrence were observed in 3 groups,and the economic analysis was conducted. RESULTS:Total response rates of group A,B and C were 90.48%,97.83% and 87.50%,and that of group B was significantly higher than other 2 groups,with statistical significance(P<0.05). But there was no statistical significance between group A and C(P>0.05). The costs of group A,B and C were 1 465.86,1 518.94,1 554.04 yuan,and cost-minimization analysis was adopted to evaluate the plans of group A and C. The plan of group A was more economical. Cost-effectiveness analysis was used to evaluate the plans of group A and B,cost-effectiveness ratio of group A and B were 1 620.09 and 1 552.63;incremental cost-effectiveness ratio was 722.18, and the plan of group B was more economical. The above conclusion was supported by the results of sensitivity analysis. Three patients in group B suffered from transient elevated blood pressure and then recovered 2-3 d after drug withdrawal. CONCLU-SIONS:The preventive effects and economics of Magnesium isoglycyrrhizinate injection is better than Reduced glutathione for injection and Polyene phosphatidylcholine injection for chemotherapy-induced liver damage in patients with gastrointestinal tu-mors. The blood pressure of patients should be monitored closely during application. Reduced glutathione for injection is more suitable for patients with primary hypertensive disease.
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OBJECTIVE:To observe the preventive effects and safety of 3 kinds of drugs on chemotherapy-induced liver dam-age in patients with gastrointestinal tumors,and to evaluate economics. METHODS:A total of 128 patients with gastrointestinal malignant tumor and systemic chemotherapy indication selected from our hospital during 2014-2015 were divided into group A(42 cases),B(46 cases)and C(40 cases)according to random number table. Since the first day of chemotherapy,group A,B and C were given Reduced glutathione for injection(1.2 g),Magnesium isoglycyrrhizinate injection(100 mg)and Polyene phosphati-dylcholine injection(465 mg)for preventing chemotherapy-induced liver damage respectively,for 7 d. The preventive effects and ADR occurrence were observed in 3 groups,and the economic analysis was conducted. RESULTS:Total response rates of group A,B and C were 90.48%,97.83% and 87.50%,and that of group B was significantly higher than other 2 groups,with statistical significance(P<0.05). But there was no statistical significance between group A and C(P>0.05). The costs of group A,B and C were 1 465.86,1 518.94,1 554.04 yuan,and cost-minimization analysis was adopted to evaluate the plans of group A and C. The plan of group A was more economical. Cost-effectiveness analysis was used to evaluate the plans of group A and B,cost-effectiveness ratio of group A and B were 1 620.09 and 1 552.63;incremental cost-effectiveness ratio was 722.18, and the plan of group B was more economical. The above conclusion was supported by the results of sensitivity analysis. Three patients in group B suffered from transient elevated blood pressure and then recovered 2-3 d after drug withdrawal. CONCLU-SIONS:The preventive effects and economics of Magnesium isoglycyrrhizinate injection is better than Reduced glutathione for injection and Polyene phosphatidylcholine injection for chemotherapy-induced liver damage in patients with gastrointestinal tu-mors. The blood pressure of patients should be monitored closely during application. Reduced glutathione for injection is more suitable for patients with primary hypertensive disease.
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OBJECTIVE:To explore the regularity and characteristics of anaphylactoid reactions induced by Magnesium iso-glycyrrhizinate injection,and provide reference for clinical rational drug use. METHODS:27 ADR reports induced by Magnesium isoglycyrrhizinate injection from Hunan Center for ADR Monitoring from Jan. 2014 to Mar. 2015 were retrospectively analyzed. RE-SULTS:In the 27 cases,15 were male (55.56%) and 12 were female (44.44%),with percentage of 1.25∶1;ADR mainly oc-curred in patients with 41-60 years old(51.85%);involved organ/system were mainly skin and its appendages(35.85%)and sys-temic damage(26.42%),the main clinical manifestations were rash,itching,fever,chills,vomiting and dizziness;there were 7 severe ADR reports(25.92%),mainly showed chills,fever and other systemic symptoms;most ADR can be cured(40.74%)or relieved(55.56%)by related processing. CONCLUSIONS:There are no risk tips for severe allergic reactions in instruction,it is necessary to strengthen post-marketing surveillance and further improve the drug instructions to reduce the risk of severe ADR in-duced by Magnesium isoglycyrrhizinate injection.
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OBJECTIVE:To systematically review the efficacy and safety of Magnesium isoglycyrrhizinate injection versus 4 comnon medicines in the treatment of drug-induced liver damage,and to provide evidence-based reference for clinic treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,Wanfang Database and VIP Database,random-ized controlled trials (RCT) about Magnesium isoglycyrrhizinate injection versus other medicines in the treatment of drug-induced liver damage were enrolled. Meta-analysis was performed by using Rev Man 5.3 software after literature selection,data extract and quality assessment. RESULTS:A total of 13 RCTs were included,involving 1 093 patients. Results of Meta-analysis showed clini-cal effective in magnesium isoglycyrrhizinate group was significantly higher than tiopronin group[RD=0.29,95%CI(0.17,0.42), P<0.001] and diammonium glycyrrhizinate group [RD=0.07,95%CI(0.01,0.12),P=0.02],compared with glutathione group and compound ammonium glycyrrhetate group,there were no significant differences ;incidence of adverse reactions in magnesium iso-glycyrrhizinate group was significantly lower than diammonium glycyrrhizinate group [RD=-0.07,95%CI(-0.11,-0.03),P<0.001] and compound ammonium glycyrrhetate group[RD=-0.21,95%CI(-0.38,-0.04),P=0.02],compared with triopro-nin group and glutathione group,there were no significant differences among 3 groups. CONCLUSIONS:Magnesium isoglycyrrhiz-inate injection has better efficacy and safety than other 4 commons hepatoprotective medicines in the treatment of drug-induced liver damage. Due to the limit of methodological quality,more large-scale and long-term follow-up studies with strict designed are need-ed for the further verification of the conclusion.
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Objective To observe the curative effect of magnesium isoglycyrrhizinate in prevention of liver injury induced by oxaliplatin .Methods The control group used oxaliplatin ,leucovorin ,5‐fluorouracil chemotherapy ,the treatment group were treated with oxaliplatin ,leucovorin ,5‐fluorouracil chemotherapy and simultaneous magnesium isoglycyrrhizinate were used at the same time .With 28 d for 1 course of treatment ,the treatment period consisted of 2‐4 courses ,observation of pa‐tients and the proportion of liver injury were made .Results In the control group ,liver injury incidence rate was 44 .4% ,the rate of injury was 19 .4% in treatment group ,there was significant difference between the two groups (P<0 .01) .Conclusion Magnesium isoglycyrrhizinate could be effective in prevention of oxaliplatin induced liver injury .
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Objective To investigate the therapeutic effect of chronic hepatitis treated by Magnesium Isoglycyrrhizinate injection.Methods Eighty chronic hepatitis patients were treated by Magnesium Isoglycyrrhizinate injection,ivgtt,150mg,qd.The control group were 80 chronic hepatitis patients treated by Diammonium Glycyrrhetate injection,ivgtt,150mg,qd.To observe therapeutic effect after four weeks treatment.Results The therapeutic effect rate in treatment group was 91.2％,excellence rate is 63.8％.There was significant difference between the two groups (64.2％,46.2％ all P ＜0.05).Conclusion Magnesium Isoglycyrrhizinate injection can effectively treat chronic hepatitis.
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Objective To explore ffie effects of magnesium isoglycyrrhizinate injection,polyene phosphatidylcholine(PPC)and reduced glutathione(GSH)in patients with liver cirrhosis accompanied by benign obstructive jaundice after surSery.Methods Fifty-nine patients with liver cirrhosis and benign obstructive jaundice caused by gallstones were selected,and all of them were treated with magnesium isoglycyrrhizinate injection and GSH preoperatively.Thirty-one odd number patients received magnesium isoglycyrrhizinate injection,PPC and GSH treatment(group A)after surgery immediately,28 even number patients still continued to be treated with magnesium isoglycyrrhizinate injection and GSH(group B).The plasma alanine aminotransferase(ALT),aspartate aminotramsferase(AST),total cholesterol(TBIL)and cholinesterase(ChE),and prealbumin at the time of 1,3 and 7 day after surgery were compared between the two groups.Results Seven patients were excluded from this research including 3 cases in group A,4 cases in group B.The plasma ALT,AST,TBIL of the group A at postoperative 3,7 day[(193 ± 48)and(63 ± 17)U/L,(194 ± 57)and(54 ± 19)U/L,(99 ± 20)and(28 ± 9)μmol/L]were significantly lower than those of the group B[(235 ± 50)and(103 ± 33)U/L,(235 ± 64)and(82 ± 22)U/L,(127 ± 45)and(43 ± 18)μ mol/L,respectively](P＜ 0.05),whereas the plasma ChE and prealbumin of the group A[(3781 ± 294)and(4405 ± 469)U/L,(0.22 ± 0.07)and(0.30 ± 0.04)g/L]were significantly higher than those of the there were obvious differences of the plasma ChE and prealbumin at postoperative 3 or 7 day compared with those at postoperative 1 or 3 day in the group A(P ＜ 0.05).But this were improved at postoperative 7 day compared with those at postoperative 3 day in the group B(P＜ 0.05).Conclusion Combined treatment of magnesium isoglycyrrhizinate injection,PPC and GSH can be more effective to reduce the injury of the liver cells and promote the recovery of liver function for patients with liver cirrhosis and obstructive jaundice.
