Glycyrrizinic acid: pathophysiological aspects of fibrosis formation and effectiveness in treatment of liver diseases

Abstract

The review article presents current data on the causes of the onset and development of liver fibrosis. This condition is due to excessive accumulation of the extracellular matrix, the producer of which is mainly hepatic stellate cells that, upon activation, can produce pathological collagen types I and III. The deposition of fibrillar tissue and collagen in the Disse space leads to the appearance of a basal membrane in the epithelium of the sinusoids that results in their capillarization. Portal hypertension is aggravated by endothelial dysfunction and pathological production of vasoconstrictors. Further progression of liver fibrosis is a risk factor for cirrhosis and even hepatocellular carcinoma. The data of studies on antifibrotic properties of glycyrrhizin, a herbal preparation, are given. Almost 40-year history of official study has proved its anti-inflammatory, antiviral, antifibrotic properties. The therapeutic effect of glycyrrhizin is due to the impact on immune cells, inhibition of hepatocyte apoptosis, and, on the contrary, to the acceleration of apoptosis of pathologically activated stellate cells. A selective influence on the transcription factors can explain the anticarcinogenic effect of the drug in case of chronic course of viral hepatitis.

Keywords

• fibrosis
• glycyrrhizin
• apoptosis
• hepatic stellate cells
• collagen
• carcinogenesis
• review