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A possible involvement of 3-monoglucuronyl-glycyrrhetinic acid, a metabolite of glycyrrhizin (GL), in GL-induced pseudoaldosteronism.

机译:3-单葡糖醛酸-甘草次酸(一种甘草甜素(GL)的代谢产物)可能与GL引起的假醛固酮增多症有关。

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摘要

Glycyrrhizin (GL), a major ingredient of Glycyrrhiza Radix (licorice), is widely used to treat various disorders or as a sweetener. It is also known that GL occasionally induces pseudoaldosteronism. It is conceivable that the active form of GL in pseudoaldosteronism induction is glycyrrhetinic acid (GA). Although it is reported that 3-monoglucuronyl-glycyrrhetinic acid (3MGA) is detectable specifically in the plasma of patients with GL-induced hypokalemia, pharmacokinetics and a hypokalemia induction mode of action for 3MGA have not been clarified. We investigated the toxicokinetics of GL, GA and 3MGA in a single or multiple oral administration of GL. The results suggested that higher blood concentrations of 3MGA were maintained by the multiple administration compared to the single dose, whereas the concentrations of GA and GL showed no difference. We injected 3MGA intravenously and found that it can decrease the plasma potassium level (PPL) in vivo. It is clinically recommended to avoid a combination treatment of GL and furosemide. While treatment with a low dosage of furosemide had no effect on PPL, the multiple administration of GL and furosemide markedly decreased PPL compared to the effect of administering GL alone. In the single dosage regime, there was no difference between PPL after the combination treatment and after administering GL alone. Collectively, these findings suggested that accumulation of 3MGA may be involved in the pathogenesis of pseudoaldosteronism induced by chronic GL treatment.
机译:甘草(GL)是甘草的主要成分(甘草),被广泛用于治疗各种疾病或用作甜味剂。还已知GL偶尔会诱发假醛固酮增多症。可以想象,在假醛固酮增多症诱导中GL的活性形式是甘草次酸(GA)。尽管据报道在GL诱导的低钾血症患者的血浆中可特异性检测到3-单葡糖醛酸-甘草次酸(3MGA),但尚不清楚3MGA的药代动力学和低钾血症诱导作用方式。我们研究了单次或多次口服GL时GL,GA和3MGA的毒代动力学。结果表明,与单剂量相比,多次给药可维持较高的3MGA血液浓度,而GA和GL的浓度无差异。我们静脉注射3MGA,发现它可以降低体内血浆钾水平(PPL)。临床上建议避免合并使用GL和速尿。虽然低剂量速尿的治疗对PPL没有影响,但与单独给药GL的效果相比,多次给药GL和速尿显着降低了PPL。在单剂量方案中,联合治疗后和单独给予GL后的PPL之间没有差异。总的来说,这些发现表明3MGA的积累可能与慢性GL治疗引起的假醛固酮增多症的发病机理有关。

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