Assessment of Herb-Drug Interaction Potential of Five Common Species of Licorice and Their Phytochemical Constituents

• Published in: Journal of dietary supplements 2023-07, Vol.20 (4), p.582-601
• Main Authors: Haron, Mona H., Avula, Bharathi, Ali, Zulfiqar, Chittiboyina, Amar G., Khan, Ikhlas A., Li, Jing, Wang, Vivian, Wu, Charles, Khan, Shabana I.
• Format: Article
• Language: English
• Subjects: AhR; CYP450; Cytochrome P-450 CYP1A2; Cytochrome P-450 CYP3A; Glycyrrhiza - chemistry; Glycyrrhiza spp; herb drug interaction; Herb-Drug Interactions; Phytochemicals - pharmacology; Plant Extracts - chemistry; PXR
• ISSN: 1939-0211; 1939-022X
• DOI: 10.1080/19390211.2022.2050875

The dried roots and rhizomes of Glycyrrhiza species (G. glabra, G. uralensis and G. inflata), commonly known as licorice, have long been used in traditional medicine. In addition, two other species, G. echinata and G. lepidota are also considered "licorice" in select markets. Currently, licorice is an integral part of several botanical drugs and dietary supplements. To probe the botanicals' safety, herb-drug interaction potential of the hydroethanolic extracts of five Glycyrrhiza species and their key constituents was investigated by determining their effects on pregnane X receptor, aryl hydrocarbon receptor, two major cytochrome P450 isoforms (CYP3A4 and CYP1A2), and the metabolic clearance of antiviral drugs. All extracts enhanced transcriptional activity of PXR and AhR (>2-fold) and increased the enzyme activity of CYP3A4 and CYP1A2. The highest increase in CYP3A4 was seen with G. echinata (4-fold), and the highest increase in CYP1A2 was seen with G. uralensis (18-fold) and G. inflata (16-fold). Among the constituents, glabridin, licoisoflavone A, glyasperin C, and glycycoumarin activated PXR and AhR, glabridin being the most effective (6- and 27-fold increase, respectively). Licoisoflavone A, glyasperin C, and glycycoumarin increased CYP3A4 activity while glabridin, glyasperin C, glycycoumarin, and formononetin increased CYP1A2 activity (>2-fold). The metabolism of antiretroviral drugs (rilpivirine and dolutegravir) was increased by G. uralensis (2.0 and 2.5-fold) and its marker compound glycycoumarin (2.3 and 1.6-fold). The metabolism of dolutegravir was also increased by G. glabra (2.8-fold) but not by its marker compound, glabridin. These results suggest that licorice and its phytochemicals could affect the metabolism and clearance of certain drugs that are substrates of CYP3A4 and CYP1A2. Supplemental data for this article is available online at https://doi.org/10.1080/19390211.2022.2050875 .