Editorial
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 15, 2023; 14(12): 1717-1720
Published online Dec 15, 2023. doi: 10.4239/wjd.v14.i12.1717
Potential therapeutic targets for the prevention of diabetic nephropathy: Glycyrrhetinic acid
Lu Cai, Michael Horowitz, Md Shahidul Islam
Lu Cai, Pediatric Research Institute, Department of Pediatrics, University of Louisville, Louisville, KY 40202, United States
Michael Horowitz, Department of Medicine, University of Adelaide, Adelaide 5005, Australia
Md Shahidul Islam, Department of Biochemistry, School of Life Sciences, University of KwaZulu-Natal, Durban 4000, KwaZulu-Natal, South Africa
Author contributions: Cai L conceptualized and drafted the first draft of the editorial; Islam MS and Horowitz M did further revisions and editorial corrections before submission; All authors have read and approve the final manuscript.
Conflict-of-interest statement: Cai L, Horowitz M, and Islam MS have no conflict of interest within this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lu Cai, MD, PhD, Director, Professor, Pediatric Research Institute, Department of Pediatrics, University of Louisville, 570 S. Preston Street, Baxter I, Rm: 304F, Louisville, KY 40202, United States. lu.cai@louisville.edu
Received: November 5, 2023
Peer-review started: November 5, 2023
First decision: November 23, 2023
Revised: November 29, 2023
Accepted: December 6, 2023
Article in press: December 6, 2023
Published online: December 15, 2023
Abstract

Uncontrolled hyperglycemia or poorly managed disease increases the propensity for a number of diabetes-related complications targeting major organs including the heart, eyes, and kidney. Although the mechanisms by which diabetes induces cardiovascular diseases include oxidative stress and inflammation, when insulin resistance remains the key to the pathogenesis, as implicated in the two reviews in this issue. This editorial mainly comments on the potential preventive application of glycyrrhetinic acid (or 18β-GA) in relation to diabetic nephropathy. The thera-peutic or preventive effects of 18β-GA, as a hydrolytic product of glycyrrhizic acid that is a component of licorice, have been appreciated in other disorders, but have received much less attention in relation to diabetic complications. A study in this issue has identified 18β-GA as a therapeutic for preventing diabetic nephropathy and provides evidence to support efficacy in cultured human renal tubule cells in vitro. Although it represents a pilot study, the observations support a new therapeutic approach that warrants further ex-ploration.

Keywords: Insulin resistance, Diabetic cardiomyopathy, Diabetic nephropathy, Glycyrrhetinic acid, Licorice, Chinese herbal remedy

Core Tip: Uncontrolled hyperglycemia or poorly managed disease increases the propensity for a number of diabetes-related complications targeting major organs including the heart, eyes, and kidney. Although the mechanisms by which diabetes induces cardiovascular diseases include oxidative stress and inflammation, when insulin resistance remains the key to the pathogenesis, as implicated in the two reviews in this issue. This editorial mainly comments on the potential preventive application of glycyrrhetinic acid (or 18β-GA) in relation to diabetic nephropathy (DN). The therapeutic or preventive effects of 18β-GA, as a hydrolytic product of glycyrrhizic acid that is a component of licorice, have been appreciated in other disorders, but have received much less attention in relation to diabetic complications. A study in this issue has identified 18β-GA as a therapeutic for preventing DN and provides evidence to support efficacy in cultured human renal tubule cells in vitro. Although it represents a pilot study, the observations support a new therapeutic approach that warrants further exploration.