{
  "abstract": "Glycyrrhizic acid class compounds are used empirically for checkpoint inhibitor-induced liver injury (ChILI), but their effects on antitumour efficacy remain uncertain. This narrative review examines isomer-specific pharmacology, clinical evidence and the candidate mechanisms proposed for this class, of which the high-mobility group box 1 (HMGB1) axis is the most developed. In a propensity-score-matched cohort of 229 patients, magnesium isoglycyrrhizinate (MgIG) plus corticosteroids was associated with higher day-10 alanine aminotransferase normalization than corticosteroids alone (30.7% versus 17.4%). A single-arm study of 67 patients reported study-defined liver injury in 9.0% during prophylaxis. Neither study reported antitumour efficacy or established causal clinical benefit. Modulating extracellular HMGB1 might reduce organ inflammation while altering tumor immunosuppression. However, neither direct HMGB1 engagement by MgIG nor a causal contribution of HMGB1 to ChILI was established in the identified literature. HMGB1 can also support antitumour immune priming; its net effect depends on redox state, tissue and timing. The corresponding 18α aglycone shows no measurable inhibition of 11β-hydroxysteroid dehydrogenase type 2 up to 20 µM in vitro, which does not establish clinical safety. Controlled trials should assess liver injury, corticosteroid exposure, antitumour outcomes and electrolyte safety together; routine prophylaxis is not supported.",
  "abstract_shown": true,
  "affiliations": [
    "Science and Innovation Center of Xinjiang Second Medical College, Karamay 834000, China",
    "School of Pharmacy, Xinjiang Second Medical College, Karamay 834000, China"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Jie Li",
      "orcid": "0009-0003-1850-8902"
    },
    {
      "affs": [
        0
      ],
      "name": "Baojian Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Ying Gao"
    },
    {
      "affs": [
        0
      ],
      "name": "Boshen Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Jasur Kasim",
      "orcid": "0009-0006-1579-6023"
    },
    {
      "affs": [
        0
      ],
      "name": "Nanqi Shao",
      "orcid": "0009-0008-4172-0828"
    },
    {
      "affs": [
        0
      ],
      "name": "Zheng Gao"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Zhan Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhongxing Song"
    },
    {
      "affs": [
        1
      ],
      "name": "Yinglai Yang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jianguang Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bxn6d4pzpvbqh.bib",
  "cited_by": 0,
  "doi": "10.3390/ijms27219987",
  "fulltext_url": null,
  "id": "bxn6d4pzpvbqh",
  "issns": [
    "1422-0067"
  ],
  "landing_url": "https://www.mdpi.com/1422-0067/27/21/9987",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-07",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/bxn6d4pzpvbqh.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T00:21:27Z",
      "native_id": "10.3390/ijms27219987",
      "source": "crossref",
      "url": "https://www.mdpi.com/1422-0067/27/21/9987"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "issn:1422-0067",
      "subfield": "general"
    }
  ],
  "title": "Glycyrrhizic Acid Class Compounds in Immune Checkpoint Inhibitor Therapy: Stereochemistry, Mechanistic Hypotheses, and Protection Against Immune-Related Organ Injury",
  "title_text": "Glycyrrhizic Acid Class Compounds in Immune Checkpoint Inhibitor Therapy: Stereochemistry, Mechanistic Hypotheses, and Protection Against Immune-Related Organ Injury",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T00:21:27Z",
  "url": "https://research.draconitic.com/paper/bxn6d4pzpvbqh",
  "venue": "International Journal of Molecular Sciences",
  "versions": []
}