September 28, 2018


Licorice Compound Offers New Cancer Prevention Strategy

Liquorice or licorice is the root of Glycyrrhiza glabra from which a sweet flavour can be extracted. The liquorice plant is an herbaceous perennial legume native to southern Europe and parts of Asia, such as India.

Anise, Fennel and Licorice are three entirely different plants, but they all have similar taste properties. They are all sweet and aromatic. This often leads to confusion when eating products that contain any one of them.

The chemical component of licorice may offer a new approach to preventing
colorectal cancer without the adverse side effects of other preventive
therapies, Vanderbilt University Medical Center researchers report.

In the study published in the Journal of Clinical Investigation,
Raymond Harris, M.D., Ming-Zhi Zhang, M.D., and colleagues show that
inhibiting the enzyme 11β-hydroxysteroid dehydrogenase type 2 (11βHSD2) –
either by treatment with a natural compound found in licorice or by
silencing the 11βHSD2 gene – prevents colorectal cancer progression in mice
predisposed to the disease.

Colorectal cancer is the second leading cause of cancer deaths in the
United States. While prevention is the best approach for reducing colorectal
cancer deaths, few medical strategies exist to prevent the disease.

One promising target for chemoprevention is the enzyme cyclooxygenase 2
(COX-2), which promotes colorectal cancer progression via the action of the
enzyme’s inflammatory products, the prostaglandins. Inhibiting this enzyme –
with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or with
selective COX-2 inhibitors like Vioxx or Celebrex – reduces the number and
size of colon polyps in mice and in patients with an inherited
predisposition to colon cancer. However, both types of drugs cause serious
adverse side effects that limit their utility for chemoprevention.

Harris and Zhang – nephrologists who are also members of the
Vanderbilt-Ingram Cancer Center – have been investigating COX-2 regulation
in the kidney. They previously found that inhibiting 11βHSD2 in the kidney
suppresses COX-2 expression in that organ.

The colon is one of the only other organs (besides the kidney) with high
expression of 11βHSD2, suggesting that this enzyme might play a role in
colorectal cancer progression.

“Since studies here and elsewhere have shown the importance of COX-2 and
colonic carcinogenesis, we postulated that maybe one of the mechanisms by
which the normal colon might prevent excessive expression of COX-2 is by
11βHSD2,” said Harris, the Ann and Roscoe R. Robinson Professor of
Nephrology and director of the division.

The researchers examined expression of 11βHSD2 in human colon polyps and
in the colons of mice predisposed to colon cancer. They found that 11βHSD2
was increased in polyps found in both mice and humans and correlated with
COX-2 expression and activity.

They then inhibited 11βHSD2 with glycyrrhizic acid, the main
sweet-tasting component of licorice, and by silencing the gene for 11βHSD2.

Both treatments inhibited the production of prostaglandin E2 (an
inflammatory molecule produced by the COX-2 enzyme) and prevented the
development of polyps (adenomas) and tumor growth and metastasis.

Because 11βHSD2 is highly expressed only in kidney and colon, blocking
the enzyme produces effects specific to those tissues – unlike NSAIDs,
selective COX-2 inhibitors, and steroid treatments that can prevent cancer
progression but also cause serious side effects like gastrointestinal
irritation, cardiovascular events, and immunosuppression, respectively.

Licorice, Harris noted, has been used as a nutraceutical for thousands of
years for ailments ranging from coughs to constipation. But even licorice is
not without side effects; long-term consumption can lead to low blood
potassium and increases in blood pressure – side effects linked to the
inhibition of 11βHSD2.

“These are relatively minor compared to the cardiovascular side effects
of COX-2 inhibitors,” Harris said. “We didn’t see (these side effects) in
the mice we treated…but it would be something to be aware of, and something
that could easily be treated with a diuretic.”

Harris and colleagues are continuing to investigate the mechanism of
11βHSD2 inhibition. Zhang, an assistant professor of Medicine and of Cancer
Biology, also plans to look at the enzyme’s role in lung cancer and other

And although this natural chemical is an appealing drug lead in itself,
the researchers are also working with the Vanderbilt Institute for Chemical
Biology to develop more specific and potent inhibitors of 11βHSD2.

“We think we can make (an inhibitor) that is more specific and has better
delivery to the target tissues,” Zhang said.

The research was supported by grants from the American Cancer Society,
the National Institutes of Health and the Department of Veterans Affairs.
Vanderbilt co-authors include: Jie Xu, Bing Yao, Ph.D., Huiyong Yin, Ph.D.,
Qiuyin Cai, M.D., Ph.D., Martha Shrubsole, Ph.D., Xiwu Chen, M.D., Ph.D.,
Valentina Kon, M.D., Wei Zheng, M.D., Ph.D., and Ambra Pozzi, Ph.D.

Journal reference:

  1. . Inhibition of 11-beta-hydroxysteroid dehydrogenase type II
    selectively blocks the tumor COX-2 pathway and suppresses colon
    carcinogenesis in mice and humans
    . Journal of Clinical
    , March 24, 2009

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