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Prace oryginalne / Original papers
Dermatologia Kliniczna 2005, 7 (3):
Copyright © 2005 Cornetis
ISSN 1730-7201
Preparations containing glycyrrhizic acid employed in dermatovenereologic
practice. Conclusions of an international multicentre study
Zastosowanie preparatów zawieraj¹cych wyci¹g z Glycyrrhiza glabra w praktyce dermatowenerologicznej.
Podsumowanie miêdzynarodowego, wielooœrodkowego badania klinicznego
Zelenková Hana1, Nejdková Alena2, Škutilová Eva3, Urbáni Milan4, Švecová Danka5, Cabalová Jirina6
1
DOST Svidník, SR
Private Department of Dermatology, Žilina, SR
3
Private Department of Dermatology, Podunajské Biskupice, SR
4
Department of Dermatology of the Faculty Hospital, Banská Bystrica, SR
5
Clinics of Dermatovenerology of the Faculty Hospital, Bratislava, SR
6
Private Department of Dermatology, Prague, Czech Republic
2
Streszczenie Introduction: Epigen® (Laboratorios Cheminova International) represents an up-to-date preparation the development of which resulted from the
experience obtained in the field of traditional medicine. Its excellent antiviral properties have been repeatedly proven by many studies. The indications of the employment of Epigen® are as follows: herpes simplex – labialis, genitalis (vulvovaginitis herpetica, balanopostitis herpetica), herpes
simplex recidivans, herpes zoster, HPV infections – verrucae, condylomata acuminata.
Material and methods: 55 patients diagnosed with herpes simplex – labialis, genitalis (vulvovaginitis herpetica, balanopostitis herpetica), herpes
simplex recidivans, herpes zoster and condylomata acuminata were being observed at six departments of dermatovenereology as part of an international multicentre study. The series of patients consisted of 26 men (with the average age of 38.5) and 29 women (with the average age of 40.5).
The youngest patient was a 12-year-old boy with herpes simplex, the oldest patient was a 78-year-old woman with herpes zoster facialis. The most
numerous group of patients consisted of individuals with Herpes simplex and Herpes simplex recidivans amounting to the total of 24 patients.
Results: 11 relapses were recorded. The tolerability of the preparation Epigen® was very good in all patients, none of the patients had to discontinue the therapy and no adverse effects were recorded. Even patients with disease relapses spontaneously decided to continue with the application of Epigen® after the termination of the study. The application of Epigen® has significantly accelerated the healing process in local manifestations. The application of Epigen® spray or cream in patients with herpetic infections was followed by desiccation of vesicles without crust formation, which significantly reduced the abuse of analgesics. The effect was excellent in minor manifestations of condylomata acuminata. The treatment of more extensive condylomata manifestations requires a combination of Epigen® application and cryotherapy.
Conclusions: Epigen® cream and spray is a clear contribution to the portfolio of topically employed dermatologic agents.
Key words: glycyrrhizic acid, therapy, virus diseases
Abstract
Wprowadzenie: Epigen® (produkt Laboratories Cheminova International, Hiszpania) jest wspó³czesnym preparatem, który powsta³ w wyniku doœwiadczeñ medycyny tradycyjnej. Jego szczególne w³aœciwoœci przeciwwirusowe by³y wielokrotnie potwierdzone w licznych badaniach klinicznych.
Wskazania do zastosowania preparatu Epigen® s¹ nastêpuj¹ce: opryszczka zwyk³a (herpes simplex) – zmiany umiejscowione na twarzy i wargach
(herpes labialis) oraz w okolicach genitalnych (herpes genitalis: vulvovaginitis herpetica, balanopostitis herpetica), opryszczka zwyk³a postaæ
nawrotowa (herpes simplex recidivans), pó³pasiec (herpes zoster) oraz zaka¿enia HPV – takie jak: brodawki zwyk³e (verrucae vulgares) oraz k³ykciny koñczyste (condylomata acuminata).
Materia³ i metody: 55 pacjentów z jednym z rozpoznañ: Herpes simplex – labialis, genitalis (vulvovaginitis herpetica, balanopostitis herpetica),
Herpes simplex recidivans, Herpes zoster oraz condylomata acuminata by³o w³¹czonych do badania klinicznego prowadzonego w 6 oœrodkach
dermatowenerologicznych na S³owacji i w Czechach. Badanie by³o zaplanowane jako wielooœrodkowe, miêdzynarodowe. Grupê badanych stanowi³o 26 mê¿czyzn (œrednia wieku 38,5 roku) oraz 29 kobiet (œrednia wieku 40,5 roku). Najm³odszym pacjentem by³ 12-letni ch³opiec choruj¹cy na
opryszczkê zwyk³¹, najstarsza zaœ by³a 78-letnia pacjentka z pó³paœcem twarzy. Najliczniejsz¹ grupê (n=24) stanowili pacjenci z opryszczk¹ zwyk³¹, w tej grupie u wielu z postaci¹ nawrotow¹.
Wyniki: Tylko w 11 przypadkach wyst¹pi³ nawrót zmian. Preparat by³ bardzo dobrze tolerowany przez wszystkich pacjentów, ¿aden z nich nie przerwa³ leczenia, nie odnotowano ¿adnych dzia³añ niepo¿¹danych. Pacjenci, u których dosz³o do nawrotów zmian, zdecydowali siê na kontynuacjê
terapii preparatem Epigen® ju¿ po zakoñczeniu badania klinicznego. Stosowanie go w sposób istotny przyspiesza³o proces gojenia zmian. W przypadku pacjentów z infekcj¹ wirusem opryszczki leczenie powodowa³o ustêpowanie pêcherzyków bez tworzenia strupów, co spowodowa³o znaczne
zmniejszenie koniecznoœci stosowania leków przeciwbólowych. Efekt terapii by³ znamienny w przypadku mniej nasilonych zmian typu condylomata
acuminata. Zmiany bardziej nasilone wymaga³y po³¹czenia stosowania preparatu Epigen® z krioterapi¹.
Wnioski: Epigen®, krem i spray, nale¿y uznaæ za cenne uzupe³nienie mo¿liwoœci farmakoterapii miejscowej we wskazaniach dermatologicznych.
S³owa kluczowe: wyci¹g z Glycyrrhiza glabra, leczenie, choroby wirusowe
Address for correspondence: Hana Zelenková, M.D., Ph.D.
DOST Svidník
ul. Dr. Pribulu 2, 089 01 Svidník, Slovakia
tel.: + 421 54 788 2611, + 421 54 788 2612
tel./fax: + 421 54 752 1521, e-mail: [email protected]
Introduction
Glycyrrhiza glabra also known as “sweet root” is a perennial
plant and one of the oldest drugs in the world. The melliferous 1
Zelenková Hana et al.
Preparations containing glycyrrhizic acid employed in dermatovenereologic practice. Conclusions of an international ...
active antiviral group
aktywna grupa
o dzia³aniu
przeciwwirusowym
(C 42H62O16:822.92)
Fig. 1. Chemical formula of GA (4, 14, 17)
Ryc. 1. Wzór chemiczny glycyrrhizic acid (4, 14, 17)
source plant is a member of the pea family. The name of the
plant essentially derives from the Greek words – glykys meaning sweet and rhiza – the cognate of the English word root.
Liquiritia is a later loaned Latin form of the plant’s name. Glabra is the name of the species and relates to the sticky glands
on the resiny leaves. Glycyrrhiza glabra was mentioned on
Egyptian papyruses a few centuries B.C. as the drug for the
treatment of respiratory tract catarrh. Similarly, it has been
used in Chinese medicine for ages due to its considerable antiinflammatory properties.
Glycyrrhiza glabra is used in pharmacy today as well. The
contained active substances in the extract of the root drug can
be divided into two groups:
• group I – saponin-like substances – Glycyrrhizin,
• group II – flavonoids – liquiritine and isoliquiritine.
Glycyrrhizin is a substance of sour character (a more appropriate name of the substance is glycyrrhizic acid – GA) contained in the plant as potassium and calcium salt. The commonly
traded glycyrrhizin ammonium salt is used in confectionery.
GA is the representative of substances exhibiting corticomimetic activity. The drug is best known for its expectorant effect.
During WWII, the anti-ulcerous effect of GA on the mucous
membrane of the stomach was observed and verified. GA also
demonstrates laxative and slightly diuretic properties. In case
of prolonged use of the drug, which is not advisable, oedema
may occur (1).
During the performance of targeted research activities it
has been proven that GA contains an active antiviral group. In
1979 the first study on the antiviral properties of GA was published (2). Other studies and experience developed as the result
of its employment in practice followed continuously (3-10). The
most numerous and extensive studies in vitro were published
by Japanese authors in the work from 1988 by Ohtsuki and Iahida (11) considered to be the breakthrough in this field.
The knowledge of the best foreign centres was taken advantage of by the Spanish company Laboratorios Cheminova International and became part of their production programme. For
2 the development of the recipe of a topical preparation for the
Dermatologia Kliniczna 2005, 7 (3)
treatment of various virus infections named Epigen the latest
knowledge of scientific research was used. In the development
of the preparation the method of molecular activation increasing its biological activity (12) was utilised. The ultimate goal
was to present a preparation that would fully meet the attributes of absolute safety and maximum efficacy. The introduction
of Epigen in the market was preceded by elaborated laboratory and clinical studies (13-22). The indication spectrum of Epigen is as follows: herpes simplex – labialis, genitalis (vulvovaginitis herpetica, balanopostitis herpetica), herpes simplex
recidivans, herpes zoster and HPV infections: verrucae, condylomata acuminata.
After elaborated multicentre studies had been performed
abroad, Czech and Slovak dermatovenereologists were contacted by Laboratorios Cheminova International (Spain) and instructed to perform a study the aim of which would be to verify
the effect of Epigen in patients with virus infections such as
herpes simplex, herpes zoster, herpes progenitalis, condylomata acuminata, including both the acute as well as relapsing
forms in all groups. During the course of performance of the
study results were obtained verifying that Epigen exhibits
a significantly positive effect on mucous membrane of the patients affected by bullous diseases of pemphigus and pemphigoid group. The results of the study are now subject of continuous scientific work.
The study was performed at six departments of dermatovenerology in the Slovak and Czech republic from December
2002 till May 2003. Type of study: open, type IV. Post registration observation.
Material and methods
55 patients with herpes simplex – labialis, genitalis (vulvovaginitis herpetica, balanopostitis herpetica), herpes simplex
recidivans, herpes zoster and condylomata acuminata were
observed at 6 clinics. The representation of single diagnoses is
stated in table I.
26 males (average age of 40.6 year) and 29 females (average age of 36.7 year) were included into study. The youngest
patient was a 12-year-old boy with herpes simplex and the oldest patient was a 78-year-old woman with herpes zoster facialis. The most numerous group of patients was the group with
Herpes simplex and Herpes simplex recidivans consisting of
the total of 24 patients.
Inclusion criteria:
• first disease bout,
• disease relapse,
• age: 12-80 years,
• failure of previous therapies with other topical preparations,
• resistance of the local finding to other preparations.
Exclusion criteria:
• pregnancy and lactation,
• patients younger than 12 years,
• bad cooperation between the doctor and the patient,
• patients with polyvalent allergy,
• patients on steroids, immunomodulants, immunosuppressives, topical antiviral agents.
The employed agent: Epigen® cream or spray with effective
substance content of 0.1 g in 100 ml of excipient.
Number of applications: 3-5 times a day until the optimisation of the condition, the application duration differs according
to single diagnoses from 3 to 60 days.
Application information: provided by the therapist.
Documentation: working protocol.
Photo documentation: 2-3 times in selected patients.
Zelenková Hana i wsp.
Zastosowanie preparatów zawieraj¹cych wyci¹g z Glycyrrhiza glabra w praktyce dermatowenerologicznej. Podsumowanie miêdzynarodowego, wielooœrodkowego...
Table I: Basic data on patients included into the international multicentre study. The effect of preparations containing glycyrrhizic acid (Epigen®)
in dermatovenereologic practice
Tabela I: Podstawowe dane pacjentów w³¹czonych do miêdzynarodowego, wielooœrodkowego badania klinicznego. Zastosowanie preparatów zawieraj¹cych wyci¹g
z Glycyrrhiza glabra w praktyce dermatowenerologicznej
Diagnose
Men / Mê¿czyŸni
Women / Kobiety
Total / Ogó³em
Number of applications
Application duration
Rozpoznanie
(per day)/average
(in days)/average
Number
Average age
Number
Average age
Number/average
Liczba aplikacji
Czas stosowania
Liczba
Œredni wiek
Liczba
Œredni wiek
age
(w dniach)/œrednia
Liczba/œredni wiek (w ciagu dnia)/œrednia
Herpes zoster
Herpes simplex
(also/równie¿ H. simplex
recidivans)
Herpes progenitalis
Condylomata acuminata
Verrucae vulgares
Total / Ogó³em
6
8
51.7
31.5
2
16
67.00
40.60
8/59.62
24/37.50
3-5/4.10
3-5/4.45
7-14/9.7
3-30/10.4
7
5
38.8
29.8
4
5
2
37.70
26.04
23.50
11/38.40
10/28.10
2/23.50
3-5/4.10
3-5/4.30
3-4/3.50
3-28/7.7
7-60/26.1
5/5
26
40.6
29
36.70
55/38.50
∅ 4.29
∅ 12.4
Table II: International multicentre study. The effect of preparations containing glycyrrhizic acid (Epigen®) in dermatovenereologic practice – relapses, application
discontinuation, adverse effects
Tabela II: ?????????????
Diagnosis
Men / Mê¿czyŸni
Women / Kobiety
Total / Ogó³em
Relapses
Discontinuation
Adverse effects
Rozponanie
Przerwane leczenie Dzia³ania niepo¿¹dane
Number
Relapses
Number
Relapses Number/Average age Nawroty
Liczba
Nawroty
Liczba
Nawroty
Liczba/Œredni wiek
Herpes zoster
6
0
2
0
8/59.6
0
0
0
Herpes simplex
8
3
16
4
24/37.5
7
0
0
(also / równie¿: Herpes
simplex recidivans
Herpes progenitalis
7
3
4
1
11/38.4
4
0
0
Condylomata acuminata
5
0
5
0
10/28.1
0
0
0
Verrucae vulgares
0
0
2
0
2/23.5
0
0
0
Total / Ogó³em
26
6
29
5
55/38.5
11
0
0
Table III: International multicentre study. Effect of the preparations containing glycyrrhizinic acid (Epigen®) in dermatovenereologic practice – efficacy and tolerance
Tabela III: Miêdzynarodowe, wielooœrodkowe badanie kliniczne. Zastosowanie preparatów zawieraj¹cych wyci¹g z Glycyrrhiza glabra (Epigen®) w praktyce dermatowenerologicznej – ocena skutecznoœci i tolerancji
Diagnosis
Efficacy and tolerance
Rozpoznanie
SkutecznoϾ i tolerancja
Men / Mê¿czyŸni (n=26)
Women / Kobiety (n=29)
Therapist / Lekarz
Patient / Pacjent
Therapist / Lekarz
Patient / Pacjent
Number of patients × evaluation Number of patients × evaluation Number of patients × evaluation Number of patients × evaluation
Liczba pacjentów × ocena
Liczba pacjentów × ocena
Liczba pacjentów × ocena
Liczba pacjentów × ocena
Herpes zoster
6×1
6×1
2×1
2×1
Herpes simplex
8×1
7×1
11×1
11×1
(also/równie¿
1×2
2×2
3×2
H. simplex recidivans)
3×3
2×3
Herpes progenitalis
7×1
6×1
4×1
4×1
1×2
Condyloma acuminata
4×1
3×1
4×1
3×1
1×2
2×2
1×2
1×2
1×3
Verrucae vulgares
2×1
2×1
Total / Ogó³em
25/1 1/2
22/1 4/4
23/1
3/2 3/3
22/1 4/2 3/3
Evaluation of the therapeutic effect: grade 1-5 (1 – healing, 2 – significant improvement, 3 – improvement, 4 – no improvement, 5 – exacerbation) / Ocena skuteczoœci: stopnie 1-5
(1 – wyleczenie, 2 – znaczna poprawa, 3 – poprawa, 4 – bez poprawy, 5 – pogorszenie)
Subjective evaluation of the condition by the patient: grade 1-5 (1- excellent, 2 – very good, 3 – good, 4 – without changes, 5 – exacerbation, irritation) / Subiektywna ocena wg pacjenta:
stopnie 1-5 (1 – wyœmienity, 2 – bardzo dobry, 3 – dobry, 4 – bez zmian, 5 – pogorszenie, podra¿nienie)
Basic laboratory screening: in every patient, serology PL: in
every patient. The evaluation was not subject of the study.
Recommended personal hygiene: Use of non-irritating preparations with no influence on the treatment process.
Other medication: restricted to preparations recommended
by other experts and necessary for the health comfort of the
patient.
Evaluation of the therapeutic effect: grade l – 5 (1 – healing,
2 – significant improvement, 3 – improvement, 4 – no improvement, 5 – exacerbation).
Subjective evaluation of the condition by the patient: grade
1-5 (1 – excellent, 2 – very good, 3 – good, 4 – without changes, 5 – exacerbation, irritation)
Evaluation of adverse effects and their connection with the
application.
Results
The tolerance of Epigen® was very good in all patients and
there was no need to discontinue the therapy in any patient 3
Zelenková Hana et al.
Preparations containing glycyrrhizic acid employed in dermatovenereologic practice. Conclusions of an international ...
during the observation period (tab. II). Even after finish of the
study in patients with relapses the preparation Epigen® is continuously used. Evaluation of efficacy and tolerance of the preparation in each groups were detailed in table III.
Herpes zoster: it is evident that the application of Epigen®
significantly accelerated the healing of topical manifestations.
The application of Epigen® spray or cream resulted in the desiccation of vesicular eruptions without crust formation. The abuse
of analgesics was reduced significantly (one of the female patients discontinued their use on the third day already). The healing occurred without the formation of scars in extensive manifestations as well. In one case light depigmentation of the affected area occurred in a male patient. Efficacy and tolerance were
assessed as excellent by both the doctor and the patients.
Herpes simplex: In most of the patients the application and
effects of Epigen® were evaluated as excellent. Nearly all of the
patients reported an instant relief sensation – burning pain relief and the sensation of local anaesthesia. The vesicular eruptions rapidly changed into small hemorrhagic crusts and the
inflammatory infiltration receded within 72 hours. Most of the
patients reported total healing on the fifth day of application.
Whereas in men the efficacy and tolerance were evaluated as
excellent by the patients as well as the therapist, in women the
results were slightly different. In ten patients with herpes simplex labii oris eruptions the effect and tolerance were excellent.
Three patients with permanent manifestations on the lips were
utilising Epigen for nearly a month with short breaks the result
of which was the final healing of the symptoms and the lack of
relapses for the period of the following two months. In two patients – one with herpes simplex labii oris sup. recidand and
the other with herpes simplex reg. glutealis recid. the healing
was slow and the efficacy and tolerance were evaluated as
good and comparable with other external agents utilised by the
patients in the past. Within the three months of observation
the total of 6 patients experienced a relapse of herpes simplex
labii oris. After repeated application of Epigen® the lesions
were healed within 72 hours.
Herpes progenitalis: Efficacy and tolerance were assessed
as excellent by both the doctor and the patients. Similarly to
the group of patients with herpes simplex, in all monitored patients there was a rapid change in vesiculation and the inflammatory infiltration receded within 72 hours. Most of the patients reported healing on the fourth or fifth day of application.
The patients were in favour mainly of the rapid remission of the
subjective symptoms such as burning sensation and algia. The
mental wellbeing of the patients improved significantly. There
was a relapse in three patients, which was suppresses rapidly
by the repeated application of Epigen®. In one of the patients
there was no relapse recorded within the period of four months
despite the fact that he had suffered from very frequent relapses prior to Epigen® therapy.
Condylomata acuminata: The application of Epigen® on
small condylomata (up to 1 mm) had an excellent effect and
was well tolerated. The regression of the finding was evident
within 7 up to the maximum of 14 days. In the end the lesions
were healed. The most significant effect was observed in
a married couple. In two female patients with an extraordinarily
extended finding the application of Epigen® was prolonged necessarily from 35 to 60 days. Having had the experience with
previous aggressive therapies the patients were demanding to
be treated with Epigen®. In patients with more extensive condylomata the employment of other form of treatment such as
cryotherapy was inevitable. Epigen® exhibited excellent properties in the treatment of residual manifestations. Moreover, patients after cryotherapy reported an analgesic effect of the
4 preparation. No relapses have been recorded.
Dermatologia Kliniczna 2005, 7 (3)
We have recorded no differences between the application of
creme and spray, however, we preferred to use spray on more
extensive areas as well as the intimate parts.
In the group of patients with bullous diseases (the preparation was applied to mucous membrane lesions) the excellent
anti-inflammatory and immunomodulatory effect of the preparation has been proven in 14 patients (11 female, 3 male, with
the average age of 46.07 years). The treatment took 9 to 28
days. In 7 patients total healing occurred (50%). In 4 cases
(28.57%) clinical improvement and in 3 probands (21.42%) visible clinical improvement was recorded. The therapy was well
tolerated and no adverse effects were recorded. The study verified that the employment of preparations containing glycyrrhizic acid represents a new possibility of topical treatment of the
pemphigus and pemphigoid group.
Discussion
Glycyrrhiza glabra is not only one of the starting substances
utilised in the food industry (1, 5), bud can be used in pharmacy mainly as root drug – radix liquiritiae and radix Glycyrrhizae
glabrae (1) as well. The roots and shoots of the plant are collected ergo dug out after the third vegetation year.
The sort that grows in our climate comes from southern Europe and the Near East. The imported sorts come from Spain,
Russia and China and differ in the processing form (finishing),
peeling as well as in other properties. The highest specific weight of Glycyrrhiza glabra is represented in the Spanish sort.
The content of glycyrrhizin (GA), which is highest in the Chinese
peeled sort (5.5%) and the Spanish unpeeled sort (8.9%), is
responsible for the sweet taste of liquorice and its extract
which is 50 times sweeter than beet sugar. Water extract – succus – comes predominantly from the Italian drug. What is really
interesting is the fact that the drug in powder form is very often
fake! (1)
Glycyrrhizic acid (Glycyrrhizin, GA) is a substance of glycosidic character. Aglycon is represented by glycyrrhetinic acid
(glycyrrhetin). The pentacyclic triterpene acid glucuronide is of
steroid character. The sugar component is represented by two
molecules of glucuronic acid. The following split of the sugar
component results in the loss of sweet character.
One of the basic properties of GA is the water foaming property and its low haemolytic efficacy. GA causes the inhibition
of prostaglandin E2 in the affected tissue and stops the replication of viruses as the result of virus P Kinase activity inhibition. The induction of interpherone formation results in the activation of macrophages and potentiation of their phagocytary
and bactericidal property. Interpherones exhibit antiviral and
antiproliferative effect (10, 13, 15, 17-22).
In the end, it is possible to characterise the effect of GA as:
• anti-ulcerous,
• anti-inflammatory,
• antiviral (DNA and RNA virus inhibition ability) – varicella
zoster, HIV, influenza A, B, herpes simplex, hepatitis.
The main active substance of Epigen® (Laboratorios Cheminova International Madrid) is the water extract of GA in the
amount of 0.1 g in 100 g of vehicle. Laboratory experiments in
vitro have proven its inhibitory effect. Animal testing has proven the zero mortality index as well as the minimal ocular and
dermal irritation (6, 11, 13, 17, 20)
Numerous clinical studies with Epigen® performed during
the last ten years at clinics of dermatovenereology and gynaecology (15, 16, 18, 19, 21, 23) have proven the exceptional
activity of the preparation against infections. Epigen® was applied in pregnant women without any problems. Excellent effects have been described in connection with the application in
Zelenková Hana i wsp.
Zastosowanie preparatów zawieraj¹cych wyci¹g z Glycyrrhiza glabra w praktyce dermatowenerologicznej. Podsumowanie miêdzynarodowego, wielooœrodkowego...
the initial phase in which the agent exhibited a 100% efficacy
and 90% efficacy in recurrent cases (16, 19, 21, 22).
Promising effects have been recorded in patients with mucous membrane manifestations in pemphigus and pemphigoid
group (24). The first case was the female patient with genital
lesions of pemphigus vulgaris. The application resulted in the
amelioration of burning, pain and desiccation of eroded areas.
Even more significant effects were recorded in a female patient
with pemphigus chronicus benignus familiaris (Hailey-Hailey
disesase) localised on the loins, the perigenital area and axillae. The results obtained by monitoring the total of 14 patients
were subjected of further study published and presented at the
EADV congress in Barcelona 2003.
All of the participating subjects confirm that Epigen® significantly reduces: oedema, hyperaemia, burning, itching and accelerates the epithelization of eroded areas. The confirmation
of the declared properties of Epigen® in 46 patients monitored
within the framework of this multicentre international study
needs to be supported by the evaluation of application properties. The use of Epigen® topical highly effective preparation is
restricted to external application on mucous membranes and
can be assessed as quick and simple. The preparation is registered in the Slovak Republic in both its cream and spray formulation.
Conclusion
Epigen® (Laboratorios Cheminova International) is a modern
preparation developed based on the experience of traditional
medicine. Its excellent antiviral properties were proven by means of the presented multicentre study. It represents an alternative treatment agent for a big group of patients with herpes
simplex – labialis, genitalis (vulvovaginitis herpetica, balanopostitis herpetica), herpes simplex recidivans, Herpes zoster,
condylomata acuminata, verrucae vulgares. There were extremely interesting effects observed in patients with bullous dermatoses.
The preparation is extremely well tolerated and causes neither irritation nor other adverse effects. The application is
simple and comfortable. What is positive about the application
is that it can be applied concomitantly with other systemically
applied agents as well as other types of mechanic or physical
treatment forms.
The results of the multicentre study fully verified the presumed effect of the utilised molecular activation method increasing the biological efficacy of the preparation (12).
References
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2. Doll R., Hill I.D., Hutton C., Underwood D.L.: Antiviral activity of glycyrrhizic acid.
Lancet, 1979, 11, 793-796.
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