In situ detection of H1-receptor mRNA and absence of apoptosis in the transient histamine system of the embryonic rat brain

In the developing brain, histamine is one of the first neurotransmitters to appear. The concentration of histamine in the prenatal brain is fivefold that of adult levels. During the prenatal development a large transiently histamine-immunoreactive cell population distinct from the adult histaminergic system can be found within a subpopulation of the developing serotonergic raphe nuclei neurons. Also histamine-immunoreactive nerve fibers are widely distributed already during the prenatal development extending to the diencephalon, the thalamus, the cortex, and the spinal cord. Large numbers of histamine-containing mast cells also migrate into the brain during the late prenatal life. The wide distribution and high prenatal concentrations imply important functions for the histaminergic system during intrauterine development. However, little is known about the actual functions of histamine during development, and which of the histamine receptors are present in the prenatal rat brain is currently unknown. In the present study, we used in situ hybridization to study the distribution of H1-receptor (H1R) mRNA in the embryonic rat brain and spinal cord. H1R mRNA could be detected in rat brain and in spinal cord on embryonic day (E) 14, and the expression pattern seemed to partially localize in areas containing histamine-immunoreactive nerve fibers through E14-E20. H1R mRNA was also detected by reverse transcriptase polymerase chain reaction from embryonic brain samples and by Northern hybridization. The possible involvement of apoptosis in the disappearance of the developing transiently histaminergic system was studied by using apoptosis detection based on the terminal dUTP nick end labeling (TUNEL) technique and with c-Fos immunostaining. Although histamine immunoreactivity disappears dramatically from the developing raphe nuclei after E18, only occasional apoptotic nuclei could be seen in the histamine-immunoreactive cell bodies. The presence of H1R mRNA during the embryonic development renders it possible that histamine could exert an H1R-specific function at the time of the embryonic histamine peak.

Isolation and characterization of an invertase and its repressor genes from Schizosaccharomyces pombe

PCR was used to isolate an invertase homolog gene from the fission yeast Schizosaccharomyces pombe. The cloned inv1(+) gene encodes a protein of 581 amino acids with 16 potential asparagine-linked glycosylation sites, and has 39% and 38% identity to the Schwanniomyces occidentalis and Saccharomyces cerevisiae SUC2 invertases. When the inv1(+) gene was disrupted, S. pombe strains lacked detectable invertase activity. This result showed that the inv1(+) gene encodes only one active invertase in S. pombe cells. The transcription of inv1(+) is repressed in the presence of glucose. The transcription of inv1(+) was not affected in cyr1Delta strain which lacks adenylate cyclase activity, unlike transcription of S. pombe fbp1(+) gene. We have identified an S. pombe gene (scr1(+)) that encodes a homolog of the Aspergillus nidulans CREA which is required for glucose repression of the glyconeogenic pathway. Although the deletion of scr1(+) did not influence the transcription of fbp1(+) gene, glucose repression of the inv1(+) gene was severely affected. These results showed that glucose repression of inv1(+) gene is dependent on scr1(+) gene, and S. pombe cAMP signalling pathway may not be essential for glucose repression of inv1(+) gene.

Unique binding pocket for KW-4679 in the histamine H1 receptor

The histamine H1 receptor has an aspartate (Asp) residue in transmembrane helix 3 (TM3), which is well-conserved among biogenic amine receptors. The Asp residue is one of the most crucial amino acids for ligand binding. The tested histamine H1 receptor antagonists with tri- and tetracyclic structures were not selective for histamine H1 receptors and showed affinity for several other biogenic amine receptors. In contrast, KW-4679 ((Z)-11-[3-(dimethylamino)propylidene]-6,11-dihydrodibenz[b, e]oxepin-2-acetic acid hydrochloride), a tricyclic compound, was a selective histamine H1 receptor antagonist. [3H]KW-4679 had high affinity (Kd value of 2.5 +/- 0.12 nM) for wild-type human histamine H1 receptors. In the [3H]KW-4679 binding assay, replacement of Asp107 by alanine by site-directed mutagenesis greatly reduced the affinities (280-2100-fold) of tri- and tetracyclic compounds, whereas this mutation led to a comparatively small reduction (14-fold) in KW-4679 affinity. These results demonstrate that the tested tri- and tetracyclic histamine H1 receptor antagonists which have a tight interaction with the Asp residue are not selective for the histamine H1 receptor. Furthermore, the high selectivity of KW-4679 might be explained by a unique binding pocket, which consists of the Asp residue and other acceptor sites, in the histamine H1 receptor.

Histamine-induced calcium mobilization in single cultured cells expressing histamine H1 receptors: a relationship between its sensitivity and the density of H1 receptors

Stimulation of histamine H1 receptors initiates the hydrolysis of phosphatidylinositides and results in the production of inositol (1, 4,5)-triphosphate and intracellular Ca2+ mobilization. Although the mechanism for signal transduction via the H1 recptor has been extensively investigated, little is known about the correlation between the sensitivity of histamine-induced Ca2+ mobilization and the density of H1 receptors in cultured cells. Cytosolic free Ca2+ concentration ([Ca2+]i) after stimulation by histamine was monitored in single CHO and rat C6-glioma cells stably expressed with H1 receptors and astrocytoma 1321N1 cells using the Ca2+-sensitive dye Indo-1 and dynamic single cell imaging techniques (ACAS 570 laser cytometer). Both of the H1 receptor-expressed CHO cells and C6-glioma cells were over 10 times more sensitive to histamine than astrocytoma 1321N1 cells in which H1 receptors were naturally present. The density of H1 receptors in the transfected cells was also more than 10-fold that of 1321N1 cells. In addition, inhibition of intracellular Ca2+-ATPase by thapsigargin elicited an increase in [Ca2+]i in H1 receptor-overexpessed cells and astrocytoma 1321N1 cells with similar sensitivity. These data suggest that the sensitivity of Ca2+ mobilization by histamine in these cells was correlatively augmented with the increase in the density of H1 receptors.

Severe muscle damage induced by high carbohydrate intake from elemental diet in a patient with Crohn's disease

Crohn's disease is associated with complications in multiple organs. However, there are very few reported cases of patients with Crohn's disease with muscle symptoms and/or high serum creatine phospho-kinase (CPK) levels. We report here a patient with Crohn's disease who experienced skeletal muscle damage with extremely high serum CPK level during treatment with an elemental diet. The non-parenteral administration of large amounts of carbohydrate and limited glycogen degradation capability may be a possible causative mechanism for this elemental diet-induced muscle damage.

Effect of aging on gastrin receptor gene expression in rat stomach

Gastrin is a pivotal humoral factor which regulates gastric acid secretion through its receptors. There is no report, however, concerning the age-related changes of gastrin receptor gene expression in the stomach. Northern blot analysis and in situ hybridization were performed to clarify the changes of gastrin receptor expression during the aging. In situ hybridization clarified that gastrin receptor mRNA was expressed mainly in enterochromaffin-like (ECL) cells in adult rat gastric mucosa. With aging, gastrin receptor gene expression in the stomach increased with the concomitant increase in histidine decarboxylase mRNA. Since histidine decarboxylase is a marker of gastric ECL cells, the augmented gastrin receptor mRNA in aged rats may be caused by the increased ECL cells in gastric mucosa during the aging.

Intragastric administration of ursodeoxycholic acid suppresses immunoglobulin secretion by lymphocytes from liver, but not from peripheral blood, spleen or Peyer's patches in mice

Ursodeoxycholic acid (UDCA) has been recognized as a therapeutic drug for primary biliary cirrhosis (PBC) and chronic viral hepatitis. As one of the mechanisms by which UDCA improves liver function tests in those patients, its immunomodulatory effect is currently considered important. Although the suppressive effects of UDCA on some cytokine productions, T-cell mediated cytotoxicity and immunoglobulin production were observed from in vitro studies, the immunomodulation in vivo by UDCA remains unclear. In the present study, we investigated the effect of UDCA administration on the number of immunoglobulin secreting cells in liver, peripheral blood, spleen and Peyer's patches in mice using the enzyme linked immunospot assay and assessed whether the UDCA-mediated immunomodulation is liver-specific. It was demonstrated that intragastric administration of UDCA reduced immunoglobulin secretion by lymphocytes from liver, but not from peripheral blood, spleen, or Peyer's patches. However, immunoglobulin production of those lymphocytes cultured in the presence of UDCA was suppressed, irrespective of their distribution sites, in a UDCA dose-dependent manner. When the concentrations of UDCA in portal and peripheral blood were measured using high performance liquid chromatography, UDCA was detectable in the portal blood in UDCA-treated mice, but not in peripheral blood, suggesting that the concentrations of UDCA in the environment surrounding lymphocytes may be an important factor for the modulation of lymphocyte functions.

Intragastric distribution of nonsteroidal anti-inflammatory drug-related ulcers in patients without collagen diseases

During the long-term administration of nonsteroidal anti-inflammatory drugs (NSAIDs), approximately 3% of patients have gastric ulcers develop in each year. Although much is known about the endoscopic characteristics of NSAID-induced gastric ulcers in patients with rheumatoid arthritis (RA), it is not clear where in the stomach NSAIDs induce ulcers in patients without RA. We looked at that question. During the 1-year study period, 29 patients with gastric ulcer, who had been taking NSAIDs regularly for more than 4 weeks mainly for osteoarthritis, were identified. Seventy-five patients with gastric ulcers who had not taken NSAID also were found. The sites of gastric ulcers of these two groups were quite different. The NSAID-induced ulcers mainly were found in the gastric antrum, whereas the majority of NSAID-unrelated ulcers were in the gastric corpus. We conclude that NSAID-induced ulcers in non-RA patients mainly are formed in the gastric antrum.

[A case of esophagopleural fistula successfully cured by conservative therapy after middle and lower lobectomy of right lung]

We experience a case of esophagopleural fistula successfully cured by conservative therapy after the lung cancer operation. A 46-year-old man was received middle and lower lobectomy for adenoid cystic carcinoma of the right lung. Complication of empyema associated with an esophagopleural fistula occurred on postoperative 4th day. Conservative therapy of nothing by mouth, intravenous hyperalimentation and antibiotics was started. Three thoracic drains were inserted and the thoracic irrigation of total 3,000 ml warm saline per day twice on one day was continued. The esophagopleural fistula was closed on 6th week and the patient was discharged on 11th week after the therapy start. This complication is much rare, but recent advance in the diagnostic methods seemed to increase the indication of conservative therapy in future.

Anticholinergic and calcium antagonistic activities of NS-21 contribute to the inhibition of rat urinary bladder contractions

1. Pharmacological characteristics of NS-21 and its main metabolite, RCC-36, in the inhibition of rat urinary bladder contractions were investigated both in vitro and in vivo. 2. NS-21 and RCC-36 inhibited muscarinic receptor bindings to rat bladder membranes with [3H]3-quinuclidinyl bezilate (pKi 6.19 and 7.24, respectively), whereas they failed to inhibit the following receptor bindings: adrenergic (alpha 1, alpha 2 and beta), dopaminergic (D1 and D2), adenosine (A1 and A2), histaminergic (H1) and opioid (mu, delta and kappa) receptors. 3. NS-21 and RCC-36 suppressed carbachol-induced contractions of isolated rat detrusor strips in competitive (pA2 6.80 and 7.93, respectively) and noncompetitive (pD'2 5.93 and 5.77, respectively) manners. 4. NS-21 and RCC-36 inhibited CaCl2-induced contractions of rat detrusor strips in the presence of 100 mM K+ (pIC50 6.54 and 5.76, respectively), as well as the 100 mM K(+)-induced 45Ca influx into the isolated bladder strips at > or = 1 microM. 5. Electrical stimulation of the peripheral end of the pelvic nerve in anesthetized rats induced bladder contractions composed of two phases: an initial phasic contraction that was weakly suppressed by atropine, and a tonic contraction that was strongly suppressed by atropine. NS-21 suppressed both contractions to the same degree (ID50 2.65 and 2.19 mg/kg, i.v., respectively). RCC-36 suppressed the tonic contraction (ID50 1.20 mg/kg, i.v.) more markedly than the initial contraction (ID50 7.43 mg/kg, i.v.). 6. These results suggest that NS-21 and RCC-36 suppressed bladder contractions owing to their anticholinergic and calcium antagonistic activities.

[Usefulness of continuous venous daily chemotherapy of 5-fluorouracil and low-dose cisplatin for patients undergoing noncurative surgery]

We examined the usefulness of continuous venous daily chemotherapy of 5-FU and low/I dose CDDP for patients undergoing noncurative surgery. Twelve patients with carcinoma (1 esophageal, 6 gastric, 4 colorectal carcinoma cases and 1 carcinoma case of unknown origin) underwent resection of primary lesion and postoperative adjuvant chemotherapy. The schedule for the chemotherapy was as follows: 2-7 courses of 24-hours continuous venous infusion of CDDP (5mg/day on day 1, 2, 3, 4, 5) and 5-FU (250 mg/day on day 1, 2, 3, 4, 5 or 1, 3, 5). Several patients received a bolus infusion of Epirubicin (10 mg/1 week or 30 mg/2 week). Mean total volumes of CDDP and 5-FU were 120 mg and 5.38 g, respectively. Nine cases could be evaluated. Results of the chemotherapy were 1 CR, 1 PR, 3 NC and 4 PD, and the overall response rate was 22%. Side effects were found in 6 cases, but were not so severe. One-year survival rate was 47%, and 50% survival time was 9 months. The prognosis of the patients seemed to be relatively good. These results suggest that continuous chemotherapy of 5-FU and low dose CDDP may be useful for patients undergoing noncurative surgery.

Effect of treatment with paromomycin on endotoxemia in patients with alcoholic liver disease--a double-blind, placebo-controlled trial

The results of experimental and clinical studies support the hypothesis that gut-derived endotoxins might be of relevance for the development and course of alcoholic liver disease. The aim of this study was to test the effect of a nonabsorbable, broad-spectrum antibiotic on endotoxemia in patients with alcoholic liver disease. Fifty patients with alcoholic liver disease (27 with cirrhosis, 23 without cirrhosis) were randomly assigned to receive either paromomycin sulfate (3 x 1 g/day) or placebo in a double-blind fashion for at least 3 weeks, and if possible 4 weeks. Endotoxin concentration, liver function tests, and other laboratory parameters were determined in weekly intervals. Endotoxin concentration was also determined in 15 healthy controls. Groups receiving paromomycin or placebo were similar for clinical and biological items collected initially. Mean initial endotoxin concentrations were significantly elevated in both groups (mean +/- SEM; paromomycin, 16.7 +/- 5.3 pg/ml; placebo, 17.5 +/- 6.9 pg/ml; healthy controls, 2.3 +/- 0.4 pg/ml). Although the mean endotoxin concentration was lower in the verum group after 1 week (paromomycin, 8.0 +/- 1.9 pg/ml; placebo, 14.6 +/- 3.5 pg/ml; p > 0.05), paromomycin treatment had no significant effect on endotoxin concentration or liver function tests during the 4-week period. The beneficial effect of paromomycin treatment on endotoxemia in cirrhotics reported in earlier studies could not be reproduced under the conditions of this trial in patients with alcoholic liver disease.

Helicobacter pylori induces proinflammatory cytokines and major histocompatibility complex class II antigen in mouse gastric epithelial cells

Although Helicobacter pylori has been reported to stimulate the release of various cytokines from gastric tissue, it remains unknown whether normal and nontumorous gastric epithelial cells produce these cytokines. Therefore, in this study, we used a normal mouse gastric surface mucous cell line (GSM06) to determine whether gastric epithelial cells produce proinflammatory cytokines in response to H. pylori. The expression of MHC class II antigen was also examined, to investigate whether gastric epithelial cells participate in the immune response to H. pylori. In the study, GSM06 cells were incubated with H. pylori or its lipopolysaccharide (LPS). Proinflammatory cytokines were detected by Northern and Western blot analysis. The expression of MHC class II antigen was examined by fluorescence activated cell sorter (FACS) analysis. Genetic expression of proinflammatory cytokines such as interleukin-1alpha, tumor necrosis factor-alpha, and cytokine-induced neutrophil chemoattractant-2beta was enhanced by both intact and sonicated H. pylori, but not by H. pylori LPS. The expression of MHC class II antigen was induced by H. pylori more strongly than by interferon-gamma. We conclude that H. pylori induces the expression of proinflammatory cytokines and MHC class II antigen in gastric epithelial cells. Gastric epithelial cells may act as antigen-presenting cells and participate in the immune response to H. pylori infection.

Effect of smoking on the serum concentration of erythropoietin and granulocyte-colony stimulating factor

Smoking is the most common cause of secondary polycythemia and may induce leukocytosis. We studied the relationship between hematopoietic growth factors and erythrocytosis and leukocytosis. Two sets of healthy male volunteers, consisting of 177 and 202 (age: 19-59 years) were each divided into four groups according to whether or not they smoked at least one package daily and their leukocyte count. Serum erythropoietin (Epo) concentration and granulocyte-colony stimulating factor (G-CSF) concentration were measured in the 177 and 202 volunteers, respectively. The mean serum Epo concentration was lower in smokers than in nonsmokers (p = 0.01 in the subjects without leukocytosis and p = 0.107 in those with leukocytosis, respectively). After 3 smokers stopped smoking, the Epo concentration increased 2 weeks later, and remained constant for 20 weeks. Smokers tended to have a higher mean serum G-CSF concentration than nonsmokers in the subjects without leukocytosis. Neither Epo nor G-CSF is the main etiology of smokers' polycythemia, and Epo production may be down-regulated by an elevated red-cell volume.

Cationic Surfactant Adsolubilization of 2-Naphthol and Naphthalene with Titanium Dioxide Having Dodecyl Chain

Adsolubilization of 2-naphthol and naphthalene by cationic surfactant-adsorbed layers formed on titanium dioxides with or without a dodecyl chain was investigated. The cationic surfactants used were dodecyltrimethylammonium bromide and 1,2-bis(dodecyldimethylammonio) ethane dibromide (2RenQ). It was found that the adsolubilized amounts of 2-naphthol and naphthalene increase and reach a maximum and then decrease for both surfactants and titanium dioxides with or without the dodecyl chain, where in the absence of surfactants the incorporated amount of naphthalene on the titanium dioxide with the dodecyl chain is markedly large. The adsolubilized amounts of 2-naphthol and naphthalene were enhanced with the titanium dioxide with the dodecyl chain by adsorption of surfactants, in particular 2RenQ. The admicellar partitioning coefficients also showed that naphthalene is adsolubilized preferentially rather than 2-naphthol and the surface treatment with the dodecyl chain enhances the adsolubilization for two adsolubilizates. Copyright 1997 Academic Press. Copyright 1997Academic Press

Effect of dibutyryl cyclic AMP on the cyclin-dependent kinase inhibitor p27Kip1 in the human hepatoma cells PLC/PRF/5

The cyclin-dependent kinase (cdk) inhibitor p27Kip1 is known to play a role in cell-cycle regulation at G1 and G1/S phase. We investigated the effect of the putative growth-inhibiting agent dibutyryl cyclic AMP (DBcAMP) on the serial changes of p27Kip1 expression in the human hepatoma cells PLC/PRF/5 in culture. The p27Kip1 protein level increased at an early stage of G1 phase (2 hours) after a release from serum-starvation and subsequently maintained the level until the entry to S phase, whereas an addition of DBcAMP at 1mM increased the p27Kip1 protein level during G1 phase. In contrast, the relative expression levels of p27Kip1 mRNA at 2 hours, 4 hours and 6 hours were lower in DBcAMP-added cells. The effects of DBcAMP on cell growth were, reduction of S-phase cells, inhibition of DNA synthesis, and accumulation of G2-phase cells. In the presence of the antisense oligodeoxynucleotides against p27Kip1 mRNA, DBcAMP-induced growth inhibition was partially abolished. These findings suggest that DBcAMP elevates p27Kip1 protein expression during G1 phase, which could be associated with growth inhibition. DBcAMP may inhibit the degradation of p27Kip1 protein.

Development of neo red cells (NRC) with the enzymatic reduction system of methemoglobin

To assess the oxygen transport capacity and safety of Neo Red Cells (NRC) with the enzymatic reduction system of methemoglobin in vitro and in experimental animals. Stroma free hemoglobin (SFH) prepared without damage of enzymes from outdated human red blood cells, together with inositol hexaphosphate as an allosteric effector, NAD as a coenzyme and glucose, adenine and inosine as a substrate was encapsulated within liposomes composed of hydrogenated soy phosphatidylcholine, cholesterol, myristic acid and alpha-tocopherol in the ratio of 7:7:2:0.28 respectively. NRC thus prepared with a mean diameter of 220 nm, encapsulation efficiency of 1.3 g-Hb:1 g-lipid and P50O2 of 50-60 mmHg were then coated with polyethylene glycol bound to hydrogenated soy phosphatidylethanolamine as a surface modifier to prevent aggregation of NRC in plasma. The methemoglobin formation of the NRC with enzymatic reduction system were evaluated by in-vitro examination and exchange transfusion with rats as in-vivo examination, then the methemoglobin formation was reduced from 1%/hr to 0.4%/hr by the addition of methemoglobin reduction system. The generation of the pyruvate and the lactate were observed within the NRC with enzymatic reduction system, then the activation of the Embden-Meyerhof pathway was confirmed. And we concerned about the availability of the NRC as a perfusate for the cardiopulmonary bypass during moderate or profound hypothermia, then we evaluated the oxygen transporting efficiency and capacity of the NRC under the using of the artificial lung system in vitro examination. The present investigation suggest that the effectiveness of the NRC with enzymatic reduction system, they restrained the formation of methemoglobin and they are efficient oxygen carriers as a perfusate of the artificial lung, and we suggest the new extracorporeal circulation system using of the NRC as a perfusate for the cardiopulmonary bypass.

Developmental gene expression of gastrin receptor in rat stomach

Gastrin, which is present in fetal plasma, may have important roles in the development of gastric mucosa, since it is not only a potent stimulator of gastric acid secretion but also a growth promoting factor. Gastrin regulates various cellular functions via its receptors on cell membrane. Therefore, in order to elucidate a role for gastrin in the development of gastrointestinal system during gestation, Northern blot analysis was performed. The results of the study suggested that gastrin receptor is mainly present on parietal cells. Furthermore, proton pump and gastrin receptor gene expressions in parietal cells were strongly stimulated by the administration of exogenous gastrin. In conclusion, gastrin may be involved in the developmental change of parietal cells through its receptors.

Tissue-specific expression of HSV-tk gene can induce efficient antitumor effect and protective immunity to wild-type hepatocellular carcinoma

The efficacy of expression of the herpes simplex virus thymidine kinase (HSV-tk) gene under the transcriptional control of the liver-specific albumin gene promoter, followed by ganciclovir treatment, was investigated both in vitro and in vivo. Murine and rat hepatocellular carcinoma (HCC) cells infected with retroviruses carrying the HSV-tk gene under the control of the murine albumin gene promoter were selectively killed by ganciclovir treatment in vitro, whereas non-HCC cells, such as murine mammary tumor cells and fibroblast cells, which were infected with the same retroviruses, were not. Susceptibility of the retroviral-infected HCC cells to ganciclovir was more than 100-fold higher than that of the retroviral-infected non-HCC cells. When mice bearing a bulky HCC mass consisting of the retroviral-infected HCC cells were treated with systemic ganciclovir administration, complete regression of the tumors was observed without any signs of overt toxicity. Profound antitumor effects on preestablished murine HCCs were observed when wild-type HCC cells were implanted into animals with a small percentage of the retroviral-infected counterparts. When only 5% of the cells were infected with retroviruses carrying the HSV-tk gene, significant inhibition of tumor development was observed with systemic ganciclovir treatment. Importantly, animals that were treated with implantation of mixtures of the retroviral-infected and parental HCC cells, followed by ganciclovir administration, did not exhibit tumor formation and resisted subsequent rechallenge with wild-type HCC cells. Our results indicate the feasibility of combination therapy with the HSV-tk gene and ganciclovir for the treatment of HCC.

Effects of glycyrrhizin on immune-mediated cytotoxicity

Intravenous administration of glycyrrhizin is known to decrease elevated plasma transaminase levels in patients with chronic viral hepatitis, in which immune-mediated cytotoxicity by cytotoxic T lymphocytes and tumour necrosis factor (TNF)-alpha is considered to play an important pathogenic role. However, the immunological interpretation of the transaminase-lowering action of glycyrrhizin is not known. Studies were performed to elucidate this action immunologically by assessing the effects of glycyrrhizin on immune-mediated cytotoxicity using an antigen-specific murine CD4+ T hybridoma line, which exhibits cytotoxicity against antigen-presenting cells after stimulation with specific antigen, and a murine TNF-alpha-sensitive fibroblast line. Glycyrrhizin inhibited the cytotoxic activity of the T cells against antigen-presenting cells and also suppressed TNF-alpha-induced cytotoxicity in the TNF-alpha-sensitive cell line in vitro. These results suggest that the decrease of elevated transaminase levels by glycyrrhizin in patients with chronic viral hepatitis is mediated in part by inhibition of immune-mediated cytotoxicity against hepatocytes.