Abstract: Objective The aim of this study was to investigate efficacy of magnesium isoglycyrrhizinate and reduced glutathione combination in treatment of patients with chemotherapeutic drug-induced liver injury (cDILI) and its impact on serum oxidative stress indexes. Methods 146 patients withcDILI were encountered in our hospital between January 2022 and January 2024, and were randomly divided into control (n=73) and observation (n=73) groups. Patients in the control group were treated with intravenous reduced glutathione, and those in the observation group were given intravenous magnesium isoglycyrrhizinate and reduced glutathione combination for two to four weeks. Serum malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels were assayed routinely. Serum tumor necrosis factor-α (TNF-α), macrophage migration inhibitory factor (MIF), soluble tumor necrosis factor receptor 1 (sTNFR1) and interleukin-10 (IL-10) levels were detected by ELISA. Results By the end of treatment, serum ALT,AST, ALPand GGT levels in the combination group were (58.5±10.1)U/L, (53.7±4.3)U/L, (79.2±13.1)U/L and (56.1±5.9)U/L, all significantly lower than [(76.2±10.9)U/L,(71.5±6.6)U/L, (92.2±12.7)U/Land (71.9±6.3)U/L, respectively, P<0.05] in the control; serum MDA level was (2.9±0.6)μmol/L, significantly lower than [(5.6±0.7)μmol/L, P<0.05], while serum SOD and GSH-Px levels were (96.5±7.1)U/L and (121.7±10.3)U/L, both significantly higher than [(80.6±7.5)U/Land (100.5±9.2)U/L, respectively, P<0.05] in the control; serum TNF-α and MIF levels in the combination group were (3.8±0.5)ng/mL and (9.1±1.5)ng/mL, both significantly lower than [(7.6±1.7)ng/mL and (13.2±1.3)ng/mL, respectively, P<0.05], while serum sTNFR1 and IL-10 levels were (3.1±0.5) pg/mL and (34.5±3.8)pg/mL, both significantly higher than [(1.5±0.4)pg/mL and (21.2±3.1)pg/mL, respectively, P<0.05] in the control. Conclusion Magnesium isoglycyrrhizinate and reduced glutathione combination in the treatment of patients with cDILI is efficacious, which might be related to reduction of body oxidative stress and modulation of cytokine metabolism. We hope that our experience could facilitate physicians to correctly identify DILI early in presentation and provide a choice of management.

Key words: Drug-induced liver injury, Magnesium isoglycyrrhizinate, Reduced glutathione, Oxidative stress, Therapy