Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial

Parés, Albert; Planas, Ramón; Torres, M.; Caballería, Joan; Viver, Josep Maria; Acero, Doroteo; Panés, J; Rigau, Joaquim; Santos, J.; Rodés, Joan

doi:10.1016/s0168-8278(98)80285-7

Cited by 281 publications

(187 citation statements)

References 28 publications

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“…It was concluded that silymarin did not change the evolution in this trial. A subsequent Spanish study was specifically aimed to determine the effect of silymarin in the patients with alcoholic liver cirrhosis, respect to survival, clinical and laboratory changes (Parés et al, 1998). From …”

Section: Liver Cirrhosismentioning

confidence: 99%

Milk thistle in liver diseases: past, present, future

Abenavoli

Capasso²,

Milić

et al. 2010

Phytotherapy Research

485

350

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Silybum marianum or milk thistle (MT) is the most well‐researched plant in the treatment of liver disease. The active complex of MT is a lipophilic extract from the seeds of the plant and is composed of three isomer flavonolignans (silybin, silydianin, and silychristin) collectively known as silymarin. Silybin is a component with the greatest degree of biological activity and makes up 50% to 70% of silymarin. Silymarin is found in the entire plant but it is concentrated in the fruit and seeds. Silymarin acts as an antioxidant by reducing free radical production and lipid peroxidation, has antifibrotic activity and may act as a toxin blockade agent by inhibiting binding of toxins to the hepatocyte cell membrane receptors. In animals, silymarin reduces liver injury caused by acetaminophen, carbon tetrachloride, radiation, iron overload, phenylhydrazine, alcohol, cold ischaemia and Amanita phalloides. Silymarin has been used to treat alcoholic liver disease, acute and chronic viral hepatitis and toxin‐induced liver diseases. Copyright © 2010 John Wiley & Sons, Ltd.

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Section: Liver Cirrhosismentioning

confidence: 99%

Milk thistle in liver diseases: past, present, future

Abenavoli

Capasso²,

Milić

et al. 2010

Phytotherapy Research

485

350

View full text Add to dashboard Cite

show abstract

“…28 Study subjects were given 150 mg of silymarin or a placebo 3 times daily for 2 years. Complications in this study included a high dropout rate, poor compliance, and limited outcome measures.…”

Section: Silymarin (Milk Thistle)mentioning

confidence: 99%

Complementary and alternative medicine in chronic liver disease

et al. 2001

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“…Preliminary studies of experimental injury suggest a protective effect of vitamin E against oxidant stress injury (Parola et al, 1992). Also, an herbal remedy, silymarin, which is the active principal in milk thistle extract, and malotilate have anti-oxidant activities; experimental studies have been encouraging (Boigk et al, 1997), but the clinical data are as yet incomplete (Ferenci et al, 1989;Pares et al, 1998;Angulo et al, 2000).…”

Section: Anti-inflammatory and Anti-oxidant Agentsmentioning

confidence: 99%

Chronic liver injury, TGF-β, and cancer

Bissell

2001

Exp Mol Med

155

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Cells termed myofibroblasts are prominent in the injury response of all epithelial tissues. They exhibit proliferation, migration, production of collagen and other extracellular matrix (ECM) molecules, and contraction, all for containing the injury and closing the wound. When the injury is limited in time, the final stage of the repair involves a dismantling of the cellular apparatus and restoration of normal tissue structure. With multiple cycles of repair, however, there is net accumulation of ECM, to the detriment of tissue structure and function. Repair-related ECM coalesces into fibrous bundles and, over time, undergoes changes that render it resistant to degradation. The result is a scar. In the skin, a scar may have cosmetic importance only. In the liver, however, extensive scarring is the setting for unregulated growth and neoplasia; also, fibrous bands disrupt normal blood flow, leading to portal hypertension and its complications. With regard to therapy for fibrosis, the first consideration is elimination of the injury factor. However, given that many liver diseases do not have effective therapies at present, strategies targeting fibrogenesis per se are under development. The main source of myofibroblast-like cells and ECM production in the liver is the perisinusoidal stellate cell, which responds to injury with a pleiotypic change termed activation. Activation is orchestrated by cytokines and the ECM itself. Among the cytokines involved in this process, transforming growth factor-beta (TGF-β) is particularly prominent. The early changes in ECM include de novo production of a specific "fetal" isoform of fibronectin, which arises from sinusoidal endothelial cells. It is stimulated by TGF-β and acts directly on stellate cells to promote their activation. Based on these and other advances in understanding the fundamentals of the injury response, several strategies now exist for altering fibrogenesis, ranging from agents that block TGF-β to traditional Chinese herbal extracts. Arrest of fibrogenesis, even with underlying cirrhosis, is likely to extend life or prolong the time to transplant. Whether it reduces the risk of hepatocellular carcinoma remains to be proven. Although TGF-β antagonists are effective anti-fibrogenic agents, they will require detailed safety testing because of the finding that several forms of epithelial neoplasia are associated with altered regulation of TGF-β.

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Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial

Cited by 281 publications

References 28 publications

Milk thistle in liver diseases: past, present, future

Milk thistle in liver diseases: past, present, future

Complementary and alternative medicine in chronic liver disease

Chronic liver injury, TGF-β, and cancer

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