Magnesium = Robert K. Rude

Coates, Paul M.; Paul, Manish; Blackman, Marc R.; Cragg, Gordon M.; Levine, Mark; White, Jeffrey D.; Moss, Joel

doi:10.1201/b13959-50

Cited by 3 publications

(5 citation statements)

References 60 publications

(116 reference statements)

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“…We monitored for published side-effects associated with administration of MT. (14) A safety monitoring rule was incorporated into the statistical analysis to screen for rates of Grade 3 and 4 toxicities. We also monitored for any unexpected side-effects, related to milk thistle, through weekly telephone contact by our research assistant using a standardized questionnaire that was administered to the subject or primary guardian during the intervention period.…”

Section: Methodsmentioning

confidence: 99%

A randomized, controlled, double‐blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL)

Ladas

Kroll

Oberlies

et al. 2009

Cancer

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Background Milk thistle (MT) is often used for the treatment of chemotherapy associated hepatotoxicity despite limited preclinical and clinical investigations. Limited treatment options exist for chemotherapy-related hepatoxicity. Given the wide use of MT, we investigated MT in both the laboratory and clinical setting. Methods In a double-blind study, children with ALL with hepatic toxicity were randomized to MT or placebo orally for 28 days. Liver function tests were evaluated during the study period. To assess MT in vitro, we evaluated supratherapeutic concentrations in an ALL cell line. Results 50 children were enrolled. No significant differences in the frequency of side effects, incidence and severity of toxicities, or infections were observed between groups. There were no significant changes in mean AST, ALT, or TB at day 28. At day 56, the MT group had a significantly lower AST (p=0.05) and a trend towards a significantly lower ALT (p=0.07). Although not significantly different, chemotherapy doses were reduced in 61% of the MT group, compared to 72% of the placebo group. In vitro experiments revealed no antagonistic interactions between MT and vincristine or L-asparaginase in CCRF-CEM cells. A modest synergistic effect with vincristine was observed. Conclusions In children with ALL with liver toxicity, MT was associated with a trend towards significant reductions in liver toxicity. MT does not antagonize the effects of chemotherapy agents used for the treatment of ALL. Future study is needed to determine the most effective dose and duration of MT and its effect on hepatotoxicity and leukemia-free survival.

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Section: Methodsmentioning

confidence: 99%

A randomized, controlled, double‐blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL)

Ladas

Kroll

Oberlies

et al. 2009

Cancer

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“…We strongly recommend that investigators should either (1) give the exact composition of the "silymarin complex" or "the principle" used, or (2) use pure, chemically defined compounds. Implementation of these changes would greatly clarify the literature describing the biology of silymarin and its constituents.…”

Section: Nomenclature Of Milk Thistle Compoundsmentioning

confidence: 99%

“…Silymarin is simply the initial extract of milk thistle seeds made with ethanol (or other solvents 10,11 ) that contains 65% to 80% total flavonolignans and a small amount of a flavonoid (taxifolin, barely discernable in the HPLC chromatogram of silymarin) (Figure 2), with the remainder containing fatty acids and polyphenolic compounds. 1,6,12 The most commonly cited silymarin product used in clinical trials is Legalon, or Thisilyn in The most common class of compound present in milk thistle extract. Milk thistle flavonolignans result from a peroxidase reaction in the plant that fuses the flavonoid, taxifolin (known also as dihydroquercetin), with coniferyl alcohol, resulting in at least 7 compounds that all share the formula weight of 482.1.…”

Section: Nomenclature Of Milk Thistle Compoundsmentioning

confidence: 99%

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Milk Thistle Nomenclature: Why It Matters in Cancer Research and Pharmacokinetic Studies

2007

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Extracts of milk thistle have been recognized for centuries as "liver tonics" and are well-known to prevent or reverse hepatotoxicity of reactive drug metabolites or naturally occurring toxins. Milk thistle extracts are now under intense study in the experimental therapeutics of cancer for chemoprevention, treatment, and amelioration of chemotherapy side effects. Precision in nomenclature, however, has lagged behind this progress. The crude commercial product of milk thistle is termed silymarin, a complex of at least 7 flavonolignans and 1 flavonoid that comprises 65% to 80% of milk thistle extract. From silymarin is derived silibinin, a semipurified fraction once thought to be a single compound but now recognized as a 1:1 mixture of 2 diastereoisomers, silybin A and silybin B. The distinction between silymarin and silibinin is not only important to understanding the historical literature, but thorough characterization and use of chemically defined mixtures in preclinical and clinical studies are essential to the progress of these botanical compounds as human therapeutics. As a result, we urge clinicians and preclinical investigators alike to exercise rigor in nomenclature and use pure compounds or precisely defined chemical mixtures in subsequent studies. Herein, we provide a guide to the proper nomenclature and composition of milk thistle extracts and discuss the known pharmacokinetic studies of these botanical medicines. The druginteraction potential of these extracts appears to be quite low, and in fact, silibinin appears to synergize with the antitumor effects of some commonly used chemotherapeutics. However, some precautions are advised as highdose, phase II studies are conducted.

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“…Most of this research has been in exposures to alcohol 7,8 and drugs, 9-12 occupational exposures such as toluene and xylene, 13,14 and ingestion of Amanita phalloides mushrooms. [15][16][17][18][19][20][21][22] Chemotherapy is a conceptual analog to these hepatic toxins. Many forms of chemotherapy are metabolized by the liver and can increase liver enzymes or cause hepatotoxicity.…”

Section: Use As a Hepatoprotectant And To Prevent Hepatotoxicity Durimentioning

confidence: 99%

Clinical Applications of Silybum marianum in Oncology

Greenlee

Abascal²,

Yarnell

et al. 2007

Integr Cancer Ther

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Milk thistle (Silybum marianum) is an herb that is increasingly used in oncology research and treatment settings. Historically, it has been used to treat liver and biliary disorders and has been used in detoxification and cleansing protocols. However, milk thistle is increasingly being investigated for its use in adult and pediatric populations for oncology indications. Possible indications during cancer treatment include cleansing and detoxification after chemotherapy, preventing hepatotoxicity during chemotherapy, treating hepatotoxicity after chemotherapy, and potentiating chemotherapy and radiation therapy as an adjunctive treatment. Milk thistle (Silybum marianum [L.] Gaertn., plant family Asteraceae) seed is an herb commonly used by Western herbalists and naturopathic physicians to treat liver disorders in adults. The German Commission E currently recommends its use for dyspeptic complaints, toxin-induced liver damage, and hepatic cirrhosis and as a supportive therapy for chronic inflammatory liver conditions. 1 However, milk thistle is increasingly used in research and clinical practice in adult and pediatric populations in the oncology setting. It is being used for detoxification after chemotherapy, as a hepatoprotectant during chemotherapy, as an adjunct to cancer treatment, and to ameliorate long-term effects of cancer treatment. Researchers are actively investigating its role as a chemopreventive agent and possible treatment of cancer.Much of milk thistle's current clinical use is based on recent research on the actions of silymarin, milk thistle's flavonoid complex. The plant in its whole form, however, has a long history of use that has not been fully explored. In its native Mediterranean region, it has been used for liver ailments since the Greco-Roman era, and today it remains in folk use as a digestive aid, aperient, anti-inflammatory, antineoplastic, hypotensive, styptic, diuretic, and general tonifier.2 Other confirmed folk applications include its use for pruritus, hemorrhoids, colic, malaria, and psoriasis, and as a galactagogue.3 Milk thistle traveled to North America with the Europeans and was used by North American physicians to treat gallstones, vomiting in pregnancy, amenorrhea, uterine hemorrhage, hematuria, painful dysuria, and congestion of the liver, spleen, or kidneys. 2One of the more recent directions of milk thistle research is its use in oncology. Silymarin and silibinin (1 of the components of silymarin, also called silibin or silybin) have been evaluated for their ability to exert direct cytotoxic effects, mitigate toxicity of certain anticancer agents, and enhance the efficacy of chemotherapeutic agents. Milk thistle is increasingly used as an adjunct treatment for many types of cancer, with recent research also suggesting cancer prevention applications.In this article we describe current and potential clinical applications of milk thistle in the oncology setting. Milk thistle use is usually based on historical indications. Very little clinical research has been conducted in ...

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Magnesium = Robert K. Rude

Cited by 3 publications

References 60 publications

A randomized, controlled, double‐blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL)

A randomized, controlled, double‐blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL)

Milk Thistle Nomenclature: Why It Matters in Cancer Research and Pharmacokinetic Studies

Clinical Applications of Silybum marianum in Oncology

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