Milk thistle for the treatment of liver disease

Jacobs, Bradly; Dennehy, Cathi; Ramı́rez, Gilbert; Sapp, Jodi; Lawrence, Valerie A.

doi:10.1016/s0002-9343(02)01244-5

Cited by 205 publications

(112 citation statements)

References 30 publications

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“…The use of silymarin in patients with alcoholic cirrhosis has shown no beneficial effect in other studies (Singal et al, 2011). In other trials, silymarin, at daily doses of 210-800 mg, showed no effect on mortality or improvements in liver histology or liver functions in patients with chronic liver disease (Jacobs et al, 2002). In addition, serious adverse effects including gastroenteritis have been reported in patients using silymarin (Jacobs et al, 2002).…”

Section: Introductionmentioning

confidence: 97%

“…However, interferons are expensive and have serious side effects (Muriel & Rivera-Espinoza, 2008). Silymarin is a widely used hepatoprotective drug and has been used clinically for the treatment of acute and chronic hepatitis, alcoholic liver disease and toxin-induced hepatitis (Jacobs et al, 2002). Silymarin is a favored drug for liver diseases because of its oral effectiveness, low cost, and safety (Muriel & Rivera-Espinoza, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Hepatoprotective and antioxidant activity ofMelaleuca styphelioideson carbon tetrachloride-induced hepatotoxicity in mice

Al‐Sayed

El-Lakkany

el-Din

et al. 2014

Pharmaceutical Biology

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Context: Liver disease is a serious problem. Polyphenolic compounds have marked antioxidant effect and can prevent the liver damage caused by free radicals. In vitro studies have revealed the strong antioxidant activity of an ellagitannin-rich plant, namely, Melaleuca styphelioides Sm. (Myrtaceae). Objective: In view of the limited therapeutic options available for the treatment of liver diseases, the hepatoprotective potential of the methanol extract of M. styphelioides leaves (MSE) was investigated against CCl 4 -induced liver injury in mice. Materials and methods: MSE was administered (500 and 1000 mg/kg/d p.o.) along with CCl 4 for 6 weeks. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) were determined in the serum. Glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione transferase (GST), and malondialdehyde (MDA) were estimated in the liver homogenate. The bioactive components of MSE were identified by NMR, UV and HRESI-MS/MS data. Results: MSE treatment (500 and 1000 mg/kg/d) markedly inhibited the CCl 4 -induced increase in the levels of AST (31 and 38%), ALT (29 and 32%), ALP (13 and 19%), and MDA (22 and 37%) at the tested doses, respectively. MSE treatment markedly increased the levels of GSH (29 and 57%) and antioxidant enzymes compared with the CCl 4 -treated group. MSE was more effective than silymarin in restoring the liver architecture and reducing the fatty changes, central vein congestion, Kupffer cell hyperplasia, inflammatory infiltration, and necrosis induced by CCl 4 . The LD 50 of MSE was more than 5000 mg/kg. Conclusion: MSE confers potent antioxidant and hepatoprotective effects against CCl 4 -induced toxicity.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Hepatoprotective and antioxidant activity ofMelaleuca styphelioideson carbon tetrachloride-induced hepatotoxicity in mice

Al‐Sayed

El-Lakkany

el-Din

et al. 2014

Pharmaceutical Biology

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“…Silymarin (Silybum marianum), the polyphenolic fraction from Milk Thistle is used for hepatoprotection in humans (Flora et al 1998, Jacobs et al 2002, Fraschini et al 2002, Ladas and Kelly, 2003, Wen et al 2007) and demonstrated good protection in various toxic paradigms of experimental liver diseases in small laboratory animals (Radko and Cybulski 2007). Silymarin functions as an antioxidant, which absorbs and regulates the intracellular glutathione.…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Silymarin and Choline Chloride (Liver Tonics) in Preventing the Effects of Aflatoxin B1 in Bovine Calves

Naseer

Khan

Omer

et al. 2016

Polish Journal of Veterinary Sciences

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Aflatoxins are secondary metabolites produced by Aspergillus spp. which are injurious to animals and humans The aim of this study was to determine the effects of aflatoxin B 1 (AFB 1 ) on Average Daily Feed Intake (ADFI), Average Daily Weight Gain (ADWG), haematological and serum biochemical responses of Bovine Calves and to determine the comparative efficacy of two different liver tonics against AFB 1 . Twenty seven calves were selected from herd and divided into 3 groups. All calves were fed with 1.0 mg/kg AFB 1 for a period of 10 days. After that they were fed with liver tonics: Silymarin fed at a rate of 600 mg/kg and Choline chloride 500 mg/kg for 7 days. The results indicate that the ADFI and ADWG of AFB 1 treated calves decreased significantly. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and creatinine significantly increased due to AFB 1 . In haematology the total erythrocyte count (TEC), total leukocyte count (TLC), haemoglobin concentration (HGB), haematocrit levels (HCT), mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC), lymphocyte %, neutrophil % and monocyte % significantly decreased in AFB 1 treated calves after 10 days of feeding. Both liver tonics significantly (p<0.05) improved all the parameters, including ADFI, ADWG, hematologial and serum biochemical test. However, Silymarin comparatively more efficiently ameliorate the effects induced by AFB 1 than choline chloride.

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“…Although silymarin has been described to possess antioxidant, immunomodulatory, antiproliferative, antifibrotic, and antiviral activities (8,9), its mechanisms of action remain to be fully defined. Although its clinical efficacy is currently uncertain (8,10), interest in this botanical medicine has been piqued by studies showing silymarin blocks HCV cell culture (HCVcc) infection (9). Intravenous administration of silibinin, composed of a 1:1 mixture of silybin A and silybin B, causes dose-dependent reduction of viral load in patients with chronic hepatitis C (11).…”

mentioning

confidence: 99%

Identification of hepatoprotective flavonolignans from silymarin

Polyak

Morishima

Lohmann

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

281

217

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Silymarin, also known as milk thistle extract, inhibits hepatitis C virus (HCV) infection and also displays antioxidant, anti-inflammatory, and immunomodulatory actions that contribute to its hepatoprotective effects. In the current study, we evaluated the hepatoprotective actions of the seven major flavonolignans and one flavonoid that comprise silymarin. Activities tested included inhibition of: HCV cell culture infection, NS5B polymerase activity, TNF-α-induced NF-κB transcription, virus-induced oxidative stress, and T-cell proliferation. All compounds were well tolerated by Huh7 human hepatoma cells up to 80 μM, except for isosilybin B, which was toxic to cells above 10 μM. Select compounds had stronger hepatoprotective functions than silymarin in all assays tested except in T cell proliferation. Pure compounds inhibited JFH-1 NS5B polymerase but only at concentrations above 300 μM. Silymarin suppressed TNF-α activation of NF-κB dependent transcription, which involved partial inhibition of IκB and RelA/p65 serine phosphorylation, and p50 and p65 nuclear translocation, without affecting binding of p50 and p65 to DNA. All compounds blocked JFH-1 virus-induced oxidative stress, including compounds that lacked antiviral activity. The most potent compounds across multiple assays were taxifolin, isosilybin A, silybin A, silybin B, and silibinin, a mixture of silybin A and silybin B. The data suggest that silymarin-and silymarin-derived compounds may influence HCV disease course in some patients. Studies where standardized silymarin is dosed to identify specific clinical endpoints are urgently needed.hepatitis C | liver disease | milk thistle | botanical medicine | hepatoprotection C hronic hepatitis C virus (HCV) is a major global medical problem. In the United States, millions of people are affected, the number of patients with HCV-induced end-stage liver disease is growing (1), and this condition is already the leading indication for liver transplantation (2). The current standard of care for chronic hepatitis C, pegylated IFN-α and ribavirin, results in sustained elimination of virus in 55% of treated patients (3, 4). However, significant numbers of patients do not clear the virus and are intolerant to, have contraindications to, or opt out of therapy. Furthermore, because emerging specifically targeted antiviral therapy for HCV therapies need to be administered with pegylated IFN plus ribavirin (5), it is likely that many patients will not tolerate this therapy. Thus, there are many patients who have no other Food and Drug Administration-approved options to eliminate HCV and prevent progression of liver disease. As a result, many individuals have opted for complementary and alternative medicine-based approaches, including botanicals, to treat their chronic hepatitis C. Indeed, as many as 13 to 23% of American patients with chronic liver disease use botanical medicines, with silymarin being the most popular (6, 7).Silymarin, an extract from the seeds of the milk thistle plant, Silybum marianum, has been used fo...

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Milk thistle for the treatment of liver disease

Cited by 205 publications

References 30 publications

Hepatoprotective and antioxidant activity ofMelaleuca styphelioideson carbon tetrachloride-induced hepatotoxicity in mice

Hepatoprotective and antioxidant activity ofMelaleuca styphelioideson carbon tetrachloride-induced hepatotoxicity in mice

Comparative Efficacy of Silymarin and Choline Chloride (Liver Tonics) in Preventing the Effects of Aflatoxin B1 in Bovine Calves

Identification of hepatoprotective flavonolignans from silymarin

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