Milk thistle (Silybum marianum): A concise overview on its chemistry, pharmacological, and nutraceutical uses in liver diseases

Abstract

Milk thistle (MT; Silybum marianum), a member of the Asteraceae family, is a therapeutic herb with a 2,000-year history of use. MT fruits contain a mixture of flavonolignans collectively known as silymarin, being silybin (also named silibinin) the main component. This article reviews the chemistry of MT, the pharmacokinetics and bioavailability, the pharmacologically relevant actions for liver diseases (e.g., anti-inflammatory, immunomodulating, antifibrotic, antioxidant, and liver-regenerating properties) as well as the clinical potential in patients with alcoholic liver disease, nonalcoholic fatty liver disease, viral hepatitis, drug-induced liver injury, and mushroom poisoning. Overall, literature data suggest that, despite encouraging preclinical data, further well-designed randomized clinical trials are needed to fully substantiate the real value of MT preparations in liver diseases.

ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

“…Commercial formulations of silybin complexed with phosphatidylcholine have improved bioavailability (4.4‐fold increase over uncomplexed extract), but it is unknown if this formulation achieves therapeutic relevance. A single study of complexed silymarin with SAMe showed protection against lomustine‐associated hepatotoxicosis in dogs .…”

“…312 Studies of silymarin in humans, including National Institutes of Health-sponsored clinical trials using highly standardized preparations, have failed to achieve projected therapeutic endpoints. [322][323][324] Commercial formulations of silybin complexed with phosphatidylcholine have improved bioavailability (4.4-fold increase over uncomplexed extract), [325][326][327][328] but it is unknown if this formulation achieves therapeutic relevance. A single study of complexed silymarin with SAMe showed protection against lomustine-associated hepatotoxicosis in dogs.…”

Polyphenols: A concise overview on the chemistry, occurrence, and human health

“…Flavonoids are classified into the following subclasses: anthocyanins, flavanols, flavanones, flavonols, flavonones, and isoflavones (Amarowicz et al, ; Kabera et al, ; Kumar & Pandey, ). A wide range of pharmacological activities, including antioxidant, antibacterial, hepatoprotective, antinflammatory, and antihyperlipidemic effect, are attributed to flavonoids (Abenavoli et al, ; Azzini et al, ; Belwal, Nabavi, Nabavi, & Habtemariam, ; D'Evoli et al, ; Farhadi, Khameneh, Iranshahi, & Iranshahy, ; Farhat, Drummond, & Al‐Dujaili, ; Iriti et al, ; Miccadei et al, ; Ninfali, Antonini, Frati, & Scarpa, ; Rasouli, Mohammad‐Bagher Hosseini‐Ghazvini, & Khodarahmi, ; Rees, Dodd, & Spencer, ; Riccio et al, ; Tungmunnithum, Thongboonyou, Pholboon, & Yangsabai, ). The term flavonoid generally indicates a phenol compound having a phenylbenzopyran chemical structure with a carbon skeleton of a C6–C3–C6 joined to a chroman ring (Pereira, Valentão, Pereira, & Andrade, ).…”

Fruit‐based juices: Focus on antioxidant properties—Study approach and update

“…Flavonoids family is constituted by subclasses, namely, anthocyanins, flavanols, flavanones, flavonols, flavonones, and isoflavones (Amarowicz et al, 2009;Kabera et al, 2014;Kumar & Pandey, 2013). They exert a wide range of pharmacological actions, including antioxidant, antibacterial, hepatoprotective, antinflammatory, and anti-hyperlipidemic activities (Miccadei et al, 2008;D'Evoli et al, 2013;Azzini et al, 2016;Belwal, Nabavi, Nabavi, and Habtemariam (2017) ;Farhat, Drummond, & Al-Dujaili, 2017;Lin, Gong, Song, & Cui, 2017;Ninfali, Antonini, Frati, & Scarpa, 2017;Iriti et al, 2017;Peluso & Serafini, 2017;Jiang, Wang, Sun, & Zhang, 2017;Abenavoli et al, 2018;Farhadi, Khameneh, Iranshahi, & Iranshahy, 2018;Rees, Dodd, & Spencer, 2018;Riccio et al, 2018;Tungmunnithum, Thongboonyou, Pholboon, & Yangsabai, 2018). The term flavonoid is generally referred to phenolic compounds having a phenylbenzopyran chemical structure with a carbon skeleton of a C6-C3-C6 joined to a chroman ring (Marais, Deavours, Dixon, & Ferreira, 2006;Pereira, Valentão, Pereira, & Andrade, 2009).…”