Silymarin and management of liver function in nonalcoholic steatohepatitis: a case report

Abstract

Non-alcoholic fatty liver disease (NAFLD) and its progressive form (non-alcoholic steatohepatitis; NASH) are the main reason for chronic liver disease in the general population, characterized by fat accumulation in hepatocytes (steatosis) and anomalies in liver biochemical analyses. To date, no pharmacological agents have been approved for NAFLD or NASH treatment. However, silymarin, the active ingredient in milk thistle, has been used in the last decades for the treatment of several liver diseases. In this case report, treatment with silymarin 140 mg three-times daily highlighted moderate efficacy and a good safety profile in the management of NASH and liver function, as it decreased serum AST and ALT levels over the treatment period with no side-effects, supporting silymarin as a promising supplemental intervention that can normalize liver activity in NAFLD and NASH. This article is part of the Current clinical use of silymarin in the treatment of toxic liver diseases: a case series . Special Issue: https://www.drugsincontext.com/special_issues/current-clinical-use-of-silymarin-in-the-treatment-of-toxic-liver-diseases-a-case-series

Natural compounds proposed for the management of non-alcoholic fatty liver disease

“…This meta-analysis also showed that silymarin is well tolerated and could therefore be of great interest in the treatment of NAFLD, especially NASH. Several recent clinical trials have also supported these findings [ 124 , 125 ].…”

“…The plant methanolic extract contains a significant content of bioactive phytochemicals such as terpenoids, betanins, carotenoids, polyphenols, saponins, and phytoecdysteroids [ 126 ]. Several studies have recently described quinoa as a highly promising functional food component to treat obesity and metabolic diseases such as metabolic syndrome, T2DM and NAFLD [ 125 – 127 ]. A study investigating the effects of quinoa intake on high-fed rats suggests that quinoa phytochemicals are the causes of lipid metabolism dysfunction regulation, leading to a resolution of IR, liver steatosis decrease, and anti-inflammation and antioxidative quinoa properties [ 128 ].…”

Review and expert opinion on MAFLD, oxidative stress and multifunctional management

“…Various studies have been conducted or are ongoing to further confirm the evidence on silymarin and improve its clinical use. [54][55][56][57][58][59]…”

Chronic liver disease and management with silymarin: an introductory review of a clinical case collection

“…In the case reports published by Chantarojanasiri 6 and Torre, 5 liver stiffness and controlled attenuation parameter assessments by transient elastography (Fibroscan system) were used to evaluate and monitor hepatic steatosis over time, whilst a hepatic fibrosis biomarker (FIB-4 index) was used to assess the degree of liver fibrosis in the case presented by Hashem. 7 …”

“…This review is an opening paper to the clinical case collection entitled 'Current clinical use of silymarin in the treatment of toxic liver diseases: a case series', focused on the management and treatment of major liver diseases with silymarin. [5][6][7][8][9][10]…”