Silymarin treatment of viral hepatitis: a systematic review

Mayer, Ken; Myers, Robert P.; Lee, S S

doi:10.1111/j.1365-2893.2005.00636.x

Cited by 157 publications

(112 citation statements)

References 48 publications

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“…This also was in agreement with Shindo et al who concluded that silymarin treatment resulted in a statistically significant decrease in transaminases in four studies compared with baseline and in one compared with placebo in patients with chronic viral hepatitis (Shindo, Hamada, et al 2001). If silymarin does indeed lower ALT levels and help achieve a biochemical response, it may also act synergistically with interferon to increase the rates of sustained virological response, but this hypothesis has yet to be clinically investigated (Mayer, Myers, et al 2005). …”

Section: Discussionsupporting

confidence: 79%

Evaluation of Silibinin Enriched Silymarin in Chronic HCV Patients

Hamed¹,

Khaled²,

Fathelbab³

et al. 2017

IAM

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Background/ Aim: Silymarin is a polyphenolic compound with anti-hepatotoxic activity. It has low oral bioavailability due to its poor aqueous solubility. Thus enhancement of its dissolution may lead to a better bioavailability. The objective of the presented study was to prepare fast dissolving enriched silymarin preparation via the preparation of enriched silymarin as solid dispersion and compare it with Legalon capsules in chronic HCV patients in a clinical study. Method: Enriched silymarin solid dispersion was prepared in sufficient amount. A clinical study was conducted including 24 patients. The patients were divided into two groups; each group had 12 patients. One group received the solid dispersion. The second group received Legalon capsules. Patients received capsules 3 times daily for 12 weeks. All these patients had been subjected to full medical history, abdominal ultrasonography, laboratory investigations and quality of life assessment at baseline and after treatment. Results: Solid dispersion had significantly faster dissolution rate. It is effective in reducing AST, ALT, total bilirubin, improving prothrombin concentration, prothrombin time and quality of life. Conclusion: Silymarin solid dispersion is a promising preparation. Large scale and longer duration may be required to ascertain its effects.

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Section: Discussionsupporting

confidence: 79%

Evaluation of Silibinin Enriched Silymarin in Chronic HCV Patients

Hamed¹,

Khaled²,

Fathelbab³

et al. 2017

IAM

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“…Other agents known to lower aminotransferase activity such as silymarin and ribavirin (when used alone) do not have significant effects on disease progression. 19,20 However, these agents lower aminotransferase activity much more slowly and presumably by different mechanisms. Longer studies with IDN-6556 are needed to determine whether it can affect endpoints such as serum markers of apoptosis, inflammation, and fibrosis on liver biopsy and ultimately clinical outcomes of chronic liver disease.…”

Section: Discussionmentioning

confidence: 99%

Oral IDN-6556, an antiapoptotic caspase inhibitor, may lower aminotransferase activity in patients with chronic hepatitis C

et al. 2007

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Increased rates of apoptosis (programmed cell death) have been demonstrated in many hepatic diseases including chronic hepatitis C. IDN-6556 is a potent inhibitor of caspases, the proteases that execute apoptosis. In a prior phase 1 study, IDN-6556 lowered aminotransferase activity in a small number of patients with liver impairment. The purpose of this study was to further explore the effect of IDN-6556 in patients with liver disease in a multicenter, double-blind, placebo-controlled, dose-ranging study with a 14-day dosing period. A total of 105 patients were enrolled in the study; 79 received active drug; 80 patients had chronic hepatitis C and 25 had other liver diseases including nonalcoholic steatohepatitis (NASH), hepatitis B, primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC). IDN-6556 doses ranged from 5 mg to 400 mg daily, given from 1 to 3 times per day. In the HCV patients, all doses of IDN-6556 significantly lowered ALT and AST (P ‫؍‬ 0.0041 to P < 0.0001 for various dosing groups in Wilcoxon tests comparing IDN-6556 to placebo), with the exception of the lowest dose. Declines in aminotransferase activity were also seen in patients with NASH but effects were not apparent in the small number of other liver diseases. Adverse experiences were not different between IDN-6556 and placebo. There were no clinically meaningful changes in other laboratory parameters. In particular, mean HCV RNA levels did not show significant changes. Conclusion: Oral IDN-6556, given for 14 days, significantly lowered aminotransferase activity in HCV patients and appeared to be well tolerated. Longer studies to assess potential effects of IDN-6556 on liver inflammation and fibrosis are merited. (HEPATOLOGY 2007;46:324-329.) P rogrammed cell death or apoptosis is a tightly controlled process of cellular suicide that occurs during normal development, normal tissue turnover, and in numerous diseases. 1 Caspases are proteolytic enzymes that cleave a series of cellular substrates during the execution phase of apoptosis. Caspases are activated from their inactive zymogen forms (procaspases) when a cell is triggered to undergo apoptosis. IDN-6556 is a novel broad-

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“…Évtizedek óta szerepel az alkoholos májbetegség terápiás eszköztá-rában [1,15], de HCV-infekcióban is alkalmazták, ellentmondó -de leginkább negatív -eredményekkel [22]. Hazai placebokontrollos tanulmányunkban a P/R antivirális terápia szilimarinnal történő kiegészítésének hatását, az oxidatív stressz és a virológiai válasz (SVR) alakulását vizsgálva nem tudtuk igazolni a fl avonoidkomplex-szupportáció előnyét [18].…”

Section: Inzulinrezisztencia (Ir) éS Steatosisunclassified

Immunválasz és oxidatív stressz hepatitis C-vírus-infekcióban

Pár

2015

Orvosi Hetilap

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A szerzők áttekintik a természetes és a szerzett immunválasz jellemzőit hepatitis C-vírus-infekcióban, és röviden tár-gyalják a betegség kimenetelét befolyásoló genetikai polimorfi zmusokat. Ezenkívül ismertetik a reaktívoxigén-metabolitok és az oxidatív stressz szerepét a hepatitis C-vírus okozta kórfolyamatokban (hepatitis, fi brosis, hepatocellularis carcinoma, steatosis és inzulinrezisztencia). Orv. Hetil., 2015, 156(47), 1898-1903 Kulcsszavak: hepatitis C-vírus, immunválasz, genetikai polimorfi zmusok, oxidatív stressz Immune response and oxidative stress in hepatitis C virus infectionThis review summarizes our current knowledge on the innate and adaptive immune responses induced by hepatitis C virus, and on the genetic polymorphisms that may determine the outcome of the disease. In addition, the authors discuss the role of reactive oxygen species and oxidative stress in hepatitis C virus-related pathogenic processess, such as hepatitis, fi brosis, hepatocellular carcinoma, steatosis and insulin resistance. Fehér János professzor pályája elején ígéretes fi atal patoló-gusként indult, majd klinikusként a májbetegek gyógyí-tásának és a májbetegségek kutatásának szentelte az éle-tét. Az 1970-es években a lueshepatitis első leírásával jegyezte be nevét a nemzetközi irodalomba, és tanulmá-nyokat közölt a májbetegségekben előforduló immunológiai eltérésekről (1. ábra).Később a szabadgyök-kutatás került érdeklődésének előterébe [1]. Mivel magunk a hepatitis C-vírus (HCV) felfedezését követően szintén az immunitás és az oxidatív stressz kérdéseivel foglalkoztunk, ezért választottuk jelen témánkat a tiszteletére írt dolgozatunkban. IMMUNVÁLASZ HCV-FERTŐZÉSBEN2006-ban az Orvosi Hetilapban áttekintést adtunk a HCV-infekció immunológiájáról és e téren végzett kutatásainkról [2]. Azóta közel egy évtized telt el, ami a HCV-re vonatkozó ismereteink bővülését hozta, bár számos kérdés ma is megoldatlan, például a HCV elleni vakcináció. A direkt ható antivirális szerek (DAA) felfedezésével viszont a víruseliminációhoz (eradikációhoz) vezető terápia korszakába léptünk [3].A HCV-infekció mindössze az esetek 25%-ában gyó-gyul spontán, a fertőzöttek többségében krónikussá válik, és hepatitis, cirrhosis, hepatocellularis carcinoma (HCC) vagy extrahepaticus manifesztációk -mint cryoglobuli-

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Silymarin treatment of viral hepatitis: a systematic review

Cited by 157 publications

References 48 publications

Evaluation of Silibinin Enriched Silymarin in Chronic HCV Patients

Evaluation of Silibinin Enriched Silymarin in Chronic HCV Patients

Oral IDN-6556, an antiapoptotic caspase inhibitor, may lower aminotransferase activity in patients with chronic hepatitis C

Immunválasz és oxidatív stressz hepatitis C-vírus-infekcióban

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