The use of SAMe in chemotherapy-induced liver injury

Vincenzi, Bruno; Russo, Antonio; Terenzio, Antonella; Santini, Daniele; Vorini, Ferruccio; Incalzi, Raffaele Antonelli; Vespasiani‐Gentilucci, Umberto; Tonini, Giuseppe

doi:10.1016/j.critrevonc.2018.06.019

Cited by 24 publications

(17 citation statements)

References 109 publications

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“…Agents used for cancer chemotherapy are very frequently associated with DILI. For this reason, patients who receive chemotherapy require careful liver function assessment prior to treatment to determine the most appropriate choice of chemotherapeutic agent and whether dose modification is required [93]. In a study in China, patients with acute lymphoblastic or acute myeloid leukemia undergoing chemotherapy (n = 70) received either the Eurosil 85 Ò -derived formulation of silymarin (420 mg/day) plus diammonium glycyrrhizinate or diammonium glycyrrhizinate alone [94].…”

Section: Drug-induced Liver Injurymentioning

confidence: 99%

Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review

Gillessen¹,

2020

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Silymarin, an extract from milk thistle seeds, has been used for centuries to treat hepatic conditions. Preclinical data indicate that silymarin can reduce oxidative stress and consequent cytotoxicity, thereby protecting intact liver cells or cells not yet irreversibly damaged. Eurosil 85 Ò is a proprietary formulation developed to maximize the oral bioavailability of silymarin. Most of the clinical research on silymarin has used this formulation. Silymarin acts as a free radical scavenger and modulates enzymes associated with the development of cellular damage, fibrosis and cirrhosis. These hepatoprotective effects were observed in clinical studies in patients with alcoholic or nonalcoholic fatty liver disease, including patients with cirrhosis. In a pooled analysis of trials in patients with cirrhosis, silymarin treatment was associated with a significant reduction in liverrelated deaths. Moreover, in patients with diabetes and alcoholic cirrhosis, silymarin was also able to improve glycemic parameters. Patients with drug-induced liver injuries were also successfully treated with silymarin. Silymarin is generally very well tolerated, with a low incidence of adverse events and no treatment-related serious adverse events or deaths reported in clinical trials. For maximum benefit, treatment with silymarin should be initiated as early as possible in patients with fatty liver disease and other distinct liver disease manifestations such as acute liver failure, when the regenerative potential of the liver is still high and when removal of oxidative stress, the cause of cytotoxicity, can achieve the best results.

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Section: Drug-induced Liver Injurymentioning

confidence: 99%

Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review

Gillessen¹,

2020

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“…Indeed, elevated concentrations of circulating methionine in patients with liver disease have been reported [ 26 ], and excess methionine was shown to have toxic effects, including a decrease in hepatic ATP [ 5 , 27 ]. Numerous preclinical studies support a potential role for AdoMet in the treatment of chronic liver diseases [ 28 ] inter alia in reducing hepatic fibrosis [ 29 , 30 ] and in experimental liver injury [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

S-Adenosylmethionine Deficiency and Brain Accumulation of S-Adenosylhomocysteine in Thioacetamide-Induced Acute Liver Failure

2020

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Background: Acute liver failure (ALF) impairs cerebral function and induces hepatic encephalopathy (HE) due to the accumulation of neurotoxic and neuroactive substances in the brain. Cerebral oxidative stress (OS), under control of the glutathione-based defense system, contributes to the HE pathogenesis. Glutathione synthesis is regulated by cysteine synthesized from homocysteine via the transsulfuration pathway present in the brain. The transsulfuration-transmethylation interdependence is controlled by a methyl group donor, S-adenosylmethionine (AdoMet) conversion to S-adenosylhomocysteine (AdoHcy), whose removal by subsequent hydrolysis to homocysteine counteract AdoHcy accumulation-induced OS and excitotoxicity. Methods: Rats received three consecutive intraperitoneal injections of thioacetamide (TAA) at 24 h intervals. We measured AdoMet and AdoHcy concentrations by HPLC-FD, glutathione (GSH/GSSG) ratio (Quantification kit). Results: AdoMet/AdoHcy ratio was reduced in the brain but not in the liver. The total glutathione level and GSH/GSSG ratio, decreased in TAA rats, were restored by AdoMet treatment. Conclusion: Data indicate that disturbance of redox homeostasis caused by AdoHcy in the TAA rat brain may represent a deleterious mechanism of brain damage in HE. The correction of the GSH/GSSG ratio following AdoMet administration indicates its therapeutic value in maintaining cellular redox potential in the cerebral cortex of ALF rats.

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“…Patients who received SAMe were noted to have lower serum concentrations of aspartate transaminase and alanine transaminase, and this persisted throughout their course of SAMe treatment. [63][64][65] Additional research is required, but certainly preliminary data suggests that SAMe likely has a protective effect for chemotherapy-induced liver injury.…”

Section: Strategies To Lower Incidence Of Liver Injury Due To Systemimentioning

confidence: 99%

Chemotherapy-associated liver injury in colorectal cancer

Gangi

2020

Therap Adv Gastroenterol

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Patients with colorectal cancer (CRC) have benefited significantly from advances in multimodal treatment with significant improvements in long-term survival. More patients are currently being treated with surgical resection or ablation following neoadjuvant or adjuvant chemotherapy. However, several cytotoxic agents that are administered routinely have been linked to liver toxicities that impair liver function and regeneration. Recognition of chemotherapy-related liver toxicity emphasizes the importance of multidisciplinary planning to optimize care. This review aims to summarize current data on multimodal treatment concepts for CRC, provide an overview of liver damage caused by commonly administered chemotherapeutic agents, and evaluate currently suggested protective agents.

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The use of SAMe in chemotherapy-induced liver injury

Cited by 24 publications

References 109 publications

Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review

Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review

S-Adenosylmethionine Deficiency and Brain Accumulation of S-Adenosylhomocysteine in Thioacetamide-Induced Acute Liver Failure

Chemotherapy-associated liver injury in colorectal cancer

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