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Titolo:
Silymarin: A review of its clinical properties in the management of hepatic disorders
Autore:
Wellington, K; Jarvis, B;
Indirizzi:
Adis Int Ltd, Auckland 10, New Zealand Adis Int Ltd Auckland New Zealand10 s Int Ltd, Auckland 10, New Zealand
Titolo Testata:
BIODRUGS
fascicolo: 7, volume: 15, anno: 2001,
pagine: 465 - 489
SICI:
1173-8804(2001)15:7<465:SAROIC>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
ALCOHOLIC LIVER-DISEASE; LONG-TERM TREATMENT; DOUBLE-BLIND; CONTROLLED TRIAL; SILIBININ DIASTEREOMERS; URSODEOXYCHOLIC ACID; LIPID-PEROXIDATION; SILYBUM-MARIANUM; MILK THISTLE; PROTECTION;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
108
Recensione:
Indirizzi per estratti:
Indirizzo: Wellington, K Adis Int Ltd, 41 Centorian Dr,Private Bag 65901, Auckland 10, New Zealand Adis Int Ltd 41 Centorian Dr,Private Bag 65901 Auckland New Zealand 10
Citazione:
K. Wellington e B. Jarvis, "Silymarin: A review of its clinical properties in the management of hepatic disorders", BIODRUGS, 15(7), 2001, pp. 465-489

Abstract

The mechanisms of action of silymarin involve different biochemical events, such as the stimulation of the synthetic rate of ribosomal RNA (rRNA) species through stimulation of polymerise I and rRNA transcription, protectingthe cell membrane from radical-induced damage and blockage of the uptake of toxins such as alpha -amanitin. Studies in patients with liver disease have shown that silymarin increasessuperoxide dismutase (SOD) activity of lymphocytes and erythrocytes, as well as the expression of SOD in lymphocytes. Silymarin has also been shown to increase patient serum levels of glutathione and glutathione peroxidase. Silybin 20 to 48 mg/kg/day has shown promise as a clinical antidote to acute Amanita (deathcap mushroom) poisoning. Primary efficacy data from 3 trials which examined the therapeutic potential of silymarin in patients with cirrhosis, and included patient survival as an endpoint, demonstrated that silymarin had no significant beneficial effect on patient mortality. However, upon subanalysis, silymarin 420 mg/day had a significantly beneficial effect on patient survival rate (compared with patients receiving placebo) in 1 randomised, double-blind trial in patients with alcoholic cirrhosis. Silymarin 420 mg/day was also shown to improve indices of liver function [AST, ALT, gamma -glutamyl transferase and bilirubin] in patients with liverdisease of various aetiology, including those exposed to toxic levels of toluene or xylene; however, it was largely ineffective in patients with viral hepatitis. Reports of adverse events while receiving silymarin therapy are rare. However, there have been accounts of nausea, epigastric discomfort, arthralgia,pruritus, headache and urticaria. Silymarin has also been reported to havepossibly caused a mild laxative effect. Conclusion: The antioxidant properties of silymarin (a mixture of at least4 closely related flavonolignans, 60 to 70% of which is a mixture of 2 diastereomers of silybin) have been demonstrated in vitro and in animal and human studies. However, studies evaluating relevant health outcomes associated with these properties are lacking. Although silymarin has low oral absorption, oral dosages of 420 mg/day have shown some therapeutic potential, with good tolerability, in the treatment of alcoholic cirrhosis. Moreover, silybin 20 to 48 mg/kg/day has shown promise as an antidote for acute mushroompoisoning by Amanita phalloides; however, further studies paying attentionto the amount of ingested mushroom and time elapsed before administration of treatment are needed to clarify its role in this indication. Studies in patients with the early onset of liver disease may demonstrate the liver regeneration properties that silymarin is promoted as possessing.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 02:55:55