Effects of silybum marianum on patients with chronic hepatitis C

Associate Professor of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Journal of research in medical sciences (Impact Factor: 0.65). 03/2011; 16(3):287-90.
Source: PubMed

ABSTRACT Silymarin derived from silybum marianum (milk thistle), a flowering member of the daisy family, may benefit liver function in people infected with the hepatitis C virus. The aims of this pilot study were to assess the efficacy and safety of silymarin on serum hepatitis C virus (HCV) RNA, serum aminotransferases (ALT, AST) levels, liver fibrosis and well-being in patients with chronic hepatitis C (CHC).
This prospective self-controlled trial study was conducted from March to September 2006 at Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran. 55 patients with HCV (10 female and 45 male) with a mean age of 31.8 ± 6.4 years (10-67 years) were participated in the study. Patients received 24 weeks of silymarin (630 mg/day). Baseline virological biochemical, liver fibrosis (by a serum fibrosis markers, including YKL-40 and Hyaluronic acid), and SF-36 questionnaire were performed with biochemical tests repeated at the end of the treatment period.
There was statistically difference in mean of ALT (108.7 ± 86.6 vs 70.3 ± 57.7) before and after the treatment (p < 0.001). The means of AST were 99.4 ± 139.7 and 59.7 ± 64.32 before and after the treatment with statistically differences (p = 0.004). After the treatment, nine patients were found with negative HCV-RNA (p = 0.004) and statistically significant improvement in results of liver fibrosis markers were found only in fibrosis group (p = 0.015). Quality of life was improved significantly (p < 0.001).
This study indicated that in patients with CHC performing silymarin (650 mg/day) for 6 months, improved serum HCV-RNA titer, serum aminotransferases (ALT, AST), hepatic fibrosis and patient's quality of life. More future studies are warranted.

Download full-text


Available from: Hamid Kalantari, Jul 11, 2014
95 Reads
  • Source
    • "So, for its antioxidant and anti-inflammatory actions, sylimarin could result useful in reducing hepatic inflammation in chronic liver disease, including HCV-related damage. It has been hypothesized that decreased hepatic inflammation-due to both direct and indirect effects of silymarin in decreasing viral replication has the potential to induce long-term benefit to the infected liver [62]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Complementary and alternative medicine soughts and encompasses a wide range of approaches; its use begun in ancient China at the time of Xia dynasty and in India during the Vedic period, but thanks to its long-lasting curative effect, easy availability, natural way of healing, and poor side-effects it is gaining importance throughout the world in clinical practice. We conducted a review describing the effects and the limits of using herbal products in chronic liver disease, focusing our attention on those most known, such as quercetin or curcumin. We tried to describe their pharmacokinetics, biological properties, and their beneficial effects (as antioxidant role) in metabolic, alcoholic, and viral hepatitis (considering that oxidative stress is the common pathway of chronic liver diseases of different etiology). The main limit of applicability of CAM comes from the lacking of randomized, placebo-controlled clinical trials giving a real proof of efficacy of those products, so that anecdotal success and personal experience are frequently the driving force for acceptance of CAM in the population.
    Evidence-based Complementary and Alternative Medicine 09/2012; 2012(9):837939. DOI:10.1155/2012/837939 · 1.88 Impact Factor
  • Source
    • "The naturally occurring flavonoid silymarin, an extract from Silybum marianum, inhibits hepatic stellate cell activation that is crucial for fibrogenesis [21]. Moreover, silymarin exerted inhibitory activities on HCV RNA replication and hepatic fibrosis in HCV patients [22]. Glycyrrhizin, a major component of Glycyrrhiza glabra extract, modified glycosylation and suppressed sialyation of hepatitis B surface antigen (HBsAg), which inhibited secretion of HBsAg [23]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Saponins are a group of naturally occurring plant glycosides which possess a wide range of pharmacological properties, including anti-tumorigenic and antiviral activities. To investigate whether saponin has anti-hepatitis C virus (HCV) activity, we examined the effect of saponin on HCV replication. HCV replication was efficiently inhibited at a concentration of 10 µg/ml of saponin in cell culture grown HCV (HCVcc)-infected cells. Inhibitory effect of saponin on HCV replication was verified by quantitative real-time PCR, reporter assay, and immunoblot analysis. In addition, saponin potentiated IFN-α-induced anti-HCV activity. Moreover, saponin exerted antiviral activity even in IFN-α resistant mutant HCVcc-infected cells. To investigate how cellular genes were regulated by saponin, we performed microarray analysis using HCVcc-infected cells. We demonstrated that suppressor of cytokine signaling 2 (SOCS2) protein level was distinctively increased by saponin, which in turn resulted in inhibition of HCV replication. We further showed that silencing of SOCS2 resurrected HCV replication and overexpression of SOCS2 suppressed HCV replication. These data imply that saponin inhibits HCV replication via SOCS2 signaling pathway. These findings suggest that saponin may be a potent therapeutic agent for HCV patients.
    PLoS ONE 06/2012; 7(6):e39366. DOI:10.1371/journal.pone.0039366 · 3.23 Impact Factor
    • "The Hepatitis C virus affects 100 to 300 million people worldwide. Chronic HCV infection is one of the leading causes of chronic liver disease and related complications such as cirrhosis and hepatocellular carcinoma.[56] These two diseases, like many other chronic diseases, can impose various kinds of costs on patients and health systems worldwide. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study is to estimate the average diagnosis and treatment costs of chronic hepatitis B and C, with respect to different therapeutic strategies in Iran. This is a descriptive, analytical, and cross-sectional study carried out on patients with hepatitis B and C, who were referred to the Liver Disease Research Center for Prevention and Treatment of Hepatitis, Isfahan University of Medical Sciences, in 2011. We have estimated the direct medical costs including doctors' fees, cost of para-clinical tests, medical treatments, and liver biopsy, in different treatment strategies. The results of this study showed that the total cost of diagnostic services for hepatitis B virus (HBV) and hepatitis C virus (HCV) patients, with state medical tariffs, was US$ 1499.07 and US$ 2084.89, respectively. The patients' profiles showed that there were currently seven therapeutic strategies available to treat HBV patients. The total cost of treatment strategies varied significantly from US$ 73 to US$ 8256. There were also four main strategies for HCV patients, each of these could be applied in two periods of time. The total cost of these treatment strategies showed a high discrepancy from US$ 242 to US$ 8256. The results confirmed that the total direct medical cost for an HBV patient in Iran exceeded US$ 5.5 Milliard in 2011. The results implied that the market price of direct medical cost of HBV and HCV patients in Iran is much higher than the estimated state costs. These costs would likely be saved or reduced by effective disease management and early prevention.
    International journal of preventive medicine 03/2012; 3(3):191-6.
Show more