Silymarin in the Treatment of Patients with Primary Sclerosing Cholangitis: An Open-Label Pilot Study

Angulo, Paul; Jorgensen, Roberta A.; Kowdley, Kris V.; Lindor, Keith D.

doi:10.1007/s10620-007-0052-6

Cited by 36 publications

(16 citation statements)

References 21 publications

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“…Improved alkaline phosphatase and Mayo risk score were noted with treatment [45]. A small study with silymarin also reported improved liver biochemistries [46]. Similar results were reported with bezafibrate in very small case series [47].…”

Section: Other Agentsmentioning

confidence: 56%

Latest and Emerging Therapies for Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis

Zein

Lindor

2010

Curr Gastroenterol Rep

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Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) are the two most common causes of chronic cholestatic liver disease in adults. In PBC, therapy with ursodeoxycholic acid (UDCA) is safe and has been associated with tangible biochemical, histologic, and survival benefits. However, a need for different or adjuvant therapies remains for specific subsets of PBC patients, including those who do not respond to UDCA and those who have advanced histologic disease at presentation. Similarly, beneficial therapies for disease-related symptoms that do not typically respond to UDCA (eg, fatigue and pruritus) are still needed. In contrast to PBC, no medical therapy of proven benefit has been identified for patients with PSC. In PBC and PSC, adequate management of complications of chronic cholestasis is important. For both diseases, liver transplantation is the only curative option.

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Section: Other Agentsmentioning

confidence: 56%

Latest and Emerging Therapies for Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis

Zein

Lindor

2010

Curr Gastroenterol Rep

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“…The patients reported symptoms from the gastrointestinal tract; two patients reported headache/dizziness, and one pruritus [34]. Similarly, in patients with primary sclerosing cholangiitis, a silimarin dose of 140 mg three times a day for 7 to 221 months caused dyspepsia in some patients, with one reporting diarrhea, which disappeared after silimarin's discontinuation [35]. Silimarin seems to reverse increased AST levels induced by maca, such that it can be safely co-administered with the latter for 90 days in patients with the metabolic syndrome [36].…”

Section: Safetymentioning

confidence: 97%

The Therapeutic Potential of Milk Thistle in Diabetes

Kazazis¹,

Evangelopoulos²,

Kollas³

et al. 2014

Rev Diabet Stud

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■ AbstractMilk thistle has been known for more than 2.000 years as a herbal remedy for a variety of disorders. It has mainly been used to treat liver and gallbladder diseases. Silibum marianum, the Latin term for the plant, and its seeds contain a whole family of natural compounds, called flavonolignans. Silimarin is a dry mixture of these compounds; it is extracted after processing with ethanol, methanol, and acetone. Silimarin contains mainly silibin A, silibin B, taxifolin, isosilibin A, isosilibin B, silichristin A, silidianin, and other compounds in smaller concentrations. Apart from its use in liver and gallbladder disorders, milk thistle has recently gained attention due to its hypoglycemic and hypolipidemic properties. Recently, a substance from milk thistle has been shown to possess peroxisome proliferator-activated receptor γ (PPARγ) agonist properties. PPARγ is the molecular target of thiazolidinediones, which are used clinically as insulin sensitizers to lower blood glucose levels in diabetes type 2 patients. The thiazolidinedione type of PPARγ ligands is an agonist with a very high binding affinity. However, this ligand type demonstrates a range of undesirable side effects, thus necessitating the search for new effective PPARγ agonists. Interestingly, studies indicate that partial agonism of PPARγ induces promising activity patterns by retaining the positive effects attributed to the full agonists, with reduced side effects. In this review, the therapeutic potential of milk thistle in the management of diabetes and its complications are discussed.

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“…Finally, silymarin possesses immunomodulatory [27], anti-angiogenesis [28] and anti-fibrotic functions [29]. These conspicuous characteristics of silymarin have led to some investigations on gastrointestinal diseases in which the beneficial effects of silymarin have been shown, including hepatic impairments like primary sclerosing cholangitis and liver cirrhosis [36,37].…”

Section: Introductionmentioning

confidence: 99%

On the benefits of silymarin in murine colitis by improving balance of destructive cytokines and reduction of toxic stress in the bowel cells

et al. 2009

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Inflammatory bowel disease (IBD) is a multifactorial disease with an unknown etiology characterized by oxidative stress, leukocyte infiltration and a rise in inflammatory cytokines. In this study, we have investigated the effects of silymarin, a mixture of several flavonolignans with established antioxidant and anti-inflammatory properties, on trinitrobenzene sulphonic acid (TNBS)-induced colitis in rats. Experimental colitis was induced in male Wistar-albino rats by delivering TNBS to the distal colon. All the medicines were administered by gavage for seven days. Thirty-six male rats were divided into six groups containing six rats in each one. Control rats received only TNBS. In the treated groups, animals were given different doses of silymarin (40, 80, and 160 mg/kg). Dexamethasone (1 mg/kg) was used as the positive treatment. Colonic status was investigated seven days post induction of colitis through macroscopic, histological, and biochemical analyses. Amelioration of the morphological signs including macroscopic damage, necrotic area, and histology were seen subsequent to treating animals with silymarin. These observations were accompanied by a significant reduction in the degree of both neutrophil infiltration, indicated by decreased myeloperoxidase activity, and lipid peroxidation, as measured by a decline in malodialdehyde content in inflamed colon as well as a decrease in levels of inflammatory cytokines (TNF-α and IL-1β). The results of the present study reveal that the beneficial effect of silymarin in bowel cells is mediated through its anti-oxidant and anti-inflammatory potentials.

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Silymarin in the Treatment of Patients with Primary Sclerosing Cholangitis: An Open-Label Pilot Study

Cited by 36 publications

References 21 publications

Latest and Emerging Therapies for Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis

Latest and Emerging Therapies for Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis

The Therapeutic Potential of Milk Thistle in Diabetes

On the benefits of silymarin in murine colitis by improving balance of destructive cytokines and reduction of toxic stress in the bowel cells

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