Silymarin (Milk Thistle) can revoke liver enzyme changes during chemotherapy of breast cancer with Taxanes

Mohaghegh, Fathollah; Solhi, Hassan; Kazemifar, Amir Mohammad

doi:10.1016/j.eujim.2015.10.012

Cited by 9 publications

(15 citation statements)

References 13 publications

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“…Silymarin as an herbal drug also has both antioxidant and anti-inflammatory properties. We used silymarin in the present study owing to the promising results reported in various other cases of poisoning [19][20][21]. Also, the outcome of the present study with silymarin alone is supportive evidence.…”

Section: Discussionsupporting

confidence: 68%

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Prevention of Lung Complications following Paraquat Poisoning by Silymarin, N-acetyl Cysteine and Hydrocortisone: An Experimental Study

Solhi

Ghasemi

Rahbari

et al. 2020

IJT

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Background: Paraquat poisoning results in multi-organ failure, primarily pulmonary fibrosis, acute renal failure, and hepatic impairment. The present study was designed to evaluate three treatment regimens, such as N-Acetyl cysteine (NAC), silymarin and hydrocortisone in the prevention of lung fibrosis after ingestion of toxic doses of paraquat in rats. Methods: Male Sprague-Dawley rats (N=20) were randomly divided into four groups of five each. The drugs and paraquat were given to the rats orally. All rat groups received one oral dose of paraquat (10 mg/kg) once daily for 1 week. The first group received a daily oral dose of silymarin (600 mg/kg) for 2 weeks. The second group received a daily oral dose of NAC (500 mg/kg) for 2 weeks. The third group was given daily oral doses of NAC (500 mg/kg) and hydrocortisone (50 mg/kg) for 2 weeks. The fourth group (controls) received no drugs other than paraquat. The experiment continued for 4 weeks. After the experiment, autopsy was performed on all rats and the lungs were examined histopathologically. Results: The results of histopathology examinations for peribronchial inflammation in the groups were shown that NAC plus hydrocortisone and silymarin had notable effects in the prevention of lung inflammation. Septal widening in the lungs was also observed in group three less than that in the other groups. Conclusion: Based on the results, silymarin, NAC and hydrocortisone may be used as a palliative treatment in paraquat poisoning specifically aimed at preventing the acute and chronic lung injuries as the worst complication of the poisoning.

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Section: Discussionsupporting

confidence: 68%

“…In this context, experimentation with agents that may have beneficial effects seems prudent. Antioxidant and anti-inflammatory effects of silymarin has been studied previously by researchers in different cases of poisonings [19][20][21]. Silymarin and NAC have been studied in paraquat poisoning in few previous studies.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Lung Complications following Paraquat Poisoning by Silymarin, N-acetyl Cysteine and Hydrocortisone: An Experimental Study

Solhi

Ghasemi

Rahbari

et al. 2020

IJT

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“…Another trial by Mohaghegh et al ( 10 ) focused on the effects of silymarin on taxane-based CILI. In their study, 99 patients with invasive breast cancer treated with anthracyclines followed by taxanes (docetaxel or paclitaxel) were randomly divided into two study arms.…”

Section: Introductionmentioning

confidence: 99%

“…The control arm was administered a placebo. The levels of two liver enzymes [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] and serum bilirubin (Bil) levels were measured after each dose of taxane ( 10 ). Although there was initially only a small difference in the levels of liver enzymes and Bil between the groups, a statistically significant difference between the groups was observed in the levels of liver enzymes after 1 month of treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Although there was initially only a small difference in the levels of liver enzymes and Bil between the groups, a statistically significant difference between the groups was observed in the levels of liver enzymes after 1 month of treatment. They thus concluded that silymarin can revoke the increase in the levels of liver enzymes when administered to patients treated with taxanes, and stated that this effect may be enhanced with higher doses of silymarin ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Optimal dose of silymarin for the management of drug‑induced liver injury in oncology

Kohutek

Bystrický

2023

Mol Clin Oncol

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Systemic oncological treatment may cause drug-induced liver injury (DILI). Therefore, there is a pressing need for an active drug able to accelerate liver regeneration. Silymarin mitigates oxidative stress, and inhibits pro-inflammatory and pro-apoptotic cytokines and the fibrotic transformation of liver tissue. Currently, there are a lack of data regarding the optimal dosage of silymarin and its efficacy. Thus, the present retrospective study aimed to determine the optimal dose of silymarin for use in oncological DILI treatment. For this purpose, 180 patients with solid malignancies treated with systemic oncological therapy and silymarin between January, 2015 and November, 2021 were enrolled in the study. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (Bil) levels, as well as the dose of silymarin were assessed at the initiation of silymarin treatment, after 3-6 weeks and after 6-12 weeks. Pearson's correlation analysis was performed to evaluate the correlation between the initial dose of silymarin (IDoS), and the ALT, AST and Bil levels. The effects of four independent variables, namely IDoS, the initial dose reduction of systemic treatment, the systemic treatment dose reduction at first assessment (DR1M) and the elevation of the silymarin dose at first control on the ALT, AST and Bil levels were evaluated using regression analysis. The median IDoS was 450 mg. A decrease in or the stabilization of the ALT, AST and Bil levels after 6-12 weeks were observed in 68.63, 65.85 and 53.25% of patients, respectively. There was a weak correlation between IDoS and the decrease in ALT and AST levels after 6-12 weeks (correlation coefficient, R=0.361 and 0.277 respectively, P<0.001). No significant correlation between the IDoS and a decrease in Bil levels was observed. DR1M was a negative predictor for a decrease in Bil levels in patients with liver tumors. On the whole, the present study demonstrates that silymarin appears to be efficient in alleviating DILI at a dose of 300-450 mg. A further increase in the dose of silymarin may not lead to an adequate increase in its efficacy.

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Effects of silymarin supplementation on liver and kidney functions: A systematic review and dose–response meta‐analysis

Mohammadi,

Ashtary‐Larky,

Asbaghi

et al. 2024

Phytotherapy Research

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It is suggested that supplementation with silymarin (SIL) has beneficial impacts on kidney and liver functions. This systematic review and dose–response meta‐analysis assessed the impact of SIL administration on certain hepatic, renal, and oxidative stress markers. A systematic search was conducted in various databases to identify relevant trials published until January 2023. Randomized controlled trials (RCTs) that evaluated the effects of SIL on kidney and liver markers were included. A random‐effects model was used for the analysis and 41 RCTs were included. The pooled results indicated that SIL supplementation led to a significant reduction in serum levels of alkaline phosphatase, alanine transaminase, creatinine, and aspartate aminotransferase, along with a substantial elevation in serum glutathione in the SIL‐treated group compared to their untreated counterparts. In addition, there was a nonsignificant decrease in serum levels of gamma‐glutamyl transferase, malondialdehyde (MDA), total bilirubin, albumin (Alb), total antioxidant capacity, and blood urea nitrogen. Sub‐group analyses revealed a considerable decline in MDA and Alb serum values among SIL‐treated participants with liver disease in trials with a longer duration (≥12 weeks). These findings suggest that SIL may ameliorate certain liver markers with potential hepatoprotective effects, specifically with long‐term and high‐dose supplementation. However, its nephroprotective effects and impact on oxidative stress markers were not observed. Additional high‐quality RCTs with longer durations are required to determine the clinical efficacy of SIL supplementation on renal and oxidative stress markers.

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Silymarin (Milk Thistle) can revoke liver enzyme changes during chemotherapy of breast cancer with Taxanes

Cited by 9 publications

References 13 publications

Prevention of Lung Complications following Paraquat Poisoning by Silymarin, N-acetyl Cysteine and Hydrocortisone: An Experimental Study

Prevention of Lung Complications following Paraquat Poisoning by Silymarin, N-acetyl Cysteine and Hydrocortisone: An Experimental Study

Optimal dose of silymarin for the management of drug‑induced liver injury in oncology

Effects of silymarin supplementation on liver and kidney functions: A systematic review and dose–response meta‐analysis

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