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Силимарин: традиционные и новые эффекты

https://doi.org/10.34883/PI.2021.24.1.003

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Аннотация

Силимарин – смесь изомерных флавонолигнанов расторопши пятнистой (Silybum marianum). В статье представлена характеристика фармакологических свойств силимарина, характеристика стандартизированного экстракта расторопши по силимарину и силибину Легалон (Legalon)®, клинические эффекты с обзором результатов применения силимарина при заболеваниях печени различной этиологии. Представлены данные об эффектах силимарина при перегрузке железа, онкологических заболеваниях, сахарном диабете. Приведены литературные данные с обоснованием потенциальных эффектов силимарина в отношении вируса SARS-CoV-2 как основа для разработки новых противовирусных препаратов или подходов к поддерживающей терапии инфекции COVID-19.

Об авторах

Н. Н. Силивончик
Белорусская медицинская академия последипломного образования
Беларусь


Т. Н. Якубчик
Гродненский государственный медицинский университет
Беларусь


Список литературы

1. Abenavoli L., Capasso R., Milic N., Capasso F. (2010) Milk thistle in liver diseases: past, present, future. Phytother. Res., vol. 24, no 10, pp. 1423–1432. DOI: 10.1002/ptr.3207

2. Marahovskij Yu.H. (2011) Legalon. Monografiya [Legalon. Monograph]. M., 53 p. (in Russian)

3. Federico A., Dallio M., Loguercio C. (2017) Silymarin/silybin and chronic liver disease: A marriage of many years. Molecules., vol. 22, no 2, pp. 191. DOI: 10.3390/ molecules22020191

4. Jacobs B.P., Dennehy C, Ramirez G., Sapp J., Lawrence W.A. (2002) Milk thistle for the treatment of liver disease: a systematic review and meta-analysis. Am. J. Med., vol. 113, no 6, pp. 506–515. doi: 10.1016/s0002-9343(02)01244-5.

5. Kim N.C., Graf T.N., Sparacino C.M., Wani M.C., Wallet N.T. (2003) Complete isolation and characterization of silybins and isosilybins from milk thistle (Silybum marianum). Org. Biomol. Chem., vol. 1, no 10, pp. 1684–1689. doi: 10.1039/b300099k.

6. Neha, Jaggi A.S., Singh N. (2016) Silymarin and its role in chronic diseases. Adv. Exp. Med Biol., vol. 929, pp. 25–44. DOI: 10.1007/978-3-319-41342-6_2

7. Kurchenko V.P., Shchekatihina A.S. Soderzhanie flavolignanov rastoropshi pyatnistoj v plodah i gepatoprotektornyh preparatah [Content of flavanolignans of milk thistle in fruits and hepatoprotective drugs]. Zdorov’ya Ukraini. microlabD:2011Gastro_2Rotafarm_madaus

8. Calani L., Brighenti F. Bruni R., Del Rio D. (2012) Absorption and metabolism of milk thistle flavanolignans in humans. Phytomedicine, vol. 20, no 13, pp. 40–46. doi: 10.1016/ j.phymed.2012.09.004.

9. Li W.-Y., Yu G., Hogan R.M., Mohandas R., Frye R.F., Gumpricht E., Markowitz J.S. (2018) Relative bioavailability of Silybin A and Silybin B from 2 multiconstituent dietary supplement formulations containing Milk Thistle extract: A single-dose study. Clin. Ther., vol. 40, no 1, pp. 103–113. doi: 10.1016/j.clinthera.2017.11.013.

10. Rainone F. (2005) Milk thistle. Am. Fam. Physician., vol. 72, no 7, pp. 1285–1288.

11. Ross S. M. (2008) Milk thistle (Silybum marianum): an ancient botanical medicine for modern times. Holist. Nurs. Pract, vol. 22, no 5, pp. 299–300. doi: 10.1097/01. HNP.0000334924.77174.6d.

12. Fehér J., Láng I., Nékám K., Müzes G., Deák G. (1988). Effect of free radical scavengers on superoxide dismutase (SOD) enzyme in patients with alcoholic cirrhosis. Acta Med. Hung., vol. 45, no 3–4, pp. 265–276.

13. Pradhan S.C., Girish C. (2006) Hepatoprotective herbal drug, silymarin from experimental pharmacology to clinical medicine. Indian J. Med. Res., vol. 124, pp. 491–504.

14. Ramasamy K., Agarwal R. (2008) Multitargeted therapy of cancer by silymarin. Cancer Lett., vol. 269, no 2, pp. 352–362. doi: 10.1016/j.canlet.2008.03.053.

15. Wu Y.T., Wu S.B., Wei Y.H. (2014) Metabolic reprogramming of human cells in response to oxidative stress: implications in the pathophysiology and therapy of mitochondrial diseases. Curr. Pharm. Des., vol. 20, no 35, pp. 5510–5526. doi: 10.2174/1381612820666140306103401.

16. Shaker E., Mahmoud H., Mnaa S. (2010) Silymarin, the antioxidant component and Silybum marianum extracts prevent liver damage. Food Chem. Toxicol., vol. 48, no 3, pp. 803–806. doi: 10.1016/j.fct.2009.12.011.

17. Ross S.M. (2008) Milk thistle (Silybum marianum): an ancient botanical medicine for modern times. Holist. Nurs. Pract, vol. 22, no 5, pp. 299–300. doi: 10.1097/01. HNP.0000334924.77174.6d.

18. Dehmlow C., Erhard J., de Groot H. (1996) Inhibition of Kupffer cell functions as an explanation for the hepatoprotective properties of silibinin. Hepatology, vol. 23, no 5, pp. 749–754. doi: 10.1053/jhep.1996.v23.pm0008666328.

19. Köksal E., Gülçin I., Beyza S., Sarikaya O., Bursal E. (2009) In vitro antioxidant activity of silymarin. J. Enzyme Inhib. Med. Chem., vol. 24, pp. 395–405. doi. org/10.1080/14756360802188081

20. Sepulveda S.A., Bryan-Marrugo O.L., Cordova-Fletes C., Gutierrez-Ruiz, M.C., Rivas-Estilla A.M. (2015) Oxidative stress modulation in hepatitis C virus infected cells. World J. Hepatol., vol. 7, no 29, pp. 2880–2889. doi: 10.4254/wjh.v7.i29.2880

21. Yoo H.G., Jung S.N., Hwang Y., Park J.S., Kim M.H., Jeong M., Ahn S.J., Ahn B.W., Shin B.A., Park R.K., Jung Y.D. (2004) Involvement of NF-kappaB and caspases in silibinin-induced apoptosis of endothelial cells. Int. J. Mol. Med., vol. 13, no 1, pp. 81–86.

22. Lin Y.-L., Hsu Y.-C., Chiu Y.-T., Huanget Y.-N. (2008) Antifibrotic effects of a herbal combination regimen on hepatic fibrotic rats. Phytother. Res., vol. 22, no 1, pp. 69–76. DOI: 10.1002/ptr.2265

23. Fathalah W.F., Abdel Aziz M.A., Abou El Soud N.H., El Raziky M.E.S. (2017) High dose of silymarin in patients with decompensated liver disease: A randomized controlled trial.J. Interferon. Cytokine. Res., vol. 37, no 11, pp. 480–487. DOI: 10.14218/JCTH.2020.00012

24. Hajiaghamohammadi A.A, Ziaee A., Oveisi S., Masroor H. (2012) Effects of metformin, pioglitazone, and silymarin treatment on nonalcoholic fatty disease: A randomized controlled pilot study. Hepat. Mon., vol. 12, no 8, e6099. doi: 10.5812/hepatmon.6099

25. Loguercio C., Andreone P., Brisc C., Bugianesi E., Chiaramonte M., Cursaro C., Danila M., de Sio M., Floreani A., Freni M.A., Grieco A., Groppo M., Lazzari R., Lobello S., Lorefice E., Margotti M, Miele L., Milani S., Okolicsanyi L., Palasciano G., Portincasa P., Saltarelli P., Smedile A., Somalvico F., Spadaro A., Sporea I., Sorrentino P., Vecchione R., Tuccillo C., Del Vecchio Blanco C., Federico A. (2012) Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radic. Biol. Med., vol. 52, no 9, pp. 1658–1665. doi: 10.1016/j.freeradbiomed.2012.02.008.

26. Luangchosiri C., Thakkinstian A., Chitphuk S., Stitchantrakul W., Petraksa S., Sobhonslidsuk A. (2015) A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury. BMC Complement Altern. Med., vol. 15, pp. 334. DOI: 10.1186/s12906-015-0861-7

27. Ribeiro de Avelar C., Pereira E.M., Costa P.R.d.F, Passos de Jesus R. (2017) Effect of silymarin on biochemical indicators in patients with liver disease: systematic review with meta-analysis. World J. Gastroenterol., vol. 23, no 27, pp. 5004–5017. doi: 10.3748/wjg.v23.i27.5004

28. Lucena M.I., Andrade R.J., de la Cruz J.P., Rodriguez-Mendizabal M., Blanco E., de la Cuesta F.S. (2002). Effects of silymarin MZ-80 on oxidative stress in patients with alcoholic cirrhosis. Results of a randomized, double-blind, placebo-controlled clinical study. Int. J. Clin. Pharmacol. Ther., vol. 40, no 1, pp. 2–8. DOI: 10.5414/cpp40002

29. Pár A., Roth E., Miseta A., Hegedüs G., Pár G., Hunyady B., Vincze A. (2009) Effects of supplementation with the antioxidant flavonoid, silymarin, in chronic hepatitis C patients treated with peg-interferon + ribavirin. A placebo-controlled double blind study. Orv. Hetil., vol. 150, no 2, pp. 73–79. doi: 10.1556/OH.2009.28517.

30. Gillessen A., Schmidt H. H.-J. (2014) Effect of silymarin on liver health and quality of life. Results of a non-interventional study. MMW – Fortschritte der Medizin., vol. 56 (Suppl. 4), pp. 120–126.

31. Solhi H., Ghahremani R., Kazemifar A.M., Hoseini Yazdi Z. (2014) Silymarin in treatment of non-alcoholic steatohepatitis: A randomized clinical trial. Caspian J. Intern. Med.,vol. 5, no 1, pp. 9–12.

32. Rendina M., D’Amato M. Castellaneta A. et al. (2014) Antiviral activity and safety profile of silibinin in HCV patients with advanced fibrosis after liver transplantation: a randomized clinical trial. Transpl. Int., no 27, pp. 696–704.

33. Aller R., Izaola O., Gómez S., Tafur C., González G., Berroa E., Mora N., González J.M., de Luis D.A. (20150 Effect of silymarin plus vitamin E in patients with non-alcoholic fatty liver disease. A randomized clinical pilot study. Eur. Rev. Med. Pharmacol. Sci., vol. 19, no 16, pp. 3118–3124.

34. Wah Kheong C., Nik Mustapha N.R., Mahadeva S. (2017) A randomized trial of silymarin for the treatment of nonalcoholic steatohepatitis. Clin. Gastroenterol. Hepatol., vol. 15, no 12, pp. 1940–1949. doi: 10.1016/j.cgh.2017.04.016.

35. Asgarshirazi M., Shariat M., Sheikh M. (2017) Comparison of efficacy of folic acid and silymarin in the management of antiepileptic drug induced liver injury: a randomized clinical trial. Hepatobiliary Pancreat. Dis. Int., vol. 16, no 3, pp. 296–302. doi: 10.1016/s1499-3872(16)60142-x.

36. Anushiravani A., Haddadi N., Pourfarmanbar M., Mohammadkarimi V. (2019) Treatment options for nonalcoholic fatty liver disease: a double-blinded randomized placebo- controlled trial. Eur. J. Gastroenterol. Hepatol., vol. 31, no 5, pp. 613–617. doi: 10.1097/MEG.0000000000001369.

37. Trappoliere M., Federico A., Tuccillo C., de Sio I., Di Leva A., Niosi M., D’Auria M., Loguercio C., Real Sud Group 2 (2005). Effects of a new pharmacological complex (silybin + vitamin-E + phospholipids) on some markers of the metabolic syndrome and of liver fibrosis in patients with hepatic steatosis. Preliminary study. Minerva Gastroenterol. Dietol., vol. 51, no 2, pp. 193–199.

38. Wei F., Liu S.K., Liu X.Y., Li Z.-J., Li B., Zhou Y.-L., Zhang H.-Y., Li Y.-W. (2013) Meta-analysis: Silymarin and its combination therapy for the treatment of chronic hepatitis B. Eur. J. Clin. Microbiol. Infect. Dis., vol. 32, no 5, pp. 657–669. doi: 10.1007/s10096-012-1789-1.

39. Ebrahimpour-Koujan S., Gargari B.P., Mobasseri M., Valizadeh H., Asghari-Jafarabadi M. (2018) Lower glycemic indices and lipid profile among type 2 diabetes mellitus patients who received novel dose of Silybum marianum (L.) Gaertn. (silymarin) extract supplement: A Triple-blinded randomized controlled clinical trial. Phytomedicine., vol. 44, pp. 39–44. doi: 10.1016/j.phymed.2018.03.050.

40. Fallahzadeh M.K., Dormanesh B., Sagheb M.M., Roozbeh J., Vessal G., Pakfetrat M., Daneshbod Y., Kamali-Sarvestani E., Lankarani K.B. (2012) Effect of addition of silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic patients with overt nephropathy: a randomized, double-blind, placebo-controlled trial. Am. J. Kidney Dis., vol. 60, no 6, pp. 896–903. DOI: 10.1053/j.ajkd.2012.06.005

41. Butorova L.I., Kadnikova N.G., Kalashnikova M.A. (2014) Drug-induced liver damage in patients with metabolic syndrome and non-alcoholic fatty liver disease: new possibilities of prevention and treatment. Meditsinskie novosti, no 8, pp. 41–47.

42. Lozano-Sepulveda S.A., Bryan-Marrugo, O.L., Cordova-Fletes C., Lozano-Sepulveda S.A., Bryan-Marrugo O.R., Cordova-Fletes C., C Gutierrez-Ruiz M.C., Rivas-Estillaet A.M. (2015) Oxidative stress modulation in hepatitis C virus infected cells. World J. Hepatol., vol. 5, no 7, pp. 2880–2889. doi: 10.4254/wjh.v7.i29.2880

43. Salamone F., Galvano F., Cappello F., Mangiameli A., Barbagallo I., Li Vol.ti G. (2012) Silibinin modulates lipid homeostasis and inhibits nuclear factor kappa B activation in experimental nonalcoholic steatohepatitis. Transl. Res., vol. 159, pp. 477–486. doi: 10.1016/j.trsl.2011.12.003

44. Ahmed-Belkacem A., Ahnou N., Barbotte L., Wychowski C., Pallier C., Brillet R., Pohl R.-T., Pawlotsky J.-M. (2010). Silibinin and related compounds are direct inhibitors of hepatitis C virus RNA-dependent RNA polymerase. Gastroenterology, vol. 138, no 3, pp. 1112–1122. doi: 10.1053/j.gastro.2009.11.053.

45. Liu C.H., Jassey A., Hsu H.Y., Lin L.T. (2019) Antiviral activities of silymarin and derivatives. Molecules., vol. 24, no 8, pii: E1552. doi: 10.3390/molecules24081552.

46. Darvishi-Khezri H., Salehifar E., Kosaryan M., Karami H., Alipour A., Shaki F., Aliasgharian A. (2015) The impact of silymarin on antioxidant and oxidative status in patients with β-thalassemia major: A crossover, randomized controlled trial. Infect. Disord. Drug. Targets., vol. 15, pp. 189–195. doi: 10.1016/j.ctim.2017.08.007.

47. Moayedi B., Gharagozloo M., Esmaeil N., Maracy M.R., Hoorfar H., Jalaeikaret M. (2013) A randomized double-blind, placebo-controlled study of therapeutic effects of silymarin in β-thalassemia major patients receiving desferrioxamine. Eur. J. Haematol., vol. 90, no 3, pp. 202–209. DOI: 10.1111/ejh.12061

48. Imam M.U., Zhang S., Ma J., Wang H., Wang F. (2017) Antioxidants mediate both iron homeostasis and oxidative stress. Nutrients, vol. 9, no 7, pp. 671. doi: 10.3390/nu9070671.

49. Kontoghiorghe C.N., Kolnagou A., Kontoghiorghes G.J. (2015) Phytochelators intended for clinical use in iron, Overload, other diseases of iron imbalance and free radical pathology. Molecules., vol. 20, no 11, pp. 20841–20872. doi.org/10.3390/molecules201119725

50. Orisakwe O.E., Amadi C.N., Frazzoli Ch. (2020) Management of iron overload in resource poor nations: A systematic review of phlebotomy and natural chelators. Hindawi J. Toxicol. Article ID 4084538, 14 pages doi.org/10.1155/2020/4084538.

51. Vostalova J., Vidlar A., Ulrichova J., Vostalova J., Vidlar A., Ulrichova J., Vrbkova J., Simanek V., Student V. (2013) Use of selenium-silymarin mix reduces lower urinary tract symptoms and prostate specific antigen in men. Phytomedicine, vol. 21, no 1, pp. 75–81. doi: 10.1016/j.phymed.2013.07.018.

52. Vidlar A., Vostalova А., Ulrichova J., Student V., Krajicek M., Vrbkova J., Simanek V. (2010) The safety and efficacy of a silymarin and selenium combination in men after radical prostatectomy – a six month placebo-controlled double-blind clinical trial. Biomed. Pap. Med. Fac. Univ. Palacky Olomouc. Czech Repub., vol. 154, no 3, pp. 239–544. doi: 10.5507/bp.2010.036.

53. Elyasi S., Hosseini S., Moghadam M.R.N., Aledavood S.A., Karimi G. (2016) Effect of oral silymarin administration on prevention of radiotherapy induced mucositis: A randomized, double-blinded, placebo-controlled clinical trial. Phytother. Res., vol. 30, no 11, pp. 1879–1885. doi.org/10.1002/ptr.5704

54. Bosch-Barrera J., Martin-Castillo B., Buxó M., Brunet J., J.A. Encinar, Menendez J.A. (2020) Silibinin and SARS-CoV-2: Dual Targeting of Host Cytokine Storm and Virus Replication Machinery for Clinical Management of COVID-19 Patients. J. Clin. Med., vol. 9, p. 1770. doi: 10.3390/jcm9061770

55. Ivashkin V.T., Sheptulin A.A., Zolnikova O.Yu., Okhlobystin A.V., Poluektova E.A., Trukhmanov A.S., Shirokova E.N., Gonik M.I., Trofimivskaya N.I. New Coronavirus Infection (COVID-19) and Digestive System (2020). Russian Journal of Gastroenterology, Hepatology, Coloproctology, vol. 30, no 3, pp. 7–13. doi.org/10.22416/1382-4376-2020-30-3-7


Для цитирования:


Силивончик Н.Н., Якубчик Т.Н. Силимарин: традиционные и новые эффекты. Рецепт. 2021;(1):30-42. https://doi.org/10.34883/PI.2021.24.1.003

For citation:


Silivontchik .N., Yakubchik .T. Sylimarin: Traditional and New Effects. Recipe. 2021;(1):30-42. (In Russ.) https://doi.org/10.34883/PI.2021.24.1.003

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