Definition
ChEBI: 3,5,7-trihydroxy-2-[3-(4-hydroxy-3-methoxyphenyl)-2-(hydroxymethyl)-2,3-dihydro-1,4-benzodioxin-6-yl]-3,4-dihydro-2H-1-benzopyran-4-one is a flavonolignan.
Indications
Milk thistle (Silybum [Carduus] marianus) is a spiny
European plant with white-veined leaves and milky sap,
the seed of which is used to treat liver disease.Milk thistle
seed extract is used orally in the treatment of alcoholic
and other cirrhoses and in Europe intravenously
for its hepatoprotective effect in Amanita and other
mushroom poisonings. It is grown in this country primarily
as a “liver cleanser” and is reputed to protect this
organ from a wide array of toxins.Milk thistle seed contains
the active principle silymarin, a complex of
flavonolignan compounds including silibinin (silybin),
silidianin, and silychristin.
General Description
Silymarin is a flavonolignan, obtained from milk thistle (Silybum marianum) plant.
Biochem/physiol Actions
Silymarin was shown to protect the liver from the cytotoxic effects of anti-tuberculosis drugs by decreasing serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) levels. This effect was related to the anti-oxidant effects of silymarin.
Clinical Use
Alcoholic cirrhosis has been improved (faster return
of liver enzymes to baseline) in at least three trials, although
one multicenter Spanish study failed to
demonstrate any change in the clinical course.There is
no evidence to support the use of milk thistle to increase
alcohol tolerance, although it is certainly being
used for this purpose. The effectiveness of silymarin
for viral hepatitis is not clear, although several trials
demonstrated enough benefit to encourage further
studies.
Intravenous silymarin has been demonstrated to
lower mortality from Amanita mushroom poisonings,
but this formulation is available only in Europe.Animal
studies have demonstrated hepatic protection against
alcohol, acetaminophen, and mushroom toxins and protection
against hepatic fibrosis with bile duct occlusion.
There is also evidence of silybin protecting against cisplatin-
induced nephrotoxicity in rats. It is not yet clear
whether milk thistle extract offers any renal protection
to humans.
Toxicity evaluation
Silymarin has been known for its very low toxicity, Acute toxicity studies of silymarin after intravenous infusion have been carried out in mice, rats, rabbits and dogs. The LD50 values were 400 mg/kg in mice, 385 mg/ kg in rats, and 140 mg/kg in rabbits and dogs though these values were dependent on infusion rate. With slow infusion rate (over 2 to 3 h) the LD50 increased to 2 g/kg in rats and after oral administration it was even 10 g/kg.