Nephrology Ward, Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Phytother Res. 2010 Nov;24(11):1654-7. doi: 10.1002/ptr.3175.
Chronic inflammation in dialysis patients increases the production of cytokines such as TNF-α, IL-1β and IFN- IFN-γ and there is evidence of a significant mortality rate in dialysis patients due to inflammation. Overproduction of inflammatory cytokines can induce complications such as atherosclerosis, malnutrition and anaemia, which are mostly resistant to erythropoietin treatment. Cardiovascular disease is the leading cause of death in haemodialysis patients and about half of the mortality is attributable to cardiovascular disease. Silymarin modulates the immune system by inhibition of neutrophil immigration, mast cell immobilization, prostaglandin production and leukotriene synthesis. Furthermore, silymarin suppresses the induction of TNF-α and it was hypothesized that silymarin could decrease the serum concentration of TNF-α in peritoneal dialysis patients, and thus treat anaemia. Fifteen peritoneal dialysis patients were enrolled in this study and serum levels of soluble TNF-α were measured using an enzyme-linked immunosorbant assay (ELISA) kit. Serum TNF-α was found to be decreased in some patients and in the response group, the haemoglobin concentration after 8 weeks of silymarin administration was increased significantly (p < 0.05). Based on the results of this study, it is suggested that silymarin may be useful in the treatment of inflammation for peritoneal dialysis patients.
透析患者的慢性炎症会增加细胞因子的产生，如 TNF-α、IL-1β 和 IFN-γ，并且有证据表明炎症会导致透析患者的死亡率显著上升。炎症细胞因子的过度产生会导致并发症，如动脉粥样硬化、营养不良和贫血，而这些并发症大多对促红细胞生成素治疗有抗性。心血管疾病是血液透析患者的主要死亡原因，大约一半的死亡率归因于心血管疾病。水飞蓟素通过抑制中性粒细胞迁移、肥大细胞固定、前列腺素产生和白三烯合成来调节免疫系统。此外，水飞蓟素还能抑制 TNF-α 的诱导，因此有人假设水飞蓟素可以降低腹膜透析患者的血清 TNF-α 浓度，从而治疗贫血。本研究纳入了 15 名腹膜透析患者，使用酶联免疫吸附测定（ELISA）试剂盒测量了可溶性 TNF-α 的血清水平。结果发现，一些患者的血清 TNF-α 水平降低，而在应答组中，水飞蓟素治疗 8 周后血红蛋白浓度显著升高（p < 0.05）。基于这项研究的结果，提示水飞蓟素可能对腹膜透析患者的炎症治疗有用。
