2nd Department of Medicine, Semmelweis University, Budapest, Hungary.
Curr Pharm Biotechnol. 2012 Jan;13(1):210-7. doi: 10.2174/138920112798868818.
In chronic liver diseases caused by oxidative stress (alcoholic and non-alcoholic fatty liver diseases, drug- and chemical-induced hepatic toxicity), the antioxidant medicines such as silymarin can have beneficial effect. Liver cirrhosis, non-alcoholic fatty liver and steatohepatitis are risk factors for hepatocellular carcinoma (HCC). Insulin resistance and oxidative stress are the major pathogenetic mechanisms leading the hepatic cell injury in these patients. The silymarin exerts membrane-stabilizing and antioxidant activity, it promotes hepatocyte regeneration; furthermore it reduces the inflammatory reaction, and inhibits the fibrogenesis in the liver. These results have been established by experimental and clinical trials. According to open studies the long-term administration of silymarin significantly increased survival time of patients with alcohol induced liver cirrhosis. Based on the results of studies using methods of molecular biology, silymarin can significantly reduce tumor cell proliferation, angiogenesis as well as insulin resistance. Furthermore, it exerts an anti-atherosclerotic effect, and suppresses tumor necrosis factor-alpha-induced protein production and mRNA expression due to adhesion molecules. The chemopreventive effect of silymarin on HCC has been established in several studies using in vitro and in vivo methods; it can exert a beneficial effect on the balance of cell survival and apoptosis by interfering cytokines. In addition to this, anti-inflammatory activity and inhibitory effect of silymarin on the development of metastases have also been detected. In some neoplastic diseases silymarin can be administered as adjuvant therapy as well.
在由氧化应激引起的慢性肝脏疾病（酒精性和非酒精性脂肪性肝病、药物和化学物质引起的肝毒性）中，抗氧化药物如水飞蓟素可能具有有益的作用。肝硬化、非酒精性脂肪肝和脂肪性肝炎是肝细胞癌（HCC）的危险因素。胰岛素抵抗和氧化应激是导致这些患者肝细胞损伤的主要发病机制。水飞蓟素具有稳定膜和抗氧化活性，可促进肝细胞再生；此外，它还可减轻炎症反应，抑制肝脏纤维化。这些结果已通过实验和临床试验得到证实。根据开放研究，长期给予水飞蓟素可显著延长酒精性肝硬化患者的生存时间。基于使用分子生物学方法的研究结果，水飞蓟素可显著降低肿瘤细胞增殖、血管生成和胰岛素抵抗。此外，它还具有抗动脉粥样硬化作用，并通过抑制黏附分子抑制肿瘤坏死因子-α诱导的蛋白产生和 mRNA 表达。几项使用体外和体内方法的研究已经证实了水飞蓟素对 HCC 的化学预防作用；它可以通过干扰细胞因子来发挥有益的作用，使细胞存活和凋亡达到平衡。除此之外，还检测到水飞蓟素的抗炎活性和对转移发展的抑制作用。在某些肿瘤疾病中，水飞蓟素也可以作为辅助治疗药物。
