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解释不确定的肝脏保护作用：水飞蓟宾与其他药物联合使用时的情况。

Explaining Uncertain Hepatoprotective Effects: When Silibinin Co-Administered with Other Drugs.

作者信息

Pu Dong, Sun Qinwei, Zhao Zengxiang, Wang Sisi, Li Ji, Yu Feng

机构信息

China Pharmaceutical University School of Basic Medical Sciences and Clinical Pharmacy, Department of Clinical Pharmacy, Nanjing, China.

出版信息

Medeni Med J. 2025 Jun 26;40(2):37-45. doi: 10.4274/MMJ.galenos.2025.71163.

DOI:10.4274/MMJ.galenos.2025.71163
PMID:40569711
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12203441/
Abstract

OBJECTIVE

This study investigated the herb-drug interaction between silibinin and carbamazepine (CBZ) and the potential risk of adverse drug reactions (ADR) when silibinin is co-administered with other drugs.

METHODS

Primary fresh hepatocytes were cultured, and an methylthiazolyldiphenyl-tetrazolium bromide assay was performed after administration of different concentrations of CBZ, and silibinin. Meanwhile, a retrospective study on hepatic adverse reactions involving the combination of silibinin with other drugs was performed using the Food and Drug Administration Adverse Event Reporting System (FAERS).

RESULTS

The protective effects of silibinin on CBZ do not appear on hepatocytes in a dose-dependent manner. When silibinin (25μM) was co-administered with CBZ (2mM), the cell viability increased from 47.8% to 75.9% (p<0.05), while increasing the silibinin concentration to 50μM with CBZ (2mM), the hepatocyte viability significantly declined from 47.8% to 38.7% (p<0.05). In the FAERS database, the risk of adverse reactions significantly increases when combined with silibinin. The silibinin co-administration was significantly associated with hepatotoxicity reports.

CONCLUSIONS

The results of the cell experiment showed that silibinin's liver protective effects were uncertain when it was combined with CBZ. FAERS database analysis revealed elevated risks of ADRs with silibinin co-administration, collectively highlighting the necessity for vigilance against unanticipated herb-drug interactions.

摘要

目的

本研究调查了水飞蓟宾与卡马西平（CBZ）之间的药草-药物相互作用，以及水飞蓟宾与其他药物合用时发生药物不良反应（ADR）的潜在风险。

方法

培养原代新鲜肝细胞，给予不同浓度的CBZ和水飞蓟宾后进行甲基噻唑基二苯基四氮唑溴盐检测。同时，使用美国食品药品监督管理局不良事件报告系统（FAERS）对涉及水飞蓟宾与其他药物联合使用的肝脏不良反应进行回顾性研究。

结果

水飞蓟宾对CBZ的保护作用在肝细胞上未呈现剂量依赖性。当水飞蓟宾（25μM）与CBZ（2mM）合用时，细胞活力从47.8%增至75.9%（p<0.05），而将水飞蓟宾浓度增至50μM并与CBZ（2mM）合用时，肝细胞活力从47.8%显著降至38.7%（p<0.05）。在FAERS数据库中，与水飞蓟宾联合使用时不良反应风险显著增加。水飞蓟宾合用与肝毒性报告显著相关。

结论

细胞实验结果表明，水飞蓟宾与CBZ合用时其肝脏保护作用不确定。FAERS数据库分析显示水飞蓟宾合用会增加ADR风险，共同凸显了警惕意外药草-药物相互作用的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/10e5a3c7e038/MedeniMedJ-40-2-37-figure-7a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/08612bb75dbf/MedeniMedJ-40-2-37-figure-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/f683ca6eec6f/MedeniMedJ-40-2-37-figure-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/41c2f1e38b2d/MedeniMedJ-40-2-37-figure-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/f5f4591f1a56/MedeniMedJ-40-2-37-figure-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/0929ecdbea07/MedeniMedJ-40-2-37-figure-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/03f8e961bfd0/MedeniMedJ-40-2-37-figure-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/10e5a3c7e038/MedeniMedJ-40-2-37-figure-7a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/08612bb75dbf/MedeniMedJ-40-2-37-figure-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/f683ca6eec6f/MedeniMedJ-40-2-37-figure-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/41c2f1e38b2d/MedeniMedJ-40-2-37-figure-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/f5f4591f1a56/MedeniMedJ-40-2-37-figure-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/0929ecdbea07/MedeniMedJ-40-2-37-figure-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/03f8e961bfd0/MedeniMedJ-40-2-37-figure-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eb2/12203441/10e5a3c7e038/MedeniMedJ-40-2-37-figure-7a.jpg

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