Review
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World J Gastroenterol. May 14, 2011; 17(18): 2288-2301
Published online May 14, 2011. doi: 10.3748/wjg.v17.i18.2288
Silybin and the liver: From basic research to clinical practice
Carmela Loguercio, Davide Festi
Carmela Loguercio, Gastroenterology School-Interuniversity Research Centre on Foods, Nutrition and Gastrointestinal Tract (CIRANAD), 2nd University of Naples, 80131 Naples, Italy
Davide Festi, Department of Clinical Medicine, University of Bologna, 40138 Bologna, Italy
Author contributions: Both authors wrote the manuscript.
Correspondence to: Carmela Loguercio, MD, Gastroenterology School-Interuniversity Research Centre on Foods, Nutrition and Gastrointestinal Tract (CIRANAD), 2nd University of Naples; Via Pansini 5, 80131 Napoli, Italy. carmelina.loguercio@unina2.it
Telephone: +39-81-5666837 Fax:+39-81-5666837
Received: November 18, 2010
Revised: December 23, 2010
Accepted: December 30, 2010
Published online: May 14, 2011
Abstract

Herbal products are increasingly used, mainly in chronic liver disease. Extracts of milk thistle, Silymarin and silybin, are the most prescribed natural compounds, with different indications, but with no definitive results in terms of clinical efficacy. This review analyzes the available studies on the effects of the purified product silybin, both as a free and a conjugated molecule, on liver cells or on experimentally induced liver damage, and in patients with liver disease. We searched PUBMED for articles pertaining to the in vitro and in vivo effects of silybin, its antifibrotic, anti-inflammatory, and antioxidant properties, as well as its metabolic effects, combined with the authors’ own knowledge of the literature. Results indicate that the bioavailability of silybin phytosome is higher than that of silymarin and is less influenced by liver damage; silybin does not show significant interactions with other drugs and at doses < 10 g/d has no significant side effects. Experimental studies have clearly demonstrated the antifibrotic, antioxidant and metabolic effects of silybin; previous human studies were insufficient for confirming the clinical efficacy in chronic liver disease, while ongoing clinical trials are promising. On the basis of literature data, silybin seems a promising drug for chronic liver disease.

Keywords: Milk thistle; Silymarin; Liver disease; Hepatic fibrosis; Hepatic inflammation; Radical species