Effects of Silymarin on Reducing Liver Aminotransferases in Patients with Nonalcoholic Fatty Liver Diseases Mohesn Masoodi1,2,3,4, Amirmansoor Rezadoost1,2, Mohammad Panahian1,2, Mahdi Vojdanian4 Colorectal Research Center, RasoolAkram Hospital, Iran University of Medical Sciences, Tehran, Iran *DVWURLQWHVWLQDODQG/LYHU'LVHDVH5HVHDUFK&HQWHU *,/'5& ,UDQ8QLYHUVLW\RI0HGLFDO6FLHQFHV7HKUDQ,UDQ 'LJHVWLYH'LVHDVH5HVHDUFK,QVWLWXWH ''5, 7HKUDQ8QLYHUVLW\RI0HGLFDO6FLHQFHV7HKUDQ,UDQ 7URSLFDODQG,QIHFWLRXV'LVHDVH5HVHDUFK&HQWHU+RUPR]JDQ8QLYHUVLW\RI0HGLFDO6FLHQFHV%DQGDU$EEDV,UDQ ABSTRACT Background: 7KHKHSDWRSURWHFWLYHHIIHFWVRIVLO\PDULQKDYHEHHQFRQ¿UPHGE\YDULRXVUHVHDUFKHUVZRUOGZLGH KRZHYHUIHZ studies are available about the therapeutic impact of silymarin on the level of aminotransferases in patients with QRQDOFRKROLFVWHDWRKHSDWLWLV 1$6+ 2XUSXUSRVHLVWRGHWHUPLQHZKHWKHUVLO\PDULQLPSURYHVWKHVHUXPOHYHORI DPLQRWUDQVIHUDVHVLQSDWLHQWVZLWK1$6+ Materials and Methods: 7KLVZDVDGRXEOHEOLQGUDQGRPL]HGSODFHERFRQWUROOHGWULDOSHUIRUPHGRQSDWLHQWVZLWK1$6+6XEMHFWVZHUH randomized to receive silymarin (140 mg/q12h) for three months or placebo, given in the same manner A blood sample was drawn at baseline (before treatment) and after completion of the treatment schedule to assess serum aminotransferase levels We measured body mass index (BMI) before and after administration of the treatments for both groups of patients Results: 7KHUHZHUHLQVLJQL¿FDQWFKDQJHVLQ%0,IRUERWKJURXSV7KHPHDQVHUXPDODQLQHDPLQRWUDQVIHUDVH $/7 OHYHO LQWKHFDVHJURXSVLJQL¿FDQWO\FKDQJHGIURPWR,8P/IROORZLQJWUHDWPHQWZLWKVLO\PDULQ p0.05) The mean serum ALT level in the case group was 84.06 IU/mL before treatment, which declined to 68.54 IU/mL after treatment with silymarin (p0.05) The mean serum AST level in the case group VLJQL¿FDQWO\GHFUHDVHGIURP WR,8P/DIWHU treatment with silymarin (p0.05) On the other hand, the decline in mean ALT and AST levels did not differ in the placebo JURXS ZKHUHDV WKHVH FKDQJHV ZHUH VLJQL¿FDQW LQ WKH VLO\PDULQ JURXS 7DEOH 1R VHULRXV DGYHUVH HYHQWV were recorded; side-effects were similar in frequency and uncommon in both groups DISCUSSION ([SHULPHQWDO VWXGLHV KDYH LGHQWL¿HG D QXPEHU of hepatoprotective mechanisms for silymarin The cytoprotective effects of silymarin are attributable to its antioxidant and free radical scavenging properties as well as its interaction with cell membrane components to prevent any abnormalities in the lipid fractions responsible for maintenance of normal ÀXLGLW\ $OVR LW FDQ VWLPXODWH SURWHLQ V\QWKHVLV WKURXJK DFWLQJ 51$ SRO\PHUDVH HQ]\PHV WKDW UHVXOW in increased ribosomal formation(18) Silymarin has DQWLLQÀDPPDWRU\ DQG DQWL¿EURWLF DFWLYLWLHV Moreover, silymarin has a regulatory action on cellular and mitochondrial membrane permeability in association with an increase in membrane stability against xenobiotic injury(24) It can prevent the absorption of toxins into hepatocytes by occupying the binding sites as well as inhibiting many transport proteins at the membrane level(4) Most clinical trials performed on the hepatoprotective effects of silymarin have mainly focused on its therapeutic effects on alcoholic liver diseases, liver cirrhosis, viral hepatitis, toxic and iatrogenic liver diseases, and liver related mortality due Table 1: Baseline characteristics and clinical data of the study population Characteristics Case group (n=50) Control group (n=50) Male gender 31 (62%) 31 (62%) Age (years) 48.42±6.75 48.32±5.45 Body mass index (BMI, kg/m2) 29.04±3.66 29.18±3.32 *UDGH,IDWW\OLYHUE\VRQRJUDSK\ 30 28 *UDGH,,IDWW\OLYHUE\VRQRJUDSK\ 16 17 *UDGH,,,IDWW\OLYHUE\VRQRJUDSK\ Table 2: Results of silymarin and placebo effect on nonalcoholic steatohepatitis (NASH) Indicator Silymarin group (n=50) Placebo group (n=50) Before treatment After treatment Before treatment After treatment 29.04±3.66 28.70±2.56 29.18±3.32 28.84±2.89 ** 74.48±4.45 73.32±5.58 54.70±5.51 ** 62.94±4.45 61.56±3.39 IBMI (kg/m2) ** ALT 84.06±6.65 AST 71.94±4.56 ** 68.54±5.54 ** p[...]... studies with competitive and non-competitive inhibitors of phalloidin transport Biochem Biophys Actan 1 986 ;86 0:91 -8 Hashemi SJ, Hajiani A, Sardabi EH.A placebo-controlled trial of Silymarin in patients with nonalcoholic fatty liver disease Hepat Mon 2009;9: 265-70 185 26 27 28 29 30 31 32 33 34 35 36 5DW]LX9 &KDUORWWH ) +HXUWLHU$ *RPEHUW 6 *LUDO 3 Bruckert E, et al Sampling variability of. .. nonalcoholic steatohepatitis (NASH) Indicator Silymarin group (n=50) Placebo group (n=50) Before treatment After treatment Before treatment After treatment 29.04 3. 66 28. 70±2.56 29 . 18 3. 32 28. 84±2 .89 ** 74. 48 4.45 73. 32±5. 58 54.70±5.51 ** 62.94±4.45 61.56 3. 39 IBMI (kg/m2) ** ALT 84 .06±6.65 AST 71.94±4.56 ** 68. 54±5.54 ** p