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Published in: Inflammopharmacology 2/2024

19-02-2024 | Thalassemia | Review

The effects of silymarin consumption on inflammation and oxidative stress in adults: a systematic review and meta-analysis

Authors: Hossein Bahari, Mostafa Shahraki Jazinaki, Mohammad Rashidmayvan, Shaghayegh Taheri, Mohammad Reza Amini, Mahsa Malekahmadi

Published in: Inflammopharmacology | Issue 2/2024

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Abstract

Background

Owing to the rich phytochemical content of Silymarin, it may effectively manage inflammation and oxidative stress. We, therefore, aimed to examine the existing evidence on the effect of Silymarin consumption on inflammation and oxidative stress factors by conducting a systematic review and meta-analysis of randomized controlled trials.

Methods

A systematic literature search up to September 2023 was completed in PubMed/Medline, Scopus, and Web of Science, to identify eligible RCTs. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as weighted mean differences with a 95% confidence interval.

Results

Fifteen RCTs were included in this meta-analysis. Our findings showed that Silymarin consumption significantly decreased CRP (WMD, − 0.50 mg/L; 95% CI, (− 0.95 to − 0.04); p = 0.03), MDA (WMD, − 1.19 nmol/mL; 95% CI, (− 1.99 to − 0.38); p = 0.004), and IL-6 (WMD, − 0.44 pg/ml; 95% CI, (− 0.75 to − 0.12); p = 0.006). Silymarin consumption had no significant effects on IL-10, TAC, and GSH. A significant non-linear relationship was observed between the duration of the intervention and MDA changes.

Conclusions

Silymarin can help reduce inflammation in patients with diabetes and thalassemia by reducing MDA as an oxidative stress marker and CRP and IL-6 as inflammatory markers.
Appendix
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Literature
go back to reference Abenavoli L, Izzo AA, Milić N, Cicala C, Santini A, Capasso R (2018) Milk thistle (Silybum marianum): a concise overview on its chemistry, pharmacological, and nutraceutical uses in liver diseases. Phytother Res 32(11):2202–2213PubMedCrossRef Abenavoli L, Izzo AA, Milić N, Cicala C, Santini A, Capasso R (2018) Milk thistle (Silybum marianum): a concise overview on its chemistry, pharmacological, and nutraceutical uses in liver diseases. Phytother Res 32(11):2202–2213PubMedCrossRef
go back to reference Alidoost F, Gharagozloo M, Bagherpour B, Jafarian A, Sajjadi SE, Hourfar H, Moayedi B (2006) Effects of silymarin on the proliferation and glutathione levels of peripheral blood mononuclear cells from β-thalassemia major patients. Int Immunopharmacol 6(8):1305–1310PubMedCrossRef Alidoost F, Gharagozloo M, Bagherpour B, Jafarian A, Sajjadi SE, Hourfar H, Moayedi B (2006) Effects of silymarin on the proliferation and glutathione levels of peripheral blood mononuclear cells from β-thalassemia major patients. Int Immunopharmacol 6(8):1305–1310PubMedCrossRef
go back to reference Amir-Behghadami M, Janati A (2020) Population, Intervention, Comparison, Outcomes and Study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews. Emerg Med J 37:387PubMedCrossRef Amir-Behghadami M, Janati A (2020) Population, Intervention, Comparison, Outcomes and Study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews. Emerg Med J 37:387PubMedCrossRef
go back to reference Anushiravani A, Haddadi N, Pourfarmanbar M, Mohammadkarimi V (2019) Treatment options for nonalcoholic fatty liver disease: a double-blinded randomized placebo-controlled trial. Eur J Gastroenterol Hepatol 31(5):613–617PubMedCrossRef Anushiravani A, Haddadi N, Pourfarmanbar M, Mohammadkarimi V (2019) Treatment options for nonalcoholic fatty liver disease: a double-blinded randomized placebo-controlled trial. Eur J Gastroenterol Hepatol 31(5):613–617PubMedCrossRef
go back to reference Asbaghi O, Ashtary-Larky D, Naseri K, Saadati S, Zamani M, Rezaei Kelishadi M, Haghighat N (2022) The effects of conjugated linoleic acid supplementation on lipid profile in adults: a systematic review and dose–response meta-analysis. Front Nutr 9:953012PubMedPubMedCentralCrossRef Asbaghi O, Ashtary-Larky D, Naseri K, Saadati S, Zamani M, Rezaei Kelishadi M, Haghighat N (2022) The effects of conjugated linoleic acid supplementation on lipid profile in adults: a systematic review and dose–response meta-analysis. Front Nutr 9:953012PubMedPubMedCentralCrossRef
go back to reference Ashkavand Z, Malekinejad H, Vishwanath B (2014) Combined action of Silymarin and Celecoxib in modulating inflammatory mediators in osteoarthritis. Biomed Prev Nutr 4(4):485–490CrossRef Ashkavand Z, Malekinejad H, Vishwanath B (2014) Combined action of Silymarin and Celecoxib in modulating inflammatory mediators in osteoarthritis. Biomed Prev Nutr 4(4):485–490CrossRef
go back to reference Atawia RT, Mosli HH, Tadros MG, Khalifa AE, Mosli HA, Abdel-Naim AB (2014) Modulatory effect of silymarin on inflammatory mediators in experimentally induced benign prostatic hyperplasia: emphasis on PTEN, HIF-1α, and NF-κB. Naunyn Schmiedebergs Arch Pharmacol 387:1131–1140PubMedCrossRef Atawia RT, Mosli HH, Tadros MG, Khalifa AE, Mosli HA, Abdel-Naim AB (2014) Modulatory effect of silymarin on inflammatory mediators in experimentally induced benign prostatic hyperplasia: emphasis on PTEN, HIF-1α, and NF-κB. Naunyn Schmiedebergs Arch Pharmacol 387:1131–1140PubMedCrossRef
go back to reference Balouchi S, Gharagozloo M, Esmaeil N, Mirmoghtadaei M, Moayedi B (2014) Serum levels of TGFβ, IL-10, IL-17, and IL-23 cytokines in β-thalassemia major patients: the impact of silymarin therapy. Immunopharmacol Immunotoxicol 36(4):271–274PubMedCrossRef Balouchi S, Gharagozloo M, Esmaeil N, Mirmoghtadaei M, Moayedi B (2014) Serum levels of TGFβ, IL-10, IL-17, and IL-23 cytokines in β-thalassemia major patients: the impact of silymarin therapy. Immunopharmacol Immunotoxicol 36(4):271–274PubMedCrossRef
go back to reference Borenstein M, Hedges LV, Higgins JP, Rothstein HR (2021) Introduction to meta-analysis. WileyCrossRef Borenstein M, Hedges LV, Higgins JP, Rothstein HR (2021) Introduction to meta-analysis. WileyCrossRef
go back to reference Borsari M, Gabbi C, Ghelfi F, Grandi R, Saladini M, Severi S, Borella F (2001) Silybin, a new iron-chelating agent. J Inorg Biochem 85(2–3):123–129PubMedCrossRef Borsari M, Gabbi C, Ghelfi F, Grandi R, Saladini M, Severi S, Borella F (2001) Silybin, a new iron-chelating agent. J Inorg Biochem 85(2–3):123–129PubMedCrossRef
go back to reference Chang J-M, Kuo M-C, Kuo H-T, Chiu Y-W, Chen H-C (2005) Increased glomerular and extracellular malondialdehyde levels in patients and rats with diabetic nephropathy. J Lab Clin Med 146(4):210–215PubMedCrossRef Chang J-M, Kuo M-C, Kuo H-T, Chiu Y-W, Chen H-C (2005) Increased glomerular and extracellular malondialdehyde levels in patients and rats with diabetic nephropathy. J Lab Clin Med 146(4):210–215PubMedCrossRef
go back to reference Cheng MI, Ho HY, Tseng HC, Lee CH, Shih LY, Chiu DTY (2005) Antioxidant deficit and enhanced susceptibility to oxidative damage in individuals with different forms of α-thalassaemia. Br J Haematol 128(1):119–127PubMedCrossRef Cheng MI, Ho HY, Tseng HC, Lee CH, Shih LY, Chiu DTY (2005) Antioxidant deficit and enhanced susceptibility to oxidative damage in individuals with different forms of α-thalassaemia. Br J Haematol 128(1):119–127PubMedCrossRef
go back to reference Comelli MC, Mengs U, Schneider C, Prosdocimi M (2007) Toward the definition of the mechanism of action of silymarin: activities related to cellular protection from toxic damage induced by chemotherapy. Integr Cancer Ther 6(2):120–129PubMedCrossRef Comelli MC, Mengs U, Schneider C, Prosdocimi M (2007) Toward the definition of the mechanism of action of silymarin: activities related to cellular protection from toxic damage induced by chemotherapy. Integr Cancer Ther 6(2):120–129PubMedCrossRef
go back to reference Cvetković T, Mitić B, Lazarević G, Vlahović P, Antić S, Stefanović V (2009) Oxidative stress parameters as possible urine markers in patients with diabetic nephropathy. J Diabetes Complications 23(5):337–342PubMedCrossRef Cvetković T, Mitić B, Lazarević G, Vlahović P, Antić S, Stefanović V (2009) Oxidative stress parameters as possible urine markers in patients with diabetic nephropathy. J Diabetes Complications 23(5):337–342PubMedCrossRef
go back to reference Darvishi-Khezri H, Kosaryan M, Karami H, Salehifar E, Mahdavi M, Alipour A, Aliasgharian A (2021) Can use of silymarin improve inflammatory status in patients with β-thalassemia major? a crossover, randomized controlled trial. Complement Med Res 28(2):123–130PubMedCrossRef Darvishi-Khezri H, Kosaryan M, Karami H, Salehifar E, Mahdavi M, Alipour A, Aliasgharian A (2021) Can use of silymarin improve inflammatory status in patients with β-thalassemia major? a crossover, randomized controlled trial. Complement Med Res 28(2):123–130PubMedCrossRef
go back to reference Darvishi-Khezri H, Salehifar E, Kosaryan M, Karami H, Alipour A, Shaki F, Aliasgharian A (2017) The impact of silymarin on antioxidant and oxidative status in patients with β-thalassemia major: A crossover, randomized controlled trial. Complement Ther Med 35:25–32PubMedCrossRef Darvishi-Khezri H, Salehifar E, Kosaryan M, Karami H, Alipour A, Shaki F, Aliasgharian A (2017) The impact of silymarin on antioxidant and oxidative status in patients with β-thalassemia major: A crossover, randomized controlled trial. Complement Ther Med 35:25–32PubMedCrossRef
go back to reference De La Lastra CA, Martin M, Marhuenda E (1992) Gastric anti-ulcer activity of silymarin, a lipoxygenase inhibitor, in rats. J Pharm Pharmacol 44(11):929–931CrossRef De La Lastra CA, Martin M, Marhuenda E (1992) Gastric anti-ulcer activity of silymarin, a lipoxygenase inhibitor, in rats. J Pharm Pharmacol 44(11):929–931CrossRef
go back to reference Ebrahimpour Koujan S, Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M (2015) Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: a randomized, triple-blind, placebo-controlled clinical trial. Phytomedicine 22(2):290–296. https://doi.org/10.1016/j.phymed.2014.12.010CrossRefPubMed Ebrahimpour Koujan S, Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M (2015) Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: a randomized, triple-blind, placebo-controlled clinical trial. Phytomedicine 22(2):290–296. https://​doi.​org/​10.​1016/​j.​phymed.​2014.​12.​010CrossRefPubMed
go back to reference Elgarf AT, Mahdy MM, Sabri NA (2015) Effect of silymarin supplementation on glycemic control, lipid profile and insulin resistance in patients with type 2 diabetes mellitus. Int J Adv Res 3:812–821 Elgarf AT, Mahdy MM, Sabri NA (2015) Effect of silymarin supplementation on glycemic control, lipid profile and insulin resistance in patients with type 2 diabetes mellitus. Int J Adv Res 3:812–821
go back to reference Fallahzadeh MK, Dormanesh B, Sagheb MM, Roozbeh J, Vessal G, Pakfetrat M, Lankarani KB (2012) Effect of addition of silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic patients with overt nephropathy: a randomized, double-blind, placebo-controlled trial. Am J Kidney Dis 60(6):896–903PubMedCrossRef Fallahzadeh MK, Dormanesh B, Sagheb MM, Roozbeh J, Vessal G, Pakfetrat M, Lankarani KB (2012) Effect of addition of silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic patients with overt nephropathy: a randomized, double-blind, placebo-controlled trial. Am J Kidney Dis 60(6):896–903PubMedCrossRef
go back to reference Fogacci F, Grassi D, Rizzo M, Cicero AF (2019) Metabolic effect of berberine–silymarin association: a meta-analysis of randomized, double-blind, placebo-controlled clinical trials. Phytother Res 33(4):862–870PubMedPubMedCentralCrossRef Fogacci F, Grassi D, Rizzo M, Cicero AF (2019) Metabolic effect of berberine–silymarin association: a meta-analysis of randomized, double-blind, placebo-controlled clinical trials. Phytother Res 33(4):862–870PubMedPubMedCentralCrossRef
go back to reference Fraschini F, Demartini G, Esposti D (2002) Pharmacology of silymarin. Clin Drug Investig 22:51–65CrossRef Fraschini F, Demartini G, Esposti D (2002) Pharmacology of silymarin. Clin Drug Investig 22:51–65CrossRef
go back to reference Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M (2015) Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: a randomized, triple-blind, placebo-controlled clinical trial. Phytomedicine 22(2):290–296PubMedCrossRef Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M (2015) Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: a randomized, triple-blind, placebo-controlled clinical trial. Phytomedicine 22(2):290–296PubMedCrossRef
go back to reference Ghiasian M, Nafisi H, Ranjbar A, Mohammadi Y, Ataei S (2021) Antioxidative effects of Silymarin on the reduction of liver complications of fingolimod in patients with relapsing—remitting multiple sclerosis: a clinical trial study. J Biochem Mol Toxicol 35(8):e22800PubMedCrossRef Ghiasian M, Nafisi H, Ranjbar A, Mohammadi Y, Ataei S (2021) Antioxidative effects of Silymarin on the reduction of liver complications of fingolimod in patients with relapsing—remitting multiple sclerosis: a clinical trial study. J Biochem Mol Toxicol 35(8):e22800PubMedCrossRef
go back to reference Gupta O, Sing S, Bani S, Sharma N, Malhotra S, Gupta B, Handa S (2000) Anti-inflammatory and anti-arthritic activities of silymarin acting through inhibition of 5-lipoxygenase. Phytomedicine 7(1):21–24PubMedCrossRef Gupta O, Sing S, Bani S, Sharma N, Malhotra S, Gupta B, Handa S (2000) Anti-inflammatory and anti-arthritic activities of silymarin acting through inhibition of 5-lipoxygenase. Phytomedicine 7(1):21–24PubMedCrossRef
go back to reference Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schünemann HJ (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336(7650):924–926PubMedPubMedCentralCrossRef Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schünemann HJ (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336(7650):924–926PubMedPubMedCentralCrossRef
go back to reference Hackett E, Twedt D, Gustafson D (2013) Milk thistle and its derivative compounds: a review of opportunities for treatment of liver disease. J Vet Intern Med 27(1):10–16PubMedCrossRef Hackett E, Twedt D, Gustafson D (2013) Milk thistle and its derivative compounds: a review of opportunities for treatment of liver disease. J Vet Intern Med 27(1):10–16PubMedCrossRef
go back to reference Hanje AJ, Fortune B, Song M, Hill D, McClain C (2006) The use of selected nutrition supplements and complementary and alternative medicine in liver disease. Nutr Clin Pract 21(3):255–272PubMedPubMedCentralCrossRef Hanje AJ, Fortune B, Song M, Hill D, McClain C (2006) The use of selected nutrition supplements and complementary and alternative medicine in liver disease. Nutr Clin Pract 21(3):255–272PubMedPubMedCentralCrossRef
go back to reference Higgins J and Green S (2010) Cochrane handbook for systematic reviews of interventions, version 5.0. 2 [updated Sept 2009], The Cochrane Collaboration, 2009. In Higgins J and Green S (2010) Cochrane handbook for systematic reviews of interventions, version 5.0. 2 [updated Sept 2009], The Cochrane Collaboration, 2009. In
go back to reference Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5(1):1–10CrossRef Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5(1):1–10CrossRef
go back to reference Huseini HF, Larijani B, Heshmat R, Fakhrzadeh H, Radjabipour B, Toliat T, Raza M (2006) The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res 20(12):1036–1039PubMedCrossRef Huseini HF, Larijani B, Heshmat R, Fakhrzadeh H, Radjabipour B, Toliat T, Raza M (2006) The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res 20(12):1036–1039PubMedCrossRef
go back to reference Hussain SA, Mortada AH, Jasim NA, Gorial FI (2016) Silibinin improves the effects of methotrexate in patients with active rheumatoid arthritis: pilot clinical study. Oman Med J 31(4):263PubMedPubMedCentralCrossRef Hussain SA, Mortada AH, Jasim NA, Gorial FI (2016) Silibinin improves the effects of methotrexate in patients with active rheumatoid arthritis: pilot clinical study. Oman Med J 31(4):263PubMedPubMedCentralCrossRef
go back to reference Hutchinson C, Bomford A, Geissler CA (2010) The iron-chelating potential of silybin in patients with hereditary haemochromatosis. Eur J Clin Nutr 64(10):1239–1241PubMedPubMedCentralCrossRef Hutchinson C, Bomford A, Geissler CA (2010) The iron-chelating potential of silybin in patients with hereditary haemochromatosis. Eur J Clin Nutr 64(10):1239–1241PubMedPubMedCentralCrossRef
go back to reference Kalopitas G, Antza C, Doundoulakis I, Siargkas A, Kouroumalis E, Germanidis G, Chourdakis M (2020) The impact of silymarin in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis. Clin Nutr ESPEN 40:515CrossRef Kalopitas G, Antza C, Doundoulakis I, Siargkas A, Kouroumalis E, Germanidis G, Chourdakis M (2020) The impact of silymarin in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis. Clin Nutr ESPEN 40:515CrossRef
go back to reference Kang JS, Jeon YJ, Park S-K, Yang K-H, Kim HM (2004) Protection against lipopolysaccharide-induced sepsis and inhibition of interleukin-1β and prostaglandin E2 synthesis by silymarin. Biochem Pharmacol 67(1):175–181PubMedCrossRef Kang JS, Jeon YJ, Park S-K, Yang K-H, Kim HM (2004) Protection against lipopolysaccharide-induced sepsis and inhibition of interleukin-1β and prostaglandin E2 synthesis by silymarin. Biochem Pharmacol 67(1):175–181PubMedCrossRef
go back to reference Kheong CW, Mustapha NRN, Mahadeva S (2017) A randomized trial of silymarin for the treatment of nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol 15(12):1940-1949.e8CrossRef Kheong CW, Mustapha NRN, Mahadeva S (2017) A randomized trial of silymarin for the treatment of nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol 15(12):1940-1949.e8CrossRef
go back to reference Kumar S, Pandey A (2015) Free radicals: health implications and their mitigation by herbals. Br J Med Med Res 7(6):438–457CrossRef Kumar S, Pandey A (2015) Free radicals: health implications and their mitigation by herbals. Br J Med Med Res 7(6):438–457CrossRef
go back to reference Kumar S, Pandey AK (2013) Chemistry and biological activities of flavonoids: an overview. Sci World J 2013:1–16 Kumar S, Pandey AK (2013) Chemistry and biological activities of flavonoids: an overview. Sci World J 2013:1–16
go back to reference Lassmann H, van Horssen J (2016) Oxidative stress and its impact on neurons and glia in multiple sclerosis lesions. Biochim Biophys Acta 1862:506–510PubMedCrossRef Lassmann H, van Horssen J (2016) Oxidative stress and its impact on neurons and glia in multiple sclerosis lesions. Biochim Biophys Acta 1862:506–510PubMedCrossRef
go back to reference Luangchosiri C, Thakkinstian A, Chitphuk S, Stitchantrakul W, Petraksa S, Sobhonslidsuk A (2015) A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury. BMC Complement Altern Med 15:1–7CrossRef Luangchosiri C, Thakkinstian A, Chitphuk S, Stitchantrakul W, Petraksa S, Sobhonslidsuk A (2015) A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury. BMC Complement Altern Med 15:1–7CrossRef
go back to reference Mahi-Birjand M, Karimzadeh I, Zarban A, Abdollahpour-Alitappeh M, Saadatjoo SA, Ziaee M (2020) Protective effects of silymarin on gentamicin-induced nephrotoxicity in infectious patients: a randomized double blinded placebo-controlled clinical trial. Pharm Sci 26(3):287–295CrossRef Mahi-Birjand M, Karimzadeh I, Zarban A, Abdollahpour-Alitappeh M, Saadatjoo SA, Ziaee M (2020) Protective effects of silymarin on gentamicin-induced nephrotoxicity in infectious patients: a randomized double blinded placebo-controlled clinical trial. Pharm Sci 26(3):287–295CrossRef
go back to reference Manna SK, Mukhopadhyay A, Van NT, Aggarwal BB (1999) Silymarin suppresses TNF-induced activation of NF-κB, c-Jun N-terminal kinase, and apoptosis. J Immunol 163(12):6800–6809PubMedCrossRef Manna SK, Mukhopadhyay A, Van NT, Aggarwal BB (1999) Silymarin suppresses TNF-induced activation of NF-κB, c-Jun N-terminal kinase, and apoptosis. J Immunol 163(12):6800–6809PubMedCrossRef
go back to reference Mirzaei E, Sabetian G, Masjedi M, Heidari R, Mirjalili M, Dehghanian A, Vazin A (2021) The effect of silymarin on liver enzymes and antioxidant status in trauma patients in the intensive care unit: a randomized double blinded placebo-controlled clinical trial. Clin Exp Hepatol 7(2):149–155PubMedPubMedCentralCrossRef Mirzaei E, Sabetian G, Masjedi M, Heidari R, Mirjalili M, Dehghanian A, Vazin A (2021) The effect of silymarin on liver enzymes and antioxidant status in trauma patients in the intensive care unit: a randomized double blinded placebo-controlled clinical trial. Clin Exp Hepatol 7(2):149–155PubMedPubMedCentralCrossRef
go back to reference Mirzaei N, Jahanian Sadatmahalleh S, Rouholamin S, Nasiri M (2022) A randomized trial assessing the efficacy of Silymarin on endometrioma-related manifestations. Sci Rep 12(1):17549PubMedPubMedCentralCrossRef Mirzaei N, Jahanian Sadatmahalleh S, Rouholamin S, Nasiri M (2022) A randomized trial assessing the efficacy of Silymarin on endometrioma-related manifestations. Sci Rep 12(1):17549PubMedPubMedCentralCrossRef
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269PubMedCrossRef Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269PubMedCrossRef
go back to reference Naithani R, Chandra J, Bhattacharjee J, Verma P, Narayan S (2006) Peroxidative stress and antioxidant enzymes in children with β-thalassemia major. Pediatr Blood Cancer 46(7):780–785PubMedCrossRef Naithani R, Chandra J, Bhattacharjee J, Verma P, Narayan S (2006) Peroxidative stress and antioxidant enzymes in children with β-thalassemia major. Pediatr Blood Cancer 46(7):780–785PubMedCrossRef
go back to reference Navarro VJ, Belle SH, D’Amato M, Adfhal N, Brunt EM, Fried MW, Group CHS (2019) Silymarin in non-cirrhotics with non-alcoholic steatohepatitis: a randomized, double-blind, placebo controlled trial. PLoS ONE 14(9):e0221683PubMedPubMedCentralCrossRef Navarro VJ, Belle SH, D’Amato M, Adfhal N, Brunt EM, Fried MW, Group CHS (2019) Silymarin in non-cirrhotics with non-alcoholic steatohepatitis: a randomized, double-blind, placebo controlled trial. PLoS ONE 14(9):e0221683PubMedPubMedCentralCrossRef
go back to reference Polyak SJ, Ferenci P, Pawlotsky J-M (2013) Hepatoprotective and antiviral functions of silymarin components in HCV infection. Hepatology (baltimore, MD) 57(3):1262–1271PubMedCrossRef Polyak SJ, Ferenci P, Pawlotsky J-M (2013) Hepatoprotective and antiviral functions of silymarin components in HCV infection. Hepatology (baltimore, MD) 57(3):1262–1271PubMedCrossRef
go back to reference Polyak SJ, Morishima C, Lohmann V, Pal S, Lee DY, Liu Y, Oberlies NH (2010) Identification of hepatoprotective flavonolignans from silymarin. Proc Nat Acad Sci USA 107(13):5995–5999PubMedPubMedCentralCrossRef Polyak SJ, Morishima C, Lohmann V, Pal S, Lee DY, Liu Y, Oberlies NH (2010) Identification of hepatoprotective flavonolignans from silymarin. Proc Nat Acad Sci USA 107(13):5995–5999PubMedPubMedCentralCrossRef
go back to reference Popa-Wagner A, Mitran S, Sivanesan S, Chang E, Buga A-M (2013) ROS and brain diseases: the good, the bad, and the ugly. Oxid Med Cell Longev 2013:1–14CrossRef Popa-Wagner A, Mitran S, Sivanesan S, Chang E, Buga A-M (2013) ROS and brain diseases: the good, the bad, and the ugly. Oxid Med Cell Longev 2013:1–14CrossRef
go back to reference Radi E, Formichi P, Battisti C, Federico A (2014) Apoptosis and oxidative stress in neurodegenerative diseases. J Alzheimers Dis 42(s3):S125–S152PubMedCrossRef Radi E, Formichi P, Battisti C, Federico A (2014) Apoptosis and oxidative stress in neurodegenerative diseases. J Alzheimers Dis 42(s3):S125–S152PubMedCrossRef
go back to reference Rajendra VKP, Kurapati S, Balineni SK, Gogineni NTT (2022) A blend of Sphaeranthus indicus flower head and Terminalia chebula fruit extracts reduces fatty liver and improves liver function in non-alcoholic, overweight adults. Funct Food Health Dis 12(7):361CrossRef Rajendra VKP, Kurapati S, Balineni SK, Gogineni NTT (2022) A blend of Sphaeranthus indicus flower head and Terminalia chebula fruit extracts reduces fatty liver and improves liver function in non-alcoholic, overweight adults. Funct Food Health Dis 12(7):361CrossRef
go back to reference Rashidi A, Nakhjavani M, Esteghamati A, Asgarani F, Khalilzadeh O, Abbasi M, Safari R (2009) Association between oxidant/antioxidant markers and proteinuria in type 2 diabetes: results in 142 patients. J Nephrol 22(6):733–738PubMed Rashidi A, Nakhjavani M, Esteghamati A, Asgarani F, Khalilzadeh O, Abbasi M, Safari R (2009) Association between oxidant/antioxidant markers and proteinuria in type 2 diabetes: results in 142 patients. J Nephrol 22(6):733–738PubMed
go back to reference Richardson M, Garner P, Donegan S (2019) Interpretation of subgroup analyses in systematic reviews: a tutorial. Clin Epidemiol Global Health 7(2):192–198CrossRef Richardson M, Garner P, Donegan S (2019) Interpretation of subgroup analyses in systematic reviews: a tutorial. Clin Epidemiol Global Health 7(2):192–198CrossRef
go back to reference Roozbeh J, Shahriyari B, Akmali M, Vessal G, Pakfetrat M, Raees Jalali GA, Ghahramani N (2011) Comparative effects of silymarin and vitamin E supplementation on oxidative stress markers, and hemoglobin levels among patients on hemodialysis. Ren Fail 33(2):118–123PubMedCrossRef Roozbeh J, Shahriyari B, Akmali M, Vessal G, Pakfetrat M, Raees Jalali GA, Ghahramani N (2011) Comparative effects of silymarin and vitamin E supplementation on oxidative stress markers, and hemoglobin levels among patients on hemodialysis. Ren Fail 33(2):118–123PubMedCrossRef
go back to reference Sherif IO, Al-Gayyar MM (2013) Antioxidant, anti-inflammatory and hepatoprotective effects of silymarin on hepatic dysfunction induced by sodium nitrite. Eur Cytokine Netw 24(3):114–121PubMedCrossRef Sherif IO, Al-Gayyar MM (2013) Antioxidant, anti-inflammatory and hepatoprotective effects of silymarin on hepatic dysfunction induced by sodium nitrite. Eur Cytokine Netw 24(3):114–121PubMedCrossRef
go back to reference Soto C, Pérez J, García V, Uría E, Vadillo M, Raya L (2010) Effect of silymarin on kidneys of rats suffering from alloxan-induced diabetes mellitus. Phytomedicine 17(14):1090–1094PubMedCrossRef Soto C, Pérez J, García V, Uría E, Vadillo M, Raya L (2010) Effect of silymarin on kidneys of rats suffering from alloxan-induced diabetes mellitus. Phytomedicine 17(14):1090–1094PubMedCrossRef
go back to reference Tobias A (1999) Assessing the influence of a single study in the meta-analysis estimate. Stata Tech Bull 47:15–17 Tobias A (1999) Assessing the influence of a single study in the meta-analysis estimate. Stata Tech Bull 47:15–17
go back to reference Tvrdý V, Pourová J, Jirkovský E, Křen V, Valentová K, Mladěnka P (2021) Systematic review of pharmacokinetics and potential pharmacokinetic interactions of flavonolignans from silymarin. Med Res Rev 41(4):2195–2246PubMedCrossRef Tvrdý V, Pourová J, Jirkovský E, Křen V, Valentová K, Mladěnka P (2021) Systematic review of pharmacokinetics and potential pharmacokinetic interactions of flavonolignans from silymarin. Med Res Rev 41(4):2195–2246PubMedCrossRef
go back to reference Valenzuela A, Aspillaga M, Vial S, Guerra R (1989) Selectivity of silymarin on the increase of the glutathione content in different tissues of the rat. Planta Med 55(05):420–422PubMedCrossRef Valenzuela A, Aspillaga M, Vial S, Guerra R (1989) Selectivity of silymarin on the increase of the glutathione content in different tissues of the rat. Planta Med 55(05):420–422PubMedCrossRef
go back to reference Velussi M, Cernigoi AM, Dapas F, Caffau C, Zilli M (1997) Long-term (23 months) treatment with an anti-oxidant drug (silymarin) is effective on hyperinsulinemia, exogenous insulin need and malondialdehyde levels in cirrhotic diabetic patients. J Hepatol 26(4):871–879PubMedCrossRef Velussi M, Cernigoi AM, Dapas F, Caffau C, Zilli M (1997) Long-term (23 months) treatment with an anti-oxidant drug (silymarin) is effective on hyperinsulinemia, exogenous insulin need and malondialdehyde levels in cirrhotic diabetic patients. J Hepatol 26(4):871–879PubMedCrossRef
go back to reference Vessal G, Akmali M, Najafi P, Moein MR, Sagheb MM (2010) Silymarin and milk thistle extract may prevent the progression of diabetic nephropathy in streptozotocin-induced diabetic rats. Ren Fail 32(6):733–739PubMedCrossRef Vessal G, Akmali M, Najafi P, Moein MR, Sagheb MM (2010) Silymarin and milk thistle extract may prevent the progression of diabetic nephropathy in streptozotocin-induced diabetic rats. Ren Fail 32(6):733–739PubMedCrossRef
go back to reference Vidimce J, Pennell EN, Foo M, Shiels RG, Shibeeb S, Watson M, Bulmer AC (2021) Effect of Silymarin treatment on circulating bilirubin and cardiovascular disease risk factors in healthy men: a single-blind, randomized crossover trial. Clin Pharm Drug Dev 10(10):1156–1165CrossRef Vidimce J, Pennell EN, Foo M, Shiels RG, Shibeeb S, Watson M, Bulmer AC (2021) Effect of Silymarin treatment on circulating bilirubin and cardiovascular disease risk factors in healthy men: a single-blind, randomized crossover trial. Clin Pharm Drug Dev 10(10):1156–1165CrossRef
go back to reference Voroneanu L, Nistor I, Dumea R, Apetrii M, Covic A (2016) Silymarin in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. J Diabetes Res 2016:1–10CrossRef Voroneanu L, Nistor I, Dumea R, Apetrii M, Covic A (2016) Silymarin in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. J Diabetes Res 2016:1–10CrossRef
go back to reference Xu C, Doi SA (2018) The robust error meta-regression method for dose–response meta-analysis. JBI Evid Implement 16(3):138–144 Xu C, Doi SA (2018) The robust error meta-regression method for dose–response meta-analysis. JBI Evid Implement 16(3):138–144
Metadata
Title
The effects of silymarin consumption on inflammation and oxidative stress in adults: a systematic review and meta-analysis
Authors
Hossein Bahari
Mostafa Shahraki Jazinaki
Mohammad Rashidmayvan
Shaghayegh Taheri
Mohammad Reza Amini
Mahsa Malekahmadi
Publication date
19-02-2024
Publisher
Springer International Publishing
Keyword
Thalassemia
Published in
Inflammopharmacology / Issue 2/2024
Print ISSN: 0925-4692
Electronic ISSN: 1568-5608
DOI
https://doi.org/10.1007/s10787-023-01423-6

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