Hepatoprotective and antiviral functions of silymarin components in hepatitis C virus infection

There exists a widely held view that silymarin (a.k.a. milk thistle) promotes liver health through anti-oxidant, anti-inflammatory, anti-proliferative, and immunomodulatory effects (1). In fact, silymarin is one of the top 10 most popular natural products consumed by western society, and is the most commonly consumed botanical medicine reported in patients with chronic hepatitis C (2, 3). Presently, there is no clear evidence that any of the currently available over-the-counter preparations have efficacy in the treatment of liver disease. While there are compelling in vitro and animal data supporting the hepatoprotective effects of silymarin and inhibition of in vitro HCV infection(4), clinical data are equivocal, with some studies suggesting a protective effect of silymarin against progression of liver disease in subjects with hepatitis C (5), while other studies found no such effect (6, 7). Thus, there is clinical controversy around whether silymarin and silymarin-derived compounds protect the liver. It is the intention of this review article to summarize the current state of knowledge on whether and how silymarin (and the mixture of silymarin components known as silibinin) protects the liver and modulates HCV infection, and to make recommendations for areas of further research.

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