In chronic
liver diseases caused by oxidative stress (alcoholic and non-
alcoholic fatty liver diseases,
drug- and chemical-induced hepatic toxicity), the
antioxidant medicines such as
silymarin can have beneficial effect.
Liver cirrhosis, non-
alcoholic fatty liver and
steatohepatitis are risk factors for
hepatocellular carcinoma (HCC).
Insulin resistance and oxidative stress are the major pathogenetic mechanisms leading the hepatic cell injury in these patients. The
silymarin exerts membrane-stabilizing and
antioxidant activity, it promotes hepatocyte regeneration; furthermore it reduces the inflammatory reaction, and inhibits the fibrogenesis in the liver. These results have been established by experimental and clinical trials. According to open studies the long-term administration of
silymarin significantly increased survival time of patients with alcohol induced
liver cirrhosis. Based on the results of studies using methods of molecular biology,
silymarin can significantly reduce
tumor cell proliferation, angiogenesis as well as
insulin resistance. Furthermore, it exerts an anti-atherosclerotic effect, and suppresses
tumor necrosis factor-alpha-induced
protein production and
mRNA expression due to adhesion molecules. The chemopreventive effect of
silymarin on HCC has been established in several studies using in vitro and in vivo methods; it can exert a beneficial effect on the balance of cell survival and apoptosis by interfering
cytokines. In addition to this, anti-inflammatory activity and inhibitory effect of
silymarin on the development of
metastases have also been detected. In some neoplastic diseases
silymarin can be administered as adjuvant
therapy as well.