Clinical Studies of Silymarin as a Protective Agent Against Liver Damage Caused by Anti-TB Drugs, Methotrexate, and in Cases of Chronic Hepatitis C and Diabetes Mellitus

The liver is the organ in charge of homeostasis and metabolism of sundry substances (endogenous and exogenous, including drugs); but when these are metabolized, they generate more toxic and/or reactive metabolites, that can damage the liver causing cirrhosis, steatosis and/or hepatocarcinoma. Human have been used several medicinal plants (MP) since ancestral times to treat their ailments, diseases and liver disorders, including Sylibum marianum. This MP is used in the treatment of jaundice and other biliary diseases, as well as in support therapy for edible mushrooms poisoning and in the treatment of some hepatic diseases. From this medicinal plant, silymarin (SLM, mixture of flavonoids) is obtained, it has an important antioxidant, anti-inflammatory and hepatoprotector effect. The last activity has been demonstrated through several preclinical and in some clinical studies. To date, a few clinical studies describe the hepatoprotective and/or nephroprotective effect of SLM against the damage caused by anti- TB drugs, methotrexate and in cases of type II diabetes mellitus or chronic hepatitis C. Nevertheless, this type of research is more frequent in preclinical trials (using rats or mice) or in vitro assay.