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  • 1 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
  • 2 2nd Department of Medicine, Semmelweis University, Szentkirályi u. 46, H-1088, Budapest, Hungary
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Abstract

In the treatment of chronic liver diseases an adequate therapy can be chosen only in the knowledge of the pathogenetic processes. In liver diseases caused by oxidative stress (alcoholic and non-alcoholic fatty liver and steatohepatitis, drug- and chemical-induced hepatic toxicity) the antioxidant medicines such as silymarin, in chronic hepatitis caused by hepatitis B and hepatitis C virus the combined pegylated interferon and nucleoside analogue treatments are the primary therapeutic modalities of choice. The main effects of silymarin: it exerts membrane-stabilising and antioxidant activity, it promotes hepatocyte regeneration, it reduces inflammatory reaction, and it inhibits fibrinogenesis 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 alcoholinduced liver cirrhosis. Recently it has been demonstrated that high-dose silibinin infusion treatment could significantly reduce viral load of hepatitis C viruses following four weeks of application. Based on the results of studies using methods of molecular biology, silymarin can significantly reduce tumour cell proliferation, angiogenesis as well as insulin resistance. These results support the administration of silymarin preparations in the treatment of patients with chronic liver diseases, especially alcoholic and non-alcoholic steatohepatitis in the current clinical practice and, as it can be expected, also in the future. In some neoplastic diseases they can be administered as adjuvant therapy as well.

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