Poisoning milk thistle

Intravenous silymarin has been demonstrated to lower mortality from Amanita mushroom poisonings, but this formulation is available only in Europe. Animal studies have demonstrated hepatic protection against alcohol, acetaminophen, and mushroom toxins and protection against hepatic fibrosis with bile duct occlusion. There is also evidence of silybin protecting against cis-platin-induced nephrotoxicity in rats. It is not yet clear whether milk thistle extract offers any renal protection to humans. 

Milk thistle has shown promise in improving liver function parameters in various hepatotoxic situations, such as alcoholic cirrhosis and mushroom poisoning. It is still unclear whether it will offer protection against viral hepatitis and various nephrotoxic agents. 

Although milk thistle has not been confirmed as an antidote following acute exposure to liver toxins in humans, parenteral silybin is nevertheless marketed and used in Europe as an antidote in Amanita phalloides mushroom poisoning. This use is based on favorable outcomes reported in case-control studies. 

Milk thistle has been used to treat acute and chronic viral hepatitis, alcoholic liver disease, and toxin-induced liver injury in human patients. Milk thistle has most often been studied in the treatment of alcoholic hepatitis and cirrhosis. In both of these disorders, outcomes have been mixed and reports include significant reductions in markers of liver dysfunction and in mortality, as well as no effect. In acute viral hepatitis, studies have generally involved small sample sizes and have shown mixed outcomes of improved liver function (eg, aminotransferase values, bilirubin, prothrombin time) or no effect. Studies in chronic viral hepatitis and toxin-induced injury have also been of small size but have reported mostly favorable results. Parenteral silybin is marketed and used in Europe as an antidote in Amanitaphalloides mushroom poisoning, based on favorable outcomes reported in case-control studies. 

Some flavonoid glycosides are prepared s)mthetically or by biotransformations, usually for pharmaceutical purposes. Silybin (7) is a flavonolignan that is extracted from seeds of milk thistle (Silybum marianum) and it is used extensively as a potent hepatoprotectant and an antidote in mushroom poisoning. The major drawback of this compound is its low water solubility (about 0.43 g/L). Therefore, its glycosylation was accomplished by biological [13] and chemical methods [14]. 

MILK THISTLE Silybi marianae fructus, which is the fruit of Silibum marianum (L.) Gaert, family Asteraceae. The active ingredient in the fruit is silymarin (a mixture of isomeric flavonolignans with silibinin (silybin) as the most active substance, effective as an antidote to poisoning with fly agaric (phalloi-din and a-amanitin). 

Milk thistle T Liver function in viral hepatitis antidote to amanita mushroom poisoning Antioxidant, free radical scavenger, t SOD, 4- LTs Loose stools j. ] 1... 

Milk thistle Improves liver function in viral hepatitis antidote to Amanita mushroom poisoning... 

Pharmacology In vitro studies show that milk thistle reduces lipid peroxidation, scavenges free radicals, enhances superoxide dismutase, inhibits formation of leukotrienes, and increases hepatocyte RNA polymerase activity. In animal models, milk thistle protects against liver injury caused by alcohol, acetaminophen, and amanita mushrooms. The outcomes of clinical trials in patients with liver disease caused by alcohol have been mixed. In viral hepatitis and liver injury caused by amanita mushrooms, results of clinical trials have been mainly favorable. A commercial preparation of silybin (an isomer of silymarin) is available in some countries as an antidote to Amanita phalloides mushroom poisoning. 

B. Intravenous dosing for Amanita phalloides mushroom poisoning is 20-50 mg/kg over 24 hours divided into four infusions. Each intravenous dose is administered over 2 hours. Parenteral milk thistle extract is not available in the United States. 

B. Parenteral. A water-soluble derivative of silybinin is used parenterally in Europe for cases of Amanita phalloides mushroom poisoning. Intravenous formulations of milk thistle extract are not available in the United States. 

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