Silymarin, from the fruit of Silybum marianum, is known for its hepatoprotective action. The aim of this study was to review the mechanisms of action of the silymarin phytocomplex to expand the possibilities for its a...Silymarin, from the fruit of Silybum marianum, is known for its hepatoprotective action. The aim of this study was to review the mechanisms of action of the silymarin phytocomplex to expand the possibilities for its application in human health. The search for published articles was carried out on the CAPES Journals Portal platform, which covers worldwide scientific databases. Publications from 2010 to 2022 were included. Of the 311 articles retrieved, 21 were included. The articles discuss the diversity of silymarin’s applications and the possibility of optimizing its bioavailability using drug delivery systems. Silymarin shows promise in numerous diseases, such as liver, kidney, cardiovascular, respiratory and others. Its antiviral action has been demonstrated in studies and silymarin has the potential to be used as a complementary therapy in the treatment of many diseases, with the expectation that, in the future, it will be used in therapeutic protocols for exclusive use.展开更多
Endometriosis is an inflammatory oestrogen dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The modern advance in treatment of endometriosis management is tackling the ...Endometriosis is an inflammatory oestrogen dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The modern advance in treatment of endometriosis management is tackling the debilitating pain it causes, besides the infertility in patients desiring fertility in reproductive age group. This can be achieved by surgical or medical means, although in most cases a combination of both treatments is required. Usually, long term treatment is required in most cases. Unfortunately in most cases, pain symptoms recur between 6months and 12 months once treatment is stopped. A lot of research has gone in understanding the pathogenesis and further medical management of endometriosis besides surgery to be useful in relieving pain and use in patients desiring fertility besides hormonal treatments used earlier like hormonal contraceptives (oral, transdermal or vaginal administration), progestogens, danazol, Gonadotrophic releasing hormone agonist (GnRH), aromatase inhibitors. Newer agents like antiangiogenic drugs, phytochemical agents like resveratrol, TNF-α inhibitors, GnRH antagonists like egalogolix, statins, antiinflammatory agents like COX2 Inhibitors and PPARγ inhibitors like pioglitazone etc., with recent work of combined efficacy of telmesartan of both PPARγ partial agonism along with angiotensin 1 receptor agonism having more efficacy, role of immunomodulators like rapamycin, lipoxin 4 and pentoxyphylline, GnRH antagonists like egalogolix are still under study undergoing phase III trials although preliminary results show promising results with fewer side effects as compared to similar duration of GnRH agonist and much less BMD side effects. Increasing number of trials show the safety of SPRM’s, along with efficacy although disadvantage is suppression of fertility so cannot be used for women desiring fertility. Currently, only mifepristone and ulipristal have received FDA approval for indication in fibroid treatment, MTP and not for endometriosis as yet. The advantages and disadvantages of all the recent advances are discussed in an update in the pathophysiology as well medical treatment of endometriosis.展开更多
文摘Silymarin, from the fruit of Silybum marianum, is known for its hepatoprotective action. The aim of this study was to review the mechanisms of action of the silymarin phytocomplex to expand the possibilities for its application in human health. The search for published articles was carried out on the CAPES Journals Portal platform, which covers worldwide scientific databases. Publications from 2010 to 2022 were included. Of the 311 articles retrieved, 21 were included. The articles discuss the diversity of silymarin’s applications and the possibility of optimizing its bioavailability using drug delivery systems. Silymarin shows promise in numerous diseases, such as liver, kidney, cardiovascular, respiratory and others. Its antiviral action has been demonstrated in studies and silymarin has the potential to be used as a complementary therapy in the treatment of many diseases, with the expectation that, in the future, it will be used in therapeutic protocols for exclusive use.
文摘Endometriosis is an inflammatory oestrogen dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The modern advance in treatment of endometriosis management is tackling the debilitating pain it causes, besides the infertility in patients desiring fertility in reproductive age group. This can be achieved by surgical or medical means, although in most cases a combination of both treatments is required. Usually, long term treatment is required in most cases. Unfortunately in most cases, pain symptoms recur between 6months and 12 months once treatment is stopped. A lot of research has gone in understanding the pathogenesis and further medical management of endometriosis besides surgery to be useful in relieving pain and use in patients desiring fertility besides hormonal treatments used earlier like hormonal contraceptives (oral, transdermal or vaginal administration), progestogens, danazol, Gonadotrophic releasing hormone agonist (GnRH), aromatase inhibitors. Newer agents like antiangiogenic drugs, phytochemical agents like resveratrol, TNF-α inhibitors, GnRH antagonists like egalogolix, statins, antiinflammatory agents like COX2 Inhibitors and PPARγ inhibitors like pioglitazone etc., with recent work of combined efficacy of telmesartan of both PPARγ partial agonism along with angiotensin 1 receptor agonism having more efficacy, role of immunomodulators like rapamycin, lipoxin 4 and pentoxyphylline, GnRH antagonists like egalogolix are still under study undergoing phase III trials although preliminary results show promising results with fewer side effects as compared to similar duration of GnRH agonist and much less BMD side effects. Increasing number of trials show the safety of SPRM’s, along with efficacy although disadvantage is suppression of fertility so cannot be used for women desiring fertility. Currently, only mifepristone and ulipristal have received FDA approval for indication in fibroid treatment, MTP and not for endometriosis as yet. The advantages and disadvantages of all the recent advances are discussed in an update in the pathophysiology as well medical treatment of endometriosis.
