Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Ablasser, MJ.
Effect of Silibinin on Humoral Immunology in Patients with Chronic Hepatitis C
[ Diplomarbeit ] Medical University of Graz; 2012. pp. 65
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- Autor*innen der Med Uni Graz:
- Ablasser Klemens
- Betreuer*innen:
- Stauber Rudolf
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- Abstract:
- Abstract: Background: Chronic hepatitis C afflicts approximately 3 million individuals and is the leading cause of end-stage liver disease requiring transplantation. The current treatment recommendation for chronic Hepatitis C virus infection is the combination of Peginterferon and Ribavirin for 24 or 48 weeks, depending on the viral genotype. Only approximately half of the patients with chronic hepatitis C achieve a sustained viral response with Peginterferon and Ribavirin. Silymarin, an extract from the seeds of the milk thistle plant Silybum marianum, has been used for centuries for the treatment of chronic liver diseases. The mechanism of the antiviral effect of Silibinin is currently unknown. The hepatitis C virus is generally believed to be a noncytopathic virus, and hepatic fibrosis in hepatitis C is thought to be the end result of long-standing inflammation, cell proliferation, cytokines secretion, and the lysis of infected cells. The aim of the present study is to show the effects of Silibinin application on viral load and to assess humoral immunology, of non-responders to standard Ribavirin/Peginterferon therapy, during intravenous Silibinin treatment. Methods: 20mg/kg bodyweight Silibinin (Legalon) was applied daily within two hours for 21 days. After one week of Silibinin application, Peginterferon (Pegasys) and Ribavirin where added for the following two weeks. Peginterferon was applied once a week 180¿g parenteral. Serious side effects did not occur in which case the dose would have been reduced to 135¿g once a week. Ribavirin was administered oral, 2 times a day 3 pills with 200mg each. HCV RNA levels were determined by COBAS HCV TaqMan/COBAS® AmpliPrep assay (Roche Diagnostics). Cytokines were determined by Bio¿Plex 200 multiplex suspension array system with Luminex xMAP¿technology. Serum lipids were routinely determined in the clinical laboratory. Results: The statistical analyse shows that there is a significant decrease in viral load concentration at four points of measurement (F=5.504, p=.029). The pairwise comparison also shows a strong downward trend of viral load between the first and second test point (mean difference 1/2=-4224589, Std. Error1/2=1279242; p<.1) where only Silibinin was applied. Cholesterol and Triglycerides showed no significant changes. The measured cytokines show no significant changes. The pairwise comparison of Interleukin 8 shows that there is a significant difference between first and third test point (mean difference t0/t2=37.803, Std. Errort0/t2=9.646; p<.05). Conclusion: We did not find any significant changes of the cytokine levels. The drop of the viral load was significant. These results are in accord with in vitro trials and earlier studies that showed reduction in viral load.