Combined therapy of silymarin and desferrioxamine in patients with β-thalassemia major: a randomized double-blind clinical trial

Fundamental and Clinical Pharmacology

Volumn 23, Issue 3, 2009, Pages 359-365

  Gharagozloo, Marjan ^a,b   Moayedi, Behjat ^b   Zakerinia, Maryam ^a   Hamidi, Mehrdad ^c   Karimi, Mehran ^a,d   Maracy, Mohammad ^b   Amirghofran, Zahra ^a,e  

^a SHIRAZ UNIVERSITY OF MEDICAL SCIENCES   (Iran)

^b ISFAHAN UNIVERSITY OF MEDICAL SCIENCES   (Iran)

^c SHIRAZ UNIVERSITY OF MEDICAL SCIENCES   (Iran)

^d SHIRAZ UNIVERSITY OF MEDICAL SCIENCES   (Iran)

^e SHIRAZ UNIVERSITY OF MEDICAL SCIENCES   (Iran)

Author keywords

thalassemia major; Desferrioxamine; iron overload; silymarin

Indexed keywords

ALKALINE PHOSPHATASE; DEFEROXAMINE; FERRITIN; GLUTATHIONE; PLACEBO; SILYMARIN;

ADD ON THERAPY; ADOLESCENT; ADULT; ALKALINE PHOSPHATASE BLOOD LEVEL; ARTICLE; BLOOD SAMPLING; BLOOD TRANSFUSION; CLINICAL TRIAL; CONTROL GROUP; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; ERYTHROCYTE; FEMALE; FERRITIN BLOOD LEVEL; HUMAN; HUMAN TISSUE; IRON CHELATION; IRON OVERLOAD; LABORATORY TEST; MAJOR CLINICAL STUDY; MALE; PATIENT COMPLIANCE; PRIORITY JOURNAL; PROTEIN BLOOD LEVEL; RANDOMIZED CONTROLLED TRIAL; THALASSEMIA MAJOR; TREATMENT DURATION;

ADOLESCENT; ADULT; ALKALINE PHOSPHATASE; ANTIOXIDANTS; BETA-THALASSEMIA; DEFEROXAMINE; DOUBLE-BLIND METHOD; DRUG THERAPY, COMBINATION; ERYTHROCYTES; FEMALE; FERRITINS; FOLLOW-UP STUDIES; GLUTATHIONE; HUMANS; LIVER; MALE; SIDEROPHORES; SILYMARIN; YOUNG ADULT;

EID: 67149141758     PISSN: 07673981     EISSN: 14728206     Source Type: Journal    
DOI: 10.1111/j.1472-8206.2009.00681.x     Document Type: Article

References (23)

1. Gazak R., Walterova D., Kren V. Silybin and silymarin - new and emerging applications in medicine. Curr. Med. Chem. (2007) 14 315 338. (Pubitemid 46313027)
2. Stickel F., Schuppan D. Herbal medicine in the treatment of liver diseases. Dig. Liver Dis. (2007) 39 293 304. (Pubitemid 46432239)
3. Saller R., Meier R., Brignoli R. The use of silymarin in the treatment of liver diseases. Drugs (2001) 61 2035 2063. (Pubitemid 33135182)
4. Pradhan S.C., Girish C. Hepatoprotective herbal drug, silymarin from experimental pharmacology to clinical medicine. Indian J. Med. Res. (2006) 124 491 504. (Pubitemid 46157708)
5. Fraschini F., Demartini G., Esposti D. Pharmacology of silymarin. Clin. Drug Invest. (2002) 22 51 65. (Pubitemid 34151333)
6. Mayer K.E., Myers R.P., Lee S.S. Silymarin treatment of viral hepatitis: a systematic review. J. Viral Hepat. (2005) 12 559 567. (Pubitemid 41532486)
7. Valenzuela A., Garrido A. Biochemical bases of the pharmacological action of the flavonoid silymarin and of its structural isomer silibinin. Biol. Res. (1994) 27 105 112. (Pubitemid 24257808)
8. Borsari M., Gabbi C., Ghelfi F. et al. Silybin, a new iron-chelating agent. J. Inorg. Biochem. (2001) 85 123 129. (Pubitemid 32611605)
9. Pietrangelo A., Borella F., Casalgrandi G. et al. Antioxidant activity of silybin in vivo during long-term iron overload in rats. Gastroenterology (1995) 109 1941 1949.
10. Rund D., Rachmilewitz E. Beta-thalassemia. N. Engl. J. Med. (2005) 353 1135 1146.
11. Olivieri N.F., Brittenham G.M. Iron-chelating therapy and the treatment of thalassemia. Blood (1997) 89 739 761. (Pubitemid 27121266)
12. Dayani P.N., Bishop M.C., Black K., Zeltzer P.M. Desferoxamine (DFO)-mediated iron chelation: rationale for a novel approach to therapy for brain cancer. J. Neurooncol. (2004) 67 367 377. (Pubitemid 39137369)
13. Neufeld E.J. Oral chelators deferasirox and deferiprone for transfusional iron overload in thalassemia major: new data, new questions. Blood (2006) 107 3436 3441.
14. Yang L.P., Keam S.J., Keating G.M. Deferasirox: a review of its use in the management of transfusional chronic iron overload. Drugs (2007) 67 2211 2230. (Pubitemid 47557095)
15. Mira L., Fernandez M.T., Santos M., Rocha R., Florencio M.H., Jennings K.R. Interactions of flavonoids with iron and copper ions: a mechanism for their antioxidant activity. Free Radic. Res. (2002) 36 1199 1208. (Pubitemid 35230240)
16. Naithani R., Chandra J., Bhattacharjee J., Verma P., Narayan S. Peroxidative stress and antioxidant enzymes in children with beta-thalassemia major. Pediatr. Blood Cancer. (2006) 46 780 785. (Pubitemid 43726427)
17. Kushner J.P., Porter J.P., Olivieri N.F. Secondary iron overload. Hematology Am. Soc. Hematol. Educ. Program. (2001) 1 47 61.
18. Rachmilewitz E.A., Weizer-Stern O., Adamsky K. et al. Role of iron in inducing oxidative stress in thalassemia: can it be prevented by inhibition of absorption and by antioxidants? Ann. N Y Acad. Sci. (2005) 1054 118 123. (Pubitemid 43031016)
19. Alidoost F., Gharagozloo M., Bagherpour B. et al. Effects of silymarin on the proliferation and glutathione levels of peripheral blood mononuclear cells from beta-thalassemia major patients. Int. Immunopharmacol. (2006) 6 1305 1310. (Pubitemid 43868191)
20. Gharagozloo M., Khoshdel Z., Amirghofran Z. The effect of an iron (III) chelator, silybin, on the proliferation and cell cycle of Jurkat cells: a comparison with desferrioxamine. Eur. J. Pharmacol. (2008) 589 1 7.
21. Prati D., Maggioni M., Milani S. et al. Clinical and histological characterization of liver disease in patients with transfusion-dependent beta-thalassemia. A multicenter study of 117 cases. Haematologica (2004) 89 1179 1186. (Pubitemid 39390441)
22. Li C.K., Chik K.W., Lam C.W. et al. Liver disease in transfusion dependent thalassaemia major. Arch. Dis. Child. (2002) 86 344 347. (Pubitemid 34478230)
23. Taher A., Isma'eel H., Cappellini M.D. Thalassemia intermedia: revisited. Blood Cells Mol. Dis. (2006) 37 12 20. (Pubitemid 44062361)