A randomized double-blind, placebo-controlled study of therapeutic effects of silymarin in β-thalassemia major patients receiving desferrioxamine

European Journal of Haematology

Volumn 90, Issue 3, 2013, Pages 202-209

  Moayedi, Behjat ^a   Gharagozloo, Marjan ^a   Esmaeil, Nafiseh ^a   Maracy, Mohammad R ^b   Hoorfar, Hamid ^c   Jalaeikar, Mohsen ^c  

^a ISFAHAN UNIVERSITY OF MEDICAL SCIENCES   (Iran)

^b ISFAHAN UNIVERSITY OF MEDICAL SCIENCES   (Iran)

^c ISFAHAN UNIVERSITY OF MEDICAL SCIENCES   (Iran)

Author keywords

Desferrioxamine; Iron chelation therapy; Legalon; Silymarin; Thalassemia

Indexed keywords

DEFEROXAMINE; FERRITIN; HEPCIDIN; IRON; PLACEBO; SILYMARIN; TRANSFERRIN;

ADULT; ARTICLE; BETA THALASSEMIA; CHELATION THERAPY; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; FEMALE; FERRITIN BLOOD LEVEL; HUMAN; IRON BINDING CAPACITY; IRON BLOOD LEVEL; LIVER FUNCTION TEST; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; THALASSEMIA MAJOR; THERAPY EFFECT; TREATMENT DURATION;

ADOLESCENT; ADULT; ANTIMICROBIAL CATIONIC PEPTIDES; BETA-THALASSEMIA; BLOOD TRANSFUSION; DEFEROXAMINE; DOUBLE-BLIND METHOD; DRUG COMBINATIONS; DRUG SYNERGISM; FEMALE; FERRITINS; HUMANS; IRON; IRON CHELATING AGENTS; IRON OVERLOAD; LIVER; MALE; MILK THISTLE; PLACEBOS; RECEPTORS, TRANSFERRIN; SILYMARIN;

EID: 84873991943     PISSN: 09024441     EISSN: 16000609     Source Type: Journal    
DOI: 10.1111/ejh.12061     Document Type: Article

References (30)

1. Rund D, Rachmilewitz E. Beta-thalassemia. N Engl J Med 2005;353:1135-46.
2. Jomova K, Valko M. Importance of iron chelation in free radical-induced oxidative stress and human disease. Curr Pharm Des 2011;17:3460-73.
3. Rachmilewitz EA, Giardina PJ. How I treat thalassemia. Blood 2011;118:3479-88.
4. Brittenham GM. Iron-chelating therapy for transfusional iron overload. N Engl J Med 2011;364:146-56.
5. Loizzo MR, Tundis R, Menichini F, Pugliese A, Bonesi M, Solimene U, Menichini F. Chelating, antioxidant and hypoglycaemic potential of Muscari comosum (L.) Mill. bulb extracts. Int J Food Sci Nutr 2010;61:780-91.
6. Bitis L, Kultur S, Melikoglu G, Ozsoy N, Can A. Flavonoids and antioxidant activity of Rosa agrestis leaves. Nat Prod Res 2010;24:580-9.
7. Ebrahimzadeh MA, Nabavi SM, Nabavi SF. Correlation between the in vitro iron chelating activity and poly phenol and flavonoid contents of some medicinal plants. Pak J Biol Sci 2009;12:934-8.
8. Mandel S, Weinreb O, Reznichenko L, Kalfon L, Amit T. Green tea catechins as brain-permeable, non toxic iron chelators to "iron out iron" from the brain. J Neural Transm Suppl 2006;71:249-57.
9. Hatcher HC, Singh RN, Torti FM, Torti SV. Synthetic and natural iron chelators: therapeutic potential and clinical use. Future Med Chem 2009;1:1643-70.
10. Gazak R, Walterova D, Kren V. Silybin and silymarin - new and emerging applications in medicine. Curr Med Chem 2007;14:315-38.
11. Borsari M, Gabbi C, Ghelfi F, Grandi R, Saladini M, Severi S, Borella F. Silybin, a new iron chelating agent. J Inorg Biochem 2001;85:123-9.
12. Hutchinson C, Bomford A, Geissler CA. The iron-chelating potential of silybin in patients with hereditary haemochromatosis. Eur J Clin Nutr 2010;64:1239-41.
13. Saller R, Meier R, Brignoli R. The use of silymarin in the treatment of liver diseases. Drugs 2001;61:2035-63.
14. Gharagozloo M, Moayedi B, Zakerinia M, Hamidi M, Karimi M, Maracy M, Amirghofran Z. Combined therapy of silymarin and desferrioxamine in patients with beta-thalassemia major: a randomized double-blind clinical trial. Fundam Clin Pharmacol 2009;23:359-65.
15. Fraschini F, Demartini G, Esposti D. Pharmacology of silymarin. Clin Drug Invest 2002;22:51-65.
16. Bares JM, Berger J, Nelson JE, Messner DJ, Schildt S, Standish LJ, Kowdley KV. Silybin treatment is associated with reduction in serum ferritin in patients with chronic hepatitis C. J Clin Gastroenterol 2008;42:937-44.
17. Galanello R. Deferiprone in the treatment of transfusion-dependent thalassemia: a review and perspective. Ther Clin Risk Manag 2007;3:795-805.
18. Hoffbrand AV, Cohen A, Hershko C. Role of deferiprone in chelation therapy for transfusional iron overload. Blood 2003;102:17-24.
19. Nemeth E, Ganz T. Regulation of iron metabolism by hepcidin. Annu Rev Nutr 2006;26:323-42.
20. Nicolas G, Chauvet C, Viatte L, Danan JL, Bigard X, Devaux I, Beaumont C, Kahn A, Vaulont S. The gene encoding the iron regulatory peptide hepcidin is regulated by anemia, hypoxia, and inflammation. J Clin Invest 2002;110:1037-44.
21. Origa R, Galanello R, Ganz T, Giagu N, Maccioni L, Faa G, Nemeth E. Liver iron concentrations and urinary hepcidin in beta-thalassemia. Haematologica 2007;92:583-8.
22. Ghoti H, Fibach E, Westerman M, Gordana O, Ganz T, Rachmilewitz EA. Increased serum hepcidin levels during treatment with deferasirox in iron-overloaded patients with myelodysplastic syndrome. Br J Haematol 2011;153:118-20.
23. Kroot JJ, Tjalsma H, Fleming RE, Swinkels DW. Hepcidin in human iron disorders: diagnostic implications. Clin Chem 2011;57:1650-69.
24. Beguin Y. Soluble transferrin receptor for the evaluation of erythropoiesis and iron status. Clin Chim Acta 2003;32:9-22.
25. Lee CT, Liao SC, Hsu KT, Lam KK, Chen JB. Low dose desferrioxamine can improve erythropoiesis in iron-overload hemodialysis patients without side effects. Ren Fail 1999;2:665-73.
26. Fibach E, Rachmilewitz EA. The role of antioxidants and iron chelators in the treatment of oxidative stress in thalassemia. Ann N Y Acad Sci 2010;1202:10-6.
27. Thephinlap C, Phisalaphong C, Lailerd N, Chattipakorn N, Winichagoon P, Vadolus J, Fucharoen S, Porter JB, Srichairatanakool S. Reversal of cardiac iron loading and dysfunction in thalassemic mice by curcuminoids. Med Chem 2011;7:62-9.
28. de Franceschi L, Turrini F, Honczarenko M, et al. In vivo reduction of erythrocyte oxidant stress in a murine model of beta-thalassemia. Haematologica 2004;89:1287-98.
29. Angelucci E, Brittenham GM, McLaren CE, Ripalti M, Baronciani D, Giardini C, Galimberti M, Polchi P, Lucarelli G. Hepatic iron concentration and total body iron stores in thalassemia major. N Engl J Med 2000;343:327-31.
30. Miura Y, Matsui Y, Kaneko H, Watanabe M, Tsudo M. Iron chelation therapy with deferasirox results in improvement of liver enzyme level in patients with iron overload-associated liver dysfunction. Case Report Med 2010;2010:675060.