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Nutraceutical Intervention for Treatment of Alcoholism and Drinking Problems
Published in Raj K. Keservani, Anil K. Sharma, Rajesh K. Kesharwani, Nutraceuticals and Dietary Supplements, 2020
Chemically, silymarin is a cluster of flavonoids (silibinin, silidianin, and silicristin), that aid in repairing damaged liver cells caused by alcohol and other noxious ingredients. Silymarin also helps in keeping new liver cells from being destroyed by the same substance(s), reduces inflammation (effective in liver inflammation or hepatitis), and is a powerful antioxidant. It also helps in the recovery process by supporting and healing the liver, detoxifying the body. It is typically used to treat liver cirrhosis, chronic hepatitis (liver inflammation), toxin-induced liver damage (including the prevention of severe liver damage) from Amanita phalloides (death cap) mushroom poisoning, and gallbladder disorders (Greenlee et al., 2007; Tamayo and Diamond 2007).
Normal and Abnormal Intestinal Absorption by Humans
Published in Shayne C. Gad, Toxicology of the Gastrointestinal Tract, 2018
David W. Hobson, Valerie L. Hobson Balldin
Fungal toxins, such as amatoxins and orellanine, can cause severe organ damage in the human body. Amatoxins are bicyclic octapeptides, occurring in some Amanita, Galerina, and Lepiota species, that induce deficient protein synthesis resulting in cell death and also may exert toxicity through inducing apoptosis. Target organs are intestinal mucosa, liver, and kidneys. Poisoning generally results in dehydration and electrolyte imbalance, liver necrosis, and possibly kidney damage. Amatozins from Amanita phalloides and related species of mushrooms are associated with severe morbidity and a high mortality rate. Circulating amatoxins can be detected in the serum of poisoned patients as long as 30 hours after ingestion. Toxic effects are particularly high in susceptible cells, such as hepatocytes. The administration of cathartics, adsorbent agents, and gastroduodenal lavage are of value in preventing further absorption of toxins from the GI tract [77,78]
Use of Complementary and Alternative Therapies in Hepatic Disorders
Published in Mary J. Marian, Gerard E. Mullin, Integrating Nutrition Into Practice, 2017
Milk thistle is marketed as capsules or tablets containing ethanol-extracted silymarin in amounts of 250–750 mg and is purported to be beneficial for liver disease, including alcoholic and viral liver disease. The daily dosage varies, but it is typically taken two to three times daily. Intravenous preparations of purified silibinin are approved in Europe for therapy of Amanita phalloides mushroom poisoning. The IV form of silibinin is not currently available in the United States, but is used in Europe; however, an oral form (silymarin) may be obtained. Silibinin is thought to interfere with hepatic uptake of alpha-amanitin, a deadly cyclic peptide. Trials using the impact of milk thistle on liver diseases such as hepatitis C have not been conducted with any validity. The differing virology of hepatitis C based on genotype, IL28B, Q80K, and the rise of ever-evolving therapy in hepatitis C would make the effect of milk thistle difficult to assess.
Silibinin: a toxicologist’s herbal medicine?
Published in Clinical Toxicology, 2022
A long-debated question is whether the use of silibinin is therapeutic for amanitin-containing mushroom poisoning. Definitive studies are lacking; randomized controlled trials are impossible to undertake. To date toxicologists have relied on animal studies, human case series, or retrospective reviews to decide on its use. In the U.S. the ability to use IV silibinin is hindered by its lack of availability as a Food and Drug Administration (FDA) approved intravenous pharmaceutical preparation, often limiting its addition to an oral herbal medication. In this issue of Clinical Toxicology, Dekkers et al. from the Netherlands have undertaken a massive 40-years retrospective systematic review of publications regarding Amanita phalloides mushroom poisoning [1]. They concluded that monotherapy with either silibinin or penicillin was statistically superior to supportive care. Has the question of silibinin’s utility been answered? The journey to certainty, as Pliny the Elder once warned, is often fleeting.
Investigation and analysis of Galerina sulciceps poisoning in a canteen
Published in Clinical Toxicology, 2018
Hong Xiang, Yajuan Zhou, Changlin Zhou, Shiguang Lei, Hong Yu, Yafang Wang, Shu Zhu
Galerina sulciceps is an amanitin-containing toxic mushroom in China, regarded locally as potentially as deadly as the Amanita phalloides (death cap). Ingestion can result in serious toxicity or even fatality. Amatoxin contained in G. sulciceps is responsible for the symptoms. Patients can develop serious liver and kidney damage without timely and effective treatment. However, no specific treatment for G. sulciceps poisoning is available. Poisoning usually occurs as a result of unintentional consumption of poisonous wild mushrooms. If wild mushroom poisoning is suspected, early diagnosis and aggressive treatment play an important role in saving life. It is necessary to educate the public, so they can correctly distinguish between edible and poisonous mushrooms, and to train medical staff in rapid diagnosis and treatment most important, the best preventive measure is to educate the public not to gather and eat any unidentified wild mushrooms.
Amanitin intoxication: effects of therapies on clinical outcomes – a review of 40 years of reported cases
Published in Clinical Toxicology, 2022
Jia Lin Tan, Janine Stam, Aad P. van den Berg, Patrick F. van Rheenen, Bart G. J. Dekkers, Daan J. Touw
Poisoning with the highly toxic amanitin-containing mushroom has been a long-standing problem and has a wide range of reported overall mortality with rates between 1.8% and 22% in patients receiving either supportive care or treatment [1–5]. Amanita species that contain amanitin are hepatotoxic, and Amanita phalloides is responsible for most of the fatal intoxications with Amanita species [6–8].