PDF(Pubmed)
Abstract：
Chronic liver disease (CLD) is a leading health problem impacting the quality of life globally. China shares a major global burden of CLD-including alcoholic liver disease, nonalcoholic fatty liver disease/metabolic dysfunction-associated fatty liver disease, and drug-induced liver injury, except for chronic viral hepatitis. Several exogenous toxins or endogenous metabolic insults trigger hepatic pathology toward steatosis, inflammation, and fibrosis, which, if left untreated, may culminate in liver cirrhosis. Oxidative stress is a common pathomechanism underlying all phenotypes of toxic liver injury; thus, these may be brought under a unified entity, viz. toxic liver disease (TLD). Therefore, a common strategy to treat TLD is to use antioxidants as hepatoprotective agents. The cornerstone for treating fatty liver disease is lifestyle modification, diet, exercise, and behavioral therapy, along with the limited use of pharmacological agents. Available preclinical and clinical evidence indicates that silymarin is a hepatoprotective agent with established antioxidant, anti-inflammatory, antifibrotic effects. An international expert panel of clinicians was convened to discuss combining alcoholic liver disease, nonalcoholic fatty liver disease/metabolic dysfunction-associated fatty liver disease, drug-induced liver injury, and liver cirrhosis under the single definition of TLD, based on the shared pathologic mechanism of oxidative stress. The panel highlighted the significance of silymarin as an antioxidant treatment for TLD.
摘要：
慢性肝病（CLD）是影响全球生活质量的主要健康问题。中国承担着CLD的主要全球负担，包括酒精性肝病，非酒精性脂肪性肝病/代谢功能障碍相关性脂肪性肝病,和药物性肝损伤，除了慢性病毒性肝炎。几种外源性毒素或内源性代谢损害触发肝脏病理朝向脂肪变性，炎症,和纤维化，which,如果不及时治疗，可能会导致肝硬化。氧化应激是中毒性肝损伤所有表型的共同病理机制；因此，这些可以被置于一个统一的实体之下，viz.中毒性肝病（TLD）。因此,治疗TLD的常用策略是使用抗氧化剂作为保肝药物.治疗脂肪肝的基石是改变生活方式，饮食，锻炼,和行为疗法,随着药物的有限使用。可用的临床前和临床证据表明，水飞蓟素是建立抗氧化剂的肝脏保护剂，抗炎,抗纤维化作用。召开了一个由临床医生组成的国际专家小组，讨论酒精性肝病的合并，非酒精性脂肪性肝病/代谢功能障碍相关性脂肪性肝病,药物性肝损伤，和TLD单一定义下的肝硬化，基于氧化应激的共同病理机制。小组强调了水飞蓟素作为TLD抗氧化剂治疗的重要性。
