Silymarin antiproliferative and apoptotic effects: Insights into its clinical impact in various types of cancer

Phytother Res. 2019 Nov;33(11):2849-2861. doi: 10.1002/ptr.6470. Epub 2019 Aug 12.

Abstract

Silymarin is a complex extract isolated from the plant Silybum marianum, widely known for its prominent antioxidant and hepatoprotective effects, although increasing evidences have reported extraordinary antiproliferative and apoptotic abilities. As a result, several signaling pathways involved in cell cycle control, cell proliferation, and cell death have been deconvoluted as critical mechanisms. In this regard, cyclin and cyclin-dependent pathways have been the most studied ones. Following that, apoptotic pathways, such as p53, Akt, STAT-3, Ras, and caspases pathways, have been extensively studied, although other mechanisms involved in inflammation and angiogenesis have also been highlighted as silymarin-likely targets in cancer therapy. Therefore, the main challenge of this review is to discuss the diverse molecular mechanisms for silymarin antiproliferative and apoptotic effects; most of them largely studied in various types of cancers so far. Clinical trials and combination therapies related to silymarin application in cancer prevention and treatment are presented as well.

Keywords: antiproliferative; apoptosis; cancer; cell cycle; molecular mechanism; silymarin.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Phytogenic / pharmacology*
  • Antineoplastic Agents, Phytogenic / therapeutic use
  • Antioxidants / therapeutic use
  • Apoptosis / drug effects*
  • Cell Cycle Checkpoints / drug effects
  • Cell Proliferation / drug effects*
  • Drug Screening Assays, Antitumor
  • Flavonoids / pharmacology
  • Flavonoids / therapeutic use
  • Humans
  • Neoplasms / classification
  • Neoplasms / drug therapy
  • Neoplasms / pathology*
  • Neovascularization, Pathologic / drug therapy
  • Silybum marianum / chemistry
  • Silymarin / pharmacology*
  • Silymarin / therapeutic use

Substances

  • Antineoplastic Agents, Phytogenic
  • Antioxidants
  • Flavonoids
  • Silymarin