 Milk 
                  thistle (Silybum marianum) has an extensive history of 
                  use as a remedy for liver problems in both Eastern and Western 
                  traditional medicine. Silymarin is a flavonoid comprised of 
                  a mix of milk thistle components including silibinin. Most silymarin 
                  studies have looked at its effect on liver fibrosis, but in 
                  recent years researchers have studied its direct activity against 
                  HCV in the laboratory and in vivo.
Milk 
                  thistle (Silybum marianum) has an extensive history of 
                  use as a remedy for liver problems in both Eastern and Western 
                  traditional medicine. Silymarin is a flavonoid comprised of 
                  a mix of milk thistle components including silibinin. Most silymarin 
                  studies have looked at its effect on liver fibrosis, but in 
                  recent years researchers have studied its direct activity against 
                  HCV in the laboratory and in vivo.
                  
                  A survey 
                  of participants in the HALT-C trial -- which evaluated the 
                  benefits of long-term pegylated interferon for patients who 
                  did not respond to standard treatment with pegylated interferon 
                  plus ribavirin -- found that participants who said they used 
                  silymarin did not have lower HCV viral load on average than 
                  non-users. Another 
                  recent study, however, showed that silymarin inhibited activity 
                  of the HCV polymerase, which copies viral genetic material as 
                  part of replication.
                  
                  In the present study, Jessica Wagoner from the University of 
                  Washington in Seattle and colleagues further characterized the 
                  antiviral action of silymarin in the laboratory.
                  
                  Results 
                   
                  
                
                   
                    |  | Silymarin 
                      had antiviral effects against HCV in cell cultures, including 
                      inhibition of virus entry into cells, HCV RNA and protein 
                      expression, and production of infectious virus particles. | 
                   
                    |  | Silymarin 
                      did not block HCV binding to cells, but did inhibit entry 
                      of viral pseudoparticles and fusion of HCV pseudoparticles 
                      with liposomes, or fat bubbles. | 
                   
                    |  | Silymarin 
                      -- but not silibinin -- inhibited activity of the HCV genotype 
                      2a NS5B RNA-dependent RNA polymerase at concentrations 5-10 
                      times higher than required for an anti-HCV effect in cell 
                      culture. | 
                   
                    |  | Silymarin 
                      had only minimal activity against genotype 1b isolate BK 
                      and 4 genotype 1b polymerases derived from HCV-infected 
                      patients, however. | 
                   
                    |  | Silymarin 
                      did not inhibit HCV replication in 5 independent genotype 
                      1a, 1b, and 2a replicon model cell lines that did not produce 
                      infectious virus. | 
                   
                    |  | Silymarin 
                      inhibited microsomal triglyceride transfer protein activity, 
                      apolipoprotein B secretion, and infectious virion production 
                      in cell culture medium. | 
                   
                    |  | Silymarin 
                      also blocked cell-to-cell spread of HCV. | 
                
                Based 
                  on these findings, the study authors concluded, "Although 
                  inhibition of in vitro NS5B polymerase activity is demonstrable, 
                  the mechanisms of silymarin's antiviral action appear to include 
                  blocking of virus entry and transmission, possibly by targeting 
                  the host cell."
                  
                  Investigator affiliations: Departments of Laboratory Medicine, 
                  Microbiology, and Global Health, University of Washington, Seattle, 
                  WA; Center for Engineering in Medicine, Massachusetts General 
                  Hospital, Boston, MA; Department of Pediatrics, University of 
                  Texas Medical Branch, Galveston, TX; School of Medicine, University 
                  of Texas Southwestern Medical Center, Dallas, TX; Hepatitis 
                  C Virus Research Group, Institute of Biomedical Research, University 
                  of Birmingham, Birmingham, UK; Institut de Biologie et Chimie 
                  des Protéines, Université Lyon 1, IFR128 Lyon 
                  Biosciences Gerland, CNRS-Universite Claude Bernard, Lyon, France; 
                  Department of Chemistry and Biochemistry, University of North 
                  Carolina at Greensboro, Greensboro, NC; Department of Molecular 
                  Virology, University of Heidelberg, Heidelberg, Germany; Department 
                  of Molecular Microbiology and Immunology, Saint Louis University 
                  School of Medicine, St. Louis, MO.
                  
                  8/20/10
                Reference
                  J Wagoner, A Negash, OJ Kane, and others. Multiple effects of 
                  silymarin on the hepatitis C virus lifecycle. Hepatology 
                  51(6): 1912-1921 (Abstract). 
                  June 2010.