Effect of Silymarin Administration on TNF-α Serum Concentration in Peritoneal Dialysis Patients

Chronic inflammation in dialysis patients increases the production of cytokines such as TNF-alpha, IL-1 beta and IFN-IFN-gamma and there is evidence of a significant mortality rate in dialysis patients due to inflammation. Overproduction of inflammatory cytokines can induce complications such as atherosclerosis, malnutrition and anaemia, which are mostly resistant to erythropoietin treatment. Cardiovascular disease is the leading cause of death in haemodialysis patients and about half of the mortality is attributable to cardiovascular disease. Silymarin modulates the immune system by inhibition of neutrophil immigration, mast cell immobilization, prostaglandin production and leukotriene synthesis. Furthermore, silymarin suppresses the induction of TNF-alpha and it was hypothesized that silymarin could decrease the serum concentration of TNF-alpha in peritoneal dialysis patients, and thus treat anaemia. Fifteen peritoneal dialysis patients were enrolled in this study and serum levels of soluble TNF-alpha were measured using an enzyme-linked immunosorbant assay (ELISA) kit. Serum TNF-alpha was found to be decreased in some patients and in the response group, the haemoglobin concentration after 8 weeks of silymarin administration was increased significantly (p < 0.05). Based on the results of this study, it is suggested that silymarin may be useful in the treatment of inflammation for peritoneal dialysis patients. Copyright (C) 2010 John Wiley & Sons, Ltd.