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Background  Cystic echinococcosis (CE), is a parasitic zoonosis caused by  Echinococcus granulosus  ( E. granulosus ) larvae in liver and lungs of both humans and animals. Surgical intervention is the mainstay for CE treatment, using scolicidal agents that inactivate live protoscolices. This study evaluated the scolicidal effects of  Silybum marianum  ethanolic extract and its combination with albendazole in vitro for the first time. Moreover, in a literature review, we investigated the effects of a wide range of Iranian medicinal plants on protoscolices of  E. granulosus .    Methods   S. marianum  ethanolic extract was prepared and high-performance liquid chromatography (HPLC) analysis was used to establish the proportions of its component compounds in the extract. Cytotoxicity was evaluated in mouse macrophage cells (J774A.1 cell line) using MTT method. Next, the scolicidal activity of the extract alone and combined with albendazole was tested as triplicate at various concentrations incubated for 5, 10, 20, 30, and 60 min. Finally, protoscolex viability was determined using 0.1% eosin as a vital stain. PCR–RFLP and DNA sequencing techniques were used to characterize the genotype of  E. granulosus .    Results  HPLC analysis showed that  S. marianum  ethanolic extract contained mostly silydianin (14.41%), isosilybin A (10.50%), and silychristin (10.46%). The greatest scolicidal effects were obtained with the combination of  S. marianum  with albendazole (79%),  S. marianum  ethanolic extract alone (77%) and albendazole (69%), at a concentration of 500 μg/ml for 60 min, respectively ( P  < 0.05). Molecular analysis showed that all the cysts used were G1 genotype.    Conclusion  The data suggest that  S. marianum  ethanolic extract is a potential scolicide in vitro; however, further investigations are required to determine its efficacy in vivo.

tropical medicine and health

Silybum marianum ethanolic extract: in vitro effects on protoscolices of Echinococcus granulosus G1 strain with emphasis on other Iranian medicinal plants