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צמח החיים

פתרונות טבעיים מתקדמים לאורח חיים בריא

גדילן מצוי – Silybum marianum

קוץ חד-שנתי הפורח באביב ובראשית הקיץ, ממארס עד מאי, שכיח מאוד בצידי דרכים, שולי שדות ומעזבות. הוא מתנשא לגובה של 150 ס”מ ואף יותר. עלי השושנה בבסיס הצמח גדולים ושסועים. שפת העלה מסתיימת בקוצים דוקרנים.

בסוף האביב הצמח מתייבש, ובראש כל תפרחת שנראית כמו קוץ , ישנם זרעים. הזרעים מכילים –חומר הנקרא סילמרין, המחדש ומנקה את תאי הכבד, ונחשב למשקם הכבד הטוב ביותר שיש (שגם הוכח מדעית). הזרעים הצעירים נאכלים טריים, טעימים מאוד. הזרעים היבשים (חומים) נאכלים חיים או קלויים, הקלייה מפיגה את מרירותם. ניתן לחלוט, לטחון או להנביט, וגם להפיק שמן רפואי חזק.

מחקרים בינלאומיים רבים חקרו את יכולת הגדילן לתמוך בבריאות הכבד ולהפחית סיכון למחלות כבד, ונמצאו תוצאות חיוביות: (1-3)

השם Silybum נגזר מהמילה היוונית שמשמעותה “ציצית”.

שמותיו האנגליים של הגדילן נקשרים לאגדה על מריה אֵם ישו, שהסתתרה במסתור גדילנים מפני חייליו של הורדוס אשר רדפו אותה, ובזמן שהיניקה את בנה טפטף חלב על עלי הגדילן וסימן אותם בקווים לבנים, ומאז הוא מכוּנה “החוח של גבירתנו” (Our Lady’s Thistle).

לגדילן שם בוטני נוסף, Cardus marianum.

גדילן מצוי

רכיבים פעילים עיקריים

פלבונו-ליגנאנים (1.5-3% מכלל הצמח. מתוך זה, 65-80% סילימרין (Silymarin)), וכן תרכובות פלבונואידיות נוספות: קוורצטין, קמפרול, אפיגנין. בנוסף, קיימים בצמח סטרולים וחומצות אורגניות.

*התרכובת העיקרית (Silymarin) מכילה ארבעה פלבונו-ליגנאנים (flavonoligans) ראשיים הכוללים: silybin (silibinin), isosilybin, silydianin, silychristin.

יתרונות בריאותיים של תמצית זרעי גדילן מצוי:

מקורות מחקריים:

1. מחקר פורסם בכתב העת “Phytotherapy Research” הצביע על יכולת הגדילן להפחית פגיעה בכבד ולשפר את פעילות הכבד במקרי תופעות כבדיות. Polyak SJ, Morishima C, Shuhart MC, Wang CC, Liu Y, Lee DY. Inhibition of T-cell inflammatory cytokines, hepatocyte NF-kappaB signaling, and HCV infection by standardized Silymarin. Gastroenterology. 2007;132(5):1925-1936. 2. מחקר פורסם בכתב העת “Liver International” מצביע על יכולת הגדילן לשפר את תפקודי הכבד ולהפחית דלקות בכבד על רקע של מחלות כבד. Mayer KE, Myers RP, Lee SS. Silymarin treatment of viral hepatitis: a systematic review. J Viral Hepat. 2005;12(6):559-567. 3. מחקר נוסף שפורסם בכתב העת “Phytotherapy Research” חקר את ההשפעה של סילימרין (התרכובת הפעילה בגדילן מצוי) על פונקציה תקינה של הכבד ומצבי דלקות כבד במקרי נזק כבדי. Polyak SJ, Morishima C, Lohmann V, et al. Identification of hepatoprotective flavonolignans from silymarin. Proc Natl Acad Sci U S A. 2010;107(13):5995-5999.

Ramasamy K, Agarwal R. Multitargeted therapy of cancer by silymarin. Cancer Lett. 2008 Oct 8;269(2):352-62. https://www.ncbi.nlm.nih.gov/pubmed/18472213

Chung SY, Sung MK, Kim NH, Jang JO, Go EJ, Lee HJ. Inhibition of P-glycoprotein by natural products in human breast cancer cells. Arch Pharm Res. 2005 Jul;28(7):823-8. https://www.ncbi.nlm.nih.gov/pubmed/16114498

Lee CK, Choi JS. Effects of silibinin, inhibitor of CYP3A4 and P-glycoprotein in vitro, on the pharmacokinetics of paclitaxel after oral and intravenous administration in rats. Pharmacology. 2010;85(6):350-6. https://www.ncbi.nlm.nih.gov/pubmed/20523105

Li C, Lee MY, Choi JS. Effects of silybinin, CYP3A4 and P-glycoprotein inhibitor in vitro, on the bioavailability of loratadine in rats. Pharmazie. 2010 Jul;65(7):510-4. https://www.ncbi.nlm.nih.gov/pubmed/20662320

Pereira C, Barreira JC, Calhelha RC, Queiroz MJ, Barros L, Ferreira IC. New insights into the effects of formulation type and compositional mixtures on the antioxidant and cytotoxic activities of dietary supplements based-on hepatoprotective plants. Food Funct. 2014 Sep;5(9):2052-60. https://www.ncbi.nlm.nih.gov/pubmed/25089364

Snima KS, Arunkumar P, Jayakumar R, Lakshmanan VK. Silymarin encapsulated poly(D,L-lactic-co-glycolic acid) nanoparticles: a prospective candidate for prostate cancer therapy. J Biomed Nanotechnol. 2014 Apr;10(4):559-70. https://www.ncbi.nlm.nih.gov/pubmed/24734508

Zheng N, Liu L, Liu WW, Li F, Hayashi T, Tashiro SI, Onodera S, Ikejima T. Crosstalk of ROS/RNS and autophagy in silibinin-induced apoptosis of MCF-7 human breast cancer cells in vitro. Acta Pharmacol Sin. 2017 Feb;38(2):277-289. https://www.ncbi.nlm.nih.gov/pubmed/27867187

Jiang K, Wang W, Jin X, Wang Z, Ji Z, Meng G. Silibinin, a natural flavonoid, induces autophagy via ROS-dependent mitochondrial dysfunction and loss of ATP involving BNIP3 in human MCF7 breast cancer cells. Oncol Rep. 2015 Jun;33(6):2711-8. https://www.ncbi.nlm.nih.gov/pubmed/25891311

Lovelace ES, Wagoner J, MacDonald J, et al. Silymarin Suppresses Cellular Inflammation By Inducing Reparative Stress Signaling. J Nat Prod. 2015 Aug 28;78(8):1990-2000. https://www.ncbi.nlm.nih.gov/pubmed/26186142

Kohno H, Tanaka T, Kawabata K, Hirose Y, Sugie S, Tsuda H, Mori H. Silymarin, a naturally occurring polyphenolic antioxidant flavonoid, inhibits azoxymethane-induced colon carcinogenesis in male F344 rats. Int J Cancer. 2002 Oct 10;101(5):461-8. https://www.ncbi.nlm.nih.gov/pubmed/12216075

Kim DH, Jin YH, Park JB, Kobashi K. Silymarin and its components are inhibitors of beta-glucuronidase. Biol Pharm Bull. 1994 Mar;17(3):443-5. https://www.ncbi.nlm.nih.gov/pubmed/8019514

Cheung CW, Gibbons N, Johnson DW, Nicol DL. Silibinin–a promising new treatment for cancer. Anticancer Agents Med Chem. 2010 Mar;10(3):186-95. https://www.ncbi.nlm.nih.gov/pubmed/20015009

Ramasamy K, Agarwal R. Multitargeted therapy of cancer by silymarin. Cancer Lett. 2008 Oct 8;269(2):352-62. https://www.ncbi.nlm.nih.gov/pubmed/18472213

Neha, Jaggi AS, Singh N. Silymarin and Its Role in Chronic Diseases. Adv Exp Med Biol. 2016;929:25-44. https://www.ncbi.nlm.nih.gov/pubmed/27771919

Liao CY, Lee CC, Tsai CC, et al. Novel Investigations of Flavonoids as Chemopreventive Agents for Hepatocellular Carcinoma. Biomed Res Int. 2015;2015:840542. https://www.ncbi.nlm.nih.gov/pubmed/26858957

Gioti K, Tenta R. Bioactive natural products against prostate cancer: mechanism of action and autophagic/apoptotic molecular pathways. Planta Med. 2015 May;81(7):543-62. https://www.ncbi.nlm.nih.gov/pubmed/25875508

Kim S, Han J, Kim JS, Kim JH, Choe JH, Yang JH, Nam SJ, Lee JE. Silibinin suppresses EGFR ligand-induced CD44 expression through inhibition of EGFR activity in breast cancer cells. Anticancer Res. 2011 Nov;31(11):3767-73. https://www.ncbi.nlm.nih.gov/pubmed/22110198

Singh RP, Agarwal R. Prostate cancer prevention by silibinin. Curr Cancer Drug. Curr Cancer Drug Targets. 2004 Feb;4(1):1-11. https://www.ncbi.nlm.nih.gov/pubmed/14965263

Thelen, P, Jarry H, Ringert RH, Wuttke W. Silibinin downregulates prostate epithelium-derived Ets transcription factor in LNCaP prostate cancer cells. Planta Med. 2004, 70(5), 397-400. https://www.ncbi.nlm.nih.gov/pubmed/15124082

Kauntz H, Bousserouel S, Gossé F, Raul F. The flavonolignan silibinin potentiates TRAIL-induced apoptosis in human colon adenocarcinoma and in derived TRAIL-resistant metastatic cells. Apoptosis. 2012 Aug;17(8):797-809. https://www.ncbi.nlm.nih.gov/pubmed/22555452

Son YG, Kim EH, Kim JY, Kim SU, Kwon TK, Yoon AR, Yun CO, Choi KS. Silibinin sensitizes human glioma cells to TRAIL-mediated apoptosis via DR5 up-regulation and down-regulation of c-FLIP and survivin. Cancer Res. 2007 Sep 1;67(17):8274-84. https://www.ncbi.nlm.nih.gov/pubmed/17804742

Mallikarjuna G, Dhanalakshmi S, Singh RP, Agarwal C. Silibinin protects against photocarcinogenesis via modulation of cell cycle regulators, mitogen-activated protein kinases, and Akt signalling. Cancer Res. 2004, 64(17), 6349-6356. https://www.ncbi.nlm.nih.gov/pubmed/15342425

Manna SK, Mukhopadhyay A, Van NT, Aggarwal BB. Silymarin suppresses TNF-induced activation of NF-kappa B, c-Jun N-terminal kinase, and apoptosis. J Immunol. 1999 Dec 15;163(12):6800-9. https://www.ncbi.nlm.nih.gov/pubmed/10586080

Lee SO, Jeong YJ, Im, HG, Kim CH, Chang YC, Lee IS. Silibinin suppresses PMA-induced MMP-9 expression by blocking the AP-1 activation via MAPK signalling pathways in MCF-7 human breast carcinoma cells. Biochem. Biophys. Res. Commun. 2007, 354(1) 165-171. https://www.ncbi.nlm.nih.gov/pubmed/17214970

Tilley C, Deep G, Agarwal C, et al. Silibinin and its 2,3-dehydro-derivative inhibit basal cell carcinoma growth via suppression of mitogenic signaling and transcription factors activation. Mol Carcinog. 2016 Jan;55(1):3-14. https://www.ncbi.nlm.nih.gov/pubmed/25492239

Fan S, Qi M, Yu Y, Li L, Yao G, Tashiro S, Onodera S, Ikejima T. P53 activation plays a crucial role in silibinin induced ROS generation via PUMA and JNK. Free Radic Res. 2012 Mar;46(3):310-9. https://www.ncbi.nlm.nih.gov/pubmed/22283740

Fan L, Ma Y, Liu Y, Zheng D, Huang G. Silymarin induces cell cycle arrest and apoptosis in ovarian cancer cells. Eur J Pharmacol. 2014 Nov 15;743:79-88. https://www.ncbi.nlm.nih.gov/pubmed/25242120

Thelen P, Wuttke W, Jarry H, Grzmil M, Ringert RH. Inhibition of telomerase activity and secretion of prostate specific antigen by silibinin in prostate cancer cells. J Urol 2004; 171: 1934-1938. https://www.ncbi.nlm.nih.gov/pubmed/15076315

Zhang S, Yang Y, Liang Z, et al. Silybin-mediated inhibition of Notch signaling exerts antitumor activity in human hepatocellular carcinoma cells. PLoS One. 2013 Dec 27;8(12):e83699. https://www.ncbi.nlm.nih.gov/pubmed/24386256

Vaid M, Prasad R, Sun Q, Katiyar SK. Silymarin targets β-catenin signaling in blocking migration/invasion of human melanoma cells. PLoS One. 2011;6(7):e23000. https://www.ncbi.nlm.nih.gov/pubmed/21829575

Eo HJ, Park GH, Jeong JB. Inhibition of Wnt Signaling by Silymarin in Human Colorectal Cancer Cells. Biomol Ther (Seoul). 2016 Jul 1;24(4):380-6. https://www.ncbi.nlm.nih.gov/pubmed/27068260

Atawia RT, Mosli HH, Tadros MG, et al. Modulatory effect of silymarin on inflammatory mediators in experimentally induced benign prostatic hyperplasia: emphasis on PTEN, HIF-1α, and NF-κB. Naunyn Schmiedebergs Arch Pharmacol. 2014 Dec;387(12):1131-40. https://www.ncbi.nlm.nih.gov/pubmed/25164963

McCarty MF, Barroso-Aranda J, Contreras F. Practical strategies for suppressing hypoxia-inducible factor activity in cancer therapy. Med Hypotheses. 2010 May;74(5):789-97. https://www.ncbi.nlm.nih.gov/pubmed/20089365

Surai PF. Silymarin as a natural antioxidant: an overview of the current evidence and perspectives. Antioxidants.2015;4:204–247. https://www.ncbi.nlm.nih.gov/pubmed/26785346

Esmaeil N, Anaraki SB, Gharagozloo M, Moayedi B. Silymarin impacts on immune system as an immunomodulator: One key for many locks. Int Immunopharmacol. 2017 Sep;50:194-201. https://www.ncbi.nlm.nih.gov/pubmed/28672215

Rácz K, Fehér J, Csomós G, Varga I, Kiss R, Gláz E. An antioxidant drug, silibinin, modulates steroid secretion in human pathological adrenocortical cells. J Endocrinol. 1990 Feb;124(2):341-5. https://www.ncbi.nlm.nih.gov/pubmed/2155989

Hussain SA, Jassim NA, Numan IT, Al-Khalifa II, Abdullah TA. Anti-inflammatory activity of silymarin in patients with knee osteoarthritis. A comparative study with piroxicam and meloxicam. Saudi Med J. 2009 Jan;30(1):98-103. https://www.ncbi.nlm.nih.gov/pubmed/19139781

Shavandi M, Moini A, Shakiba Y, Mashkorinia A, Dehghani M, Asar S, Kiani A. Silymarin (Livergol®) Decreases Disease Activity Score in Patients with Rheumatoid Arthritis: A Non-randomized Single-arm Clinical Trial. Iran J Allergy Asthma Immunol. 2017 Apr;16(2):99-106. https://www.ncbi.nlm.nih.gov/pubmed/28601049

Rastegarpanah M, Malekzadeh R, Vahedi H, et al. A randomized, double blinded, placebo-controlled clinical trial of silymarin in ulcerative colitis. Chin J Integr Med. 2015 Dec;21(12):902-6. https://www.ncbi.nlm.nih.gov/pubmed/22528757

Bakhshaee M, Jabbari F, Hoseini S, et al. Effect of silymarin in the treatment of allergic rhinitis. Otolaryngology – Head and Neck Surgery 2011;145:904-9. https://www.ncbi.nlm.nih.gov/pubmed/21952357

Johnson VJ, He Q, Osuchowski MF, Sharma RP. Physiological responses of a natural antioxidant flavonoid mixture, silymarin, in BALB/c mice: III. Silymarin inhibits T-lymphocyte function at low doses but stimulates inflammatory processes at high doses. Planta Med. 2003 Jan;69(1):44-9. https://www.ncbi.nlm.nih.gov/pubmed/12567278

Johnson VJ, Osuchowski MF, He Q, Sharma RP. Physiological responses to a natural antioxidant flavonoid mixture, silymarin, in BALB/c mice: II. alterations in thymic differentiation correlate with changes in c-myc gene expression. Planta Med. 2002 Nov;68(11):961-5. https://www.ncbi.nlm.nih.gov/pubmed/12451483

Wilasrusmee C, Kittur S, Shah G, et al. Immunostimulatory effect of Silybum Marianum (milk thistle) extract. Med Sci Monit. 2002 Nov;8(11):BR439-43. https://www.ncbi.nlm.nih.gov/pubmed/12444368

Min K, Yoon WK, Kim SK, Kim BH. Immunosuppressive effect of silibinin in experimental autoimmune encephalomyelitis. Arch Pharm Res. 2007 Oct;30(10):1265-72. https://www.ncbi.nlm.nih.gov/pubmed/18038905

Lee JS, Kim SG, Kim HK, et al. Silibinin polarizes Th1/Th2 immune responses through the inhibition of immunostimulatory function of dendritic cells. J Cell Physiol. 2007 Feb;210(2):385-97. https://www.ncbi.nlm.nih.gov/pubmed/17058260

Gharagozloo M, Jafari S, Esmaeil N, Javid EN, Bagherpour B, Rezaei A. Immunosuppressive effect of silymarin on mitogen-activated protein kinase signalling pathway: the impact on T cell proliferation and cytokine production. Basic Clin Pharmacol Toxicol. 2013 Sep;113(3):209-14. https://www.ncbi.nlm.nih.gov/pubmed/23701595

Kuo FH, Jan TR. Silibinin attenuates antigen-specific IgE production through the modulation of Th1/Th2 balance in ovalbumin-sensitized BALB/c mice. Phytomedicine. 2009 Mar;16(2-3):271-6. https://www.ncbi.nlm.nih.gov/pubmed/18771904

Gupta OP, Sing S, Bani S, et al. Anti-inflammatory and anti-arthritic activities of silymarin acting through inhibition of 5-lipoxygenase. Phytomedicine. 2000 Mar;7(1):21-4. https://www.ncbi.nlm.nih.gov/pubmed/10782486

Varshosaz J, Minaiyan M, Khaleghi N. Eudragit nanoparticles loaded with silybin: a detailed study of preparation, freeze-drying condition and in vitro/in vivo evaluation. J Microencapsul. 2015;32(3):211-23. https://www.ncbi.nlm.nih.gov/pubmed/25561026

Choi YH, Jin GY, Guo HS, Piao HM, Li Lc, Li GZ, Lin ZH, Yan GH. Silibinin attenuates allergic airway inflammation in mice. Biochem Biophys Res Commun. 2012 Oct 26;427(3):450-5. https://www.ncbi.nlm.nih.gov/pubmed/22842463

Dehmlow C, Erhard J, de Groot H. Inhibition of Kupffer cell functions as an explanation for the hepatoprotective properties of silibinin. Hepatology. 1996 Apr;23(4):749-54. https://www.ncbi.nlm.nih.gov/pubmed/8666328

Kang JS, Jeon YJ, Park SK, Yang KH, Kim HM. Protection against lipopolysaccharide-induced sepsis and inhibition of interleukin-1β and prostaglandin E2 synthesis by silymarin. Biochemical Pharmacology. 2004;67, 175–181. https://www.ncbi.nlm.nih.gov/pubmed/14667940

Toklu HZ, Tunali Akbay T, Velioglu-Ogunc A, et al. Silymarin, the antioxidant component of Silybum marianum, prevents sepsis-induced acute lung and brain injury. The Journal of Surgical Research. 2008; 145, 214-222. https://www.ncbi.nlm.nih.gov/pubmed/17950327

Moayedi B, Gharagozloo M, Esmaeil N, Maracy MR, Hoorfar H, Jalaeikar M. A randomized double-blind, placebo-controlled study of therapeutic effects of silymarin in β-thalassemia major patients receiving desferrioxamine. Eur J Haematol. 2013 Mar;90(3):202-9. https://www.ncbi.nlm.nih.gov/pubmed/23278124

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Hagag AA, Elfaragy MS, Elrifaey SM, Abd El-Lateef AE. Therapeutic value of combined therapy with deferiprone and silymarin as iron chelators in Egyptian children with beta thalassemia major. Infect Disord Drug Targets. 2015;15(3):189-95. https://www.ncbi.nlm.nih.gov/pubmed/26239735

Hutchinson C, Bomford A, Geissler CA. The iron-chelating potential of silybin in patients with hereditary haemochromatosis. Eur J Clin Nutr. 2010 Oct; 64(10):1239-41. https://www.ncbi.nlm.nih.gov/pubmed/20628405

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Sayyah M, Boostani H, Pakseresht S, Malayeri A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of Obsessive-Compulsive Disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2010 Mar 17;34(2):362-5. https://www.ncbi.nlm.nih.gov/pubmed/20035818

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Tsai MJ, Liao JF, Lin DY, et al. Silymarin protects spinal cord and cortical cells against oxidative stress and lipopolysaccharide stimulation. Neurochem Int. 2010 Dec;57(8):867-75. https://www.ncbi.nlm.nih.gov/pubmed/20868716

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Velmurugan K, Alam J, McCord JM, Pugazhenthi S. Synergistic induction of heme oxygenase-1 by the components of the antioxidant supplement Protandim. Free Radic Biol Med. 2009 Feb 1;46(3):430-40. https://www.ncbi.nlm.nih.gov/pubmed/19056485

Wang C, Wang Z, Zhang X, et al. Protection by silibinin against experimental ischemic stroke: up-regulated pAkt, pmTOR, HIF-1α and Bcl-2, down-regulated Bax, NF-κB expression. Neurosci Lett. 2012 Oct 31;529(1):45-50. https://www.ncbi.nlm.nih.gov/pubmed/22999929

Kim MH, Kim SH, Yang WM. Mechanisms of action of phytochemicals from medicinal herbs in the treatment of Alzheimer’s disease. Planta Med. 2014 Oct;80(15):1249-58. https://www.ncbi.nlm.nih.gov/pubmed/25210998

Pérez-H J, Carrillo-S C, García E, Ruiz-Mar G, Pérez-Tamayo R, Chavarría A. Neuroprotective effect of silymarin in a MPTP mouse model of Parkinson’s disease. Toxicology. 2014 May 7;319:38-43. https://www.ncbi.nlm.nih.gov/pubmed/24607817

Lee Y, Chun HJ, Lee KM, Jung YS, Lee J. Silibinin suppresses astroglial activation in a mouse model of acute Parkinson’s disease by modulating the ERK and JNK signaling pathways. Brain Res. 2015 Nov 19;1627:233-42. https://www.ncbi.nlm.nih.gov/pubmed/26434409

Thakare VN, Aswar MK, Kulkarni YP, Patil RR, Patel BM. Silymarin ameliorates experimentally induced depressive like behavior in rats: Involvement of hippocampal BDNF signaling, inflammatory cytokines and oxidative stress response. Physiol Behav. 2017 Oct 1;179:401-410. https://www.ncbi.nlm.nih.gov/pubmed/28711395

Kanlayavattanakul M, Lourith N. An update on cutaneous aging treatment using herbs. J Cosmet Laser Ther. 2015;17(6):343-52. https://www.ncbi.nlm.nih.gov/pubmed/25968169

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Al-Anbari HH, Sahib AS, Raghif AR. Effects of silymarin, N-acetylcysteine and selenium in the treatment of papulopustular acne. Oxid Antioxid Med Sci. 2012, 1(3): 201-207. https://www.bibliomed.org/?mno=25166

Singh RP, Agarwal R. Cosmeceuticals and silibinin. Clinics in Dermatology. 2009; 27, 479-484. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2767273/

Toklu HZ, Tunali-Akbay T, Erkanli G, Yüksel M, Ercan F, Sener G. Silymarin, the antioxidant component of Silybum marianum, protects against burn-induced oxidative skin injury. Burns. 2007 Nov;33(7):908-16. https://www.ncbi.nlm.nih.gov/pubmed/17521818

Moosavifar N, Mohammadpour AH, Jallali M, Karimiz G, Saberi H. Evaluation of effect of silymarin on granulosa cell apoptosis and follicular development in patients undergoing in vitro fertilization. East Mediterr.Health J. 2010;16(6):642-645. https://www.ncbi.nlm.nih.gov/pubmed/20799592

Vostalova J, Vidlar A, Ulrichova J, Vrbkova J, Simanek V, Student V. Use of selenium-silymarin mix reduces lower urinary tract symptoms and prostate specific antigen in men. Phytomedicine. 2013 Dec 15;21(1):75-81. https://www.ncbi.nlm.nih.gov/pubmed/24012146

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