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Silibinin has been proven to inhibit the upregulation of co-stimulatory molecules and major histocompatibility complex (MHC) class II molecules on lipopolysaccharide (LPS) stimulated mature DCs, while also suppressing the release of pro-inflammatory cytokines IL-12, IL-23, and TNF-, as well as CD4 + T cell proliferation and Th1/Th17 function, indicating strong immunosuppressive activity (112)

This may be along with general COX 1 and COX 2 specificity (24), with the pyloric sphincter less sensitive to COX 2 and the lower esophageal sphincter more sensitive, but ultimately both affected by inhibition of both COX 1 and COX 2