Meta‐analysis: antioxidant supplements for liver diseases – the Cochrane Hepato‐Biliary Group

Bjelaković, Goran; Gluud, Lise Lotte; Nikolova, Dimitrinka; Bjelaković, Marija; Nagorni, Aleksandar; Gluud, Christian

doi:10.1111/j.1365-2036.2010.04371.x

Cited by 55 publications

(33 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For many years, much money has been spent, but no great achievement has been made in the field of antioxidant therapy for hepatitis B. A meta-analysis conducted in 2010 concluded that there was no evidence to support or refute antioxidant therapy in liver diseases (114) despite the fact that oxidative stress plays a major role in the pathogenesis of hepatitis B. Therefore, the time is right to canalize our research in a standardized direction.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B and its Relationship With Oxidative Stress

Alavian

Showraki

2016

Hepat Mon

View full text Add to dashboard Cite

ContextDespite the great breakthroughs we have witnessed in the last 50 years in the prevention, diagnosis, and treatment of hepatitis B, we are still far from eradicating or even curing the disease. Achieving further progress in controlling this disease will not be possible without discovering the exact pathogenesis behind it. One prime suspect in the pathogenesis of various diseases is oxidative stress. This review will exclusively explore hepatitis B in the context of oxidative stress to obtain a more comprehensive clinical perspective on its pathogenesis and eventual medical therapy.Evidence AcquisitionWe systematically searched PubMed, Google Scholar, Web of Science, EMBASE, and Scopus using an extensive list of keywords in the following three categories: 1) Hepatitis B and oxidation 2) Hepatitis B and antioxidant system 3) Effects of approved anti-hepatitis B drugs on redox status. All relevant articles were obtained and reviewed carefully after the exclusion criteria were deployed.ResultsThere is great evidence indicating extensive oxidative stress occurs in hepatitis B. This oxidative stress takes place on multiple levels, including lipid peroxidation, DNA oxidation, protein oxidation, and reactive oxygen and nitrogen species production. However, there are also conflicting results with regard to antioxidant therapy and antioxidant status in hepatitis B, some of which may be explained by the concept of “compensatory gaps.” Nevertheless, further studies are indicated to reach a more thorough judgment.ConclusionsDespite the presence of vast oxidative stress in hepatitis B, antioxidant therapy is not always effective as a treatment strategy, especially considering that antioxidants can act as “double-edged swords” or antioxidants; if not used at the right time or place or in the right combination, these substances can easily become pro-oxidants. Therefore, several studies will be needed to determine suitable antioxidant therapies. We propose the “2-step Combined Antioxidant Adjuvant Therapy for hepatitis B (2CAAT Hep B)” as a new strategy for antioxidant adjuvant therapy. We also suggest developing an international platform and database for antioxidant adjuvant therapy in hepatitis B (IPAATH and IDAATH) to canalize this field of research in a standardized direction, especially when complexity is a problem.

show abstract

Section: Discussionmentioning

confidence: 99%

Hepatitis B and its Relationship With Oxidative Stress

Alavian

Showraki

2016

Hepat Mon

View full text Add to dashboard Cite

show abstract

“…The most attention was paid to digestive system disorders: stomach and intestine cancer [93][94][95][96], colorectal adenoma [97], various other gastrointestinal disorders [98,99], and liver diseases [100]. However, the range of works included also other types of diseases: cardiovascular, nervous, osteoarticular, renal, endocrine, ocular, dermal, and nonorgan-specific [98,99].…”

Section: Meta-analysis Of Results Of Studies On the Effectiveness Of mentioning

confidence: 99%

Adverse effects of antioxidative vitamins

Rutkowski¹,

Grzegorczyk²

2012

International Journal of Occupational Medicine and Environmental Health

View full text Add to dashboard Cite

High doses of synthetic antioxidative vitamins: A, E, C and β-carotene are often used on long-term basis in numerous preventive and therapeutic medical applications. Instead of expected health effects, the use of those vitamins may however lead to cases of hypervitaminosis and even to intoxication. The article points out main principles of safety which are to be observed during supplementation with antioxidative vitamins. Toxic effects resulting from erroneous administration of high doses of those substances on organs and systems of the organism are also discussed. Attention is drawn to interactions of antioxidative vitamins with concomitantly used drugs, as well as intensification of adverse effects caused by various exogenous chemical factors. Moreover, the article presents the evaluation of supplementation with these vitamins, which was performed in large studies.

show abstract

“…Despite these limitations, it can be summarized that (1) the use of vitamin E is associated with a decrease in aminotransferases in subjects with NASH, (2) studies where histologic endpoints were evaluated indicate that vitamin E causes improvement in steatosis, inflammation, and ballooning and resolution of steatohepatitis in adults with NASH, and (3) vitamin E has no effect on hepatic fibrosis. Although two meta-analyses 8,129 failed to observe significant histological benefits with vitamin E in patients with NASH, these analyses were conducted before PIVENS 122 and TONIC 130 trials were published. In the largest clinical trial (PIVENS) 122 reported to date, the pure form of rrr a-tocopherol was orally administered at a dose of 800 IU/day for 96 weeks.…”

Section: Vitamin Ementioning

confidence: 99%