Vitamin E for the treatment of E‐antigen‐positive chronic hepatitis B in paediatric patients: results of a randomized phase 2 controlled study

Fiorino, Sirio; Loggi, Elisabetta; Verucchi, Gabriella; Comparcola, Donatella; Vukotic, Ranka; Pavoni, Michele; Grandini, Elena; Cursaro, Carmela; Maselli, S.; Reggiani, Maria Letizia Bacchi; Puggioli, C.; Badia, Lorenzo; Galli, S.; Viale, Pierluigi; Bernardi, Mauro; Andreone, Pietro

doi:10.1111/liv.13192

Cited by 5 publications

(12 citation statements)

References 34 publications

(43 reference statements)

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“…Three randomized controlled studies, assessing the use of tocopherols in children with HBV-related chronic infection and rate of HBeAg seroconversion, met inclusion criteria and were considered in the present meta-analysis[ 18 - 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…All considered studies described serological assays, which were employed to detect viral infection markers. Serum samples were tested for the presence of both viral antigens and host antiviral antibodies, using both enzyme-linked immunosorbent assayor radioimmunoassay, as well as of HBV-DNA, by means of liquid hybridization[ 18 ] or real time PCR[ 19 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Overall, according to the Jadad scale, two trials were classified into higher quality[ 19 , 20 ] and one into lower quality[ 18 ] studies (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…We performed a systematic review and meta-analysis to search studies available in the literature assessing vitamin E ability to induce HBeAb seroconversion in children with HBeAg-positive persistent hepatitis. We found only three trials[ 18 - 20 ] meeting inclusion criteria for our meta-analysis, but, surprisingly, two of them reported high rates of HBeAg loss and HBeAb development[ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, in Fiorino’s trial a very high percentage of children (7/23, 30.4%), receiving vitamin E supplementation for 12 mo with a follow-up period of further 12 mo, obtained HBeAg clearance vs 1/23 (4.3%), in the control arm at the end of the follow-up period (24 mo)[ 20 ]. However, it has to be considered that a substantial percentage of HBeAg loss (23.2%) was also observed in the group of vitamin E-treated children for 6 mo with an additional follow-up period of 12 mo in comparison to the placebo arm (8.7%) in Gerner’s research[ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Vitamin E for the treatment of children with hepatitis B e antigen-positive chronic hepatitis: A systematic review and meta-analysis

Fiorino

Reggiani

Leandri

et al. 2017

WJH

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AIMTo assess vitamin E efficacy, defined as its ability to induce hepatitis B e antigen (HBeAg) seroconversion, in children with HBeAg-positive persistent hepatitis.METHODSIn July 2016, we extracted articles published in MEDLINE and the Cochrane Library using the following search terms: “chronic hepatitis B”, “children”, “childhood”, “therapy”, “treatment”, “vitamin E”, “tocopherols”, “tocotrienols”. Only randomized controlled trials (RCTs) published in English language were collected.RESULTSThree RCTs met inclusion criteria and were considered in the present meta-analysis. Overall, 23/122 children in the treatment group underwent HBeAg seroconversion vs 3/74 in the control group (OR = 3.96, 95%CI: 1.18-13.25, P = 0.025).CONCLUSIONAlthough our meta-analysis has several limits, including the very small number of available studies and enrolled children with HBeAg positivity-related hepatitis, it suggests that vitamin E use may enhance the probability to induce HBeAg seroconversion in these patients. Further well designed and adequately sized trials are required to confirm or deny these very preliminary results.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Overall, according to the Jadad scale, two trials were classified into higher quality[ 19 , 20 ] and one into lower quality[ 18 ] studies (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Vitamin E for the treatment of children with hepatitis B e antigen-positive chronic hepatitis: A systematic review and meta-analysis

Fiorino

Reggiani

Leandri

et al. 2017

WJH

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Cytokine storm in aged people with CoV-2: possible role of vitamins as therapy or preventive strategy

Fiorino

Gallo²,

Zippi³

et al. 2020

Aging Clin Exp Res

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Background In December 2019, a novel human-infecting coronavirus, SARS-CoV-2, had emerged. The WHO has classified the epidemic as a “public health emergency of international concern”. A dramatic situation has unfolded with thousands of deaths, occurring mainly in the aged and very ill people. Epidemiological studies suggest that immune system function is impaired in elderly individuals and these subjects often present a deficiency in fat-soluble and hydrosoluble vitamins. Methods We searched for reviews describing the characteristics of autoimmune diseases and the available therapeutic protocols for their treatment. We set them as a paradigm with the purpose to uncover common pathogenetic mechanisms between these pathological conditions and SARS-CoV-2 infection. Furthermore, we searched for studies describing the possible efficacy of vitamins A, D, E, and C in improving the immune system function. Results SARS-CoV-2 infection induces strong immune system dysfunction characterized by the development of an intense proinflammatory response in the host, and the development of a life-threatening condition defined as cytokine release syndrome (CRS). This leads to acute respiratory syndrome (ARDS), mainly in aged people. High mortality and lethality rates have been observed in elderly subjects with CoV-2-related infection. Conclusions Vitamins may shift the proinflammatory Th17-mediated immune response arising in autoimmune diseases towards a T-cell regulatory phenotype. This review discusses the possible activity of vitamins A, D, E, and C in restoring normal antiviral immune system function and the potential therapeutic role of these micronutrients as part of a therapeutic strategy against SARS-CoV-2 infection.

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The rationale for a multi-step therapeutic approach based on antivirals, drugs and nutrients with immunomodulatory activity in patients with coronavirus-SARS2-induced disease of different severities

et al. 2020

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In December 2019, a novel human-infecting coronavirus, named SARS-CoV-2, has been recognized to cause a pneumonia epidemic outbreak with different degree of severity in Wuhan, Hubei Province in China. Since then this epidemic spread worldwide in Europe, and Italy also have been involved. Effective preventive and therapeutic strategies are absolutely required to block this serious public health concern. Unfortunately, few studies about SARS-CoV-2 concerning its immunopathogenesis and treatment are available. On the basis of the assumption that the SARS-CoV-2 is genetically related to SARS-CoV (about 82% of genome homology) and that its characteristics, like the modality of transmission or the type of the immune response it may stimulate, are still poor-known, a literature search was performed to identify the reports assessing these elements in patients with SARS-CoV-induced infection. Therefore, we have analyzed: 1) the structure of SARS-CoV-2 and SARS-CoV; 2) the clinical signs and symptoms and pathogenic mechanisms observed during the development of acute respiratory syndrome and the Cytokine Release Syndrome; 3) the modification of the cell microRNome and of the immune response in patients with SARS infection; 4) the possible role of some liposoluble compounds (such as vitamin A, D and E) in modulating directly or indirectly the replication ability of SARS-CoV-2 and host immune response.

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Vitamin E for the treatment of E‐antigen‐positive chronic hepatitis B in paediatric patients: results of a randomized phase 2 controlled study

Abstract: Vitamin E administration for the treatment of paediatric CHB at the tested dosage has no significant side effects and may induce anti-HBe seroconversion. Vitamin E could represent a tool for the treatment of paediatric CHB.

Cited by 5 publications

References 34 publications

Vitamin E for the treatment of children with hepatitis B e antigen-positive chronic hepatitis: A systematic review and meta-analysis

Vitamin E for the treatment of children with hepatitis B e antigen-positive chronic hepatitis: A systematic review and meta-analysis

Cytokine storm in aged people with CoV-2: possible role of vitamins as therapy or preventive strategy

The rationale for a multi-step therapeutic approach based on antivirals, drugs and nutrients with immunomodulatory activity in patients with coronavirus-SARS2-induced disease of different severities

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