Vitamin E supplementation in people with cystic fibrosis

Okebukola, Peter O; Kansra, Sonal; Barrett, Joanne

doi:10.1002/14651858.cd009422.pub3

Cited by 21 publications

(14 citation statements)

References 41 publications

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“…Although doubling the dose of oral vitamin E resulted in increased systemic exposure after 8-week treatment as shown by its plasma concentrations, the lack of antioxidant effect of oral vitamin E 400 UI once daily observed in our study might also reflect a dose which is still insufficient to reach effective antioxidant plasma levels ( Keljo et al, 2000 ). On the other hand, fat-soluble vitamins including vitamin E are routinely supplemented in CF to prevent deficiencies associated with fat malabsorption ( Okebukola et al, 2017 ), whereas their therapeutic use as antioxidants is limited, also in view of the fact that antioxidant doses of vitamin E in CF patients are not established ( Ciofu and Lykkesfeldt, 2014 ) due to the incomplete knowledge of its clinical pharmacology. Although it did not meet the primary outcome of 15% improvement in FEV 1 % of predicted value, a 12-month study showed that treatment with inhaled glutathione improved FEV 1 values over baseline at 3, 6, and 9 months therapy in CF patients with moderate lung disease ( Calabrese et al, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Metabolomic Analysis by Nuclear Magnetic Resonance Spectroscopy as a New Approach to Understanding Inflammation and Monitoring of Pharmacological Therapy in Children and Young Adults With Cystic Fibrosis

et al. 2018

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15-F2t-Isoprostane, a reliable biomarker of oxidative stress, has been found elevated in exhaled breath condensate (EBC), a non-invasive technique for sampling of airway secretions, in patients with cystic fibrosis (CF). Azithromycin has antioxidant properties in experimental models of CF, but its effects on oxidative stress in CF patients are largely unknown. Primary objective of this pilot, proof-of-concept, prospective, parallel group, pharmacological study, was investigating the potential antioxidant effects of azithromycin in CF patients as reflected by EBC 15-F2t-isoprostane. Secondary objectives included studying the effect of azithromycin on EBC and serum metabolic profiles, and on serum 15-F2t-isoprostane. In CF patients who were on maintenance treatment with oral vitamin E (200 UI once daily), treatment with oral azithromycin (250 or 500 mg depending on body weight) plus vitamin E (400 UI once daily) (group A) (n = 24) or oral vitamin E alone (400 UI once daily) (group B) (n = 21) was not associated with changes in EBC 15-F2t-isoprostane concentrations compared with baseline values after 8–weeks treatment or 2 weeks after treatment suspension. There was no between-group difference in post-treatment EBC 15-F2t-isoprostane. Likewise, no within- or between-group differences in serum 15-F2t-isoprostane concentrations were observed in either study group. NMR spectroscopy-based metabolomics of EBC shows that suspension of both azithromycin plus vitamin E and vitamin E alone has a striking effect on metabolic profiles in EBC. Between-group comparisons show that EBC metabolite distribution after treatment and 2 weeks after treatment suspension is different. Quantitative differences in ethanol, saturated fatty acids, acetate, acetoin/acetone, and methanol are responsible for these differences. Our study was unable to show antioxidant effect of azithromycin as add-on treatment with doubling the dose of oral vitamin E as reflected by 15-F2t-isoprostane concentrations in EBC. Add-on therapy with azithromycin itself does not induce EBC metabolite changes, but its suspension is associated with EBC metabolic profiles that are different from those observed after vitamin E suspension. The pathophysiological and therapeutic implications of these findings in patients with stable CF are unknown and require further research. Preliminary data suggest that EBC NMR-based metabolomics might be used for assessing the effects of pharmacological treatment suspension in stable CF patients.

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Section: Discussionmentioning

confidence: 99%

Metabolomic Analysis by Nuclear Magnetic Resonance Spectroscopy as a New Approach to Understanding Inflammation and Monitoring of Pharmacological Therapy in Children and Young Adults With Cystic Fibrosis

et al. 2018

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“…The concentration of a specific vitamin in serum sample below the following reference value was defined as deficiency, vitamin A: 0.70 µM, vitamin B1: 80.3 nM, vitamin B2: 106 nM, vitamin B6: 20 nM, vitamin B9: 10 nM, vitamin B12: 150 pM, vitamin C: 11 µM, vitamin D: 50 nM, and vitamin E: 23 µM. Normal value of serum homocysteine is below 15 µM [ 24 – 31 ].…”

Section: Methodsmentioning

confidence: 99%

The weak correlation between serum vitamin levels and chronic kidney disease in hospitalized patients: a cross-sectional study

et al. 2021

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Background Chronic kidney disease (CKD) has become a global public health problem. Accumulating evidence suggested that vitamins play important roles in the progression of CKD. Methods A cross-sectional study was conducted to investigate the vitamin status of patients with CKD at stage 1–5. The serum concentrations of 9 vitamins, vitamin A, B1, B2, B6, B9, B12, C, D, and E were measured by electroanalytical method with a Multi-Vitamin Analyzer. Pearson correlation and multiple linear regression between serum level of vitamins were analyzed. Results The median levels of vitamin A, B1, B2, B6, B9, B12, C and E were within the reference ranges or on the borderline. Vitamin D deficiency was found in all patients. Weak correlation was found between vitamin A or vitamin D and estimated glomerular filtration rate (eGFR). The Pearson correlation coefficient were − 0.21766 and 0.19752, respectively. Hypertension, diabetes mellitus, and atherosclerosis were the major comorbidities. Conclusions For the first time, the serum levels of 9 vitamins were measured simultaneously in patients with CKD at different stages. Vitamin D deficiency was found in all patients. Weak correlation between vitamin A or vitamin D and eGFR was found.

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“…Genç çocuklarda düşük E vitamini düzeylerinin özellikle beyin fonksiyonlarını etkilediği gösterilmiştir (10). Çalışmalar, artmış vitamin E düzeylerinin kistik fibrozis semptomlarının iyileştirilmesinde etkili olabileceğini göstermektedir (13,25).…”

Section: Vitamin Eunclassified

Kistik Fibroziste Mikrobesin Ögelerinin Önemi

Durmaz¹,

Ayhan²

2021

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Cystic fibrosis is an inherited disease with an autosomal recessive transition, characterized by a clinically progressive lung disease, which is caused by mutations occurring in the transmembrane conductance regulator (KFTR) gene, affecting all cells with epithelial tissue, especially the respiratory system. Approximately 90% of individuals experience pancreatic insufficiency and malabsorption. Chronic infection and increased energy requirement in the pathogenesis of the disease, together with malabsorption, pose a risk for malnutrition. Decreased absorption of micronutrients due to malabsorptions, increase in the requirement, inadequate intake, and as a result, poor prognosis of the disease leads to decreased quality of life and duration. Nutritional status changes should be determined in cystic fibrosis and early and appropriate nutritional interventions should be made. It is recommended to follow the growth and nutritional status throughout life in cystic fibrosis. Optimal nutritional status should be provided in the early stages of life, under the control of a dietitian, with pancreatic enzyme replacement therapy (PERT), hydration and electrolyte balance. Although optimal nutrition in cystic fibrosis is effective in diet and micronutrient intake with proper cooking methods, deficiency of micronutrients in these patients can not be prevented. In this case, taking into account the recommendations of the guidelines along with optimal nutrition, vitamin-mineral supplements in accordance with the needs and biochemical values of individuals are needed.

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Vitamin E supplementation in people with cystic fibrosis

Cited by 21 publications

References 41 publications

Metabolomic Analysis by Nuclear Magnetic Resonance Spectroscopy as a New Approach to Understanding Inflammation and Monitoring of Pharmacological Therapy in Children and Young Adults With Cystic Fibrosis

Metabolomic Analysis by Nuclear Magnetic Resonance Spectroscopy as a New Approach to Understanding Inflammation and Monitoring of Pharmacological Therapy in Children and Young Adults With Cystic Fibrosis

The weak correlation between serum vitamin levels and chronic kidney disease in hospitalized patients: a cross-sectional study

Kistik Fibroziste Mikrobesin Ögelerinin Önemi

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