Burn and smoke inhalation injury in sheep depletes vitamin E: Kinetic studies using deuterated tocopherols

Abstract

To test the hypothesis that burn and smoke injury will deplete tissue α-tocopherol and cause its faster plasma disappearance, deuterium-labeled vitamin E was administered to sheep exposed to both surface skin burn and smoke insufflation that causes injury similar to human victims of fire accidents. Two different protocols were used: 1) deuterated vitamin E was administered orally with food at 0 time (just prior to injury), or 2) the labeled vitamin E was administered orally with food the day prior to injury. The animals that had been operatively prepared seven days before, were anaesthetized, then received both 40% body surface area 3rd° burn and 48 breaths of cotton smoke, or sham injuries. All were resuscitated with Ringer's lactate solution (4 ml/kg/% BSA burn/24h) and mechanically ventilated. Blood samples were collected at various times after vitamin E dosing. In both studies the depletion of plasma α-tocopherol was faster in the injured sheep. The sheep given deuterated vitamin E 24 h prior to injury had similar maximum α-tocopherol concentrations at similar times. The exponential rates of α -tocopherol disappearance were 1.5 times greater and half-lives were 12 h shorter (p<0.05) in the injured sheep. In separate studies, various tissues were obtained from sheep that were sacrificed from 4 h to 48 h after injury. The liver α -tocopherol concentrations in sheep killed at various times after injury appear to show a linear decrease at a rate of 0.1 nmol α -tocopherol/ g liver per hour, suggesting that the liver is supplying α -tocopherol to maintain the plasma and lung α -tocopherol concentrations, but that this injury is so severe that the liver is unable to maintain lung α -tocopherol concentrations. These findings suggest that α -tocopherol should be administered to burn patients to prevent vitamin E depletion and to protect against oxidative stress from burn injury.

γ-Tocopherol nebulization by a lipid aerosolization device improves pulmonary function in sheep with burn and smoke inhalation injury

“…We have previously published the sheep plasma aT levels and their response to injury [39]. In our present study, the plasma aT and gT levels did not change dramatically.…”

“…There is a report to show aT levels in bronchoalveolar lavage (BAL), the aT levels in BAL was 0.3 μM [42]. However, the lung aT concentration (5.8±0.4 nmol/g) in sheep was lower than human and swine lung [39], and as we showed previously, burn and smoke inhalation injury further reduced aT concentration in lung tissue [43]. In our present study, there were no significant differences in aT concentration in lung tissue; however, burn and smoke inhalation injury significantly reduced the gT concentration in lung tissue (Fig 2).…”

“…In our present study, the plasma aT and gT levels did not change dramatically. We have previously published the sheep plasma aT levels and their response to injury [39]. Sheep have markedly lower circulating lipid concentrations than do humans, so extrapolation to humans relative to plasma concentrations is not particularly useful.…”

Early-onset severe isoniazid-induced motordominant neuropathy: a case report

“…Therefore, isoniazid should not be dismissed as a possible cause in the event of rapid development of peripheral neuropathy with predominant motor symptoms after starting antituberculosis drugs, even in the absence of predisposing factors. It has been reported that smoking induces vitamin deficiency [2,3] but our patient had no history of smoking. The only possible explanation of this onset was his low BMI.…”

Role of antioxidants in the treatment of burn lesions

“…20 Data reported by Cetinkale et al 21 demonstrated that in addition to loss of plasma antioxidants like vitamin E and sulphydryl groups in patients with burns, vitamin C diminished early post-burn. Recently, Traber et al 22 suggested that a-tocopherol should be administered to burn patients to prevent vitamin E depletion and to protect against oxidative stress from burn injury. While vitamin E effectively scavenges free radicals within the cells, vitamin C would serve to scavenge free radicals within the extracellular space.…”