Effects of vitamin C, vitamin E, zinc gluconate, and selenomethionine supplementation on muscle function and oxidative stress biomarkers in patients with facioscapulohumeral dystrophy: A double-blind randomized controlled clinical trial

Abstract

Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant disease characterized by progressive weakness and atrophy of specific skeletal muscles. As growing evidence suggests that oxidative stress may contribute to FSHD pathology, antioxidants that might modulate or delay oxidative insults could help in maintaining FSHD muscle function. Our primary objective was to test whether oral administration of vitamin C, vitamin E, zinc gluconate, and selenomethionine could improve the physical performance of patients with FSHD. Adult patients with FSHD (n=53) were enrolled at Montpellier University Hospital (France) in a randomized, double-blind, placebo-controlled pilot clinical trial. Patients were randomly assigned to receive 500 mg vitamin C, 400mg vitamin E, 25mg zinc gluconate and 200 μg selenomethionine (n=26), or matching placebo (n=27) once a day for 17 weeks. Primary outcomes were changes in the two-minute walking test (2-MWT), maximal voluntary contraction, and endurance limit time of the dominant and nondominant quadriceps (MVCQD, MVCQND, TlimQD, and TlimQND, respectively) after 17 weeks of treatment. Secondary outcomes were changes in the antioxidant status and oxidative stress markers. Although 2-MWT, MVCQ, and TlimQ were all significantly improved in the supplemented group at the end of the treatment compared to baseline, only MVCQ and TlimQ variations were significantly different between groups (MVCQD: P=0.011; MVCQND: P=0.004; TlimQD: P=0.028; TlimQND: P=0.011). Similarly, the vitamin C (P<0.001), vitamin E as α-tocopherol (P<0.001), vitamin C/vitamin E ratio (P=0.017), vitamin E γ/α ratio (P=0.022) and lipid peroxides (P<0.001) variations were significantly different between groups. In conclusion, vitamin E, vitamin C, zinc, and selenium supplementation has no significant effect on the 2-MWT, but improves MVCQ and TlimQ of both quadriceps by enhancing the antioxidant defenses and reducing oxidative stress. This trial was registered at clinicaltrials.gov (number: NCT01596803).

Dietary selenium augments sarcoplasmic calcium release and mechanical performance in mice

“…Up to now only one clinical trial was conducted on humans [48]. In this study vitamin E, vitamin C, zinc, and selenium supplementation for 17 weeks improved maximal voluntary contraction, and endurance limit time of quadriceps by reducing oxidative stress and enhancing the antioxidant defenses.…”

Redox Control of Skeletal Muscle Regeneration

“…NAC administration results in decreased numbers of regenerating myofibers (349). FSHD patients supplemented with vitamin C, vitamin E, zinc gluconate, and selenomethionine increase their antioxidant level and improve some physical performance (251). However, it should be acknowledged that most of the results obtained with antioxidant treatments are inconsistent (167), highlighting the complexity of redox biology (Fig.…”

Clinical practice considerations in facioscapulohumeral muscular dystrophy Sydney, Australia, 21 September 2015

“…A recent study investigated antioxidant supplementation based on the premise that oxidative stress may contribute to FSHD pathology, and that antioxidants might modulate or delay oxidative insults and help maintain muscle bulk in FSHD. In this study, dietary supplementation with vitamin E, vitamin C, zinc, and selenium did not have a significant effect on the study's primary outcome, as defined by the 2-minute walk test, but did improve the maximal voluntary contraction and endurance of the quadriceps [9]. This was a preliminary study involving a small number of patients; thus, more rigorous data will be needed to confirm these findings.…”