Vitamin E is ineffective for symptomatic relief of knee osteoarthritis: a six month double blind, randomised, placebo controlled study

Brand, Caroline

doi:10.1136/ard.60.10.946

Cited by 75 publications

(31 citation statements)

References 18 publications

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“…6 However, there is also a controversial report on the inefficacy of vitamin E in the management of arthritis. 54 Furthermore, despite the massive efforts of researchers and various therapeutic triumphs, we know little about the genesis of arthritis with senescence, or its prevention, and there is a need for further research and the discovery of novel markers for early intervention in the geriatric population.…”

Section: Therapeutic Interventionsmentioning

confidence: 99%

Arthritis as a Disease of Aging and Changes in Antioxidant Status

Saxena

2014

Aging

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Section: Therapeutic Interventionsmentioning

confidence: 99%

Arthritis as a Disease of Aging and Changes in Antioxidant Status

Saxena

2014

Aging

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“…For example, it has been reported that human plasma g-tocopherol is positively associated with osteoarthritis, whereas plasma a-tocopherol is negatively associated with osteoarthritis (66). In contrast, in another report on knee osteoarthritis, vitamin E supplementation (a-tocopherol) did not relieve symptoms, but the authors did not measure patient a-tocopherol or g-tocopherol levels (67). In coronary heart disease and stroke, studies of tocopherols and heart disease are complex, because different dietary oils not only contain different forms of tocopherols but also contain different lipids that affect heart disease.…”

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confidence: 97%

Two Faces of Vitamin E in the Lung

Cook‐Mills

Abdala-Valencia

Hartert

2013

Am J Respir Crit Care Med

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Asthma and allergic lung disease occur as complex environmental and genetic interactions. Clinical studies of asthma indicate a number of protective dietary factors, such as vitamin E, on asthma risk. However, these studies have had seemingly conflicting outcomes. In this perspective, we discuss opposing regulatory effects of tocopherol isoforms of vitamin E, mechanisms for tocopherol isoform regulation of allergic lung inflammation, association of vitamin E isoforms with outcomes in clinical studies, and how the variation in global prevalence of asthma may be explained, at least in part, by vitamin E isoforms.Keywords: asthma; a-tocopherol; g-tocopherol; human; mouse Asthma and allergic lung disease occur as complex environmental and genetic interactions (1). The World Health Organization has reported that the prevalence of asthma from 1950 to the present has increased in many countries, including countries with high rates of asthma, intermediate rates of asthma, or low rates of asthma (2-4). The marked differences in rates of asthma within countries, in migrating populations, and over relatively short periods of time support an important role of the local environment, such as diet, in asthma inception. Prospective epidemiological studies, observational cross-sectional studies, and some randomized prevention trials have demonstrated the impact of a number of protective dietary factors, such as vitamin E, on asthma risk. However, these studies have had seemingly conflicting outcomes. We need to determine why there are low rates of allergic disease in developing countries and better understand the differences in diet and lifestyle that may really underpin allergic disease. One environmental change over the past 40 years has been an increase in the g-tocopherol isoform of vitamin E in the diet and in infant formulas (5, 6). We recently demonstrated that g-tocopherol increases allergic lung inflammation in mice (6)(7)(8). In this perspective, we discuss why we have yet to uncover the complex and potentially protective effects of isoforms of vitamin E on asthma in humans and in animal models of lung inflammation. We also review mechanisms for tocopherol isoform regulation of allergic lung inflammation in animals and discuss how the variation in global prevalence of asthma may be explained, at least in part, by country-specific plasma g-tocopherol differences.Vitamin E consists of natural isoforms and synthetic racemic isoforms. The eight natural isomers are d-a-, d-b-, d-g-, d-d-tocopherol and d-a-, d-b-, d-g-, d-d-tocotrienol. Plants synthesize the natural isoforms from tyrosine and chlorophyll (9). Then, these tocols are consumed in the diet from plant lipids. Mammals do not interconvert the tocopherol isoforms. The most abundant isoforms are a-tocopherol and g-tocopherol, which differ by one methyl group ( Figure 1A). There are approximately 10-fold higher tissue concentrations of a-tocopherol than g-tocopherol due to preferential transfer of a-tocopherol in the liver by a-tocopherol transfer protein and due to ...

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“…Considerable attention has been devoted to the potential use of α-tocopherol, a potent chain breaking antioxidant, in the prevention of age-related complications [Yu et al 1998]. Although in previous clinical studies vitamin E has been found to be effective in the symptomatic treatment of arthritis and osteoporosis [Edmonds et al 1997;Chavan et al 2007], controversial reports on the inefficacy of vitamin E in the management of OA have been documented [Brand et al 2001]. The mechanism underlying its effect in ameliorating the enzyme activities, levels of MDA (i.e.…”

Section: Protection Of Chondrocytes From Potentially Injurious Superomentioning

confidence: 99%

Efficacy of vitamin E in knee osteoarthritis management of North Indian geriatric population

Bhattacharya¹,

Saxena²,

Gupta³

2011

Therapeutic Advances in Musculoskeletal

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Background: Osteoarthritis (OA) is the most common cause of chronic pain and disability in the elderly. It involves progressive destruction of articular cartilage as a consequence of various factors including augmented oxidative stress with advancing age which has not yet been controlled. It is conceivable that exogenous vitamin E supplementation ameliorates the modifiable indexes via regulation of free radical production and the consumption of antioxidant reserve. The objectives of the present study were to investigate the therapeutic effect of vitamin E supplementation in ameliorating the altered activity of antioxidant enzymes (superoxide dismutase, ceruloplasmin, glutathione peroxidase and catalase), erythrocyte malondialdehyde level (MDA, i.e. marker of lipid peroxidation) and markers of systemic inflammation (plasma C-reactive protein [CRP] and synovial fluid interleukin 6 [IL-6]) in osteoarthritic elderly. Methods: Antioxidant enzymes status, MDA, IL-6 and CRP levels were estimated by using standard methods in 40 healthy individuals (control group) and in 40 osteoarthritic patients aged 50-70 years before and after 3 months of vitamin E supplementation, i.e. group I (nonsupplemented) and group II (200 mg/day vitamin E supplemented). The obtained values were compared statistically by using Student's t-test. Results: Marked alteration in antioxidant enzymes, MDA and inflammatory markers were observed in group I (p < 0.05) as compared with controls. These levels were ameliorated significantly after vitamin E supplementation (p < 0.05) in group II. However, elevated levels of serum CRP and synovial fluid IL-6 (r = 0.034; p < 0.05) were decreased insignificantly (p < 0.1) after vitamin E supplementation in knee OA patients. Conclusions: These findings confirm the protective role of vitamin E supplementation against oxidative stress mediated biomolecular deterioration in OA. However, the anti-inflammatory role of vitamin E remains to be explored.

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Vitamin E is ineffective for symptomatic relief of knee osteoarthritis: a six month double blind, randomised, placebo controlled study

Cited by 75 publications

References 18 publications

Arthritis as a Disease of Aging and Changes in Antioxidant Status

Arthritis as a Disease of Aging and Changes in Antioxidant Status

Two Faces of Vitamin E in the Lung

Efficacy of vitamin E in knee osteoarthritis management of North Indian geriatric population

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