Effects of vitamins C and E on oxidative stress markers and endothelial function in patients with systemic lupus erythematosus: a double blind, placebo controlled pilot study
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Published on: March 21, 2015
Lai S Tam1, Edmund K Li, Vivian Y F Leung
1Department of Medicine and Therapeutics, Department of Radiology, and the Clinical Immunology Unit, Hong Kong Cancer Institute, Hong Kong. tamls_813@yahoo.com
Insights
Antioxidant vitamins C and E reduced oxidative stress markers in systemic lupus erythematosus (SLE) patients. However, the 12-week therapy did not improve endothelial function, suggesting limited cardiovascular benefits.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Nutritional Science
Background:
- Systemic lupus erythematosus (SLE) patients face higher risks of coronary artery disease (CAD) beyond traditional factors.
- Oxidative stress is an emerging CAD risk factor in SLE.
- The impact of antioxidant supplementation on oxidative stress and endothelial function in SLE is not fully understood.
Purpose of the Study:
- To investigate the effects of long-term antioxidant vitamin supplementation on oxidative stress markers.
- To assess the impact of antioxidant vitamins on antioxidant defense mechanisms.
- To evaluate the influence of antioxidant vitamins on endothelial function in SLE patients.
Main Methods:
- A randomized, placebo-controlled trial involving 39 SLE patients.
- Intervention: 12 weeks of daily vitamin C (500 mg) and vitamin E (800 IU) or placebo.
- Outcome measures included lipid peroxidation (MDA), allantoin, antioxidant levels, and endothelial function markers (FMD, vWF, PAI-1).
Main Results:
- Vitamin C and E supplementation significantly increased plasma vitamin levels and decreased malondialdehyde (MDA), a marker of lipid peroxidation.
- No significant changes were observed in other oxidative stress markers or antioxidant levels.
- Endothelial function, assessed by flow-mediated dilatation (FMD) and plasma markers (vWF, PAI-1), remained unchanged in both groups.
Conclusions:
- Combined vitamin C and E therapy for 3 months reduced lipid peroxidation in SLE patients.
- This antioxidant intervention did not demonstrate significant improvements in endothelial function.
- Further research is needed to explore the long-term cardiovascular implications of antioxidant therapy in SLE.
Objective:
Patients with systemic lupus erythematosus (SLE) experience excess morbidity and mortality due to coronary artery disease (CAD) that cannot be fully explained by the classical CAD risk factors. Among emerging CAD risk factors, oxidative stress is currently being emphasized. We evaluated the effects of longterm antioxidant vitamins on markers of oxidative stress and antioxidant defense and endothelial function in 39 patients with SLE.
Methods:
Patients were randomized to receive either placebo or vitamins (500 mg vitamin C and 800 IU vitamin E daily) for 12 weeks. Markers of oxidative stress included malondialdehyde (MDA) and allantoin. Antioxidants measured included erythrocyte superoxide dismutase and glutathione peroxidase, plasma total antioxidant power (as FRAP value), and ascorbic acid and vitamin E concentrations. Endothelial function was assessed by flow-mediated dilatation (FMD) of the brachial artery and plasma concentration of von Willebrand factor (vWF) and plasminogen activator inhibitor type 1 (PAI-1). Primary outcome of the study included the change in lipid peroxidation as revealed by MDA levels. Secondary outcomes included changes in allantoin and antioxidant levels and change in endothelial function.
Results:
After treatment, plasma ascorbic acid and alpha-tocopherol concentrations were significantly (p < 0.05) increased only in the vitamin-treated group, associated with a significant decrease (p < 0.05) in plasma MDA. Other oxidative stress markers and antioxidant levels remained unchanged in both groups. FMD and vWF and PAI-1 levels remained unchanged in both groups.
Conclusion:
Combined administration of vitamins C and E was associated with decreased lipid peroxidation, but did not affect endothelial function in patients with SLE after 3 months of therapy.
