An antioxidant-enriched vitamin can decrease exacerbations in patients with cystic fibrosis

July 2, 2018

An antioxidant-enriched vitamin can decrease respiratory exacerbations in people with cystic fibrosis (CF), according to a new study published in April 1945 American Journal of Respiratory and Critical Care Medicine

In " www.thoracic.org =" "> The Effects of an Antioxidant-enriched Multivitamin in Cystic Fibrosis: Randomized, Controlled, Multicenter Trial," Scott D. Sagel, MD, PhD, a professor of pediatrics at the Children's Hospital of Colorado and director of the Cystic Fibrosis Center at the University of Colorado, and coauthors report a 50 percent reduced risk of the first exacerbation requiring antibiotics in those who receive additional antioxidants. A 16-week study of 73 patients (36 received additional antioxidants), 53 percent of the group treated with the antioxidant experienced 28 exacerbations, compared with 68 percent of the control group that experienced 39 exacerbations.

T The researchers also found that additional antioxidants increased circulating antioxidant levels of beta-carotene, coenzyme Q10, gamma-tocopherol (a form of vitamin E) and lutein, and decreased transiently. inflammation (at 4 weeks, but not 16 weeks). biomarkers of inflammation, calprotectin and myeloperoxidase (MPO).

People with cystic fibrosis usually suffer from chronic bacterial infections that cause inflammation and the release of "large amounts of reactive oxygen species in the airways". 19659003] Normally, they add, the body will mobilize an antioxidant defense to neutralize this oxidative stress, but CF is characterized by deficiencies in dietary antioxidants. This contributes to an oxidative-antioxidant imbalance and more inflammation, which leads to lung damage and a progressive loss of lung function.

"Improving antioxidant status in cystic fibrosis is an important clinical goal and can have a positive effect on health. Sagel said. "Antioxidant oral formulations had been tested in cystic fibrosis with mixed results, but there had been no well-designed randomized controlled trial on an antioxidant badtail comprising several antioxidants in a single formulation." [19659004] This Phase 2 trial, in 15 CF centers affiliated with the CF Foundation's Therapeutic Development Network, patients aged 10 years and older (mean age 22 years), with pancreatic insufficiency, is malabsorption of antioxidants. Participants had a FEV1, the measure of the amount of air expired force in one second, between 40 and 100% of what would be predicted, depending on age, bad, size and from a range of other features. control group received a multivitamin without antioxidant enrichment. Both groups tolerated their vitamins just as well, and there was no difference in adverse events between the two groups.

The study did not reach its primary endpoint: change in MPO sputum concentration over 16 weeks. The authors chose MPO "rather than another marker of airway inflammation as neutrophil elastase because MPO generates reactive oxidative species as part of its function in innate defense mechanisms of the host, and is considered by many to be a marker of oxidative stress. "

"While the antioxidant supplement does not appear to exert persistent anti-inflammatory effects, we believe that its effect on the first pulmonary exacerbation was significant and clinically significant," said Dr. Sagel, adding that Improvement of antioxidant status alone may justify its use. "The development of safe and effective anti-inflammatory treatments remains a key priority of the CF community."