Micronutrient antioxidant status in patients with primary Raynaud's phenomenon and systemic sclerosis.
OBJECTIVE
To investigate the possibility that micronutrient antioxidant status is an important factor in determining the severity of Raynaud's phenomenon (RP) and in differentiating between patients with primary Raynaud's phenomenon (PRP) and those in whom Raynaud's is secondary to systemic sclerosis (SSc).


METHODS
Four micronutrient antioxidants (selenium, vitamin E, beta-carotene and ascorbic acid) and 2 "markers" of free radical associated activity were assayed in peripheral blood from 10 patients with PRP, 9 with limited cutaneous SSc (ISSc), 9 with diffuse SSc (dSSc) and 15 healthy control subjects.


RESULTS
Plasma ascorbic acid was reduced in all 3 groups of patients: median level 10.6 mg/l in controls, 4.8 mg/l in PRP (p < 0.01), 2.5 mg/l in ISSc (p < 0.01) and 6.8 mg/l in dSSc (p < 0.05). A reduction in serum selenium was especially found in dSSc (median 75 micrograms/l compared to 100 micrograms/l in controls, p < 0.05). In keeping with these deficiencies, the serum concentration of 9, 11, linoleic acid was elevated in RP patients: median values for the molar ratio of the isomer to the parent fatty acid were 1.91% in controls, 3.70% in ISSc (p < 0.05) and 3.85% in dSSc (p < 0.01). Smoking patients showed lower levels of ascorbic acid and higher levels of the linoleic isomer than nonsmokers.


CONCLUSIONS
Deficiencies of ascorbic acid and selenium may predispose towards irreversible tissue injury in RP patients and cigarette smoke may be an independent risk factor. Micronutrient antioxidant supplements may be of therapeutic value.
Herrick
A L
AL
University of Manchester Rheumatic Diseases Centre, Hope Hospital, Salford, UK.
Rieley
F
F
Schofield
D
D
Hollis
S
S
Braganza
J M
JM
Jayson
M I
MI
D000375:Aging; D000975:Antioxidants / Q000032:analysis*; D001205:Ascorbic Acid / Q000097:blood; D002338:Carotenoids / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005609:Free Radicals / Q000097:blood; D006801:Humans; D008297:Male; D011928:Raynaud Disease / Q000097:blood*; D012595:Scleroderma, Systemic / Q000097:blood*; D012643:Selenium / Q000097:blood; D012737:Sex Factors; D012907:Smoking; D014131:Trace Elements / Q000097:blood*; D014810:Vitamin E / Q000097:blood; D019207:beta Carotene
D000975:Antioxidants; D005609:Free Radicals; D014131:Trace Elements; D019207:beta Carotene; D014810:Vitamin E; D002338:Carotenoids; D012643:Selenium; D001205:Ascorbic Acid