Vitamin E supplementation in patients with carotid atherosclerosis: reversal of altered oxidative stress status in plasma but not in plaque.
OBJECTIVE
Oxidative stress is believed to play a pivotal role in the initiation and progression of atherosclerosis. We analyzed whether vitamin E supplementation influences oxidative stress in plasma and atherosclerotic plaques of patients with severe atherosclerosis.


RESULTS
In 16 patients who were candidates for carotid endarterectomy and in 32 age- and sex-matched controls, plasma levels of 7beta-hydroxycholesterol, 7-ketocholesterol, cholesterol, and vitamin E were measured. Patients were randomly allocated to standard treatment with or without 900 mg/d vitamin E. After 6 weeks of treatment, the reported variables were measured in plasma and plaques. The plasma vitamin E/cholesterol ratio was significantly lower in patients than in controls (3.05+/-0.6 versus 6.3+/-1.7 micromol/mmol cholesterol, P<0.001). Plasma 7beta-hydroxycholesterol was significantly higher in patients than in controls (5.0+/-1.04 versus 4.4+/-0.6 ng/mL, P<0.05). Patients who were given vitamin E supplementation showed a significant increase of plasma vitamin E with concomitant decrease of 7beta-hydroxycholesterol. Conversely, no treatment dependence was observed in oxysterol or vitamin E content of plaques.


CONCLUSIONS
An imbalance between oxidative stress and antioxidant status is present in patients with advanced atherosclerosis. Vitamin E supplementation improves this imbalance in plasma but not in plaques.
Dipartimento di Medicina Interna, University La Sapienza, Via del Policlinico, 155. 00161 Rome, Italy.
Fausta
F
Micheletta
Silvia
S
Natoli
Maria
M
Misuraca
Enrico
E
Sbarigia
Ulf
U
Diczfalusy
Luigi
L
Iuliano
D000293:Adolescent; D000328:Adult; D000368:Aged; D016893:Carotid Stenosis / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D006888:Hydroxycholesterols / Q000097:blood; D007653:Ketocholesterols / Q000097:blood; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D018384:Oxidative Stress / Q000187:drug effects; D010949:Plasma; D016896:Treatment Outcome; D014810:Vitamin E / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D006888:Hydroxycholesterols; D007653:Ketocholesterols; D014810:Vitamin E; C011724:cholest-5-en-3 beta,7 alpha-diol; D002784:Cholesterol; C003001:7-ketocholesterol