title: Antioxidant levels in peripheral blood, disease activity and fibrotic stage in chronic hepatitis C.
abstract: BACKGROUND
  This study addressed the suggested association between levels of the antioxidants glutathione (GSH), vitamin C and vitamin E in peripheral blood and the histological activity and fibrosis stage in chronic hepatitis C (CHC). We then determined whether regular antioxidant supplementation influenced these antioxidant levels or disease severity.
  
  
  METHODS
  Clinical, biochemical, histological and demographic data were collected from 247 CHC patients at the time of liver biopsy. Whole blood total GSH, plasma vitamin C and E were assessed by high-performance liquid chromatography. Statistical analyses were performed to test for associations between the variables and to identify independent predictors for hepatic necroinflammatory and fibrosis scores.
  
  
  RESULTS
  GSH and vitamin C, but not vitamin E correlated with both portal/periportal activity (r = -0.19, P = 0.004; r = -0.19, P = 0.009 respectively) and fibrosis stage (r = -0.18, P = 0.007; r = -0.18, P = 0.009 respectively). GSH was an independent negative predictor of portal/periportal inflammation (P = 0.02) and fibrosis (P = 0.01). Vitamin C was an independent negative predictor of fibrosis stage (P = 0.02). Antioxidant intake was associated with higher vitamin C (P < 0.0001) and vitamin E (P = 0.005) levels, but not GSH.
  
  
  CONCLUSIONS
  Whole blood GSH and plasma vitamin C are negatively associated with hepatic portal/periportal inflammation and fibrosis stage in CHC. Controlled intervention studies with vitamin C and agents that boost endogenous GSH levels are warranted.
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, Sydney, Australia.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Bandara
authors.forename: Jacob
authors.initials: J
authors.lastname: George
authors.forename: Geoffrey
authors.initials: G
authors.lastname: McCaughan
authors.forename: Daya
authors.initials: D
authors.lastname: Naidoo
authors.forename: Ora
authors.initials: O
authors.lastname: Lux
authors.forename: Chris
authors.initials: C
authors.lastname: Salonikas
authors.forename: James
authors.initials: J
authors.lastname: Kench
authors.forename: Karen
authors.initials: K
authors.lastname: Byth
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Farrell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage / Q000378:metabolism*; D001205:Ascorbic Acid / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D005978:Glutathione / Q000097:blood; D019698:Hepatitis C, Chronic / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012720:Severity of Illness Index; D019562:Viral Load; D014810:Vitamin E / Q000097:blood
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D014810:Vitamin E; D005978:Glutathione; D001205:Ascorbic Acid