Antioxidant levels in peripheral blood, disease activity and fibrotic stage in chronic hepatitis C.
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.
Bandara
Priyanka
P
Storr Liver Unit, Westmead Millennium Institute, Sydney, Australia.
George
Jacob
J
McCaughan
Geoffrey
G
Naidoo
Daya
D
Lux
Ora
O
Salonikas
Chris
C
Kench
James
J
Byth
Karen
K
Farrell
Geoffrey C
GC
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
D000975:Antioxidants; D015415:Biomarkers; D014810:Vitamin E; D005978:Glutathione; D001205:Ascorbic Acid