Vitamin E and C supplementation prevents decrease of eicosapentaenoic acid in mononuclear cells in chronic hepatitis C patients during combination therapy of interferon alpha-2b and ribavirin.
OBJECTIVE
We investigated the effects of vitamin E and C supplementation on the fatty acid composition of mononuclear cells and on the clinical observations in patients who had chronic hepatitis C and received interferon-alpha-2b (IFN-alpha-2b) and ribavirin combination therapy.


METHODS
Patients were randomly allocated to receive daily 500 mg of vitamin E and 750 mg of vitamin C (vitamin group, n = 14) or no supplement (non-vitamin group, n = 16) in addition to IFN-alpha-2b and ribavirin therapy. The fatty acid composition of mononuclear cell phospholipids was analyzed before and at 2, 4, and 8 wk after treatment.


RESULTS
After vitamin supplementation, plasma and red blood cell alpha-tocopherol and plasma ascorbic acid levels increased in the vitamin group. Serum levels of alanine aminotransferase decreased significantly after 2 wk of treatment in both groups. At the start of treatment, a lower level of eicosapentaenoic acid (EPA) and a higher level of the molar ratio of arachidonic acid to EPA in mononuclear cells were observed in the present patients compared with healthy volunteers, and a significant correlation between the molar ratio and serum alanine aminotransferase level was found. The EPA level of mononuclear cells was maintained in the vitamin group during treatment, whereas a significant decrease was observed in the non-vitamin group at 4 and 8 wk after treatment.


CONCLUSIONS
Antioxidant vitamin supplementation during IFN-alpha-2b and ribavirin therapy prevented a decrease in EPA of mononuclear cell phospholipids. If a further decrease in the ratio of arachidonic acid to EPA can be achieved by using oral EPA supplementation, the efficacy of IFN-alpha-2b and ribavirin therapy may be improved.
Murakami
Yasuko
Y
Department of Nutritional Science, Faculty of Health and Welfare Science, Okayama Prefectual University, Okayama, Japan. yasuko@fhw.oka-pu.ac.jp
Nagai
Ayako
A
Kawakami
Takayo
T
Hino
Keisuke
K
Kitase
Akira
A
Hara
Yuh-Ichi
Y
Okuda
Michiari
M
Okita
Kiwamu
K
Okita
Misako
M
D000410:Alanine Transaminase / Q000378:metabolism; D000998:Antiviral Agents / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000097:blood / Q000627:therapeutic use*; D019587:Dietary Supplements; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D015118:Eicosapentaenoic Acid; D005231:Fatty Acids, Unsaturated / Q000032:analysis / Q000378:metabolism*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D007963:Leukocytes, Mononuclear / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load; D014810:Vitamin E / Q000097:blood / Q000627:therapeutic use*; D014815:Vitamins / Q000627:therapeutic use*
D000998:Antiviral Agents; D005231:Fatty Acids, Unsaturated; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D014815:Vitamins; D014810:Vitamin E; D012254:Ribavirin; D015118:Eicosapentaenoic Acid; D000410:Alanine Transaminase; D001205:Ascorbic Acid