Alpha-tocopherol [corrected] and ascorbic acid attenuates the ribavirin [corrected] induced decrease of eicosapentaenoic acid in erythrocyte membrane in chronic hepatitis C patients.
BACKGROUND
Oxidative damage of the erythrocyte membrane plays an important role in ribavirin-induced anemia. The purpose of the present paper was to assess whether supplementation of alpha-tocopherol and ascorbic acid (vitamins) causes changes in the erythrocyte membrane fatty acid composition during interferon and ribavirin combination therapy for chronic hepatitis C patients.


METHODS
Fatty acid compositions in erythrocyte membrane phospholipids were determined by gas chromatography at 0, 2, 4, 8 weeks, and at the end of combination therapy (26 weeks) for interferon with ribavirin in 32 patients with chronic hepatitis C who were randomized to receive vitamins or not (controls).


RESULTS
Good compliance with orally administered vitamins and ribavirin were confirmed by their concentrations in erythrocytes or plasma. The hemoglobin level was negatively correlated with the ribavirin concentration at 8 weeks (r = 0.59, P = 0.01) after initiation of therapy in controls, but not in the vitamin group. Among the 26 kinds of fatty acids analyzed, only eicosapentaenoic acid (EPA) significantly decreased at 8 weeks after initiation of therapy (P = 0.03) and at the end of therapy (P = 0.004) in controls. Vitamins did not inhibit ribavirin-induced anemia, but attenuated the decrease of EPA in erythrocytes. The EPA level was negatively correlated with the drop in hemoglobin levels at 8 weeks after initiation of therapy in controls (r = 0.58, P = 0.015), but not in the vitamin group.


CONCLUSIONS
Supplementation of alpha-tocopherol and ascorbic acid attenuates the ribavirin-induced decrease of EPA in erythrocyte membrane phospholipids in chronic hepatitis C patients.
Hino
Keisuke
K
Department of Laboratory Sciences, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan. k.hino@yamaguchi-u.ac.jp
Murakami
Yasuko
Y
Nagai
Ayako
A
Kitase
Akira
A
Hara
Yuichi
Y
Furutani
Takakazu
T
Ren
Fenyu
F
Yamaguchi
Yuhki
Y
Yutoku
Kohki
K
Yamashita
Satoyoshi
S
Okuda
Michiari
M
Okita
Misako
M
Okita
Kiwamu
K
D001205:Ascorbic Acid / Q000494:pharmacology*; D004359:Drug Therapy, Combination; D015118:Eicosapentaenoic Acid / Q000378:metabolism*; D004910:Erythrocyte Membrane / Q000187:drug effects*; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000494:pharmacology*; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000494:pharmacology*
D012254:Ribavirin; D015118:Eicosapentaenoic Acid; D024502:alpha-Tocopherol; D001205:Ascorbic Acid