title: Effect of antioxidant supplementation on surrogate markers of fibrosis in chronic pancreatitis: a randomized, placebo-controlled trial.
abstract: OBJECTIVE
  This study aimed to determine the effect of antioxidant (AO) supplementation on surrogate markers of fibrosis in patients with chronic pancreatitis (CP).
  
  
  METHODS
  In a randomized, placebo (PL)-controlled trial, patients with CP were randomized to groups that were given PL or AO for 3 months. Outcome measures were change in serum levels of transforming growth factor β1 and platelet-derived growth factor AA (PDGF-AA) (primary outcome) as well as blood markers of oxidative stress (thiobarbituric acid-reactive substances) and AO status (ferric-reducing ability of plasma) (secondary outcome). Pain relief and analgesic requirement was also recorded.
  
  
  RESULTS
  Patients (n = 61; mean [SD] age, 35.2 [10.0]; male patients, 43) were assigned to AO (n = 31) and PL (n = 30) groups. The median (range) percent reduction from baseline to 3 months in levels of PDGF-AA (17.1% [-25.3% to 88.7%] vs 2.8% [-243.1% to 30.2%]; P = 0.001), transforming growth factor β1 (P = 0.573), and thiobarbituric acid-reactive substances (P = 0.207) as well as percent increment from baseline to 3 months in ferric-reducing ability of plasma (P = 0.003) were higher in the AO group compared with the PL group. Proportion of patients who had both reduced PDGF-AA and reduced pain was greater in AO as compared with PL group (17/31 vs 9/30, P = 0.05)
  
  
  CONCLUSIONS
  Reduction in markers of fibrosis (PDGF-AA) translated into clinical outcome (reduction in pain and analgesic requirements) in those supplemented with AOs in CP (trial registration, CTRI/2011/05/001747).
authors.affiliation: Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajan
authors.initials: R
authors.lastname: Dhingra
authors.forename: Namrata
authors.initials: N
authors.lastname: Singh
authors.forename: Vikas
authors.initials: V
authors.lastname: Sachdev
authors.forename: Ashish Datt
authors.initials: AD
authors.lastname: Upadhyay
authors.forename: Anoop
authors.initials: A
authors.lastname: Saraya
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000378:metabolism / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D050500:Pancreatitis, Chronic / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy*; D010982:Platelet-Derived Growth Factor / Q000378:metabolism; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D053773:Transforming Growth Factor beta1 / Q000097:blood; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D010982:Platelet-Derived Growth Factor; D017392:Thiobarbituric Acid Reactive Substances; D053773:Transforming Growth Factor beta1; C075278:platelet-derived growth factor A