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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.

Yasuko Murakami·Ayako Nagai·Takayo Kawakami·Keisuke Hino·Akira Kitase·Yuh-Ichi Hara·Michiari Okuda·Kiwamu Okita·Misako Okita
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Abstract

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.

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Alanine TransaminaseAntiviral AgentsAscorbic AcidDietary SupplementsDrug SynergismDrug Therapy, CombinationEicosapentaenoic AcidFatty Acids, UnsaturatedFemaleHepatitis C, ChronicHumansInterferon alpha-2Interferon-alphaLeukocytes, MononuclearMaleMiddle AgedRecombinant ProteinsRibavirinTreatment OutcomeViral LoadVitamin EVitaminsJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov't

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Yasuko Murakami, Ayako Nagai, Takayo Kawakami, Keisuke Hino, Akira Kitase, Yuh-Ichi Hara, Michiari Okuda, Kiwamu Okita, Misako Okita. 2006. 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.. https://doi.org/10.1016/j.nut.2005.05.014

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