Can rectal vitamin E induce remission in UC patients

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Can rectal vitamin E induce remission in patients with mild to

moderate ulcerative colitis?

Medicine & Health / Diseases

It is believed that the generation of an exaggerated intestinal immune

response to otherwise innocuous stimuli along with generation of

oxygen free radicals plays a key role in the pathophysiology of UC.

However, no disease-specific treatment for UC has yet emerged.

Vitamin E is a major lipophilic antioxidant in cellular membranes with

excellent antioxidant activities which protects membrane lipids from

peroxidation by scavenging not only chain carrying peroxyl radicals

but also singlet oxygen and superoxide anion radicals. This is

especially interesting in case of UC, considering the pivotal role of

oxygen free radicals in the genesis of mucosal damage. Given the

recent evidence suggesting anti-inflammatory properties for Vitamin E,

one may ask whether d-alpha tocopherol, as the dominant vitamin E

isomer in plasma with the highest biopotency, can be expected to

reduce the development of tissue injury in UC.

A research article to be published on October 21, 2008 in the World

Journal of Gastroenterology addresses this question. The research team

led by Dr. Mirbagheri from Department of Internal Medicine of Amir

Alam hospital in Tehran-Iran, report for the first time the

preliminary results of an on-going open-label case-series study on

clinical and endoscopic changes of disease severity in patients with

active UC who received daily rectal doses of d-alpha tocopherol for at

least 12 wk.

All 15 participating patients responded dramatically to therapy after

12 weeks, with 9 of them going to clinical remission. The average

score of Mayo disease activity index (DAI) started to decrease after

second week and remained significantly lower for the remainder of the

study. Besides, there was no case of worsening disease activity or

report of serious adverse event during the course of study. The

observed effect are probably due to antioxidant and anti-inflammatory

effects of vitamin E which potently takes effect by local route of

administration. At the end of this interesting article the authors

suggest that rectal administration of d-alpha tocopherol might be used

safely as a new therapeutic modality to reduce the clinical severity

of ulcerative colitis without major side effects or complications of

current therapies.

Source: World Journal of Gastroenterology