May 18, 2010

Long-term vitamin E supplementation associated with reduced COPD risk

A presentation at the American Thoracic Association 2010 International Conference on May 18, 2010 revealed the discovery by researchers at Cornell University and Brigham and Women's Hospital of a lower risk of chronic obstructive pulmonary disease (COPD) in women who supplemented with vitamin E, an antioxidant.

"The oxidant/antioxidant balance in lung tissue is hypothesized to contribute to chronic obstructive pulmonary disease (COPD) risk, and observational studies consistently report high antioxidant status associated with lower risk of COPD and asthma," write researchers Anne Hermetet Agler and colleagues in an abstract that describes their findings.

The team analyzed data from 38,270 health professionals aged 45 and older who participated in the Women's Health Study, which evaluated the effects of every other day regimens of aspirin or vitamin E in cancer and heart disease prevention over a 10 year period. Follow-up questionnaires ascertained new diagnoses of chronic lung disease, including emphysema, chronic bronchitis and bronchiectasis.

While the risk of developing COPD was four times greater in smokers than in nonsmokers, the researchers uncovered a 10 percent reduction in risk in both smokers and nonsmokers who consumed 600 international units (IU) vitamin E every other day compared to those who received a placebo. Adjustment for age and other factors failed to modify the association.

"As lung disease develops, damage occurs to sensitive tissues through several proposed processes, including inflammation and damage from free radicals," observed Dr Agler, who is a doctoral candidate at Cornell's Division of Nutritional Sciences. "Vitamin E may protect the lung against such damage."

"The findings from our study suggest that increasing vitamin E prevents COPD," she continued. "Previous research found that higher intake of vitamin E was associated with a lower risk of COPD, but the studies were not designed to answer the question of whether increasing vitamin E intake would prevent COPD. Using a large, randomized controlled trial to answer this question provided stronger evidence than previous studies."

"If results of this study are borne out by further research, clinicians may recommend that women take vitamin E supplements to prevent COPD," she added.

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating lung disease. The disease is characterized by irreversible airflow limitation in the lungs. The umbrella of COPD encompasses the following conditions:

• Emphysema, in which the alveoli in the lungs, the tiny sacs where oxygen transfer takes place, are destroyed and enlarged
• Chronic bronchitis, or the permanent inflammation of airways, accompanied by a chronic cough

Because of the role of oxidant stress in causing and perpetuating COPD (Drost EM et al 2005) and the low levels of natural antioxidants in patients’ tissues (Kluchova Z et al 2006; Rahman I et al 2006; Nadeem A et al 2005), antioxidant supplementation may be helpful (Kelly FJ 2005; Spurzem JR et al 2005; Romieu I et al 2001).

Levels of vitamins A and E are significantly lower during exacerbations of COPD than they are in stable COPD, suggesting that antioxidants should be used during exacerbations (Tug T et al 2005). Although vitamins A, C, and E are beneficial, vitamin A may be most important because it catalyzes removal of the most reactive form of oxygen radical (Tug T et al 2005). Serum levels of vitamin A are lower in those with moderate or severe COPD. Vitamin A supplements for 30 days improved performance on PFTs in one small study (Paiva SA et al 1996).

Vitamin E levels are low in smokers, increasing their susceptibility to injury from free radicals. Vitamin E supplementation can reduce the risk of COPD in smokers (Daga MK et al 2003). Serum vitamin C levels are also frequently reduced in COPD (Tug T et al 2005). High-dose vitamin C may prevent oxidant-mediated lung injury during inflammation. Vitamin C also reactivates vitamin E that has been depleted by oxidant molecules.

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