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.
Reference: Mirbagheri SA, Nezami BG, Assa S, Hajimahmoodi M. Rectal administration of d-alpha tocopherol for active ulcerative colitis: A preliminary report. World J Gastroenterol 2008; 14(39): 5990-5995
http://www.wjgnet.com/1007-9327/14/5990.asp
Correspondence to: Seyed Amir Mirbagheri, MD, Depart-ment of Internal Medicine, Amir-Alam Hospital, North Sa'adi Street, Tehran 13145-784, Iran. mirbagherimd@yahoo.com Telephone: +98-216-6708688 Fax: +98-216-6704805
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection. It provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the title China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology