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Gamma-tocopherol and docosahexaenoic acid decrease inflammation in dialysis patients.

AbstractOBJECTIVE:
Increased cardiovascular risk in hemodialysis patients may be related to augmented oxidative stress and inflammation, for which no proven beneficial therapies are available.
STUDY DESIGN:
We examined the effects of gamma tocopherol and docosahexaenoic acid (DHA) administration on inflammation and oxidative stress markers in hemodialysis patients in a randomized, double-blinded, placebo-controlled, clinical trial. Active treatment consisted of capsules containing gamma tocopherol (308 mg) and DHA (800 mg).
SETTING:
Outpatient dialysis center.
PATIENTS:
Seventy maintenance hemodialysis patients.
MAIN OUTCOME MEASURES:
Plasma concentrations of interleukin-6 (IL-6) and protein carbonyl content were determined by enzyme-linked immunosorbant assay. C-reactive protein was measured by nephelometry. The F(2) isoprostanes were measured by gas chromatography-mass spectrometry. Erythrocyte DHA content was measured by gas chromatography.
RESULTS:
Sixty-three patients were enrolled, and 57 completed the study. No serious adverse events were attributed to either active treatment or placebo. In the treatment group, but not in the placebo group, there were significant decreases in IL-6 (21.4 +/- 3.5 to 16.8 +/- 3.7 pg/mL), white blood cell (WBC) count (7.4 +/- 0.3 to 6.9 +/- 0.4 10(3)/microL), and neutrophil fraction of WBCs (4.8 +/- 0.3 to 4.4 +/- 0.3 10(3)/microL), at P < .05 for all. There were no significant changes in plasma concentrations of CRP, F(2) isoprostanes, or carbonyls in either group.
CONCLUSION:
Thus, gamma tocopherol and DHA are well-tolerated and reduce selected biomarkers of inflammation in hemodialysis patients. Larger randomized, clinical trials will be required to determine if gamma tocopherol and DHA can reduce cardiovascular complications in hemodialysis patients.
AuthorsJonathan Himmelfarb, Stephen Phinney, T Alp Ikizler, Jane Kane, Ellen McMonagle, Guy Miller
JournalJournal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation (J Ren Nutr) Vol. 17 Issue 5 Pg. 296-304 (Sep 2007) ISSN: 1532-8503 [Electronic] United States
PMID17720098 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Biomarkers
  • F2-Isoprostanes
  • Interleukin-6
  • Docosahexaenoic Acids
  • gamma-Tocopherol
  • C-Reactive Protein
Topics
  • Adult
  • Aged
  • Biomarkers (blood)
  • C-Reactive Protein (analysis)
  • Chromatography, Gas
  • Dietary Supplements
  • Docosahexaenoic Acids (adverse effects, therapeutic use)
  • Double-Blind Method
  • Enzyme-Linked Immunosorbent Assay
  • Erythrocytes (chemistry)
  • F2-Isoprostanes
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Inflammation (epidemiology, prevention & control)
  • Interleukin-6 (blood)
  • Kidney Failure, Chronic (complications, therapy)
  • Male
  • Middle Aged
  • Nephelometry and Turbidimetry
  • Oxidative Stress (drug effects)
  • Protein Carbonylation (drug effects)
  • Renal Dialysis
  • Treatment Outcome
  • gamma-Tocopherol (adverse effects, therapeutic use)

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