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Rheumatology 2002; 41: 274-278
© 2002 British Society for Rheumatology
Original Papers |
Adjuvant treatment of patients with antineutrophil cytoplasmic antibody-associated vasculitis with vitamins E and C reduces superoxide production by neutrophils
MRC Centre for Immune Regulation and
1 Clinical Pharmacology Section, Department of Medicine, The Medical School, Birmingham University, Edgbaston, Birmingham B15 2TT, UK
Objectives. Neutrophils when activated generate a respiratory burst which has been implicated in the pathogenesis of primary systemic vasculitis. Neutrophils from patients with vasculitis have a greater respiratory burst than normal healthy donors. The aim of this study was to assess the effects of antioxidant treatment (vitamins E and C) on the generation of a respiratory burst from neutrophils isolated from patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis.
Methods. Neutrophils were isolated from patients with systemic vasculitis and healthy donors. Spontaneous superoxide generation was measured by the reduction of ferricytochrome c. The patients were treated with antioxidants, vitamins E and C, and spontaneous superoxide generation, vitamin C and total antioxidant capacity were measured before and after treatment.
Results. The treatment of the patients with antioxidants resulted in a reduction in spontaneous superoxide generation (pre-treatment 8.41±0.7 nmol/106 cells; post-treatment 5.64±0.6 nmol/106 cells; P<0.05). There was no significant difference in the superoxide generation from normal controls who did not receive treatment, measured prior to commencement of the study and 10 days later (first reading 4.81±0.5 nmol/106 cells; second reading 5.32±0.4 nmol/106 cells; P>0.05). Total antioxidant capacity increased significantly following treatment with vitamins C and E (555.4±142 vs 668.6±186 µmol/l trolox equivalent; P=0.01) as did vitamin C concentrations (56.5±27 vs 137.7±64 µmol/l; P=0.002).
Conclusions. In this preliminary study, the treatment of patients with antioxidants, vitamins E and C, reduced neutrophil generation of superoxide and suggests that antioxidants may have an important role as adjuvant therapy. The evidence presented should form the basis of a larger randomized placebo-controlled trial of vitamins E and C as adjuvant therapy in patients with ANCA-associated systemic vasculitis.
KEY WORDS: Neutrophils, Vitamin E, Vitamin C, Antioxidant, Superoxide, Systemic vasculitis.
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