BACKGROUND:Transplant recipients have elevated oxidative stress, which has prompted suggestions that supplementary antioxidants may be beneficial. However, only a small number of clinical trials have investigated antioxidant supplementation in transplant recipients, with very few data on their effects on patients' immunosuppressive therapy. METHODS: A randomized placebo-controlled single-blind crossover trial was conducted in 10 renal transplant recipients (RTRs) taking cyclosporin A (CsA) as part of their immunosuppressive therapy. Each phase of the trial lasted 6 months, with a 6 month wash-out period in between. During one of the phases, patients consumed a tablet twice per day which delivered 400 IU/day of vitamin E, 500 mg/day of vitamin C and 6 mg/day of beta-carotene. RESULTS: During antioxidant supplementation, there was no change in CsA dose. Antioxidant supplementation resulted in a significant decrease (P<0.05) in blood trough CsA by 24% (mean+/-SD, pre- 127.3+/-38.9, post- 97.2+/-30.7 microg/ml) compared with no change while taking the placebo (pre- 132.2+/-50.6, post- 138.6+/-56.0 microg/ml). The glomerular filtration rate was significantly (P<0.05) improved by 12% during antioxidant supplementation (pre- 66.9+/-20.7, post- 75.0+/-20.1 ml/min/1.72 m2), with no change during the placebo phase (pre- 66.8+/-11.8, post- 66.7+/-16.1 ml/min/1.72 m2). There were no significant differences (P>0.05) in markers of oxidative stress (malondialdehyde, susceptibility of plasma to oxidation) or plasma antioxidant enzymes. CONCLUSION: In CsA-treated RTRs, antioxidant supplementation decreased blood CsA, which may affect adequacy of immunosuppression.
RCT Entities:
BACKGROUND: Transplant recipients have elevated oxidative stress, which has prompted suggestions that supplementary antioxidants may be beneficial. However, only a small number of clinical trials have investigated antioxidant supplementation in transplant recipients, with very few data on their effects on patients' immunosuppressive therapy. METHODS: A randomized placebo-controlled single-blind crossover trial was conducted in 10 renal transplant recipients (RTRs) taking cyclosporin A (CsA) as part of their immunosuppressive therapy. Each phase of the trial lasted 6 months, with a 6 month wash-out period in between. During one of the phases, patients consumed a tablet twice per day which delivered 400 IU/day of vitamin E, 500 mg/day of vitamin C and 6 mg/day of beta-carotene. RESULTS: During antioxidant supplementation, there was no change in CsA dose. Antioxidant supplementation resulted in a significant decrease (P<0.05) in blood trough CsA by 24% (mean+/-SD, pre- 127.3+/-38.9, post- 97.2+/-30.7 microg/ml) compared with no change while taking the placebo (pre- 132.2+/-50.6, post- 138.6+/-56.0 microg/ml). The glomerular filtration rate was significantly (P<0.05) improved by 12% during antioxidant supplementation (pre- 66.9+/-20.7, post- 75.0+/-20.1 ml/min/1.72 m2), with no change during the placebo phase (pre- 66.8+/-11.8, post- 66.7+/-16.1 ml/min/1.72 m2). There were no significant differences (P>0.05) in markers of oxidative stress (malondialdehyde, susceptibility of plasma to oxidation) or plasma antioxidant enzymes. CONCLUSION: In CsA-treated RTRs, antioxidant supplementation decreased blood CsA, which may affect adequacy of immunosuppression.
Authors: Camilo G Sotomayor; Nicolas I Bustos; Manuela Yepes-Calderon; Diego Arauna; Martin H de Borst; Stefan P Berger; Ramón Rodrigo; Robin P F Dullaart; Gerjan J Navis; Stephan J L Bakker Journal: Antioxidants (Basel) Date: 2021-04-21
Authors: Goran Bjelakovic; Dimitrinka Nikolova; Lise Lotte Gluud; Rosa G Simonetti; Christian Gluud Journal: Cochrane Database Syst Rev Date: 2012-03-14
Authors: Robert G Fassett; Helen Healy; Ritza Driver; Iain K Robertson; Dominic P Geraghty; James E Sharman; Jeff S Coombes Journal: BMC Nephrol Date: 2008-12-18 Impact factor: 2.388