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OXIDATIVE-INFLAMMATORY DAMAGE IN CIRRHOSIS. EFFECT OF VITAMIN E AND A FERMENTED PAPAYA PREPARATION

Oxidative-inflammatory damage in cirrhosis :
Effect of vitamin E and a fermented papaya preparation

Journal of Gastroenterology and Hepatology. 22(5):697-703,2007

Oxidative DNA damage occurs as an early event in HCV infection and is an indication of the potential for carcinogenesis. The aim of this study was to test a novel antioxidant/immunomodulator in HCV-related cirrhotics.

The study group consisted of 50 patients with HCV-related cirrhosis with transaminase values less than twofold increased (ALT<80 IU/l). Patients underwent a standardised food-vitamin composition assessment and were randomly allocated into 2 groups. At the beginning, they were assessed for dietary intake, nutritional status and iron level and then given alpha-tocopherol 900IU/day or given 9g/day of a fermented papaya preparation (FPP, Immun'-Âge®, Osato Research Institute, Gifu, Japan) at bedtime for 6 months. Ten healthy subjects served as controls. Patients were checked monthly for: routine tests, Redox Status (GSH, GSH-Px, GSSG, malondialdehyde), plasma a-tocopherol, 8-OHdG level in circulating leukocyte DNA and serum levels of cytokines.

Patients with cirrhosis showed a significant imbalance of redox status (low antioxidants/high oxidative stress markers) (p<0.005 vs controls). Both treatment regimens did not affect transaminases as a whole. However, vitamin E supplementation almost normalized ALT only in the limited vitamin-E-deficient subgroup. A significant improvement of redox status was obtained by both regimens. However, only FPP significantly decreased 8-OHdG and the improvement of cytokine balance with FPP was significantly better than with vitamin-E treatment (p<0.05). While the present data seem to suggest a potential supportive role of antioxidants/immunomodulators as FPP in HCV patients, more studies are needed to substantiate their effect on the natural history of the disease.

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