Study Reveals How One Form of Natural Vitamin E Protects Brain After Stroke

COLUMBUS, Ohio – Blocking the function of an enzyme in the brain with a specific kind of vitamin E can prevent nerve cells from dying after a stroke, new research suggests.

In a study using mouse brain cells, scientists found that the tocotrienol form of vitamin E, an alternative to the popular drugstore supplement, stopped the enzyme from releasing fatty acids that eventually kill neurons.

The Ohio State University researchers have been studying how this form of vitamin E protects the brain in animal and cell models for a decade, and intend to pursue tests of its potential to both prevent and treat strokes in humans.

“Our research suggests that the different forms of natural vitamin E have distinct functions. The relatively poorly studied tocotrienol form of natural vitamin E targets specific pathways to protect against neural cell death and rescues the brain after stroke injury,” said Chandan Sen, professor and vice chair for research in Ohio State’s Department of Surgery and senior author of the study .

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UC-Davis Shows Vitamin E Role in Treating Equine Neurologic Disease

Dec 1, 2009
Ed Kane, PhD

Horses' condition makes it easier for vitamin E to do its work protecting cells from free-radical damage.

Some inflammatory or degenerative neurologic diseases that affect horses — equine degenerative myeloencephalopathy (EDM) and equine motor neuron disease (EMND) — are linked to vitamin E deficiency. Vitamin E is a dietary antioxidant that protects cell membranes and tissues from oxidant free-radical damage, which is believed to play a role in the etiology and progression of the diseases.

Now, researchers at the University of California-Davis say horses with neurologic disease may respond differently to vitamin E treatment because of disruption of the blood-brain barrier or increased oxidant damage associated with the underlying disease.

The blood-brain barrier of horses with neurologic disease may be potentially compromised, allowing vitamin E to cross more easily, show higher cerebrospinal fluid (CSF) concentrations and be more effective in reducing oxidant free-radical damage in the brain.

Conversely, vitamin E may be more readily metabolized due to increased oxidant damage, and therefore show lower CSF values at the desired site of action. The antioxidant "demand" for older horses might be greater, especially those with neurologic disease.

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Donald C. Mahan

During the last 30 years there has been a scientific debate over whether natural or synthetic vitamin E is superior to the other.  The rat fetal resorption test demonstrated that natural was superior by a 1.36 ratio.  Synthetic vitamin E is manufactured having several chemical forms which differ in bioavailability, thus the major reason why synthetic vitamin E was poorer on a mg / mg basis.  However, recent research has shown that the 1.36 ratio underestimates the relative bioequivalence of the natural vitamin E form.  Past and current research was used to calculate the bioequivalence of the 2 vitamin E forms in this presentation.  In general, swine of all productive phases seem to utilize both forms of vitamin E but the natural source of vitamin E is more effective.

A.C. Grace Company Advisory Counsel members Robert Stuart, PhD, and Ed Kane, PhD, provide valuable research and data to Donald C. Mahan, PhD, Professor in the Department of Animal Studies at The Ohio State University to provide this report showing how NATURAL Vitamin E is more effective than SYNTHETIC Vitamin E.

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By John Gever, Senior Editor, MedPage Today
November 06, 2009

BOSTON -- Vitamin E and, potentially, pioglitazone (Actos) may become the first effective treatments for nonalcoholic steatohepatitis (NASH), a researcher said here.

About 43% of NASH patients in a randomized, placebo-controlled trial met the study's primary endpoint -- a composite of improved liver function, decreased ballooning, and stabilization of fibrosis -- after about two years of vitamin E treatment, compared with less than 20% of patients on placebo (P<0.001), according to Arun Sanyal, MD, of Virginia Commonwealth University in Richmond.

The data showed that, for most of the individual measures of NASH disease activity, pioglitazone was approximately as effective as vitamin E, Sanyal said, with both agents superior to placebo.

Still, he said, the key finding was that vitamin E was clearly an effective treatment for active NASH.

Patients were randomized to receive placebo, 30 mg/day of pioglitazone, or 800 IU/day of vitamin E, in the form of rrr a-tocopherol for 96 weeks, at which point a liver biopsy was obtained. Other outcomes were measured at week 120.

Just over half of both the vitamin E and pioglitazone groups showed resolution of NASH, Sanyal said, compared with about 25% of the placebo group (P<0.01 for both active-treatment groups versus placebo).

About 55% of vitamin E patients showed improvement in steatosis, as did some 70% of those taking pioglitazone. In the placebo group, 30% improved.

Scott Friedman, MD, president of AASLD and a hepatologist at Mount Sinai School of Medicine in New York City, said the study was among the most important reported at this year's meeting.

"This should resurrect our efforts to use antioxidants for NASH," he said.

However, he cautioned that over-the-counter vitamin E supplements may not have the same effect seen in the trial. He noted that quality of commercial supplements is largely unregulated and may vary from one product to another.

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