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antioxidant

An agent that inhibits oxidation, especially peroxidative chain reactions, i.e. lipid peroxidation (see oxidative stress) Endogenous antioxidants include vitamin E, vitamin C, vitamin A, glutathione, uric acid, ubiquinone, & bilirubin. Glutathione & bilirubin may be the major endogenous cellular antioxidants, glutathione in the cytoplasm, bilirubin in cellular membranes. [4] Dietary supplementation with antioxidants is widely promoted, but proven benefits lag substantially behind the hype. Indications: - AREDS of benefit for prophylaxis/slowing progression of macular degeneration - also ee vitamin A, vitamin C, vitamin E for indications. Contraindications: - no benefit in primary prevention of cardiovascular disease [9] Laboratory: - antioxidants in serum/plasma Clinical trials: 1) SU.VLMAX study (may be some benefit for men) 2) meta-analysis of 47 randomized clinical trials [5] 230,000 participants results: beta-carotene, vitamin A, & vitamin E, given either singly or in combination with other supplements increased mortality (RR, 1.05, 1.16, & 1.04, respectively) vitamin C & selenium had no effect on mortality 3) no benefit of benefit from vitamin C, vitamin E, or beta carotene for prevention of cardiovascular events in high-risk women (mean age = 60) [6] 4) vitamin E & vitamin C supplements may blunt exercise-induced increase in insulin-sensitivity [7] 5) daily antioxidant cocktail diminished abdominal pain of chronic pancreatitis [8] - selenium 600 ug - ascorbic acid 540 mg - beta carotene 9000 IU - tocopherol 270 IU - methionine 2 g daily

Related

oxidative stress

Specific

ascorbate; ascorbic acid; vitamin C bilirubin carbocysteine (Availnex, Broncodeterge) cepharanthine curcumin (Theracurmin) ebselen edaravone (Radicava) Fructus Momordicae glutathione; gamma-glutamylcysteinylglycine (GSH) phenolic antioxidant tartaric acid ubiquinone; coenzyme Q (CoQ, CoQ10, MitoQ, ubidecarenone) urate; uric acid vitamin A vitamin E

General

bioagent

References

  1. Prescriber's Letter 10(6):33 2003
  2. Zandi PP et al Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study. Arch Neurol 6:18, 2004 PMID: 14732624 http://archneur.ama-assn.org/cgi/content/abstract/61/1/82
  3. Journal Watch 25(1):1, 2005
  4. Sedlak TW, Snyder SH. Messenger molecules and cell death: therapeutic implications. JAMA. 2006 Jan 4;295(1):81-9. PMID: 16391220
  5. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. JAMA. 2007 Feb 28;297(8):842-57. Review. PMID: 17327526
  6. Cook NR et al. A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: Results from the Women's Antioxidant Cardiovascular Study. Arch Intern Med 2007 Aug 13/27; 167:1610. PMID: 17698683
  7. Ristow M et al Antioxidants prevent health-promoting effects of physical exercise in humans. Proc Natl Acad Sci U S A 2009 May 26; 106:8665 PMID: 19433800 http://dx.doi.org/10.1073/pnas.0903485106
  8. Bhardwaj P et al A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology 2009 Jan; 136:149. PMID: 18952082
  9. The NNT: Vitamin and Antioxidant Supplements for Primary Prevention of Cardiovascular Disease. http://www.thennt.com/nnt/vitamins-and-antioxidants-for-primary-prevention-of-cardiovascular-disease/
  10. National Center for Complementary and Inegrative Health Antioxidants: : In Depth https://www.nccih.nih.gov/health/antioxidants-in-depth