Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia

Cosby A. Stone, Cynthia (Cindy) McEvoy, Judy L. Aschner, Ashudee Kirk, Christian Rosas-Salazar, Joan M. Cook-Mills, Paul E. Moore, William F. Walsh, Tina V. Hartert

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Vitamin E is obtained only through the diet and has a number of important biological activities, including functioning as an antioxidant. Evidence that free radicals may contribute to pathological processes such as bronchopulmonary dysplasia (BPD), a disease of prematurity associated with increased lung injury, inflammation and oxidative stress, led to trials of the antioxidant vitamin E (α-tocopherol) to prevent BPD with variable results. These trials were all conducted at supraphysiologic doses and 2 of these trials utilized a formulation containing a potentially harmful excipient. Since 1991, when the last of these trials was conducted, both neonatal management strategies for minimizing oxygen and ventilator-related lung injury and our understanding of vitamin E isoforms in respiratory health have advanced substantially. It is now known that there are differences between the effects of vitamin E isoforms α-tocopherol and γ-tocopherol on the development of respiratory morbidity and inflammation. What is not known is whether improvements in physiologic concentrations of individual or combinations of vitamin E isoforms during pregnancy or following preterm birth might prevent or reduce BPD development. The answers to these questions require adequately powered studies targeting pregnant women at risk of preterm birth or their premature infants immediately following birth, especially in certain subgroups that are at increased risk of vitamin E deficiency (e.g., smokers). The objective of this review is to compile, update, and interpret what is known about vitamin E isoforms and BPD since these first studies were conducted, and suggest future research directions.

Original languageEnglish (US)
Pages (from-to)366-378
Number of pages13
JournalNeonatology
DOIs
StateAccepted/In press - Mar 7 2018

Fingerprint

Bronchopulmonary Dysplasia
Vitamin E
Tocopherols
Protein Isoforms
Premature Birth
Lung Injury
Antioxidants
Vitamin E Deficiency
Excipients
Pathologic Processes
Mechanical Ventilators
Premature Infants
Free Radicals
Pregnant Women
Pneumonia
Oxidative Stress
Parturition
Oxygen
Diet
Inflammation

Keywords

  • Bronchopulmonary dysplasia
  • Chronic lung disease of prematurity
  • Oxidative stress
  • Tocopherol
  • Vitamin E
  • α-Tocopherol
  • γ-Tocopherol

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Biology

Cite this

Stone, C. A., McEvoy, C. C., Aschner, J. L., Kirk, A., Rosas-Salazar, C., Cook-Mills, J. M., ... Hartert, T. V. (Accepted/In press). Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia. Neonatology, 366-378. https://doi.org/10.1159/000487388

Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia. / Stone, Cosby A.; McEvoy, Cynthia (Cindy); Aschner, Judy L.; Kirk, Ashudee; Rosas-Salazar, Christian; Cook-Mills, Joan M.; Moore, Paul E.; Walsh, William F.; Hartert, Tina V.

In: Neonatology, 07.03.2018, p. 366-378.

Research output: Contribution to journalArticle

Stone, CA, McEvoy, CC, Aschner, JL, Kirk, A, Rosas-Salazar, C, Cook-Mills, JM, Moore, PE, Walsh, WF & Hartert, TV 2018, 'Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia', Neonatology, pp. 366-378. https://doi.org/10.1159/000487388
Stone, Cosby A. ; McEvoy, Cynthia (Cindy) ; Aschner, Judy L. ; Kirk, Ashudee ; Rosas-Salazar, Christian ; Cook-Mills, Joan M. ; Moore, Paul E. ; Walsh, William F. ; Hartert, Tina V. / Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia. In: Neonatology. 2018 ; pp. 366-378.
@article{4ebe77b98efb45f0a44b29cf415067d5,
title = "Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia",
abstract = "Vitamin E is obtained only through the diet and has a number of important biological activities, including functioning as an antioxidant. Evidence that free radicals may contribute to pathological processes such as bronchopulmonary dysplasia (BPD), a disease of prematurity associated with increased lung injury, inflammation and oxidative stress, led to trials of the antioxidant vitamin E (α-tocopherol) to prevent BPD with variable results. These trials were all conducted at supraphysiologic doses and 2 of these trials utilized a formulation containing a potentially harmful excipient. Since 1991, when the last of these trials was conducted, both neonatal management strategies for minimizing oxygen and ventilator-related lung injury and our understanding of vitamin E isoforms in respiratory health have advanced substantially. It is now known that there are differences between the effects of vitamin E isoforms α-tocopherol and γ-tocopherol on the development of respiratory morbidity and inflammation. What is not known is whether improvements in physiologic concentrations of individual or combinations of vitamin E isoforms during pregnancy or following preterm birth might prevent or reduce BPD development. The answers to these questions require adequately powered studies targeting pregnant women at risk of preterm birth or their premature infants immediately following birth, especially in certain subgroups that are at increased risk of vitamin E deficiency (e.g., smokers). The objective of this review is to compile, update, and interpret what is known about vitamin E isoforms and BPD since these first studies were conducted, and suggest future research directions.",
keywords = "Bronchopulmonary dysplasia, Chronic lung disease of prematurity, Oxidative stress, Tocopherol, Vitamin E, α-Tocopherol, γ-Tocopherol",
author = "Stone, {Cosby A.} and McEvoy, {Cynthia (Cindy)} and Aschner, {Judy L.} and Ashudee Kirk and Christian Rosas-Salazar and Cook-Mills, {Joan M.} and Moore, {Paul E.} and Walsh, {William F.} and Hartert, {Tina V.}",
year = "2018",
month = "3",
day = "7",
doi = "10.1159/000487388",
language = "English (US)",
pages = "366--378",
journal = "Neonatology",
issn = "1661-7800",
publisher = "S. Karger AG",

}

TY - JOUR

T1 - Update on Vitamin E and Its Potential Role in Preventing or Treating Bronchopulmonary Dysplasia

AU - Stone, Cosby A.

AU - McEvoy, Cynthia (Cindy)

AU - Aschner, Judy L.

AU - Kirk, Ashudee

AU - Rosas-Salazar, Christian

AU - Cook-Mills, Joan M.

AU - Moore, Paul E.

AU - Walsh, William F.

AU - Hartert, Tina V.

PY - 2018/3/7

Y1 - 2018/3/7

N2 - Vitamin E is obtained only through the diet and has a number of important biological activities, including functioning as an antioxidant. Evidence that free radicals may contribute to pathological processes such as bronchopulmonary dysplasia (BPD), a disease of prematurity associated with increased lung injury, inflammation and oxidative stress, led to trials of the antioxidant vitamin E (α-tocopherol) to prevent BPD with variable results. These trials were all conducted at supraphysiologic doses and 2 of these trials utilized a formulation containing a potentially harmful excipient. Since 1991, when the last of these trials was conducted, both neonatal management strategies for minimizing oxygen and ventilator-related lung injury and our understanding of vitamin E isoforms in respiratory health have advanced substantially. It is now known that there are differences between the effects of vitamin E isoforms α-tocopherol and γ-tocopherol on the development of respiratory morbidity and inflammation. What is not known is whether improvements in physiologic concentrations of individual or combinations of vitamin E isoforms during pregnancy or following preterm birth might prevent or reduce BPD development. The answers to these questions require adequately powered studies targeting pregnant women at risk of preterm birth or their premature infants immediately following birth, especially in certain subgroups that are at increased risk of vitamin E deficiency (e.g., smokers). The objective of this review is to compile, update, and interpret what is known about vitamin E isoforms and BPD since these first studies were conducted, and suggest future research directions.

AB - Vitamin E is obtained only through the diet and has a number of important biological activities, including functioning as an antioxidant. Evidence that free radicals may contribute to pathological processes such as bronchopulmonary dysplasia (BPD), a disease of prematurity associated with increased lung injury, inflammation and oxidative stress, led to trials of the antioxidant vitamin E (α-tocopherol) to prevent BPD with variable results. These trials were all conducted at supraphysiologic doses and 2 of these trials utilized a formulation containing a potentially harmful excipient. Since 1991, when the last of these trials was conducted, both neonatal management strategies for minimizing oxygen and ventilator-related lung injury and our understanding of vitamin E isoforms in respiratory health have advanced substantially. It is now known that there are differences between the effects of vitamin E isoforms α-tocopherol and γ-tocopherol on the development of respiratory morbidity and inflammation. What is not known is whether improvements in physiologic concentrations of individual or combinations of vitamin E isoforms during pregnancy or following preterm birth might prevent or reduce BPD development. The answers to these questions require adequately powered studies targeting pregnant women at risk of preterm birth or their premature infants immediately following birth, especially in certain subgroups that are at increased risk of vitamin E deficiency (e.g., smokers). The objective of this review is to compile, update, and interpret what is known about vitamin E isoforms and BPD since these first studies were conducted, and suggest future research directions.

KW - Bronchopulmonary dysplasia

KW - Chronic lung disease of prematurity

KW - Oxidative stress

KW - Tocopherol

KW - Vitamin E

KW - α-Tocopherol

KW - γ-Tocopherol

UR - http://www.scopus.com/inward/record.url?scp=85043464672&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85043464672&partnerID=8YFLogxK

U2 - 10.1159/000487388

DO - 10.1159/000487388

M3 - Article

C2 - 29514147

AN - SCOPUS:85043464672

SP - 366

EP - 378

JO - Neonatology

JF - Neonatology

SN - 1661-7800

ER -