Vitamin E Supplementation

Clinical

Simin Nikbin
Robert

Meydani,

Loszewsk\;

DVM, PhD; Mohsen

Claudette

Thompson;

Meydani,
Marcos

DVM, PhD; Jeffrey

C. Pedrosa,

B. Blumberg,

MD; Richard

D. Diamond,

Objective.To determine whether long-term supplementation
with vitamin E
enhances in vivo, clinically relevant measures of cell-mediated immunity in healthy
elderly subjects.Design.-Randomized,
double-blind, placebo-controlled
intervention study.
Setting and Participants.-A
total of 88 free-Iiving, healthy subjects at least 65
years of age.
Intervention.-Subjects
were randomly assigned to a placebo group or to
groups consuming 60, 200, or 800 mg/d of vitamin E for 235 days.
Main Outcome
Measures.-Delayed-type
hypersensitivity
skin response
(DTH); antibody responseto hepatitis B, tetanus and diphtheria, and pneumococcal vaccines; and autoantibodies to DNA and thyroglobulin were assessed before

PhD; Lynette

S. Leka; George

MD; B. David

Stollar,

Siber,

MD;

MD

CONSIDERABLE evidence indicates
that aging is associated with altered
regulation of the immune system, which
contributes to the increased incidence
of infectious andneoplastic diseasesas
well as to the prolonged periods of recovery after illness and ~eater morbidity observed in elderly subjects.l-5
See also p 1398.

Age-related functional changes have
been well defined for both humoral and
cell-mediated immune responses. Altered T-cell-mediated immunity is reflected in the inability of many elderly
to mount a delayed-typehypersensitivity skinresponse(DTH).2-4 he decrease
T
in DTH has been shown to be associated
with greater mortality .~ Wayne et al4
reported significantly gre~ter mortality
rates in healthy older subjects with anergy compared with those with positive
DTH response during a 7-year prospective study. Christou et al6 showed that
levels was observed.
in 245 preop~rativ~ patients (mean age
Conclusions.-Our
results indicate thata level of vitamin E greater than currently
[SD], 64 [12.8] years) DTH was the best
recommended
enhances certain clinically relevant in vivo indexes of T -cellpredictor of sepsis-relateddeath. In that
mediated function in healthy elderly persons. No adverse effects were observed with
study,th, sub.jectsw~re diVided.into 3
vitamin E supplementation.
JAMA. 1997;277:1380-1386groups: anergic,relatIvely anergic, and
reactive. Eighty-seven percent of anergic patients who developed major sepsis
The contents of this publication do not necessarily
From the Nutritional Imml!nology Laboratory (Dr S.
died from it compared with 66% in the
reflect the views or policies of the US Department of
Meydani, Ms Leka, and Mr Loszewski), Vascular Biology
relatively anergic and 16.7%in th~reAgriculture. nor does mention of trade names, camLaboratory (Dr M. Meydani), and Antioxidants Research
mercial products, or organizations imply endorsement
active groups. Thus, both relative and
Laboratory (Dr Blumberg), Jean Mayer USDA Human
by the US government.
Nutrition Research Center on Aging at Tufts University;
total anergy are associated with inReprints: Simin Nikbin Meydani, DVM, PhD.NutriLaboratory of Infectious Diseases, Dana Farber Cancer
creased morbidity and mortality outtionailmmunology
Laboratory, Jean Mayer USDA HuInstitute (Dr Siber and Ms Thompson); Department of
man Nutrition Research Center on Aging at Tufts Unicomesin the elderly. Cohn et al6adminGastroenterology, Veterans Affairs Medical Center (Dr
versity, 711 Washington St, Boston, MA 02111 (&:mail:Pedrosa); Disease Program, Universjty Hospital, Boston
istered DTH tests to elderly residents
S-Meydani-1 MCHNRC. TUFTS.EDU).
University (Dr Diamond); and Department of Bi6chemisof a nursing home and documentedtheir
try, Tufts University (Dr Stollar), Boston, Mass

and after supplementation.
Results.-Supplementation
with vitamin E for 4 months improved certain clinically relevant indexes of...