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1 Traber MG. Vitamin E. Modern nutrition in health and disease, 9th edition. Baltimore, MD: Williams & Wilkins. (1999) : E Tomassi G, Silano V. An assessment of the safety of tocopherols as food additives. Food and chemical toxicology. (1986) 24(10-11): in vitro D K Bendich A, Machlin L J. Safety of oral intake of Vitamin E. Am J Clin Nutr. (1988) 48 : E 3,200 mg/ E E K E K E Kappus H, Diplock A T. Tolerance and Safety of Vitamin E : A Toxicological Position Report. Free Radical Biology & Medicine (1992) 13 : E mg/ 1
2 3200 IU/ E E E E 2
3 - Blomstrand R, Forsgren L. Labelled tocopherols in man. Internat. Z. Vit. forschung (1968) 38 : dl-α % dl-α- 28.5% E Bioavailability dl- d-α- d-α- E d-α- - Kiyose C, Muramatsu R, Kameyama Y, Ueda T, Igarashi O. Biodiscrimination of α-tocopherol stereoisomers in humans after oral administration. Am J Clin Nutr. (1997) 65 : (21 37 ) RRR-α- all-rac- α- α RRR-α- 100 mg/ all-rac- α- 100 mg/ all-rac- α- 300 mg/ α- RRR-α- all-rac- 3
4 α- RRR or all-racα- 100 mg/ RRR-α 300 mg/ all-rac- α- R S all-rac- α- - Burton GW, Traber MG, Acuff RV, Walters DN, Kayden H, Hughes L, Ingold KU. Human plasma and tissue α-tocopherol concentrations in response to supplementation with deuterated natural and synthetic vitamin E. Am J Clin Nutr (1998) 67 : E E RRR- α- all-rac- α- E mg mg mg/ 22 α- 30 mg/ ± mg/ ±0.17 E Traber MG, Burton GW, Ingold KU, Kayden HJ, RRR- and SRR-α-tocopherols are secreted without discrimination in human chylomicrons, but RRR-α-tocopherol is preferentially secreted in very low density lipoproteins. J.Lipid.Res (1990) 31 : d 6 -RRR-α- d 3 -SRR-α- 50 mg d 6 d d 3 d 6 d 6 /d 3 4
5 d 6 RRR-α- SRR-α- RRR-α- SRR-α-VLDL - Taraber MG, Burton GW, Hughes L, Ingold KU, Hidaka H, Malloy M, Kane J, Hyams J, Kayden HJ. Discrimination between forms of vitamin E by humans with and without genetic abnormalities of lipoprotein metabolism. J.Lipid Res. (1992) 33 : E B d 6 -RRR-α d 3 -SRR-α d 2 -RRR-γ 3 d 2 -RRR-γ d 3 -SRR-α d 6 -RRR-α RRR-α VLDL VLDL RRR-α - Cheesman KH, Holley AE, Kelly FJ, Wasil M, Hughes L, Burton G. Biokinetics in human of RRR-alpha-tocopherol: the free phenol, acetate ester, and succinate ester forms of vitamine. Free Radical Biology & Medicine. (1995) 19(5) : RRR-α 51 RRR-α 12 RRR-α 1.0 RRR-α 27 5
6 - Kelleher J, Losowsky MS. The absorption of α-tocopherol in man. Br J Nutr. (1970) 24 : dl-α- 70% α- α % - Macmahon MT, Neale G. The absorption of α-tocopherol in control subjects and in patients with intestinal malabsorption. Clinical Science. (1970) 38 : α % α % - Traber MG, Ramakrishnan R, Kayden HJ. Human plasma vitamin E kinetics demonstrate rapid recycling of plasma RRR-α-tocopherol. Proc Nat.Acad Sci USA (1994) 91 : E α- RRR- SRR- α- 24 RRR- RRR- VLDL E 3 RRR- SRR-α- SRR-α- 6 RRR-α- 0.4±0.1 pool/day SRR-α- (1.2±0.6 pool/day) 2 0.8±0.6 RRR-α- 6
7 RRR-α- RRR-α- SRR-α- VLDL RRR-α- RRR-α- α- 1 pool - Traber MG, Elsner A, Brigelius-Flohe R. Synthetic as compared with natural vitamin E is preferentially excreted as α-cehc in human urine: studies using deuterated α-tocopheryl acetates. FEBS letter (1998). α-cehc 2,5,7,8-tetramethyl-2(2 carboxyethyl)-6-hydroxychroman E E α-cehc mg RRR- all-rac- α- d 3 RRR-α- d 6 all-rac-α α-cehc E α-cehc - Eichhorn J, Lee R, Dunster C, Basu S, Kelly FJ. Alpha- and gamma-tocopherol plasma and urinary biokinetics following alpha-tocopherol supplementation. Annals of the New York Academy of Science (2004)1031: , 100, 200, 400 mg CEHC -QL -CEHC 15 mg - - in vivo CEHC - -CEHC -CEHC - - 7
8 - Schultz M, Leist M, Petrzika M, Gassmann B, Brigelius-Flohe R. Novel urinary metabolite of α-tocopherol, 2,5,7,8-tetramethyl-2(2 carboxyethyl)-6-hydroxychroman, as an indicator of an adequate vitamin E supply? Am J Clin Nutr (1995) 62 : E α- α-cehc α- α- α-cehc RRR-α mg/ HPMC GC-MS α- 7 9 µ mol /g α-cehc α mg α-cehc E E 8
9 CRN( ) UL Gillilan RE, Mondell B, Warbasse JR. Quantitative evaluation of vitamin E in the treatment of angina pectoris. Am Heart J. (1977) 93 : d-α- 1,600 IU/ E SCF(EU) UL Meydani SN, Meydani M, Blumberg JB, Leka LS, Pedrosa M, Diamond R, Schaefer EJ. Assessment of the safety of supplementation with different amounts of vitamin E in healthy older adults. Am J Clin Nutr. (1998) 68 : all-rac-α IU/ mg/ 4 Candida albicans E E EVM( ) UL Stephens NG, Parsons A, Schofield PM, Kelly F, Cheeseman K, Mitchinson MJ. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet. (1996) Mar 23;347(9004) : E LDL α- CHAOS 2002 α IU/ E ( ) UL Morinobu T, Ban R, Yoshikawa S, Murata T and Tamai H. The safety of high-dose vitamin E supplementation in healthy Japanese male adults. J Nutr Sci Vitaminol. (2002) 9
10 48: 6-9. E d-α IU 800 mg d-α α- α- 28 d-α IU Cohen HM. Fatigue caused by vitamin E? Calif. Med. (1973) 119 : IU E E Briggs MH, Briggs M. Are vitamin E supplements beneficial? Med J Aust. (1974) 1: E 1) 2) 3) 4) E E Vitamin E supplements and fatigue. N Engl J Med. (1974) 290 : Cohen HM Letter Fatigue caused by vitamin E? Calif. Med. (1973) 119 : 72. (1) Briggs M. 8 d-α- 800 IU/ 3 10
11 (2) Ayres S, Mihan R. 10 E IU E E 400 1,600 IU/ E Farrell PM, Bieri JG. Megavitamin E supplementation in man. American Journal of Clinical Nutrition. (1975) 28 : E IU/ 3 Tsai AC, Kelley JJ, Peng B, Cook N. Study on the effect of megavitamin E supplementation in man. The American Journal of clinical Nutrition. (1978) 31 : dl-α- 600 mg/ 600 IU/ 4 Stampher MJ, Willett W, Castelli WP, Taylor JO, Fine J, Hennekens CH. Effect of vitamin E on lipids. Am J Clin Pathol. (1983) 79 : E HDL-C HDL-C 30 E 800 IU/ 16 E 11
12 Ernst E, Matrai A. Einflub von alpha-tocopherol (Vitamin E) auf die fliebeigenschaften des blutes. Therapiewoche (1985) 35 : α- E 10 α- 800 mg/ 4 α- Hale WE, Perkins LL, May FE, Marks RG, Stewart RB. Vitamin E effect on symptoms and laboratory values in the elderly. J Am Diet Assoc. (1986) 86 : E E 369 1,861 E E SGOT Kitagawa K, Mino M. Effect of Elevated d-alpha(rrr)-tocopherol Dosage in Man. J Nutr Sci Vitaminol (1989) 35 : mg 900IU RRR-α RBC α γ- RBC Taylor HR, Tikellis G, Robman LD, MaCarty CA, McNeil JJ. Vitamin E supplementation and macular degeneration: randomized controlled trial. BMJ (2002) 325 : E AMD IU/ 335 mg/ 12
13 d-α- 4 E AMD 2 Moharana S, Moharana DN. Letter to Editor:Hypervitaminosis E. Indian journal of physiology and pharmacology. (1999) 43 (3) : ( ) E mg/kg/ mg/kg/ E GISSI Prevention Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'infarto miocardico. Lancet (1999) Aug 7 ; 354 (9177) : GISSI 2,830 E(300 mg/ ) 3 Yusuf S, Dagenais G, Pogue J, Bosch J, Sleight P. Vitamin E supplementation and cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. (2000) Jan 20 ; 342(3) : E E 400 IU/ Sano M, Ernesto C, Thomas RG, Klauber MR, Schafer K, Grundman M, Woodbury P, Growdon J, Cotman CW, Pfeiffer E, Schneider LS, Thal LJ. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med. (1997) Apr 24 ; 336(17) :
14 mg/ α- 2,000 IU/ 2 + Mortality in DATATOP: a multicenter trial in early Parkinson's disease. Parkinson Study Group. Ann Neurol. (1998) Mar;43(3) : dl-α- 2,000 IU/ Miller ER 3rd, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality. Annals of Internal Medicine 142(1): (Epub 2004 Nov 10.) E E E Pub Med E ,967 E ,000 IU 400 IU IU/ E 150 IU/ 400 IU/ E Effect of Long-term Vitamin E Supplementation on Cardiovascular Events and Cancer. Journal of the American Medical Association (2005) 293(11):
15 Heart Outcome Prevention Evaluation-The Ongoing Outcomes HOPE-TOO 55 9, HOPE E 400 IU/ E E Bairati I, Meyer F, Gelinas M, Fortin A, Nabid A, Brochet F, Mercier JP, Tetu B, Harel F, Masse B, Vigneault E, Vass S, del Vecchio P, Roy J. A Randomized Trial of Antioxidant Vitamins to Prevent Second Primary Cancers in Head and Neck Cancer patients. Journal of the National Cancer Institute (2005) 97(7): α βfirst phase Second phase phase First phase E Second phase α 15
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