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Antioxidant vitamins E and C as adjunct therapy of severe acute lower-respiratory infection in infants and young children: a randomized controlled trial.
Eur J Clin Nutr. 2006 May; 60(5):673-80.EJ

Abstract

OBJECTIVE

To evaluate the effect of antioxidant Vitamins E and C as adjunct therapy of severe acute lower respiratory infection (ALRI) in children.

DESIGN

Randomized double-blind placebo-controlled clinical trial.

SETTING

A large childrens' hospital serving the urban poor in Kolkata, India.

SUBJECTS

Children aged 2-35 months admitted with severe ALRI.

INTERVENTION

In total, 174 children were randomly assigned to receive alpha-tocopherol 200 mg and ascorbic acid 100 mg twice daily or placebo for 5 days. All children received standard treatment for severe ALRI. Outcome measures were: time taken to recover from a very ill status, fever, tachypnoea, and feeding difficulty; and improvement in oxidative stress and immune response indicated by thiobarbituric acid reacting substances (TBARS) and response to skin antigens, respectively.

RESULTS

Recovery rate ratios (95% CI) using proportional hazards model were 0.89 (0.64-1.25), 1.01 (0.72-1.41), 0.86 (0.57-1.29), and 1.12 (0.77-1.64) for very ill status, feeding difficulty, fever, and tachypnoea, respectively. TBARS values were high and similar in the two groups at admission, discharge, and at 2 weeks follow-up. Serum alpha-tocopherol significantly increased in treated group at discharge. Immune response to skin antigens were very poor at admission and after 2 weeks, in both groups.

CONCLUSION

Infants with severe ALRI failed to benefit from two antioxidant nutrients as adjunct therapy. Severe ALRI in infants may cause cell-mediated immune dysfunction. We need a better understanding of oxidative processes in growing infants to help us better design interventions with antioxidant therapy.

Authors+Show Affiliations

Society for Applied Studies, Kolkata, WB, India. dmahalanabis@vsnl.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16391588

Citation

Mahalanabis, D, et al. "Antioxidant Vitamins E and C as Adjunct Therapy of Severe Acute Lower-respiratory Infection in Infants and Young Children: a Randomized Controlled Trial." European Journal of Clinical Nutrition, vol. 60, no. 5, 2006, pp. 673-80.
Mahalanabis D, Basak M, Paul D, et al. Antioxidant vitamins E and C as adjunct therapy of severe acute lower-respiratory infection in infants and young children: a randomized controlled trial. Eur J Clin Nutr. 2006;60(5):673-80.
Mahalanabis, D., Basak, M., Paul, D., Gupta, S., Shaikh, S., Wahed, M. A., & Khaled, M. A. (2006). Antioxidant vitamins E and C as adjunct therapy of severe acute lower-respiratory infection in infants and young children: a randomized controlled trial. European Journal of Clinical Nutrition, 60(5), 673-80.
Mahalanabis D, et al. Antioxidant Vitamins E and C as Adjunct Therapy of Severe Acute Lower-respiratory Infection in Infants and Young Children: a Randomized Controlled Trial. Eur J Clin Nutr. 2006;60(5):673-80. PubMed PMID: 16391588.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antioxidant vitamins E and C as adjunct therapy of severe acute lower-respiratory infection in infants and young children: a randomized controlled trial. AU - Mahalanabis,D, AU - Basak,M, AU - Paul,D, AU - Gupta,S, AU - Shaikh,S, AU - Wahed,M A, AU - Khaled,M A, PY - 2006/1/5/pubmed PY - 2006/6/9/medline PY - 2006/1/5/entrez SP - 673 EP - 80 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 60 IS - 5 N2 - OBJECTIVE: To evaluate the effect of antioxidant Vitamins E and C as adjunct therapy of severe acute lower respiratory infection (ALRI) in children. DESIGN: Randomized double-blind placebo-controlled clinical trial. SETTING: A large childrens' hospital serving the urban poor in Kolkata, India. SUBJECTS: Children aged 2-35 months admitted with severe ALRI. INTERVENTION: In total, 174 children were randomly assigned to receive alpha-tocopherol 200 mg and ascorbic acid 100 mg twice daily or placebo for 5 days. All children received standard treatment for severe ALRI. Outcome measures were: time taken to recover from a very ill status, fever, tachypnoea, and feeding difficulty; and improvement in oxidative stress and immune response indicated by thiobarbituric acid reacting substances (TBARS) and response to skin antigens, respectively. RESULTS: Recovery rate ratios (95% CI) using proportional hazards model were 0.89 (0.64-1.25), 1.01 (0.72-1.41), 0.86 (0.57-1.29), and 1.12 (0.77-1.64) for very ill status, feeding difficulty, fever, and tachypnoea, respectively. TBARS values were high and similar in the two groups at admission, discharge, and at 2 weeks follow-up. Serum alpha-tocopherol significantly increased in treated group at discharge. Immune response to skin antigens were very poor at admission and after 2 weeks, in both groups. CONCLUSION: Infants with severe ALRI failed to benefit from two antioxidant nutrients as adjunct therapy. Severe ALRI in infants may cause cell-mediated immune dysfunction. We need a better understanding of oxidative processes in growing infants to help us better design interventions with antioxidant therapy. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/16391588/Antioxidant_vitamins_E_and_C_as_adjunct_therapy_of_severe_acute_lower_respiratory_infection_in_infants_and_young_children:_a_randomized_controlled_trial_ L2 - https://doi.org/10.1038/sj.ejcn.1602368 DB - PRIME DP - Unbound Medicine ER -