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A Randomized Controlled Trial

Simin Nikbin Meydani, DVM, PhD; Mohsen Meydani, DVM, PhD; Jeffrey B. Blumberg, PhD; Lynette S. Leka; George Siber, MD; Robert Loszewski; Claudette Thompson; Marcos C. Pedrosa, MD; Richard D. Diamond, MD; B. David Stollar, MD

JAMA. 1997;277(17):1380-1386.

Abstract
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-living, 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 response to hepatitis B, tetanus and diphtheria, and pneumococcal vaccines; and autoantibodies to DNA and thyroglobulin were assessed before and after supplementation.

Results.
—Supplementation with vitamin E for 4 months improved certain clinically relevant indexes of cell-mediated immunity in healthy elderly. Subjects consuming 200 mg/d of vitamin E had a 65% increase in DTH and a 6-fold increase in antibody titer to hepatitis B compared with placebo (17% and 3-fold, respectively), 60-mg/d (41% and 3-fold, respectively), and 800-mg/d (49% and 2.5-fold, respectively) groups. The 200-mg/d group also had a significant increase in antibody titer to tetanus vaccine. Subjects in the upper tertile of serum -tocopherol (vitamin E) concentration (>48.4 µmol/L [2.08 mg/dL]) after supplementation had higher antibody response to hepatitis B and DTH. Vitamin E supplementation had no effect on antibody titer to diphtheria and did not affect immunoglobulin levels or levels of T and B cells. No significant effect of vitamin E supplementation on autoantibody levels was observed.

Conclusions.
—Our results indicate that a level of vitamin E greater than currently recommended enhances certain clinically relevant in vivo indexes of T-cell-mediated function in healthy elderly persons. No adverse effects were observed with vitamin E supplementation.

Author Affiliations
From the Nutritional Immunology Laboratory (Dr S. Meydani, Ms Leka, and Mr Loszewski), Vascular Biology Laboratory (Dr M. Meydani), and Antioxidants Research Laboratory (Dr Blumberg), Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University; Laboratory of Infectious Diseases, Dana Farber Cancer Institute (Dr Siber and Ms Thompson); Department of Gastroenterology, Veterans Affairs Medical Center (Dr Pedrosa); Disease Program, University Hospital, Boston University (Dr Diamond); and Department of Biochemistry, Tufts University (Dr Stollar), Boston, Mass.

Footnotes
The contents of this publication do not necessarily reflect the views or policies of the US Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government.

Reprints: Simin Nikbin Meydani, DVM, PhD, Nutritional Immunology Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111 (e-mail: S_Meydani_IM@HNRC.TUFTS.EDU).

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