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American Journal of Clinical Nutrition, Vol. 76, No. 4, 703-716, October 2002
© 2002 American Society for Clinical Nutrition


Review Article

The European perspective on vitamin E: current knowledge and future research1,2

Regina Brigelius-Flohé, Frank J Kelly, Jukka T Salonen, Jiri Neuzil, Jean-Marc Zingg and Angelo Azzi

1 From the German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany (RB-F); the School of Health & Life Sciences, King’s College London (FJK); the Research Institute of Public Health, University of Kuopio, Finland (JTS); the Division of Pathology II, Faculty of Health Sciences, University Hospital, Linköping, Sweden (JN); and the Institute of Biochemistry and Molecular Biology, University of Bern, Switzerland (J-MZ and AA).

Vitamin E is indispensible for reproduction in female rats. In humans, vitamin E deficiency primarily causes neurologic dysfunctions, but the underlying molecular mechanisms are unclear. Because of its antioxidative properties, vitamin E is believed to help prevent diseases associated with oxidative stress, such as cardiovascular disease, cancer, chronic inflammation, and neurologic disorders. However, recent clinical trials undertaken to prove this hypothesis failed to verify a consistent benefit. Given these findings, a group of European scientists met to analyze the most recent knowledge of vitamin E function and metabolism. An overview of their discussions is presented in this article, which includes considerations of the mechanisms of absorption, distribution, and metabolism of different forms of vitamin E, including the {alpha}-tocopherol transfer protein and {alpha}-tocopherol–associated proteins; the mechanism of tocopherol side-chain degradation and its putative interaction with drug metabolism; the usefulness of tocopherol metabolites as biomarkers; and the novel mechanisms of the antiatherosclerotic and anticarcinogenic properties of vitamin E, which involve modulation of cellular signaling, transcriptional regulation, and induction of apoptosis. Clinical trials were analyzed on the basis of the selection of subjects, the stage of disease, and the mode of intake, dosage, and chemical form of vitamin E. In addition, the scarce knowledge on the role of vitamin E in reproduction was summarized. In conclusion, the scientists agreed that the functions of vitamin E were underestimated if one considered only its antioxidative properties. Future research on this essential vitamin should focus on what makes it essential for humans, why the body apparently utilizes {alpha}-tocopherol preferentially, and what functions other forms of vitamin E have.

Key Words: Vitamin E • metabolism • binding proteins • novel functions • chemical forms




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