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Role of Palm Oil Vitamin E in Preventing Pre-eclampsia: A Secondary Analysis of a Randomized Clinical Trial Following ISSHP Reclassification

Nurul Afzan Aminuddin, Rosnah Sutan, Zaleha Abdullah Mahdy

Front Med (Lausanne) . 2021 Jan 21;7:596405. doi: 10.3389/fmed.2020.596405. eCollection 2020.

Abstract

Background: Preeclampsia is a significant cause of maternal and perinatal mortality worldwide. Oxidative stress plays a key role in its pathophysiology, hence antioxidants such as tocotrienol may be preventive against preeclampsia. In 2018, the ISSHP revised the definition of preeclampsia. In accordance with the new definition, we report a secondary data analysis from a clinical trial comparing palm oil vitamin E in the form of tocotrienol-rich fraction (TRF) against placebo, in preventing preeclampsia. Method: A randomized double-blind controlled trial was conducted in 2002-2005 to assess the benefits of TRF in preeclampsia prevention. A total of 299 primigravidae were recruited. The intervention group was supplemented with TRF 100 mg daily in super-olein capsules, whereas the placebo group was prescribed super-olein capsules without TRF, beginning from 12 to 16 gestational weeks until delivery. The primary outcome measure was incidence of preeclampsia. Results: The total incidence of pregnancy induced hypertension (PIH) was 5%, whereas the incidence of preeclampsia was 2.3%. The odds of developing PIH (adjusted OR 0.254; 95% CI: 0.07-0.93; p-value 0.038) and preeclampsia (adjusted OR 0.030; 95% CI: 0.001-0.65; p-value 0.025) were significantly lower in the TRF arm compared to the placebo arm. Conclusion: Antenatal supplementation with palm oil vitamin E in the form of TRF is associated with significant reductions in the incidence of preeclampsia and PIH in a single urban tertiary hospital. Palm oil vitamin E deserves further scrutiny as a potential public health preventive measure against preeclampsia and PIH.

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The Health Benefits of Tocotrienol

Tocotrienols are chemicals in the vitamin E family. Unlike other forms of vitamin E, tocotrienols are less commonly found in nature. Most of the food we eat contains tocopherols instead of tocotrienols, but several types of vegetable oils, like palm oil, contain high amounts of tocotrienols. Most vitamin E supplements contain tocopherols and not tocotrienols. Studies also suggest that tocotrienol is a more potent form of vitamin E than tocopherol. Research also tells us that tocotrienol has many health benefits.

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A Phase IIb Randomized Controlled Trial Investigating the Effects of Tocotrienol-Rich Vitamin E on Diabetic Kidney Disease

Yan Yi Koay, Gerald Chen Jie Tan, Sonia Chew Wen Phang, J-Ian Ho, Pei Fen Chuar, Loon Shin Ho, Badariah Ahmad, Khalid Abdul Kadir

Nutrients . 2021 Jan 18;13(1):258. doi: 10.3390/nu13010258.

Abstract

Diabetic kidney disease (DKD) is a debilitating complication of diabetes, which develops in 40% of the diabetic population and is responsible for up to 50% of end-stage renal disease (ESRD). Tocotrienols have shown to be a potent antioxidant, anti-inflammatory, and antifibrotic agent in animal and clinical studies. This study evaluated the effects of 400 mg tocotrienol-rich vitamin E supplementation daily on 59 DKD patients over a 12-month period. Patients with stage 3 chronic kidney disease (CKD) or positive urine microalbuminuria (urine to albumin creatinine ratio; UACR > 20-200 mg/mmol) were recruited into a randomized, double-blind, placebo-controlled trial. Patients were randomized into either intervention group (n = 31) which received tocotrienol-rich vitamin E (Tocovid SupraBioTM; Hovid Berhad, Ipoh, Malaysia) 400 mg daily or a placebo group which received placebo capsules (n = 28) for 12 months. HbA1c, renal parameters (i.e., serum creatinine, eGFR, and UACR), and serum biomarkers were collected at intervals of two months. Tocovid supplementation significantly reduced serum creatinine levels (MD: -4.28 ± 14.92 vs. 9.18 ± 24.96), p = 0.029, and significantly improved eGFR (MD: 1.90 ± 5.76 vs. -3.29 ± 9.24), p = 0.011 after eight months. Subgroup analysis of 37 patients with stage 3 CKD demonstrated persistent renoprotective effects over 12 months; Tocovid improved eGFR (MD: 4.83 ± 6.78 vs. -1.45 ± 9.18), p = 0.022 and serum creatinine (MD: -7.85(20.75) vs. 0.84(26.03), p = 0.042) but not UACR. After six months post washout, there was no improvement in serum creatinine and eGFR. There were no significant changes in the serum biomarkers, TGF-β1 and VEGF-A. Our findings verified the results from the pilot phase study where tocotrienol-rich vitamin E supplementation at two and three months improved kidney function as assessed by serum creatinine and eGFR but not UACR.

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MPOB develops three palm-based technologies for commercialisation

The Malaysian Palm Oil Board (MPOB) has developed three advanced palm-based technologies for commercialisation.

In a statement on Friday, it said the first is the process and formulation of palm vitamin E/ tocotrienol-rich fraction (TRF) chewable tablet. The second is palm oil-based polyol for floor coverings for indoor and outdoor and sports flooring markets while the third is a moisturising hand sanitiser with Vitamin E. MPOB said the three are among the technologies approved by the Minister of Plantation Industries and Commodities for commercialisation.

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Patient-derived Nerve Cells May Help Advance Pompe Research

As a proof-of-concept, the team evaluated the effects of treating the cells with a lab-made GAA — obtained after infusions of Lumyzime (alglucosidase alfa), an enzyme replacement therapy — delta-tocopherol, and hydroxypropyl-beta-cyclodextrin (HPβCD). Delta-tocopherol and HPβCD are two structurally distinct small molecules previously shown to lessen disease features in cellular and animal models of lysosomal storage diseases.

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Application of Partial Hydrogenation for the Generation of Minor Tocochromanol Homologs and Functional Evaluation of Hydrogenated Tocotrienol-rich Vitamin E Oil in Diabetic Obese Mice

Fumiaki Beppu, Aimi Sakuma, Satoshi Kasatani, Yoshinori Aoki, Naohiro Gotoh

J Oleo Sci . 2021;70(1):103-112. doi: 10.5650/jos.ess20233.

Abstract

Recent research has identified minor homologs of vitamin E with one or two double bonds in the side-chain, namely tocomonoenol (T1) and tocodienol (T2), in natural products. We first explored the effectiveness of partial hydrogenation for generating minor tocochromanols from tocotrienol (T3). During hydrogenation with pure α-T3 as a substrate, the side-chain was partially saturated in a time-dependent manner, and a large amount of α-T1 and α-T2 was obtained. To investigate the beneficial effects of the hydrogenated product, we fed diabetic obese KK-A y mice with a hydrogenated T3 mixture (HT3). Feeding HT3 revealed tissue-specific accumulation of tocochromanols, ameliorated hyperglycemia and improved ratio of high-density lipoprotein cholesterol to total cholesterol in serum, with invariant body weight and fat mass. Hence, we propose that hydrogenation is a useful method for generating T1 and T2 homologs, which can be applied to explore the structure-related function of tocochromanols.

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Palm oil may help fight cancer

Research by medical experts have revealed that palm tocotrienols act on three different mechanisms in the hallmarks of cancer – tumour suppressors, immune modulation and inflammation. Malaysian Palm Oil Board (MPOB) research officer, Dr Fu Ju Yen said the hypothesis on the study conducted showed enhanced absorption of tocotrienols by eight-fold when delivered via nanocarriers.

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Study of vitamin E microencapsulation and controlled release from chitosan/sodium lauryl ether sulfate microcapsules

Jelena Milinković Budinčić, Lidija Petrović, Ljiljana Đekić, Jadranka Fraj, Sandra Bučko, Jaroslav Katona, Ljiljana Spasojević

Carbohydr Polym . 2021 Jan 1;251:116988. doi: 10.1016/j.carbpol.2020.116988. Epub 2020 Aug 30.

Abstract

Potential benefit of microencapsulation is its ability to deliver and protect incorporated ingredients such as vitamin E. Microcapsule wall properties can be changed by adding of coss-linking agents that are usually considered toxic for application. The microcapsules were prepared by a spray-drying technique using coacervation method, by depositing the coacervate formed in the mixture of chitosan and sodium lauryl ether sulfate to the oil/water interface. All obtained microcapsules suspensions had slightly lower mean diameter compared to the starting emulsion (6.85 ± 0.213 μm), which shows their good stability during the drying process. The choice and absence of cross-linking agents had influence on kinetics of vitamin E release. Encapsulation efficiency of microcapsules without cross-linking agent was 73.17 ± 0.64 %. This study avoided the use of aldehydes as cross-linking agents and found that chitosan/SLES complex can be used as wall material for the microencapsulation of hydrophobic active molecules in cosmetic industry.

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Vitamin E-infused highly cross-linked polyethylene did not reduce the number of in vivo wear particles in total knee arthroplasty

Kumi Orita, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Hideki Ueyama, Susumu Takemura, Hiroaki Nakamura

Carbohydr Polym . 2021 Jan 1;251:116988. doi: 10.1016/j.carbpol.2020.116988. Epub 2020 Aug 30.

Abstract

Aims: Vitamin E-infused highly cross-linked polyethylene (E1) has recently been introduced in total knee arthroplasty (TKA). An in vitro wear simulator study showed that E1 reduced polyethylene wear. However there is no published information regarding in vivo wear. Previous reports suggest that newly introduced materials which reduce in vitro polyethylene wear do not necessarily reduce in vivo polyethylene wear. To assist in the evaluation of the newly introduced material before widespread use, we established an in vivo polyethylene wear particle analysis for TKA. The aim of this study was to compare in vivo polyethylene wear particle generation between E1 and conventional polyethylene (ArCom) in TKA.

Methods: A total of 34 knees undergoing TKA (17 each with ArCom or E1) were investigated. Except for the polyethylene insert material, the prostheses used for both groups were identical. Synovial fluid was obtained at a mean of 3.4 years (SD 1.3) postoperatively. The in vivo polyethylene wear particles were isolated from the synovial fluid using a previously validated method and examined by scanning electron microscopy.

Results: The total number of polyethylene wear particles obtained from the knees with E1 (mean 6.9, SD 4.0 × 107 counts/knee) was greater than that obtained from those with ArCom (mean 2.2, SD 2.6 × 107 counts/knee) (p = 0.001). The particle size (equivalent circle of diameter) from the knees with E1 was smaller (mean 0.5 μm, SD 0.1) than that of knees with ArCom (mean 1.5, SD 0.3 μm) (p = 0.001). The aspect ratio of particles from the knees with E1 (mean 1.3, SD 0.1) was smaller than that with ArCom (mean 1.4, SD 0.1) (p < 0.001 ).

Conclusion: This is the first report of in vivo wear particle analysis of E1. E1 polyethylene did not reduce the number of in vivo polyethylene wear particles compared with ArCom in early clinical stage. Further careful follow-up of newly introduced E1 for TKA should be carried out. Cite this article: Bone Joint J 2020;102-B(11):1527-1534.

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