In cystic fibrosis (CF), an imbalance between the production of reactive oxygen species and their inactivation by protective systems has been suggested. Digestive malabsorption in CF patients, especially those with exocrine pancreatic insufficiency, may lead to malnutrition and spread of oxidative conditions generated by chronic pulmonary infections. Because biological symptoms of malnutrition (such as low blood level of vitamin E) may occur in the few weeks after birth it is important to preserve normal nutritional status of CF patients. Therefore routine multivitamin supplementation should be supported by diet with adequate quantity of antioxidants. The aim of the study was to assess total antioxidant status in cystic fibrosis infants fed a complete formula containing vitamins A and E compared to healthy controls. 21 cystic fibrosis children with exocrine pancreatic insufficiency aged 3-15 months taking Milupa Cystilac Formula (vitamin A – 141 mg/100 ml; vitamin E – 3.7 mg/100 ml) were enrolled in the 6 month long study. Total antioxidant status (TAS) was measured as Trolox-equivalent antioxidant capacity and vitamin A (retinol) and E (α -tocopherol) concentrations were determined by the method of high-pressure liquid chromatography (HPLC). We have found that in plasma of CF patients before nourishing with complete formula mean concentration of TAS was significantly lower than in healthy children (1.16 ± 0.08 mmol/l vs 1.30 ± 0.04 mmol/l; p<0.0001). Plasma levels of retinol were in the controls within the normal range (0.8 – 2.8 μmol/l). In CF children vitamin A concentration below the normal limit was shown in 5 patients. Plasma levels of a -tocopherol were lower in group of CF infants (11.56 ± 4.35 μmol/l) than in healthy ones (18.41 ± 3.10 μmol/l). The differences were statistically significant (p<0.0001). In CF children TAS level elevated following treatment (pre 1.16 ± 0.04 range 1.03 – 1.31 mmol/l; post 1.23 ± 0.07 range 1.15 – 1.40 mmol/l; p<0.01). Similar increases in the plasma concentration of retinol (pre 1.13 ± 0.39 μmol/l, post 1.40 ± 0.36 μmol/l; p<0.05) and α -tocopherol (pre 11.56 ± 5.35 μmol/l, post 17.85 ± 4.09 μmol/l; p<0.0001) was observed. After six months intake of diet based on specific nutritional needs of infants with cystic fibrosis their total antioxidant status improved by about 12 % and was in the similar range as in control subjects (1.22 – 1.40 mmol/l). Our results suggested that studied diet is effective in normalising level of total antioxidant status and plasma vitamin A and E concentrations and could be associated with clinical benefit to CF patients.

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