Modulation of monocyte-macrophage function with alpha-tocopherol: implications for atherosclerosis.

Cardiovascular disease is the leading cause of morbidity and mortality in the Western world. Monocyte-macrophages are crucial cells in atherogenesis. Several lines of evidence suggest that antioxidants, especially alpha-tocopherol, have beneficial effects with regard to cardiovascular disease. Alpha-tocopherol has beneficial effects on cell functions that are pivotal in atherogenesis. Alpha-tocopherol inhibits platelet aggregation and proinflammatory activity of monocytes. In vitro data also support an effect of alpha-tocopherol on smooth muscle cell proliferation and endothelial function. Finally, recent data support an effect of alpha-tocopherol on macrophage function. The mounting evidence from in vitro and in vivo studies provides a sound scientific basis for alpha-tocopherol supplementation. Further clinical trials are required, however, before a definitive recommendation can be made for primary and secondary prevention of heart disease.