Diplock A T, Charleux J L, Crozier-Willi G, Kok F J, Rice-Evans C, Roberfroid M, Stahl W, Viña-Ribes J
International Antioxidant Research Centre, UMDS, Guy's Hospital, London, UK.
Br J Nutr. 1998 Aug;80 Suppl 1:S77-112. doi: 10.1079/bjn19980106.
This paper assesses critically the science base that underpins the argument that oxidative damage is a significant causative factor in the development of human diseases and that antioxidants are capable of preventing or ameliorating these disease processes. The assessment has been carried out under a number of headings, and some recommendations for future research are made based on the present day knowledge base. The knowledge database (1) Consideration of the basic science that underlies understanding of the role of free radicals in causing cellular pathologies, and the role of antioxidants in preventing this, shows that an imbalance of reactive oxygen species and antioxidant defence systems may lead to chemical modifications of biologically relevant macromolecules. This imbalance provides a logical pathobiochemical mechanism for the initiation and development of several disease states. Experimental data obtained in vivo provide evidence that antioxidants function in systems that scavenge reactive oxygen species and that these are relevant to what occurs in vivo. The relevance in vivo of these observations depends inter alia on knowledge of the uptake and distribution of the antioxidant within the human body, and on what tissue levels of the antioxidant may be expected in relation to dietary levels. (2) There is some way to go until validated precise methods are available for measuring biomarkers of oxidative damage in human subjects in vivo under minimally invasive conditions. With respect to oxidative damage in DNa, HPLC and GC-mass spectrophotometry methods have both merits and limitations. Lipid oxidation products in plasma are best measured as isoprostanes or as lipid hydroperoxides using specific HPLC techniques. Development of isoprostane measurement will advance specificity and precision. The measurement of oxidative damage to proteins has some potential but such methods have not been effectively exploited. (3) Epidemiological studies support the hypothesis that the major antioxidant nutrients vitamin E and vitamin C, and beta-carotene (which may or may not be acting as an antioxidant in vivo), may play a beneficial role in prevention of several chronic disorders. More research is needed on the impact of other non-nutrient compounds, such as other carotenoids and flavonoids, on human health. In general, human intervention studies using hard end-points are the gold standard. Trials are restricted mainly to the major antioxidants and do not allow firm conclusions because of inconsistent findings, an insufficient number of studies and the use of varying doses. There is evidence that large doses of beta-carotene may be deleterious to the health of certain subgroups of the population such as heavy habitual smokers. (4) With respect to the safety of administration of supplementary vitamins, vitamin C is safe at levels of supplementation up to 600 mg/d, and higher levels, up to 2000 mg/d, are without risk. Vitamin E has a very low human toxicity and an intake of 1000 mg/d is without risk; 3200 mg/d has been shown to be without any consistent risk. Large intakes of beta-carotene must be viewed with caution because they have been shown to confer detriment to a population at high risk of lung cancer when administered after many years of high risk (smoking) behaviour. Until further work clarifies the situation in heavy smokers with respect to taking supplements, larger doses should be avoided by such individuals. There is little reliable information about the human toxicology of flavonoids and related non-nutrient antioxidant constituents of the diet. (5) The food industry has long experience in the control of oxidative damage in foods and this experience can be used to advantage for the protection of food antioxidants which are beneficial. Some of these, such as vitamins C and E and beta-carotene, are well known, and strategies for their protection in foods are already exploited by food technologies. (ABSTRACT TRUNCATED)
氧化损伤是人类疾病发展的一个重要致病因素,抗氧化剂能够预防或改善这些疾病进程。评估是在若干标题下进行的,并根据目前的知识库对未来研究提出了一些建议。知识数据库(1)对自由基在导致细胞病变中的作用以及抗氧化剂在预防这种作用方面的理解所基于的基础科学的思考表明,活性氧物种和抗氧化防御系统的失衡可能导致生物相关大分子的化学修饰。这种失衡为几种疾病状态的发生和发展提供了一种合理的病理生化机制。体内获得的实验数据表明,抗氧化剂在清除活性氧物种的系统中发挥作用,并且这些与体内发生的情况相关。这些观察结果在体内的相关性尤其取决于人体对抗氧化剂的摄取和分布的了解,以及相对于饮食水平预期的抗氧化剂组织水平。(2)在微创条件下在人体受试者体内测量氧化损伤生物标志物的经过验证的精确方法问世之前,还有一段路要走。就DNA中的氧化损伤而言,高效液相色谱法(HPLC)和气相色谱 - 质谱法都有优点和局限性。血浆中的脂质氧化产物最好使用特定的HPLC技术作为异前列腺素或脂质氢过氧化物来测量。异前列腺素测量方法的发展将提高特异性和精度。蛋白质氧化损伤的测量有一定潜力,但此类方法尚未得到有效利用。(3)流行病学研究支持这样的假设:主要的抗氧化营养素维生素E、维生素C和β - 胡萝卜素(其在体内可能作为抗氧化剂,也可能不作为抗氧化剂起作用)可能在预防几种慢性疾病中发挥有益作用。关于其他非营养化合物,如其他类胡萝卜素和黄酮类化合物对人类健康的影响,还需要更多研究。一般来说,使用硬终点的人体干预研究是金标准。试验主要限于主要的抗氧化剂,由于结果不一致、研究数量不足以及使用不同剂量,无法得出确凿结论。有证据表明,大剂量的β - 胡萝卜素可能对某些人群亚组的健康有害,如重度习惯性吸烟者。(4)关于补充维生素的安全性,维生素C在每日补充量高达600毫克时是安全的,更高剂量,高达2000毫克/天,也没有风险。维生素E对人体的毒性非常低,每日摄入量1000毫克没有风险;已证明每日摄入量3200毫克也没有任何持续风险。大剂量摄入β - 胡萝卜素必须谨慎看待,因为在多年高风险(吸烟)行为后给予时,已证明其会对肺癌高风险人群造成损害。在进一步的研究阐明重度吸烟者服用补充剂的情况之前,此类人群应避免大剂量摄入。关于黄酮类化合物和饮食中相关非营养抗氧化成分的人体毒理学,几乎没有可靠信息。(5)食品行业在控制食品中的氧化损伤方面有长期经验,这一经验可用于保护有益的食品抗氧化剂。其中一些,如维生素C、维生素E和β - 胡萝卜素是众所周知的,食品技术已经采用了在食品中保护它们的策略。(摘要截断)