A Randomized Trial of Replacement Antioxidant Vitamin Therapy for Neutrophil Locomotory Dysfunction in Blunt Trauma

Abstract

Studies in patients with serious trauma indicate that the observed neutrophil (PMN) locomotory dysfunction is partly the result of auto-oxidation as shown by evidence of preactivation, diminished reducing capacity, and low serum and cellular ascorbic acid andα-tocopherol. To investigate whether replacement of the antioxidant vitamins ascorbic acid andα-tocopherol can improve the PMN locomotory defect, ascorbic acid,α-tocopherol, ascorbic acid andα-tocopherol, or placebo was administered to a total of 46 victims of blunt trauma. PMN locomotion was quantitated using a micropore filter assay. Locomotion data were analyzed by repeated measures analysis with a split plot design and data for days 2-6 after injury were compared. Compared with placebo, the antioxidants improved PMN locomotion. The mean differences in distance migrated (treated minus placebo) were ascorbic acid andα-tocopherol = 11.3 ± 3.0μm (one-tailedp= 0.001) (mean ± SE); ascorbic acid = 4.7 ± 3.4μm (p= 0.19); andα-tocopherol = 3.3 ± 2.9μm (p= 0.27). Although both antioxidants given together produced the best results, a plot of the 95% confidence intervals indicates that ascorbic acid andα-tocopherol, either given alone, were also better than placebo. We conclude that antioxidant replacement therapy significantly improves the PMN locomotory abnormality in blunt trauma.