Increased antioxidant intakes may be effective in pain relief for chronic pancreatitis

A new review from China concludes that a combined antioxidant therapy with beta-carotene, vitamin C, vitamin E and selenium may significantly reduce pain in patients with chronic pancreatitis.

The systematic review included nine randomized controlled trials from Europe, Asia and the US, involving 390 adult patients with chronic pancreatitis (CP) who received antioxidant therapy or placebo for 6 to 24 we- eks (1). The data analysis showed that patients receiving therapy with different antioxidants had increased blood levels of antioxidant biomarkers. While no significant positive effect on pain relief was shown on single antioxidants, the use of combined antioxidants, such as beta-carotene, vitamin C, vitamin E and selenium, had a strong association with pain relief. Antioxidant therapy appeared to be safe and there were no serious adverse events after therapy.

The researchers commented that subgroups of patients with CP who obtained optimal benefit from combined antioxidant therapy needed further investigation. It seemed that measures of total antioxidant status may not help to monitor the efficacy of antioxidant therapy for patients with CP. CP is a progressive inflammatory disease of the pancreas, which results in a gradual loss of normal pancreatic tissue architecture and subse- quent fibrosis. For patients with CP, abdominal pain is the most common presentation, which may signifi- cantly decrease quality of life and sometimes lead to severe malnutrition.

Currently, there is still no effective medical therapy for pain relief in patients with CP. In the West, alcohol abuse is the most common cause of CP, which accounts for 70% of cases. It is thought that oxidative stress caused by increased exposure to alcohol or nicotine causes pancreatic cell damage either directly by cell membrane destruction, toxicity from free radical peroxidation products, or through altering signaling path- ways (2).

1. Cai G.-H. et al. Antioxidant Therapy for Pain Relief in Patients with Chronic Pancreatitis: Systematic Review and Meta-analysis. Pain Physician. 2013; 16(6):521–532.
   
2. Grigsby B. et al. Antioxidants and chronic pancreatitis: Theory of oxidative stress and trials of antioxidant therapy. Dig Dis Sci. 2012; 57:835–841.