Endothelial Dysfunction in Cystic Fibrosis: Role of Oxidative Stress

Oxidative stress and vascular endothelial dysfunction are established characteristics of cystic fibrosis (CF). Oxidative stress may contribute to vascular dysfunction via inhibition of nitric oxide (NO) bioavailability. Purpose. To determine if ingestion of a single antioxidant cocktail (AOC) improves vascular endothelial function in patients with CF. Methods. In 18 patients with CF (age 8-39 y), brachial artery flow-mediated dilation (FMD) was assessed using a Doppler ultrasound prior to and two hours following either an AOC (n = 18; 1,000 mg vitamin C, 600 IU vitamin E, and 600 mg alpha-lipoic acid) or a placebo (n = 9). In a subgroup of patients (n = 9), changes in serum concentrations of alpha-tocopherol and lipid hydroperoxide (LOOH) were assessed following AOC and placebo. Results. A significant (p = 0.032) increase in FMD was observed following AOC (Delta 1.9 +/- 3.3%), compared to no change following placebo (Delta - 0.8 +/- 1 9%). Moreover, compared with placebo, AOC prevented the decrease in alpha-tocopherol (Delta 0.48 +/- 2.91 vs. -1.98 +/- 2.32 mu M, p = 0.024) and tended to decrease LOOH (Delta - 0.2 +/- 0.1 vs. 0.1 +/- 0.1 mu M, p = 0.063). Conclusions. These data demonstrate that ingestion of an antioxidant cocktail can improve vascular endothelial function and improve oxidative stress in patients with CF, providing evidence that oxidative stress is a key contributor to vascular endothelial dysfunction in CF.