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February 18, 1998

Vitamin E Supplementation and Immune Response in Elderly Patients

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(7):505-506. doi:10.1001/jama.279.7.505

To the Editor.—Dr Meydani and colleagues1report interesting data about vitamin E supplementation and in vivo immune response in healthy elderly subjects. One important confounder that was not considered in the study is smoking. Smoking is known to lead to immunosuppression2,3 and to increase the requirements for vitamin E.4 Indexes of sustained oxidant stress in smokers are partially ameliorated by vitamin E supplementation.5Moreover, recent data show that vitamin E may have pro-oxidant activity in nonsmokers at high and prolonged intakes.4Accordingly, it is relevant for the authors to clarify the number of smokers in each study group.

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