Explain Vitamin E's antioxidant role in the RBC and mitochondria.
Vitamin E is described as "the enigmatic one!" by one researcher as it does not exhibit similar actions as cofactor or have molecular targets like other fat-soluble vitamins (1). Early research using Wheat Germ extract showed that Vitamin E was a pro-fertility agent, and indeed the term tocopherol suggests "child birth" (2). A clear role came about in the 1980s that vitamin E is a "peroxyl radical scavenger" which is able to mitigate the tendency for polyunsaturated fats from oxidative damage (1). However, studies trying to induce vitamin E deficiency in normal people have shown no clear health problems (3).
Looking for specific instances of vitamin E's impact on health, I ran across the associated with vitamin E deficiency in premature infants, where lack of vitamin E creates anemia due to oxidative destruction of red blood cells (4). In this condition, there is a spontaneous resolution to the anemia as the particular newborn this effects develops the ability to absorb vitamin E by 2-3 months (4). Being sure to supplement with water soluble form of alpha-tocopherol helps treat this anemia (4). Here is an image showing hemolytic anemia of the premature newborn with vitamin E deficiency:
Note the reticulocytes (immature RBCs) and the cells that appear "bitten" which is a sign of oxidative damage (5).
Source:
1/Blaner, W.S., 2013. Vitamin E: the enigmatic one! J. Lipid Res. 54, 2293–2294. https://doi.org/10.1194/jlr.E042267
2/Gropper SS et al. Advanced Nutrition and Human Metabolism. 7th Ed. Cengage Learning. 2013.
3/Harrison's Internal Medicine, 13th Ed. McGraw Hill. 1994.
4/Dallman, P.R., 1976. Vitamin e deficiency in premature infants: interaction with iron. West. J. Med. 124, 49.
5/Red Cell Alterations in Non-Clonal Hematological Disorders. In: MA L, MS S, RE F, N W. eds. Lichtman's Atlas of Hematology 2016 New York, NY: McGraw-Hill
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