MICRONUTRIENT ANTIOXIDANT STATUS IN TROPICAL COMPARED WITH TEMPERATE-ZONE CHRONIC-PANCREATITIS

Micronutrient antioxidants interact with glutathione in tissues to fac ilitate the disposal of reactive oxygen species and xenobiotic metabol ites derived via cytochromes P450. Published evidence linking cytochro me P450I induction with chronic pancreatitis therefore led us to compa re antioxidant status in patients at Manchester in the northwest of En gland and at Madras in the southeast of India. Serum studies in health y volunteers showed that the biologic availabilities of selenium and a lpha-tocopherol were equally high in the two zones but that the availa bilities of beta-carotene and ascorbic acid were lower in the tropical area (p < 0.001), where the ratio of ascorbic acid to total vitamin C concentration in serum was substantially reduced (p < 0.001). The ser um antioxidant profiles of the chronic pancreatitis groups reflected t hese indigenous differences: a decrement in selenium and alpha-tocophe rol was evident in both zones, whereas beta-carotene and ascorbic acid values were subnormal only in the Manchester group. The concentration of inorganic sulphate in urine-an index of long-term intake of sulphu r amino acids for synthesis of glutathione and other detoxifiers-was s imilar in controls and patients from Manchester, but levels were lower than in their Madras counterparts (p < 0.02, p < 0.01, respectively). The results suggest that culinary practices that erode the biologic a vailabilities of ascorbic acid and beta-carotene may predispose to pan creatic oxidative stress and thereby to the changes leading to chronic pancreatitis at an early age in south India. These findings have impl ications for treatment and prophylaxis.