Iron, ascorbate and copper status of Sowetan Blacks with calcific chronic pancreatitis

Vitamin C can be used to overcome oxidative stress and ease pain in chronicpancreatitis. But its use is deprecated in conditions of tissue ironoverload, because its bioactive form, ascorbate, can acceleratefree-radical reactions that are driven by transition metals. We measurediron, ascorbate and copper in Sowetan Blacks (RSA) with chronicpancreatitis, obtaining serum/plasma from 14 consecutive patients and 15controls. Compared with data from corresponding groups in Manchester,African samples had less ascorbate (p < 0.0001), but more caeruloplasmin(p < 0.0001). African and British controls had comparable iron andiron-binding capacity. Plasma from African patients had less ascorbate thanthat from African controls (p < 0.005) and in six samples, ferritinexceeded 300 micrograms/l (677 pmol/l). Low- molecular-mass iron or copper,capable of participating in free radical reactions, was not detected.British patients, had similar caeruloplasmin levels to African patients buthigher ascorbate levels. There is no evidence of iron overload in ourAfrican samples. Outwardly healthy controls from Soweto have elevatedlevels of caeruloplasmin, possibly to compensate for dietary deficiency ofascorbate. Persistent oxidative stress is a unifying feature of chronicpancreatitis, but its degree is higher in African than British patients.Supplements of vitamin C should be safe in Blacks of southern Africa.