Iron, ascorbate and copper status of Sowetan Blacks with calcific chronic pancreatitis |
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Authors: | Segal I; Sharer NM; Kay PM; Gutteridge JM; Braganza JM |
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Institution: | Division of Gastroenterology, Baragwanath Hospital, Johannesburg RSA. |
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Abstract: | Vitamin C can be used to overcome oxidative stress and ease pain in chronic
pancreatitis. But its use is deprecated in conditions of tissue iron
overload, because its bioactive form, ascorbate, can accelerate
free-radical reactions that are driven by transition metals. We measured
iron, ascorbate and copper in Sowetan Blacks (RSA) with chronic
pancreatitis, obtaining serum/plasma from 14 consecutive patients and 15
controls. 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 and
iron-binding capacity. Plasma from African patients had less ascorbate than
that from African controls (p < 0.005) and in six samples, ferritin
exceeded 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 but
higher ascorbate levels. There is no evidence of iron overload in our
African samples. Outwardly healthy controls from Soweto have elevated
levels of caeruloplasmin, possibly to compensate for dietary deficiency of
ascorbate. Persistent oxidative stress is a unifying feature of chronic
pancreatitis, but its degree is higher in African than British patients.
Supplements of vitamin C should be safe in Blacks of southern Africa.
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