Vitamins E and C Modulate the Association Between Reciprocally Regulated Cytokines After an Anterior Cruciate Ligament Injury and Surgery

Barker T, Martins TB, Hill HR, Kjeldsberg CR, Trawick RH, Leonard SW, Walker JA, Traber MG: Vitamins E and C modulate the association between reciprocally regulated cytokines after an anterior cruciate ligament injury and surgery. Am J Phys Med Rehabil 2011;90:638-647. Objective: The purpose of this study was to identify the influence of vitamin E and C supplementation on inflammatory cytokines and the association between reciprocally regulated cytokines after anterior cruciate ligament surgery. Design: A double-blind, placebo-controlled study was conducted in men undergoing anterior cruciate ligament surgery who were randomly assigned to one of two groups (n = 10/group): (1) antioxidant (vitamins E and C) or (2) matching placebos starting similar to 2 wks before (baseline) and concluding 3 mos after surgery. Plasma inflammatory cytokines were measured in fasting blood draw samples before and after anterior cruciate ligament surgery. Results: Plasma interleukin (IL) 1 beta concentrations were double at 3 mos after surgery compared with baseline. Plasma IL-1 beta increased to a greater (P < 0.05) extent relative to IL-4 in the placebo group (mean +/- SE slope, 18.87 +/- 0.68; r = 0.97) than in the antioxidant group (mean T SE slope, 4.84 +/- 0.42; r = 0.89). Similarly, the relative increase in IL-1A to IL-2 was greater (P < 0.05) in the placebo (mean +/- SE slope, 2.70 +/- 0.21) than in the antioxidant (mean +/- SE slope, 1.08 +/- 0.23) group. Conclusions: Vitamins E and C were ineffective in ameliorating the increases in IL-1 beta but altered associations between reciprocally regulated cytokines after anterior cruciate ligament surgery.