Manipulations nutritionnelles du stress oxydant : état des connaissances

Abstract: Oxidative stress has deleterious effects on health of the population and of selected groups of chronically and critically ill patient, that some micronutrients and dietary patterns can modulate. These beneficial effects have been attributed to the reduction of oxidative damage caused by the excessive free radical production. The paper reviews evidence of antioxidant (AOX) supplementation trials in the general population and critically ill patients. AOX vitamin and trace element intakes are low in a large part of the European population: selenium is particularly affected. AOX micronutrients have been shown to be particularly important in the prevention of cancer, cardiovascular diseases, age related ocular diseases and in aging. In animal models, targeted interventions have been associated with reduction of tissue destruction is brain and myocardium ischemia-reperfusion models. In the critically ill AOX supplements have resulted in reduction of organ failure (kidney, lung) and of infectious complications, especially when selenium is included: diagnostic categories with benefits include major burns and trauma, sepsis and SIRS. Vitamins alone have no significant effect at nutritional doses. AOX micronutrients have beneficial effects in defined models and pathologies, in the general population and in critical illness – the inclusion of selenium appears of particular importance. Further research is required to determined the optimal micronutrient combinations and the doses required according to intervention timing. [Copyright &y& Elsevier]