Abstract
Background/Objectives:
The vitamin E derivative, α-tocopheryl acetate, is often included in formulations used in enteral nutrition. In this respect, we compared α-tocopherol and α-tocopheryl acetate absorption under ‘maldigestion’ conditions, such as occurring during enteral tube feeding, using differentially labeled RRR-[5,7-methyl-(2H6)]-α-tocopherol and RRR-[5-methyl-2H3]-α-tocopheryl acetate allowing direct comparison between free and esterified forms.
Subjects/Methods:
The two derivatives were given together in a single dose to six volunteers directly into the jejunum using a double-balloon perfusion system. Perfusion lasted for 1 h, and the collected blood and effluent samples were analyzed by liquid chromatography–mass spectrometry.
Results:
In the isolated 20-cm length of exposed jejunum, on average ∼6% of the two vitamin E forms were absorbed >1 h based on subtraction of effluent from influent. There was substantial difference in the absolute absorbed quantity between individuals, but no significant differences were observed in the absorption between the two labeled forms as assessed in the plasma. 2H3-α-tocopherol was not present in the influent, but appeared in the effluent, indicating that the acetylated form of vitamin E is cleaved by brush border enzymes in the small intestine.
Conclusions:
This study shows that even in the absence of digestive enzymes and bile salts, the appropriately solubilized acetylated form of α-tocopherol exhibits the same bioavailability as free α-tocopherol. This suggests that both forms can be absorbed equally under maldigestion conditions such as present clinically during enteral tube feeding.
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Acknowledgements
We thank Rosemarie Jenni, Corinne Appolonia-Nouzille, Veronique Clement and Drs Laurent Fay, Michael Affolter, Corinne Magliola, Serge Rezzi and Martin Leser for the constructive consultations and for their valuable help. We also thank Milagros Gallart, Monserrat Casellas, Purificación Rodríguez for their help in preparing perfusion buffers and assisting on experimental procedures. This work was funded by Nestec Ltd, Switzerland.
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Kornél Nagy, Marie-Claude Courtet-Compondu, Sophie Braga-Lagache, Karine Redeuil, Maurice Beaumont, Julie Moulin, Simon Acquistapache, Laurent Sagalowicz and Birgit Holst are employees of Nestle (Nestec Ltd). Gary Williamson was previously a part time employee of Nestle (Nestec Ltd) and Martin Kussmann was previously an employee of Nestle (Nestec Ltd). Remaining authors declare no conflict of interest.
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Nagy, K., Ramos, L., Courtet-Compondu, MC. et al. Double-balloon jejunal perfusion to compare absorption of vitamin E and vitamin E acetate in healthy volunteers under maldigestion conditions. Eur J Clin Nutr 67, 202–206 (2013). https://doi.org/10.1038/ejcn.2012.183
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DOI: https://doi.org/10.1038/ejcn.2012.183
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