***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The effect of daily supplementation of 800 mg dl alpha-tocopheryl acetate for 30 d on general health , nutrient status , hepatic and renal function , intermediary metabolism , hematological status , plasma nutrients and antioxidant status , thyroid hormones , and urinary creatinine concentrations was studied in 32 healthy elderly ( > 60 y ) people who participated in a double-blind , placebo-controlled , residential trial . The subjects reported no side effects due to the supplements . Supplementation had no effect on body weight , plasma total protein , albumin , glucose , total cholesterol and triglycerides , conjugated and unconjugated bilirubin , alkaline phosphatase , indicators of hepatic and renal function , hematologic status , thyroid hormones , or serum and urinary creatinine concentrations and creatinine clearance . Supplementation did cause a significant increase in serum vitamin E , and a small ( 5 % ) but significant ( P < 0.05 ) increase in plasma zinc in the vitamin E-supplemented group . Thus , short-term supplementation with 800 mg vitamin E/d has no adverse effect on healthy older adults BACKGROUND It has been suggested that vitamin E can counteract the age-associated decline in cellular immune responsiveness ( CIR ) . Particularly , T helper cell type 1 ( Th1 ) activity , ie , interferon ( IFN ) gamma-producing Th1 activity and , hence , delayed-type hypersensitivity ( DTH ) would be enhanced by vitamin E supplementation . OBJECTIVE Our aim was to study the effects of 6 mo supplementation with 50 and 100 mg vitamin E on CIR in the elderly . DESIGN A double-blind , placebo-controlled trial was conducted in 161 healthy elderly subjects aged 65 - 80 y. CIR was measured in vivo by means of DTH skin tests  and in vitro by assessing the production of interleukin ( IL ) 2 , IFN-gamma ( a typical Th1 cytokine ) , and IL-4 ( a typical Th2 cytokine ) by peripheral blood mononuclear cells after stimulation with phytohemagglutinin . RESULTS Both DTH and IL-2 production showed a trend toward increased responsiveness with increasing dose of vitamin E. However , IFN-gamma production decreased whereas IL-4 production increased in the groups receiving vitamin E. Only the change in the number of positive DTH reactions was borderline significantly larger in the 100-mg vitamin E group than in the placebo group ( P = 0.06 , Bonferroni adjusted ) . Subjects receiving 100 mg vitamin E with low baseline DTH reactivity or who were physically less active had a significantly larger increase in the cumulative diameter of the skin in duration result ing from the DTH test than did the placebo group ( P = 0.03 ) , although this difference was not significant after Bonferroni correction ( P = 0.07 ) . CONCLUSION Possible beneficial effects of 100-mg vitamin E supplementation may be more pronounced in particular subgroups of elderly subjects AIM To evaluate the safety and efficacy of Vitamin E in children with chronic hepatitis B. METHODS We r and omly assigned patients with chronic hepatitis B , positive for hepatitis B e antigen ( HBeAg ) , to receive either Vitamin E or placebo once daily for 6 mo in a 3:1 ratio and double-blind manner . The primary end point was HBeAg seroconversion , defined as the loss of HBeAg , undetectable levels of serum hepatitis B virus DNA , and the appearance of antibodies against HBeAg 12 mo after therapy . RESULTS At baseline visit , 49 patients had normal and 43 had increased serum aminotransferase levels . Twenty-nine patients did not respond to previous treatment with interferon-alpha or lamivudine . Seventy-six children completed the study ; 16 were non-compliant ( n = 7 ) , lost to follow-up ( n = 7 ) , or started another antiviral treatment ( n = 3 ) . Intention-to-treat analysis showed HBeAg seroconversion in 16 children ( 23.2 % ) treated with Vitamin E and two ( 8.7 % ) in the placebo group ( P = 0.13 ) . Vitamin E was well tolerated . CONCLUSION There is only a tendency that Vitamin E may promote HBeAg seroconversion . Therefore larger studies are needed to clarify the role of antioxidants in the therapy of chronic hepatitis BACKGROUND & AIMS Insulin resistance and oxidative stress contribute to the pathogenesis of nonalcoholic steatohepatitis ( NASH ) . We conducted a pilot study for the following reasons : ( 1 ) to test the hypothesis that a combination of an antioxidant ( vitamin E ) and an insulin sensitizer ( pioglitazone ) would be superior to vitamin E alone for the treatment of NASH , and ( 2 ) to define the effects of these interventions on insulin-sensitive metabolic functions and correlate the effects with changes in liver histology . METHODS A r and omized prospect i ve trial was performed to compare the efficacy and safety of vitamin E alone ( 400 IU/day ) vs. vitamin E ( 400 IU/day ) and pioglitazone ( 30 mg/day ) in nondiabetic , noncirrhotic subjects with NASH . Metabolic functions were assessed by a 2-step , hyperinsulinemic ( 10 and 40 mU/m2/min ) euglycemic clamp . RESULTS A total of 10 patients were r and omized to each arm . Two patients on combination therapy discontinued treatment ; one because of pregnancy and the other because of hepatotoxicity . Treatment with vitamin E only produced a significant decrease in steatosis ( mean grade , 2.2 vs. 1.4 ; P < .02 ) . Compared with baseline , combination therapy produced a significant decrease in steatosis ( mean , 2.3 vs. 1 ; P < .002 ) , cytologic ballooning ( 1.3 vs. 0.2 ; P < .01 ) , Mallory 's hyaline ( 0.7 vs. 0.2 ; P < .04 ) , and pericellular fibrosis ( 1.2 vs. 0.6 ; P < .03 ) . Although vitamin E had no significant effects , combination therapy produced a significant increase in metabolic clearance of glucose and a decrease in fasting free fatty acid ( FFA ) and insulin . The decrease in fasting FFA and insulin independently predicted improvement in hepatic steatosis and cytologic ballooning . CONCLUSIONS A combination of vitamin E and pioglitazone produces a greater improvement in NASH histology . The improvement in steatosis and cytologic ballooning are related to treatment-associated decreases in fasting FFA and insulin levels CONTEXT Nonalcoholic fatty liver disease ( NAFLD ) is the most common chronic liver disease in US children and adolescents and can present with advanced fibrosis or nonalcoholic steatohepatitis ( NASH ) . No treatment has been established . OBJECTIVE To determine whether children with NAFLD would improve from therapeutic intervention with vitamin E or metformin . DESIGN , SETTING , AND PATIENTS R and omized , double-blind , double-dummy , placebo-controlled clinical trial conducted at 10 university clinical research centers in 173 patients ( aged 8 - 17 years ) with biopsy-confirmed NAFLD conducted between September 2005 and March 2010 . Interventions Daily dosing of 800 IU of vitamin E ( 58 patients ) , 1000 mg of metformin ( 57 patients ) , or placebo ( 58 patients ) for 96 weeks . MAIN OUTCOME MEASURES The primary outcome was sustained reduction in alanine aminotransferase ( ALT ) defined as 50 % or less of the baseline level or 40 U/L or less at visits every 12 weeks from 48 to 96 weeks of treatment . Improvements in histological features of NAFLD and resolution of NASH were secondary outcome measures . RESULTS Sustained reduction in ALT level was similar to placebo ( 10/58 ; 17 % ; 95 % CI , 9 % to 29 % ) in both the vitamin E ( 15/58 ; 26 % ; 95 % CI , 15 % to 39 % ; P = .26 ) and metformin treatment groups ( 9/57 ; 16 % ; 95 % CI , 7 % to 28 % ; P = .83 ) . The mean change in ALT level from baseline to 96 weeks was -35.2 U/L ( 95 % CI , -56.9 to -13.5 ) with placebo vs -48.3 U/L ( 95 % CI , -66.8 to -29.8 ) with vitamin E ( P = .07 ) and -41.7 U/L ( 95 % CI , -62.9 to -20.5 ) with metformin ( P = .40 ) . The mean change at 96 weeks in hepatocellular ballooning scores was 0.1 with placebo ( 95 % CI , -0.2 to 0.3 ) vs -0.5 with vitamin E ( 95 % CI , -0.8 to -0.3 ; P = .006 ) and -0.3 with metformin ( 95 % CI , -0.6 to -0.0 ; P = .04 ) ; and in NAFLD activity score , -0.7 with placebo ( 95 % CI , -1.3 to -0.2 ) vs -1.8 with vitamin E ( 95 % CI , -2.4 to -1.2 ; P = .02 ) and -1.1 with metformin ( 95 % CI , -1.7 to -0.5 ; P = .25 ) . Among children with NASH , the proportion who resolved at 96 weeks was 28 % with placebo ( 95 % CI , 15 % to 45 % ; 11/39 ) vs 58 % with vitamin E ( 95 % CI , 42 % to 73 % ; 25/43 ; P = .006 ) and 41 % with metformin ( 95 % CI , 26 % to 58 % ; 16/39 ; P = .23 ) . Compared with placebo , neither therapy demonstrated significant improvements in other histological features . CONCLUSION Neither vitamin E nor metformin was superior to placebo in attaining the primary outcome of sustained reduction in ALT level in patients with pediatric NAFLD . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00063635 BACKGROUND The purpose of the present paper was to investigate the efficacy of vitamin E in children with immunotolerant-phase chronic hepatitis B virus ( CHB ) infection . METHODS Fifty-eight immunotolerant children were prospect ively and r and omly recruited into two groups . Group 1 ( study group ) included 30 patients who received vitamin E at a dose of 100 mg/day throughout 3 months ; group 2 ( control group ) contained 28 patients who did not receive any medication .  Comparison of serological , virologic , and biochemical response ratios were done at the end of the therapy and after 6 months of vitamin E discontinuation . RESULTS Mean alanine transaminase ( ALT ) values in group 1 at the beginning of the therapy , 3 months after the therapy initiation and 6 months after discontinuation were 30.4 + /- 7.3 IU/L , 31.3 + /- 7.8 IU/L and 32.1 + /- 8.5 IU/L , respectively . The mean hepatitis B virus (HBV)-DNA load of group 1 at onset , and at the third and ninth months of the treatment were 3106 + /- 718 pg/mL , 3530 + /- 137 pg/mL and 3364 + /- 1246 pg/mL , respectively . These changes in both ALT and HBV-DNA values did not reach significant levels ( P > 0.05 ) . In group 2 , mean ALT values at the beginning of therapy , and at the third and ninth months were 28.0 + /- 1.8 IU/L , 34.6 + /- 8.1 IU/L , and 34.1 + /- 7.0 IU/L , respectively ( P > 0.05 ) , and mean viral load of HBV-DNA was 4227 + /- 1435 pg/mL , 3368 + /- 2673 pg/mL , and 3018 + /- 2814 pg/mL , respectively ( P > 0.05 ) . There was no statistically significant difference between group 1 and group 2 at the third and ninth months in the mean ALT values and viral load of HBV-DNA ( P > 0.05 ) . Hepatitis B s antigen and hepatitis B e antigen clearance or hepatitis B s antibody and hepatitis B e antibody seroconversion were not observed in either group . CONCLUSION As a first study investigating the effect of vitamin E in children with immunotolerant CHB infection , no beneficial effect could be demonstrated . Different immunomodulator protocol s should be considered for future investigations 
    Output:
    
Based on the clinical results obtained in VE-treated chronic HBV carriers , we provide a reliable hypothesis for the possible role of this vitamin in the modulation of host miRNA profiles perturbed by this viral pathogen and in the regulation of some cellular miRNA with a suggested potential anti-HBV activity .