Integrative MedicineLutein  


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URL: http://www.mskcc.org/aboutherbs © 2003 Memorial Sloar-Kettering Cancer Center (Monograph)


Full Text

Barrie Cassileth and K. Simon Yeung

Lutein



Clinical Summary A natural pigment synthesized by plants and microorganisms. Leutein is used primarily as an antioxidant and also to prevent and treat cancer, heart disease, and macular degeneration. Lutein has antioxidant activity and is classified as a nonprovitamin A carotenoid, which also includes lycopene and zeaxanthin. Alpha-carotene, beta-carotene, and beta-cryptoxanthin are classified as provitamin A carotenoids because they can be converted into retinol. Epidemiologic studies suggest an inverse relationship between increased lutein consumption and decreased incidence of atherosclerosis, macular degeneration, and possibly colon cancer. No significant adverse effects or drug interactions have been reported.


Also Known As Xanthophyll, dihyroxycarotenoid, nonprovitamin A carotenoid


Food Sources
[2]
Kale, spinach, winter squash, cruciferous vegetables, cabbage, green beans, yellow/orange fruits, mangoes, papayas, peaches, oranges


Purported Uses Cancer prevention
Cataracts
Macular degeneration
Visual acuity


Mechanism Of Action [1], [2], [3], [6], [7] Lutein is a natural pigment synthesized by plants and microorganisms. Lutein has been associated with a decreased risk of macular degeneration and cataracts. The physiologic function of lutein in the macular membranes is not known at this time. Referred to as a nonprovitamin A carotenoid, it is not known to have any vitamin A activity. Other possible actions for carotenoids are antioxidant, immunoenhancement, inhibition of mutagenesis and transformation, and inhibition of premalignant lesions. Lutein has been associated with decreased risk of colon cancer and atherosclerosis.


Pharmacokinetics
[1], [2], [3], [8]
Absorption:
Intestinal absorption of carotenoids, including lutein, is facilitated by the formation of bile acid micelles containing carotenoids. The presence of fat in the small intestine stimulates the secretion of bile acids from the gall bladder and improves the absorption of carotenoids by increasing the size and stability of the micelles, thus allowing more carotenoids to be solubilized. Bioavailability of lutein is affected by the dose and presence of other carotenoids such as Beta carotene. The bioavailability of lutein from vegetables is approximately 70%.
Distribution:
The concentrations of various carotenoids in human serum and tissues are highly variable and depend on food sources, efficiency of absorption, and amount of fat in the diet. Lutein is transported by high-density lipoprotein (HDL) and, to a lesser extent, by very low-density lipoprotein. The serum concentration of carotenoids after a single dose peaks at 24 to 48 hours post dose. The average lutein concentration in human serum is 280 nM. Lutein is primarily stored in adipose and the liver. Of all the carotenoids circulating in the body, only two polar species, lutein and zeaxanthin, are contained in the macula.
Metabolism/Excretion:
It is assumed that lutein is excreted through the bile and kidneys.


Adverse Reactions
[1]
No adverse effects have been reported at normal doses.
Toxicity: Carotenodermia is a harmless biological effect of high carotenoid intake. Characterized by a yellowish discoloration of the skin, it results from chronically elevated serum concentrations of carotenes.


Drug Interactions
[4]
No known drug interactions at this time.


Literature Summary And Critique Dagnelie G, Zorge IS, McDonald TM. Lutein improves visual function in some patients with retinal degeneration: a pilot study via the internet. Optometry 2000;71:147-64.
A small prospective evaluation of Internet-recruited patients with either retinal pigmentation (n = 13) or macular degeneration (n = 3) given 9 weeks of lutein 40 mg/day. Patients performed bi-weekly self-evaluation of visual acuity and central visual-field extent. Although patients who received supplementation with lutein did report improvements over those who did not, randomized trials are necessary to validate findings.


References

[1] Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington (DC): National Academy Press; 2000.
[2] Khachik F, Beecher GR, Smith JC. Lutein, lycopene, and their oxidative metabolites in chemoprevention of cancer. J Cell Biochem Suppl 1995;22:236-46.
[3] van het Hof KH, et al. Bioavailability of lutein from vegetables is 5 times higher than that of beta-carotene. Am J Clin Nutr 1999;70:261-8.
[4] Elinder LS, et al. Probucol treatment decreases serum concentrations of diet-derived antioxidants. Arterioscler Thromb Vasc Biol 1995;15:1057-63.
[5] Sujak A, Okulski W, Gruszecki WI. Organisation of xanthophyll pigments lutein and zeaxanthin in lipid membranes formed with dipalmitoylphosphatiylcholine. Biochim Biophys Acta 2000;1509:255-63.
[6] Dwyer JH, et al. Oxygenated carotenoid lutein and progression of early atherosclerosis: the Los Angeles atherosclerosis study. Circulation 2001;103:2922-7.
[7] Slattery ML, et al. Carotenoids and colon cancer. Am J Clin Nutr 2000;71:575-82.
[8] Olmedilla B, et al. A European multicentre, placebo-controlled supplementation study with alpha-tocopherol, carotene-rich palm oil, lutein or lycopene; analysis of serum responses. Clin Sci (Lond) 2002;102:447-56.


Written 11/01/2001
Updated 09/30/2002


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