The effect of high doses of vitamin E (Vit.E; 400 units/ day) on ornithine decarboxylase (ODC) activity and regression of small intestinal metaplasia (SIM) was studied in a 1-year double-blind intervention trial. Biochemical and morphological parameters were estimated in 14 evaluable SIM patients of 18 in the Vit.E group and in 16 of 18 intestinal metaplasia patients enrolled in control group (placebo). In the control group, there were no statistically significant changes in Vit.E content in blood plasma, ODC activity, and the rate of SIM in multiple biopsies from antrum gastric mucosa. In the Vit.E group, after 6 and 12 months of intervention, the initial content of Vit.E in blood plasma increased from 6.4 +/- 0.9 up to 17.0 +/- 1.8 and 21.2 +/- 2.3 micrograms/ml, respectively, and the initial abnormally high activity of ODC, 62.6 +/- 7.8 units, decreased by 53 and 65%, respectively. Histological analysis of multiple biopsies, taken from the gastric antrum of patients supplemented with Vit.E, revealed that in 8 of 14 patients (57%) after 6 months and in 10 of 14 patients (71%) after 12 months, no signs of SIM were observed; gastroscopic dye procedure confirmed the regression of SIM in these cases and showed the presence of only small isolated stained areas identified as SIM.

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