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Gingival crevicular fluid shows significantly reduced GSH concentrations and markedly elevated 4-HNE levels ( 2.4 The ferroptosis-inflammation vicious cycle drives chronic periodontitis Growing evidence indicates that ferroptosis can trigger inflammatory responses, while the inflammatory microenvironment further promotes ferroptosis, forming a self-amplifying vicious cycle that drives the persistent progression of chronic periodontitis

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These cytokines, associated with activated polymorphonuclear leukocytes (PMNs) and their derived proteases, destroy newly developing tissue and degrade key growth factors

Finally, the results of one randomized controlled trial in 601 patients with common forms of retinitis pigmentosa indicated that supplementation with 400 IU/day of synthetic vitamin E (equivalent to 180 mg/day of RRR --tocopherol) modestly but significantly accelerated the loss of retinal function compared to placebo (123)

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