Absorption of water-miscible forms of vitamin E in a patient with cholestasis and in thoracic duct-cannulated rats

Oral administration of vitamin E (100 mg tocopherol · kg^-1 · day^-1) as tocopheryl polyethylene glycol 1000 succinate (TPGS) to a child with congenital hepatic cholestasis (unresponsive to oral administration of dl-α-tocopheryl acetate) promoted an increase of tocopherol in plasma and adipose tissue while tocopheryl acetate emulsified with medium chain triglycerides and polysorbate 80 (MCT-E) did not. α-Tocopherol absorption, quantitated in thoracic duct-cannulated rats receiving intraduodenal infusions of soybean oil and saline, was similar for TPGS, MCT-E and dl-α-tocopheryl acetate; γ-tocopherol absorption from soybean oil was not affected by the presence of the supplemented 1/2 -tocopherol. Following bile duct ligation in one rat. TPGS promoted the absorption of α-tocopherol while absorption of γ-tocopherol from soybean oil was decreased 30 fold, demonstrating that TPGS, which forms a micellar solution, delivers α-tocopherol through the unstirred water layer to enterocytes, while free tocopherol (α or γ) absorption requires the presence of bile salts.