Dovepress 17. Kobayashi S, Moriya H, Aso K, Ohtake T. Vitamin E-bonded hemodia- lyzer improves atherosclerosis associated with a rheological improve- ment of circulating red blood cells. Kidney Int. 2003;63:1881–1887. 18. Usberti M, Gerardi G, Bufano G, et al. Effects of erythropoietin and vitamin E-modified membrane on plasma oxidative stress markers and anemia of hemodialyzed patients. Am J Kidney Dis. 2002;40: 590–599. 19. Bonnefont-Rousselot D, Lehmann E, Jaudon MC, Delattre J, Perrone B, Rechke JP. Blood oxidative stress and lipoprotein oxidizability in haemodialysis patients: effect of the use of a vitamin E-coated dialysis membrane. Nephrol Dial Transplant. 2000;15:2020–2028. 20. Bufano G, Usberti M, Mandolfo S, Malberti F, Piroddi M, Galli F. Von Willebrand factor and autoantibodies against oxidized LDL in hemodialysis patients treated with vitamin E-modified dialyzers. Int J Artif Organs. 2004;27:214–221. Reply to Galli letter Dimitrios Kirmizis Dimitrios Chatzidimitriou Aristotle University, Thessaloniki, Greece Correspondence: Dimitrios Kirmizis Karavangeli 19 str, 55134, Kalamaria,Thessaloniki, Greece Tel +30 69 7366 8833 Fax +30 23 5103 5555 Email dkirmizis@yahoo.co.uk We thank Dr Galli for his interest in our paper1 and his useful remarks. We also appreciate his encouraging comments on our concerns regarding the possibility that the benefits from the α-T supplementation treatment might be accentuated particularly in special patient populations, such as diabetics or end-stage renal disease patients, ie, patients with high degrees of both oxidative stress and chronic inflammation. Furthermore, in accordance to the comments on vitamin Antiatherogenic effects of vitamin E 21. Mune M, Yukawa S, Kishino M, et al. Effect of vitamin E on lipid metabolism and atherosclerosis in ESRD patients. Kidney Int Suppl. 1999;71:S126–S129. 22. Nakamura T, Kawagoe Y, Matsuda T, et al. Effects of LDL apheresis and vitamin E-modified membrane on carotid atherosclerosis in hemo- dialyzed patients with arteriosclerosis obliterans. Kidney Blood Press Res. 2003;26:185–191. 23. Miyazaki H, Matsuoka H, Itabe H, et al. Hemodialysis impairs endothe- lial function via oxidative stress: effects of vitamin E-coated dialyzer. Circulation. 2000;101:1002–1006. E-modified membrane dialyzers pointed out in the letter, we ourselves have stated in our paper the importance of in situ action of the membrane-bound α-Τ, arguing that “the beneficial effects of the membrane-bound α-Τ probably take place through the protection it provides to circulating leukocytes against their repeated activation by the otherwise bioincompatible synthetic dialysis membrane and the abate- ment of the inflammatory reaction might secondarily lead to the antioxidative effects of α-Τ”. Therefore, in order to avoid any confusion, we would like to underline that we agree that any discussion on “pharmacokinetics” refers exclusively to α-Τ supplementation studies and does not apply in vitamin E-modified membrane dialyzers. Reference 1. Kirmizis D, Chatzidimitriou D. Antiatherogenic effects of vitamin E: the search for the Holy Grail. Vasc Health Risk Manag. 2009;5: 767–774. Vascular Health and Risk Management Publish your work in this journal Vascular Health and Risk Management is an international, peer- reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention and treatment of vascular disease and its sequelae; and the involvement of Submit your manuscript here: http://www.dovepress.com/vascular-health-and-risk-management-journal Dovepress metabolic disorders, particularly diabetes. This journal is indexed on PubMed Central and MedLine. The manuscript management system is completely online and includes a very quick and fair peer-review system, which is all easy to use. Visit http://www.dovepress.com/ testimonials.php to read real quotes from published authors. Vascular Health and Risk Management 2010:6 submit your manuscript | www.dovepress.com Dovepress 71