Pearson et al¹ have failed to tease out any additional benefit of vitamin E supplementation in patients with mild to moderate asthma. Before concluding that this is the case, it is relevant to highlight several points in their study.

It is notable that the authors failed to measure any surrogate marker of inflammation such as exhaled nitric oxide, sputum eosinophils, or airway hyperresponsiveness (AHR) to an indirect bronchoconstrictor stimulus. Indeed, non-specific AHR to methacholine is only very tenuously linked to underlying endobronchial inflammation and tends to be related to changes in …