scholarly journals Vitamin C Improves Microvascular Reactivity and Peripheral Tissue Perfusion in Septic Shock Patients

2021 ◽  
Author(s):  
Jean-Rémi Lavillegrand ◽  
Lisa Raia ◽  
Tomas Urbina ◽  
Geoffroy Hariri ◽  
Paul Gabarre ◽  
...  
Keyword(s):  
Septic Shock ◽  
Vitamin C ◽  
Tissue Perfusion ◽  
Peripheral Tissue ◽  
Protective Effects ◽  
Human Sepsis ◽  
Microvascular Reactivity ◽  
Vitamin C Deficiency ◽  
Beneficial Effects ◽  
Vitamin C Supplementation

Abstract Background Vitamin C has potential protective effects through anti-oxydant and anti-inflammatory properties. However, the effect of Vitamin C supplementation on microvascular function and peripheral tissue perfusion in human sepsis remains unknown. We aimed to determine vitamin C effect on microvascular endothelial dysfunction and peripheral tissue perfusion in septic shock patients. Methods Patients with septic shock were prospectively included after initial resuscitation. Bedside peripheral tissue perfusion and skin microvascular reactivity in response to acetylcholine iontophoresis in the forearm area were measured before and 1 hour after intravenous Vitamin C supplementation (40 mg/kg). Norepinephrine dose was not modified during the studied period. Results We included 30 patients with septic shock. SOFA score was 11 [8–14], SAPS II was 66 [54-79] and in-hospital mortality was 33%. Half of these patients had vitamin C deficiency at inclusion. Vitamin C supplementation strongly improved microvascular reactivity (AUC 2263 [430-4246] vs 5362 [1744-10585] UI, p=0.0004). In addition, Vitamin C supplementation improved mottling score (p=0.06), finger-tip (p=0.0003) and knee capillary refill time (3.7 [2.6-5.5] vs 2.9 [1.9-4.7] s, p<0.0001), as well as and central-to-periphery temperature gradient (6.1 [4.9-7.4] vs 4.6 [3.4-7.0] °C, p<0.0001). The beneficial effects of Vitamin C were observed both in patients with or without Vitamin C deficiency. Conclusion In resuscitated septic shock patients, vitamin C supplementation improved peripheral tissue perfusion and microvascular reactivity whatever plasma levels of vitamin C.

scholarly journals Effect of vitamin C supplementation on hematological parameters in smokeless tobacco chewers

2021 ◽  
Vol 12 (3) ◽  
pp. 2088-2094
Author(s):  
Jaywant S. Thorat ◽  
Anand G. Joshi ◽  
Kanchan C. Wingkar
Keyword(s):  
Platelet Count ◽  
Vitamin C ◽  
Smokeless Tobacco ◽  
Hematological Parameters ◽  
Protective Effects ◽  
Baseline Study ◽  
Vitamin C Supplementation ◽  
Baseline Values ◽  
Wbc Count ◽  
Rbc Count

The present study was aimed to evaluate the effect of Vitamin C (VC) supplementation on hematological parameters in Smokeless Tobacco (ST) chewers.  A total of 338 subjects aged between 31 to 60 years (168 ST chewers and 170 ST non-chewers) participated in the present study. ST chewers were further divided into 3 subgroups with respect to ST chewing duration in years. Subjects of both the groups were examined at the baseline study and after 45 days of supplementation of 1 g of Vitamin C (VC) for hematological parameters.  WBC count (p=0.04), granulocytes % (p=0.0007), HCT (p=0.01) and MCV (p=0.04) were significantly increased whereas, monocytes % (p=0.002) and platelet count (p<0.0001) were significantly decreased in ST chewers as compared to controls. After supplementation of VC, WBC count (p<0.001) and granulocytes % (p<0.0001) were significantly decreased and lymphocytes % (p=0.008), monocytes % (p<0.0001), RBC count (p=0.01) and Hb content (p=0.006) were significantly increased in ST chewers as compared to their baseline values. In conclusion,  the use of ST had deleterious effects on hematological parameters; however, supplementation of 1 g of VC showed protective effects on hematological parameters.

scholarly journals Narrative review: clinical assessment of peripheral tissue perfusion in septic shock

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Geoffroy Hariri ◽  
Jérémie Joffre ◽  
Guillaume Leblanc ◽  
Michael Bonsey ◽  
Jean-Remi Lavillegrand ◽  
...  
Keyword(s):  
Septic Shock ◽  
Clinical Assessment ◽  
Tissue Perfusion ◽  
Narrative Review ◽  
Peripheral Tissue

scholarly journals Oral vitamin C supplementation to patients with myeloid cancer on azacitidine treatment: Normalization of plasma vitamin C induces epigenetic changes

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Linn Gillberg ◽  
Andreas D. Ørskov ◽  
Ammar Nasif ◽  
Hitoshi Ohtani ◽  
Zachary Madaj ◽  
...  
Keyword(s):  
Vitamin C ◽  
Biological Effects ◽  
Pilot Trial ◽  
Dna Demethylation ◽  
Controlled Clinical Trial ◽  
Plasma Vitamin ◽  
Oral Vitamin ◽  
Oral Supplementation ◽  
Vitamin C Deficiency ◽  
Vitamin C Supplementation

Abstract Background Patients with haematological malignancies are often vitamin C deficient, and vitamin C is essential for the TET-induced conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC), the first step in active DNA demethylation. Here, we investigate whether oral vitamin C supplementation can correct vitamin C deficiency and affect the 5hmC/5mC ratio in patients with myeloid cancers treated with DNA methyltransferase inhibitors (DNMTis). Results We conducted a randomized, double-blinded, placebo-controlled pilot trial (NCT02877277) in Danish patients with myeloid cancers performed during 3 cycles of DNMTi-treatment (5-azacytidine, 100 mg/m2/d for 5 days in 28-day cycles) supplemented by oral dose of 500 mg vitamin C (n = 10) or placebo (n = 10) daily during the last 2 cycles. Fourteen patients (70%) were deficient in plasma vitamin C (< 23 μM) and four of the remaining six patients were taking vitamin supplements at inclusion. Global DNA methylation was significantly higher in patients with severe vitamin C deficiency (< 11.4 μM; 4.997 vs 4.656% 5mC relative to deoxyguanosine, 95% CI [0.126, 0.556], P = 0.004). Oral supplementation restored plasma vitamin C levels to the normal range in all patients in the vitamin C arm (mean increase 34.85 ± 7.94 μM, P = 0.0004). We show for the first time that global 5hmC/5mC levels were significantly increased in mononuclear myeloid cells from patients receiving oral vitamin C compared to placebo (0.037% vs − 0.029%, 95% CI [− 0.129, − 0.003], P = 0.041). Conclusions Normalization of plasma vitamin C by oral supplementation leads to an increase in the 5hmC/5mC ratio compared to placebo-treated patients and may enhance the biological effects of DNMTis. The clinical efficacy of oral vitamin C supplementation to DNMTis should be investigated in a large randomized, placebo-controlled clinical trial. Trial registration ClinicalTrials.gov, NCT02877277. Registered on 9 August 2016, retrospectively registered.

scholarly journals Morphological deformities in the osseous structure in spotted sorubim Pseudoplatystoma coruscans (agassiz & spix, 1829) with vitamin c deficiency

2013 ◽  
Vol 85 (1) ◽  
pp. 379-384 ◽  
Author(s):  
RODRIGO Y. FUJIMOTO ◽  
RUDÃ F.B. SANTOS ◽  
DALTON J. CARNEIRO
Keyword(s):  
Vitamin C ◽  
Vitamin C Deficiency ◽  
Cartilage Formation ◽  
Fish Diets ◽  
Vitamin C Supplementation ◽  
Diet Control ◽  
Osseous Structure ◽  
Morphological Deformities ◽  
Immunological System ◽  
And Cartilage

Vitamin C is essential for fish diets because many species cannot syntethize it. This vitamin is needed for bone and cartilage formation. Moreover, it acts as antioxidant and improve the immunological system. The present work investigated the effects of vitamin C diet supplementation to spotted sorubim (Pseudoplatystoma coruscans) fingerlings by frequency of bone and cartilage deformation. Ascorbyl poliphosphate (AP) was used as source of vitamin C in the diets for spotted sorubim fingerlings during three months. Six diets were formulated: one diet control (0 mg/kg of vitamin C) and 500, 1,000, 1,500, 2,000 and 2,500 mg AP/kg diets. Fishes fed without vitamin C supplementation presented bone deformation in head and jaws, and fin fragilities. Thus, 500 mg AP/kg diet was enough to prevent deformation and the lack of vitamin C supplementation worsening the development of fingerlings.

Vitamin C Deficiency in Patients on Long-Term Deferasirox without Supplementation.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1858-1858
Author(s):  
Konstantinos Sarantos ◽  
Patricia Evans ◽  
Maciej Garbowski ◽  
Bernard Davis ◽  
John B Porter
Keyword(s):  
Vitamin C ◽  
Iron Overload ◽  
Serum Ferritin ◽  
Plasma Levels ◽  
Plasma Vitamin ◽  
Liver Iron ◽  
Vitamin C Deficiency ◽  
Vitamin C Supplementation ◽  
Iron Excretion

Abstract Background: Under conditions of iron overload, ascorbic acid is oxidised at an increased rate leading to a risk of vitamin C deficiency. With deferoxamine (DFO) standard therapy, vitamin C is usually given at a dose of 2–3mg/kg on the days of DFO infusion as this increases iron excretion by up to 30%. With deferarisox (DFX) chelation treatment, although supplementation is permitted, there is currently no information about the effects of vitamin C supplementation on iron excretion and it is often left to patients or their clinician’s discretion as to whether supplementation is given. With long-term treatment, in the absence of supplementation there is a potential risk that vitamin C deficiency will develop and this could influence response to treatment. Patients and Methods: We have measured fasting plasma vitamin C in 41 patients who have been on long term deferasirox treatment for transfusional iron overload for between 1.5 and 5 years. 32 of these patients had received no supplementation and 9 patients had received 2–3 mg/kg/ day of supplementation. We have examined whether trends in serum ferritin, myocardial T2* and liver iron, during the final year of observation, relate to plasma levels of vitamin C. Results: Fasting plasma Vitamin C was significantly lower in the 41 patients (mean=30.3μmol/l, SD=20.8) than healthy control patients (mean=60.29μmol/l SD=12.6) (P&lt;0.0001). Fasting vitamin C levels were significantly lower in patients without supplementation (mean=26.1μmol/l, n=32) (p=0.011) than in patients who received regular supplementation (mean=45.5μmol/l, n=9). In the 32 patients without supplementation 23 (72%) had plasma levels less than two standard deviations from the control mean. Fasting vitamin C levels after a minimum of 1 year treatment without vitamin C supplementation negatively correlated with liver iron concentration as estimated by T2* MRI. One patient, who was subsequently found to have the lowest fating vitamin c level (2.9μmol/l) developed clinical signs consistent with scurvy with severe gum disease requiring dental clearance. We found no difference in the change of ferritin trend, LIC decrease or cT2* trend in the patients receiving supplementation from those who did not. We found that the correlation between LIC and serum ferritin was less clear in deficient patients (&lt;36μmol/l or 2SD from the mean, r=0.51, p&lt;0.01) than replete patients (&gt;36μmol/l) (r=0.88, p&lt;0.0001). Conclusions: We conclude that with long-term deferasirox therapy without vitamin C supplementation, there is a significant risk of vitamin C deficiency with a potential for clinical scurvy. The risk of ascorbate deficiency is further increased at higher levels of body iron loading. These findings suggest that vitamin C supplementation (2–3mg/kg/day) should be recommended as standard for patients on long-term chelation therapy with deferasirox. It would also be of value to determine whether long term-response was improved by ascorbate supplementation.

Prolonged Vitamin C Supplementation and Recovery from Demanding Exercise

2001 ◽  
Vol 11 (4) ◽  
pp. 466-481 ◽  
Author(s):  
Dylan Thompson ◽  
Clyde Williams ◽  
Stephen J. McGregor ◽  
Ceri W. Nicholas ◽  
Frank McArdle ◽  
...  
Keyword(s):  
Vitamin C ◽  
Muscle Function ◽  
Muscle Soreness ◽  
Plasma Concentrations ◽  
Serum Creatine Kinase ◽  
Post Exercise ◽  
Beneficial Effects ◽  
Vitamin C Supplementation ◽  
Group 2 ◽  
Male Subjects

The aim of the present study was to investigate whether 2 weeks of vitamin C supplementation affects recovery from an unaccustomed bout of exercise. Sixteen male subjects were allocated to either a placebo (P; n = 8) or vitamin C group (VC; n = 8). The VC group consumed 200 mg of ascorbic acid twice a day, whereas the P group consumed identical capsules containing 200 mg of lactose. Subjects performed a prolonged (90-min) intermittent shuttle-running test 14 days after supplementation began. Post-exercise serum creatine kinase activities and myoglobin concentrations were unaffected by supplementation. However, vitamin C supplementation had modest beneficial effects on muscle soreness, muscle function, and plasma concentrations of malondialdehyde. Furthermore, although plasma interleukin-6 increased immediately after exercise in both groups, values in the VC group were lower than in the P group 2 hours after exercise (p < .05). These results suggest that prolonged vitamin C supplementation has some modest beneficial effects on recovery from unaccustomed exercise.

Any Role of High-Dose Vitamin C for Septic Shock in 2021?

2021 ◽  
Vol 42 (05) ◽  
pp. 672-682
Author(s):  
Ankita Agarwal ◽  
David N. Hager ◽  
Jonathan E. Sevransky
Keyword(s):  
Septic Shock ◽  
Vitamin C ◽  
Outcome Measures ◽  
Randomized Clinical Trials ◽  
Secondary Outcome ◽  
High Dose ◽  
Healthy Humans ◽  
Vitamin C Supplementation ◽  
High Dose Vitamin

AbstractWhile the use of vitamin C as a therapeutic agent has been investigated since the 1950s, there has been substantial recent interest in the role of vitamin C supplementation in critical illness and particularly, sepsis and septic shock. Humans cannot synthesize vitamin C and rely on exogenous intake to maintain a plasma concentration of approximately 70 to 80 μmol/L. Vitamin C, in healthy humans, is involved with antioxidant function, wound healing, endothelial function, and catecholamine synthesis. Its function in the human body informs the theoretical basis for why vitamin C supplementation may be beneficial in sepsis/septic shock.Critically ill patients can be vitamin C deficient due to low dietary intake, increased metabolic demands, inefficient recycling of vitamin C metabolites, and loss due to renal replacement therapy. Intravenous supplementation is required to achieve supraphysiologic serum levels of vitamin C. While some clinical studies of intravenous vitamin C supplementation in sepsis have shown improvements in secondary outcome measures, none of the randomized clinical trials have shown differences between vitamin C supplementation and standard of care and/or placebo in the primary outcome measures of the trials. There are some ongoing studies of high-dose vitamin C administration in patients with sepsis and coronavirus disease 2019; the majority of evidence so far does not support the routine supplementation of vitamin C in patients with sepsis or septic shock.

scholarly journals Severe Pulmonary Hypertension in a Patient with Scurvy: Can a Vitamin Reverse It?

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Vandan Shah ◽  
Ruchit N. Shah ◽  
Lauren Greene ◽  
Lauren M. DiMarino
Keyword(s):  
Pulmonary Hypertension ◽  
Major Depressive Disorder ◽  
Vitamin C ◽  
Case Reports ◽  
Severe Pulmonary Hypertension ◽  
Major Depressive ◽  
Vitamin C Deficiency ◽  
Rare Manifestation ◽  
Tobacco Abuse ◽  
Vitamin C Supplementation

Introduction. Pulmonary hypertension secondary to scurvy is a rare manifestation that historically has not been well studied and is only described in a handful of case reports. Case. Our case is about a 35-year-old female with a history significant for drug and tobacco abuse, obesity, poor diet, anxiety, and major depressive disorder who was found to have severe pulmonary hypertension in the setting of vitamin C deficiency (<0.01 mg/L). Conclusion. We present a case that shows pulmonary hypertension can be associated with scurvy and reversed rapidly with adequate vitamin C supplementation.

Role of Vitamin C As an Adjuvant Therapy with Different Iron Chelators in Young β-Thalassemia Major Patients: Safety and Efficacy in Relation to Tissue Iron Overload

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4046-4046 ◽  
Author(s):  
Mohsen Saleh Elalfy ◽  
Maha Saber ◽  
Amira Adly ◽  
Eman Ismail ◽  
Mohamed Tarif ◽  
...  
Keyword(s):  
Vitamin C ◽  
Iron Overload ◽  
Cardiac Mri ◽  
Thalassemia Major ◽  
Hemoglobin Level ◽  
Iron Chelators ◽  
Vitamin C Deficiency ◽  
Tissue Iron ◽  
Vitamin C Supplementation ◽  
Laboratory Variables

Abstract Background: Treatment with antioxidants may neutralize the deleterious effects of oxidative damage by reactive oxygen species generated from labile plasma iron. Vitamin C has been known to increase the efficacy of desforaxamine (DFO). Few studies examined the influence of vitamin C supplementation in iron overloaded β-thalassemia major (β-TM) patients with oral chelators. Aim: To determine the beneficial effects of Vitamin C as an adjuvant to iron chelators in children and adolescents with β-TM and its relation to tissue iron overload. Methods: A randomized prospective study registered on ClinicalTrials.gov (NCT02083575) included 100 patients with β-TM recruited from the regular attendees of Thalassemia center. Inclusion criteria were β-TM patients 2-18 years with serum ferritin (SF) >1000-2500 ng/ml on regular transfusion-chelation therapy receiving the standard doses of Desferrioxamine (DFO), deferiprone (DFP), deferasirox (DFX) in a ratio1:1:1. All the enrolled patients had vitamin C deficiency. Exclusion criteria included patients suffered from insulin-dependent diabetes, clinical cardiac and/or advanced liver disease. The thalassemia patients received vitamin C in a dose of 100 mg daily. Patients were followed-up for 6 months with assessment of transfusion frequency and index, complete blood count, vitamin C levels, serum iron, total iron binding capacity (TIBC), SF and transferrin saturation (Tsat), liver iron content (LIC) and cardiac magnetic resonance imaging T2* before and after therapy were assessed. Results: Laboratory variables at baseline were similarly distributed among patients receiving different iron chelating agents. Upon comparing baseline and post-therapy clinical and laboratory variables among the studied β-thalassemia patients; transfusion index was significantly decreased after 6 months of vitamin C therapy (p=0.03) and the number of transfused patients <3 weeks dropped from 66% to 57% although the difference did not reach a significant level. Hemoglobin level improved (p<0.01). SF, Tsat and LIC were significantly lower after treatment than baseline levels (p=0.048, p<0.01 and p=0.035, respectively). Cardiac MRI T2* and vitamin C levels increased 6 months after treatment (p=0.025 and p<0.001, respectively). Vitamin C supplementation to patients receiving DFO had significantly lowest transfusion index (p=0.035) with significant improvement in hemoglobin level and cardiac MRI T2* as well as decreased SF, Tsat and LIC (p<0.01). Patients on DFP or DFX showed non-significant improvement in hematological and radiological variables. Vitamin C level was negatively correlated to transfusion index, SF and LIC (p<0.01). Neither serious adverse reactions related to the chelators nor to Vitamin C administration have been reported. Conclusions: Vitamin C in a dose of 100 mg, as an adjuvant therapeutic agent increased the efficacy of DFO in reducing iron burden in the moderately iron overloaded B-TM with vitamin C deficiency; it showed marginal improvement with DFP and DFX. Higher doses of vitamin C therapy might be tried with evaluation of possible additional adverse events. Disclosures No relevant conflicts of interest to declare.

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