The relationship between vitamin C or thiamine levels and outcomes for severe sepsis patients admitted to the ICU

Preliminary data have produced conflicting results regarding whether initial vitamin C levels in patients with severe sepsis correlate with mortality outcomes. We hypothesized that low plasma ascorbic acid or thiamine levels in severe sepsis patients admitted from the Emergency Department (ED) to the Intensive Care Unit (ICU) would be associated with increased mortality and an increased incidence of shock. Retrospective analysis of a prospective database of severe sepsis patients admitted to the ICU at an urban, academic medical center. Ascorbic acid and thiamine levels were analyzed in relation to survivors vs. non-survivors and shock vs. non-shock patients. 235 patients were included; mean age, 59.4 years ± 16.8 years; male, 128 (54.5%); in-hospital mortality, 16.6% (39/235); mean APACHE3 score, 61.8 ± 22.8; mean ascorbic acid level (reference range 0.40–2.10 mg/dL), 0.23 mg/dL (95% CI 0.07–4.02); and the mean thiamine level (reference range 14.6–29.5 nmol/L), 6.0 nmol/L (95% CI 4.0–9.5). When survivors were compared to non-survivors, survivors were more likely to be male (57.7% [113/196] vs. 38.5% [15/39]) and have lower APACHE3 scores (58.2 ± 22.6 vs. 79.9 ± 16.0). For the total cohort of 235 patients, there was no statistically significant relationship between a patient’s initial ascorbic acid or thiamine level and either survival or development of shock. In this analysis of early plasma samples from patients with severe sepsis admitted from the ED to the ICU, we found that mean ascorbic acid and thiamine levels were lower than normal range but that there was no relationship between these levels and outcomes, including 28 day mortality and development of shock.

Plasma ascorbic acid therapy and eosinophilic counts in allergic rhinitis: a pilot study

<p class="abstract"><strong>Background:</strong> Role of plasma ascorbic acid in reducing the eosinophilic counts in subjects of allergic rhinitis was studied.</p><p class="abstract"><strong>Methods:</strong> 60 patients were randomly selected from the Rhinology clinics of Oto- Rhino- laryngology and Head-Neck services of a tertiary health care facility. Shift in the eosinophilic counts in three groups of patients i.e., allergic rhinitis, placebo and control groups was analyzed and compared. The study was undertaken in a period of 1^1/2 years (June 2009 -January 2010) Blood eosinophilic count as %age of DLC was noted.</p><p class="abstract"><strong>Results:</strong> The mean eosinophilic count was elevated in allergic patients (8.009±2.91) with respect to that in the controls (4.70±1.26). It reverted to normal with treatment with vitamin C. No change was seen in the placebo group. (5.45±3.56).</p><p class="abstract"><strong>Conclusions:</strong> Vitamin-c reduces the eosinophilic counts in allergic rhinitis.</p><p> </p>

Plasma metabolome and circulating vitamins stratified onset age of an initial islet autoantibody and progression to type 1 diabetes: the TEDDY study

Children’s plasma metabolome, especially lipidome reflects gene regulation and dietary exposures, heralding the development of islet autoantibodies (IA) and type 1 diabetes (T1D). The TEDDY study enrolled 8676 newborns by screening HLA-DR-DQ genotypes at six clinical centers in four countries; profiled metabolome and measured concentrations of ascorbic acid, 25-hydroxyvitamin D (25(OH)D), erythrocyte membrane fatty acids following birth until IA seroconversion under nested case-control design. We grouped children having an initial autoantibody only against insulin (IAA-first) or glutamic acid decarboxylase (GADA-first) by unsupervised clustering of temporal lipidome, identifying a subgroup of children having early onset of each initial autoantibody, i.e., IAA-first by 12 months and GADA-first by 21 months, consistent with population-wide early seroconversion age. Differential analysis showed that infants having reduced plasma ascorbic acid and cholesterol experienced IAA-first earlier, while early onset of GADA-first was preceded by reduced sphingomyelins at infancy. Plasma 25(OH)D prior to either autoantibody was lower in T1D progressors compared to non-progressors, with simultaneous lower diglycerides, lysophosphatidylcholines, triglycerides, alanine before GADA-first. Plasma ascorbic acid and 25(OH)D at infancy were lower in HLA-DR3/DR4 children among IA cases but not in matched controls, implying gene expression dysregulation of circulating vitamins as latent signals for IA or T1D progression.

Plasma metabolome and circulating vitamins stratified onset age of an initial islet autoantibody and progression to type 1 diabetes: the TEDDY study

Children’s plasma metabolome, especially lipidome reflects gene regulation and dietary exposures, heralding the development of islet autoantibodies (IA) and type 1 diabetes (T1D). The TEDDY study enrolled 8676 newborns by screening HLA-DR-DQ genotypes at six clinical centers in four countries; profiled metabolome and measured concentrations of ascorbic acid, 25-hydroxyvitamin D (25(OH)D), erythrocyte membrane fatty acids following birth until IA seroconversion under nested case-control design. We grouped children having an initial autoantibody only against insulin (IAA-first) or glutamic acid decarboxylase (GADA-first) by unsupervised clustering of temporal lipidome, identifying a subgroup of children having early onset of each initial autoantibody, i.e., IAA-first by 12 months and GADA-first by 21 months, consistent with population-wide early seroconversion age. Differential analysis showed that infants having reduced plasma ascorbic acid and cholesterol experienced IAA-first earlier, while early onset of GADA-first was preceded by reduced sphingomyelins at infancy. Plasma 25(OH)D prior to either autoantibody was lower in T1D progressors compared to non-progressors, with simultaneous lower diglycerides, lysophosphatidylcholines, triglycerides, alanine before GADA-first. Plasma ascorbic acid and 25(OH)D at infancy were lower in HLA-DR3/DR4 children among IA cases but not in matched controls, implying gene expression dysregulation of circulating vitamins as latent signals for IA or T1D progression.

Study of vitamin C therapy in allergic rhinitis

<p><strong>Background:</strong> Vitamin C has a therapeutic role in allergic rhinitis by reduction of oxidative stress and inflammation. The present study has been undertaken to evaluate the improvement or otherwise in the clinical manifestations of allergic rhinitis, following supplementation of this vitamin.</p><p><strong>Methods: </strong>40 subjects of allergic rhinitis were selected from the allergy clinics of Dayanand medical college and hospital. The study period was one and a half year. Vitamin C in the dose of 1 gm per day was administered in the case group and in the placebo group a sugar tablet was administered by the oral route. Plasma levels of ascorbic acid and its effect on the symptoms and signs of rhinitis were recorded.</p><p><strong>Results:</strong> The mean duration of illness in the patients with allergic rhinitis was 10.15±3.4 years, with 25 patients having duration of less than 10 years, 10 patients were with of illness between 10 to 20 years and 5 having duration more than 20 years. The most common complaint in patients with allergic rhinitis was of nasal obstruction (57.5%).</p><p>All the patients who showed improvement had increase in plasma ascorbic after the respective treatment but not all the patients showing increase in plasma ascorbic acid post-treatment showed improvement.</p><p><strong>Conclusions: </strong>Vitamin C ameliorates the signs and symptoms of allergic rhinitis by raising the plasma ascorbic acid levels.</p>

Role of plasma ascorbic acid in nasal allergy- a review

Ascorbic acid plays a pivotal role in common cold and allergic rhinitis by affecting the innate and adaptive immunity It antagonizes mediators of allergic rhinitis like histamine, prostaglandins etc. It also maintains the normal redox potential of the cells preventing bonding of antibody to antigen. It helps in stress conditions and has stimulatory effect on interferon synthesis. The present study was undertaken to study the role of plasma ascorbic acid in patients suffering from nasal allergy.

Association between Parameters Related to Oxidative Stress and Trace Minerals in Athletes

The aim of the present study was to evaluate the basal concentrations of malondialdehyde (MDA) nonenzymatic antioxidants, such as ascorbic acid, α-tocopherol, and retinol in plasma or erythrocytes, and the plasma concentrations of 16 trace minerals in endurance athletes from Extremadura (Spain). In addition, we aimed to assess the possible relationships between some parameters related to cellular oxidative stress with plasma concentrations of some trace minerals. Sixty-two national long-distance men athletes participated in this study. The parameters related to oxidative stress and antioxidant activity were analyzed through high pressure liquid chromatography (HPLC), and trace minerals analysis was performed by inductively coupled plasma mass spectrometry (ICP-MS). We found that plasma MDA was positively correlated with selenium and rubidium. Plasma ascorbic acid was positively correlated with manganese and negatively correlated with cobalt and cadmium. Erythrocyte ascorbic acid was related to arsenic and cesium. Plasma α-tocopherol correlated with copper and manganese negatively and positively with arsenic. Erythrocyte α-tocopherol was positively related to copper, rubidium, and lithium. The findings show that athletes with a high degree of training should monitor their intake and concentrations of α-tocopherol for its fundamental role of neutralizing the excess of reactive oxygen species produced by exercise and the prooxidant effects of several minerals such as arsenic, copper, and lithium.

Association of Plasma and Aqueous Humor Ascorbic Acid Level with Morphology Pattern of Age-Related Cataract

Background: Age-related cataract is one of the most important causes of preventable blindness among elderly population in the world. Among various causes of cataract, the level of ascorbic acid in the plasma and aqueous humor is an important parameter that can prevent cataract formation. The level of ascorbic acid in the plasma and aqueous humor is also an indicator of various morphological pattern of cataract. Materials and Methods: A hospital-based cross-sectional study was conducted among 136 patients with immature age-related cataract (≥50 years) who underwent Manual Small Incision Cataract Surgery in the Ophthalmology Department of BPKIHS for the duration of 1 year. Plasma and aqueous humor ascorbic acid levels were determined by standard competitive ELISA test. Results: Ascorbic acid concentrations in aqueous humor as well as plasma were statistically significant with the nuclear type of cataract (p<0.001). There was a positive correlation between plasma and aqueous ascorbic acid level with r = 0.532 and p<0.001. Conclusion: The finding of the study concludes that nuclear type of cataract has a strong association with both aqueous humor and plasma ascorbic acid level.

Post-transplantation plasma malondialdehyde is associated with cardiovascular mortality in renal transplant recipients: a prospective cohort study

Background In renal transplant recipients (RTRs), cardiovascular mortality is the most common cause of long-term renal graft loss. Oxidative stress (OS) has been associated with cardiovascular disease and is known to be enhanced in RTRs. We aimed to prospectively investigate whether the concentration of the OS biomarker malondialdehyde (MDA) is associated with long-term risk of cardiovascular mortality in a large cohort of RTRs. Methods The plasma MDA concentration was measured using the thiobarbituric acid reaction assay in 604 extensively phenotyped RTRs with a functioning allograft for ≥1 year. The association between MDA and cardiovascular mortality was assessed using Cox proportional hazard regression analyses in the overall cohort and within subgroups according to significant effect modifiers. Results Median circulating MDA concentration at baseline was 5.38 [interquartile range (IQR) 4.31–6.45] μmol/L. During a follow-up period of 6.4 (IQR 5.6–6.8) years, 110 (18%) RTRs died, with 40% of deaths due to cardiovascular causes. MDA concentration was significantly associated with the risk for cardiovascular mortality {hazard ratio [HR] 1.31 [95% confidence interval (CI) 1.03–1.67] per 1-SD increment}, independent of adjustment for potential confounders, including renal function, immunosuppressive therapy, smoking status and blood pressure. The association between MDA concentration and the risk for cardiovascular mortality was stronger in RTRs with relatively lower plasma ascorbic acid concentrations [≤42.5 µmol/L; HR 1.79 (95% CI 1.30–2.48) per 1-SD increment] or relatively lower estimated glomerular filtration rates [≤45 mL/min/1.73 m2; HR 2.09 (95% CI 1.45–3.00) per 1-SD increment]. Conclusions Circulating MDA concentration is independently associated with long-term risk for cardiovascular mortality, particularly in RTRs with relatively lower ascorbic acid concentrations or renal function. Further studies are warranted to elucidate whether OS-targeted interventions could decrease cardiovascular mortality in RTRs.