Vit C  & Respiratory Conditions

 

Immune-enhancing role of vitamin C and zinc and effect on clinical conditions- review, Ann Nutr Metab 2006;50(2):85-94. E S Wintergerst et al, https://pubmed.ncbi.nlm.nih.gov/16373990/

A large number of randomized controlled intervention trials with intakes of up to 1 g of vitamin C and up to 30 mg of zinc are available. These trials document that adequate intakes of vitamin C and zinc ameliorate symptoms and shorten the duration of respiratory tract infections including the common cold. Furthermore, vitamin C and zinc reduce the incidence and improve the outcome of pneumonia, malaria, and diarrhea infections, especially in children in developing countries.

 

A combination of high-dose vitamin C plus zinc for the common cold, J INT MED RES,  2012;40(1):28-42, S Maggini et al,(1000 mg,10 mg)- less effective than higher- https://pubmed.ncbi.nlm.nih.gov/22429343/

 

Extra Dose of Vitamin C Based on a Daily Supplementation Shortens the Common Cold: A Meta-Analysis of 9 Randomized Controlled Trials, Biomed Res Int, 2018 Jul 5;2018:1837634. Li Ran et al, https://pubmed.ncbi.nlm.nih.gov/30069463/

administration of extra therapeutic doses at the onset of cold despite routine supplementation was found to help reduce its duration , shorten the time of confinement indoors  and relieve the symptoms associated with it,

 

The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections(1000 mg x3), J Manipulative Physiol Ther , 1999 Oct;22(8):530-3. H C Gorton et al, https://pubmed.ncbi.nlm.nih.gov/10543583/

reported flu and cold symptoms in the test group decreased 85% compared with the control group after the administration of megadose Vitamin C.

Consumption of gold kiwifruit reduces severity and duration of selected upper respiratory tract infection symptoms and increases plasma vitamin C concentration in healthy older adults, Br J Nutr 2012 Oct;108(7):1235-45. https://pubmed.ncbi.nlm.nih.gov/22172428/

Gold kiwifruit significantly reduced the severity and duration of head congestion, and the duration of sore throat. Gold kiwifruit significantly increased plasma vitamin C, α-tocopherol and lutein/zeaxanthin concentrations, and erythrocyte folate concentrations, and significantly reduced plasma lipid peroxidation.

---------------------------------------------------------------------------------

 

Bone Health and Trauma

The Role of Vitamin C in Orthopedic Trauma and Bone Health, Am J Orthop (Belle Meade, NJ), 2015 Jul;44(7):306-11. A Hart et al; https://pubmed.ncbi.nlm.nih.gov/26161758/

Observational data support the hypothesis that high dietary intake and supplementation with vitamin C may reduce the risk of hip fractures in postmenopausal women. Results of 2 high-quality trials support use of vitamin C 500 mg daily for 50 days as prophylaxis against complex regional pain syndrome after wrist fracture treated conservatively and operatively. Observational evidence exists for similar treatment after foot and ankle surgery. The role of vitamin C in preventing osteoarthritis has tremendous potential,

 

Vitamin C and Bone Health: Evidence from Cell, Animal and Human Studies, Curr Drug Targets, 2018;19(5):439-450. K Y Chin et al, https://pubmed.ncbi.nlm.nih.gov/26343111/

Human studies generally showed a positive relationship between vitamin C and bone health, indicated by bone mineral density, fracture probability and bone turnover markers.

 

Sequential analysis of oxidative stress markers and vitamin C status in acute bacterial osteomyelitis, Mediators Inflamm 2014;2014:975061. R Grbic et al; https://pubmed.ncbi.nlm.nih.gov/25180026/

Compared to 52 healthy controls, in OM group baseline serum hydroperoxides, MDA and oxidized/reduced vitamin C ratio were higher whilst Asc and AOA were lower (P < 0.05, resp.). Persistently high values of oxidized/reduced vitamin C ratio and serum MDA were found in subacute OM. In conclusion, acute OM was associated with enhanced systemic oxidative stress and the shift of vitamin C redox status towards oxidized forms. 

 

--------------------------------------------------------------------------------------------------

Intravenous vitamin C in the treatment of allergies: an interim subgroup analysis of a long-term observational study, J Int Med Res2018 Sep;46(9):3640-3655. C Vollbracht et al; https://pubmed.ncbi.nlm.nih.gov/29950123/

Between the start and end of treatment, the mean sum score of three disease-specific symptoms decreased significantly by 4.71 points and that of four nonspecific symptoms decreased significantly by 4.84 points. More than 50% of patients took no other allergy-related medication besides vitamin C. Conclusions Our observations suggest that treatment with intravenous high-dose vitamin C reduces allergy-related symptom

 

 Vitamin C Compound Mixtures Prevent Ozone-Induced Oxidative Damage in Human Keratinocytes as Initial Assessment of Pollution Protection, PLos One 2015 Aug 13;10(8):e0131097. G Valacchi et al; https://pubmed.ncbi.nlm.nih.gov/26270818/

this study was able to demonstrate a protective effect of the tested compounds versus O3-induced cell damage in human keratinocyte

 

 

 

 

 

 

Cardiovascular Health

Effect of vitamin C on endothelial function in health and disease: a systematic review and meta-analysis of randomised controlled trials, Atheroscherosis, 2014 Jul;235(1):9-20. A W Ashor et al, https://pubmed.ncbi.nlm.nih.gov/24792921/

 Pooling the data from 44 clinical trials showed a significant positive effect of vitamin C on cardiovascular EF , with stronger effects in those at higher cardiovascular disease risk.

 

Effect of vitamin E and C supplements on antioxidant defense system in cardiovascular disease patients in Zahedan, southeast Iran, J Nutr Sci Vitaminol 2010;56(6):436-40. M Karajibani et al; https://pubmed.ncbi.nlm.nih.gov/21422713/

After intervention, a significant increase in superoxide dismutase (SOD) activity (61.7%), glutathione peroxidase (GPx) activity (59.3%), the levels of vitamin E (83.7%), C (145.3%), total antioxidant capacity (TAC) (62.8%) and a significant decrease in MDA (40%) value were observed (p<0.0001). There was a significant negative correlation between MDA and TAC. The results suggest that supplementation with a combination of vitamins E and C reduced lipid peroxidation and strengthened the antioxidant defense system. Hence, there will be beneficial effects on the heart by reducing oxidative stress in CVD patients. (use natural or full-spectrum E)

 

 

The acute effect of high-dose intravenousvitamin C and other nutrients on blood pressure

a cohort study, Blood Pressure Monitoring: June 2016 - Volume 21 - Issue 3 - p 160-167, Ried, Karin, et al

Regular intake of vitamin C/ascorbate reduces blood pressure (BP) in hypertensives.

IVC alone (>30 g) reduced the mean BP up to 8–9 mmHg in prehypertensive patients

 

Vitamin C for Type 2 Diabetes Mellitus and Hypertension, 2019 Feb;50(2):11-14. U N Das,

Supplementation of vitamin C reduces hyperglycemia and lowers blood pressure in hypertensives and has several benefical actions in type 2 diabetes mellitus and hypertension.

 

Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials, Am J Clin Nutr 2012 May;95(5):1079-88. S P Jurascheck et al; https://pubmed.ncbi.nlm.nih.gov/22492364/

In short-term trials, vitamin C supplementation reduced SBP and DBP.

 

 Effects of vitamin C supplementation on essential hypertension: A systematic review and meta-analysis, Medicine (Baltimore), 2020 Feb;99(8):e19274, Y Guan et al, https://pubmed.ncbi.nlm.nih.gov/32080138/

VitC supplementation resulted in a significant reduction of blood pressure in patients with essential hypertension.

 

Critically Ill Patients-  Vitamin C: should we supplement? Curr Opin Crit Care, 2018 Aug;24(4):248-255. Spoelstra-de Man AME et al, https://pubmed.ncbi.nlm.nih.gov/29864039/

Older studies showed less organ dysfunction when vitamin C was administered in repletion dose (2-3 g intravenous vitamin C/day). Recent small controlled studies using pharmacological doses (6-16 g/day) suggest that vitamin C reduces vasopressor support and organ dysfunction, and may even decrease mortality.

 

Astaxanthin: a novel potential treatment for oxidative stress and inflammation in cardiovascular disease, Am J Cardiol. 2008 May 22;101(10A):58D-68D. F J Pashkow et al; https://pubmed.ncbi.nlm.nih.gov/18474276/

Results from multiple species support the antioxidant/anti-inflammatory properties of the prototype compound, astaxanthin, establishing it as an appropriate candidate for development as a therapeutic agent for cardiovascular oxidative stress and inflammation.

 

Treatment of Chronic Conditions

 

Effects of vitamin C supplementation on glycaemic control: a systematic review and meta-analysis of randomised controlled trials, Eur J Clin Nutr , 2017 Dec;71(12):1371-1380.

 A W Ashor et al, https://pubmed.ncbi.nlm.nih.gov/28294172/

vitamin C significantly reduced glucose concentrations  in patients with type 2 diabetes and in interventions with a duration greater than 30 days (treatment of T2 diabetes)

Vitamin C prevents oxidative damage, Free Radic Res 1996 Aug;25(2):173-9. M K Ghosh et al, https://pubmed.ncbi.nlm.nih.gov/8885335/

The observations substantiate the previous in vitro findings that ascorbate specifically prevents oxidative degradation of microsomal membranes. The results indicate that vitamin C may exert a powerful protection against degenerative diseases associated with oxidative damage and play a critical role in wellness and health maintenance.

Low vitamin C values are linked with decreased physical performance and increased oxidative stress: reversal by vitamin C supplementation Eur J Nutr 2016 Feb;55(1):45-53. V Paschalis et al; https://pubmed.ncbi.nlm.nih.gov/25526969/

We show that low vitamin C concentration is linked with decreased physical performance and increased oxidative stress, and that vitamin C supplementation decreases oxidative stress and increases exercise performance in those with low initial concentration of vitamin C.

 

N-acetylcysteine (NAC) supplementation increases exercise performance and reduces oxidative stress in individuals with low levels of glutathione, Free Radic Biol Med 2018 Feb 1;115:288-297. V Paschalis et al; https://pubmed.ncbi.nlm.nih.gov/29233792/

Individuals with low glutathione levels were linked with decreased physical performance, increased oxidative stress and impaired redox metabolism of erythrocytes. NAC supplementation restored both performance and redox homeostasis.

[Influence of soccer training on parameters of oxidative stress in erythrocytes] Nutr Hosp 2019 Aug 26;36(4):926-930. https://pubmed.ncbi.nlm.nih.gov/31192692/

Conclusions: there is higher oxidative stress in soccer players than in sedentary players, and it may be necessary to supplement with antioxidants in this group.

Changes in vitamin C and oxidative stress status during the treatment of tuberculous meningitis, Int J Tuberc Lung Dis 2013 Nov;17(11):1495-500. D Miric https://pubmed.ncbi.nlm.nih.gov/24125457/

These results indicate increased local and systemic oxidative stress, accompanied by impaired redox status, but not total vitamin C deficiency, which persisted during conventional clinical treatment of TBM.

 

Vitamin C protects rat cerebellum and encephalon from oxidative stress following exposure to radiofrequency(RDF) wave generated by a BTS antenna model, Toxicol Mech Methods 2014 Jun;24(5):347-52. https://pubmed.ncbi.nlm.nih.gov/24730455/

 The protective role of vitamin C in the treated group improved antioxidant enzymes activity and reduced MDA compared with the test group (p < 0.05). It can be concluded that RFW causes oxidative stress in the brain and vitamin C improves the antioxidant enzymes activity and decreases MDA.

 

----------------------------------------------------------------------------

Lymphocyte vitamin C levels as potential biomarker for progression of Parkinson's disease, Nutrition, 2015 Feb;31(2):406-8. K Ide et al; https://pubmed.ncbi.nlm.nih.gov/25592020/

 Vitamin C is a major antioxidant and also is known as a neuromodulator in dopaminergic neurons. 

Lymphocyte vitamin C levels in patients with severe PD were significantly lower (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.80-0.97; P < 0.01) compared with those at less severe stages. Plasma vitamin C levels also tended to be lower in patients with severe PD

 

 

Low plasma vitamin C in Alzheimer patients despite an adequate diet, Int J Geriatr Psychiatry, 1998 Nov;13(11):749-54. S Riviere et al; https://pubmed.ncbi.nlm.nih.gov/9850871/

Plasma vitamin C is lower in AD in proportion to the degree of cognitive impairment and is not explained by lower vitamin C intake. These results support the hypothesis that oxygen-free radicals may cause damage.

 

Vitamin E Supplements May Decrease the Risk of Lou Gehrig’s Disease (ALS) Linus Pauling Institute- Annals of Neurology on November 4, 2004. They found that people who reported taking vitamin E supplements regularly for more than 10 years when the study began were 60% less likely to die from ALS than those who did not take vitamin E supplements-- https://lpi.oregonstate.edu/vitamin-e-supplements-may-decrease-risk-lou-gehrig’s-disease-als

 

concussions seem to be a risk factor for ALS; recent research shows that high doses of vitamin B12 supplementation may be able to slow down the progression of ALS if you already have it. The key is that you start supplementation before or during early onset (within the first year) of having ALS symptoms.

The research involved treating people with ultra-high-dose methylcobalamin, the physiologically active form of vitamin B12, according to one report discussing the study.

Multiple Sclerosis

Vitamin C promotes oligodendrocytes generation and remyelination, Glia 2018 Jul;66(7):1302-1316.

https://pubmed.ncbi.nlm.nih.gov/29423921/

Oligodendrocyte-formed myelin sheaths play important roles in the neuronal functions in the central nervous system. In demyelinating diseases, such as Multiple Sclerosis, the myelin sheaths are damaged and the remyelinating process is somehow hindered. Restoration of the myelin sheaths requires the differentiation of the oligodendrocyte precursor cells (OPCs) into mature oligodendrocytes (OLs). To discover small molecule compounds that might promote the OPC to OL differentiation, a high-throughput screening system is established and L-ascorbyl-2-phosphate (As-2P), a stable form of Vitamin C (Vc), is found to greatly enhance the OPC to OL differentiation. As-2P promotes gradual expression of OL lineage markers, including O4, CNPase and MBP, in a dose- and time-dependent manner. It also facilitates the formation of myelin sheaths in OPC-neuron co-culture. As-2P also promotes the repair of the myelin sheaths in vivo and provides significant therapeutic effect in a cuprizone-mediated demyelination animal model. 

 

Fatty Acids and Antioxidants in Multiple Sclerosis: Therapeutic Role of GEMSP, Curr Pharm Des 2019;25(4):376-380. https://pubmed.ncbi.nlm.nih.gov/30864502/

Although there are some genetic and environmental factors that have been related to the onset of the disease, these are still not completely understood and nowadays multiple sclerosis can neither be prevented, nor its symptom effectively treated due to disease heterogeneity. GEMSP, which consists of a mixture of functional constituents as fatty acids, antioxidants, free radical scavengers and amino acids linked individually to poly-L-Lysine (PL), is emerging as a promising drug for MS treatment. Pre-clinical studies using GEMSP have demonstrated that this drug strongly inhibits brain leukocyte infiltration and completely abolishes experimental autoimmune encephalomyelitis. In addition, in an open clinical trial in humans treated with GEMSP, in 72% of the cases, a positive evolution of the state of the MS patients treated with GMSP was observed.

Serum total antioxidant capacity in patients with multiple sclerosis, Bosn J Basic Med Sci 2011 Feb;11(1):33-6. https://pubmed.ncbi.nlm.nih.gov/21342139/

Our results showed that oxidative stress plays an important role in pathogenesis of multiple sclerosis. This finding, also, suggests the importance of antioxidants in diet and therapy of MS patients.

 

Ascorbic acid acts mainly by decreasing oxidative stress and reducing the formation of protein aggregates, which may contribute to the reduction of cognitive and/or motor impairments observed in neurodegenerative processes. Although several studies support a possible role of ascorbic acid administration against neurodegeneration, more researches are essential to substantiate the existing results and accelerate the knowledge in this field.

 

 Lipoprotein oxidation, plasma total antioxidant capacity and homocysteine level in patients with multiple sclerosis, Nutr Neurosci 2003 Jun;6(3):189-96. https://pubmed.ncbi.nlm.nih.gov/12793524/

In multiple sclerosis patients during an attack, a significant increase in both in vitro lipid oxidizability for plasma and in the levels of autoantibodies against oxidized low-density lipoproteins, and a strong decrease in plasma total antioxidant capacity were detected. The present study indicates that lipoprotein oxidation may be important factor in the course of multiple sclerosis and in vitro measurements of plasma oxidation kinetics as an indication for lipoprotein oxidation might be useful as an additional tool for the clinical diagnosis of multiple sclerosis.

Does Vitamin C Influence Neurodegenerative Diseases and Psychiatric Disorders?, Nutrients 2017 Jul; 9(7): 659. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537779/         (best study I’ve seen)

Vitamin C (Vit C) is considered to be a vital antioxidant molecule in the brain. Intracellular Vit C helps maintain integrity and function of several processes in the central nervous system (CNS), including neuronal maturation and differentiation, myelin formation, synthesis of catecholamine, modulation of neurotransmission and antioxidant protection. The importance of Vit C for CNS function has been proven by the fact that targeted deletion of the sodium-vitamin C co-transporter in mice results in widespread cerebral hemorrhage and death on post-natal day one. Since neurological diseases are characterized by increased free radical generation and the highest concentrations of Vit C in the body are found in the brain and neuroendocrine tissues, it is suggested that Vit C may change the course of neurological diseases and display potential therapeutic roles

Vit C is important for proper nervous system function and its abnormal concentration in nervous tissue is thought to be accompanied with neurological disorders.

 

Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, multiple sclerosis, amyotrophic sclerosis, depression, anxiety, schizophrenia

that modulate NMDARs. However, this issue needs to be further investigated.

7. Conclusions

The crucial role of Vit C in neuronal maturation and functions, neurotransmitter action as well as responses to oxidative stress is well supported by the evidences presented in this review (Figure 2).

--------------------------------------------------------------------------------------------------

The epigenetic role of vitamin C in health and disease, Cell Mol Life Sci 2016 Apr;73(8):1645-58

https://pubmed.ncbi.nlm.nih.gov/26846695/

Recent advances have uncovered a previously unknown function of vitamin C in epigenetic regulation. Vitamin C exists predominantly as an ascorbate anion under physiological pH conditions. Ascorbate was discovered as a cofactor for methylcytosine dioxygenases that are responsible for DNA demethylation, and also as a likely cofactor for some JmjC domain-containing histone demethylases that catalyze histone demethylation. Variation in ascorbate bioavailability thus can influence the demethylation of both DNA and histone, further leading to different phenotypic presentations. Ascorbate deficiency can be presented systematically, spatially and temporally in different tissues at the different stages of development and aging. Here, we review how ascorbate deficiency could potentially be involved in embryonic and postnatal development, and plays a role in various diseases such as neurodegeneration and cancer through epigenetic dysregulation.

 

Preventive and therapeutic potential of ascorbic acid in neurodegenerative diseases, CNS Neurosci Therapy 017 Dec;23(12):921-929. https://pubmed.ncbi.nlm.nih.gov/28980404/

Ascorbic acid acts mainly by decreasing oxidative stress and reducing the formation of protein aggregates, which may contribute to the reduction of cognitive and/or motor impairments observed in neurodegenerative processes. Although several studies support a possible role of ascorbic acid administration against neurodegeneration, more researches are essential to substantiate the existing results and accelerate the knowledge in this field.

 

High-dose Vitamin B12 May Improve ALS Prognosis if Started Early, Study Suggests

Treatment with ultra-high-dose methylcobalamin, the physiologically active form of vitamin B12, may improve the prognosis of patients with amyotrophic lateral sclerosis (ALS) who receive it a year or less after symptom onset, a long-term study of Japanese reports. methylcobalamin was able to decrease homocysteine levels.  This molecule’s accumulation has been linked with motor neuron degeneration in patients with ALS.   https://alsnewstoday.com/news-posts/2019/01/17/high-dose-vitamin-b12-helpful-early-diagnosis/

 

 Journal of Neurology, Neurosurgery & Psychiatry. Jan 17 2019

 

 

 

Vitamin C Status and Cognitive Function: A Systematic Review, Nutrients, 2017 Aug 30;9(9):960., N Travika et al; https://pubmed.ncbi.nlm.nih.gov/28867798/

Studies demonstrated higher mean vitamin C concentrations in the cognitively intact groups of participants compared to cognitively impaired groups. qualitative assessment revealed a potential association between plasma vitamin C concentrations and cognition

 

A critical review of vitamin C for the prevention of age-related cognitive decline and Alzheimer's disease, J Alzheimer’s Dis, 2012;29(4):711-26. F E Harrison, https://pubmed.ncbi.nlm.nih.gov/22366772/

there is a large body of evidence that maintaining healthy vitamin C levels can have a protective function against age-related cognitive decline and Alzheimer's disease,

 

Serum levels of vitamin E forms and risk of cognitive impairment in a Finnish cohort of older adults, Exp Gerontol. 2013 Dec;48(12):1428-35. M Kivipelto et al; https://pubmed.ncbi.nlm.nih.gov/24113154/

Elevated levels of tocopherol and tocotrienol forms are associated with reduced risk of cognitive impairment in older adults.

 

 

Protective Role for Antioxidants in Acute Kidney Disease, Nutrients, 2017 Jul 7;9(7):718, J M Dennis et al; https://pubmed.ncbi.nlm.nih.gov/28686196/

Acute kidney injury is associated with increased oxidative damage, and various endogenous and synthetic antioxidants that mitigate source and derived oxidants are beneficial in cell-based and animal studies.

ascorbate (vitamin C), has been shown to be a promising therapeutic in human renal injury in critical illness and nephrotoxicity. 

 

Vitamin C improves liver and renal functions in hypothyroid rats by reducing tissue oxidative injury, Int J Vitam Nutr Res, 2020 Jan;90(1-2):84-94, M Esmaeilizadeh et al; https://pubmed.ncbi.nlm.nih.gov/30789800/

Vit C improved liver and renal function of hypothyroid rats which might be due to its protective effects against tissues oxidative damage.

 

 

Entacapone is an Antioxidant More Potent than Vitamin C and Vitamin E for Scavenging of Hypochlorous Acid and Peroxynitrite, and the Inhibition of Oxidative Stress-Induced Cell Death, Med Sci Monit 2016 Mar 1;22:687-96; A Y Chen et al; https://pubmed.ncbi.nlm.nih.gov/26927838/

Entacapone (ENT), a clinical drug for the treatment of Parkinson's disease, has been shown to have antioxidant effects. ENT is an antioxidant that can scavenge toxic HOCl and ONOO- species and inhibit oxidative stress-induced cell death more effectively than vitamin C and vitamin E. ENT may have new clinical applications as an antioxidant in the treatment of ROS-induced diseases including cardiovascular disease, cancer, and neurodegenerative diseases. 

 

-------------------------------------------------------------------------

 

(vit C is effective at reducing pain after injury or operation)

Efficacy of vitamin C in preventing complex regional pain syndrome after wrist fracture: A systematic review and meta-analysis, Orthop Traumatol Surg Res , 2017 May;103(3):465-470 F Aim et al, https://pubmed.ncbi.nlm.nih.gov/28274883/

 Daily supplementation with 500mg of vitamin C per day for 50 days decreases the 1-year risk of CRPS-I after wrist fracture.

Prospective randomized study of the vitamin C effect on pain and complex pain regional syndrome after total knee arthroplasty, Int Orthop 2021 Jan 12, H Jacques et al, https://pubmed.ncbi.nlm.nih.gov/33438072/

Taking 1 g per day of vitamin C during 40 days after a TKA reduces the risk of CRPS.

 

Vitamin C revisited, Crit Care, 2014 Aug 6;18(4):460. Heleen M Oudemans-van Straaten et al; https://pubmed.ncbi.nlm.nih.gov/25185110/

Vitamin C can restore vascular responsiveness to vasoconstrictors, preserve endothelial barrier by maintaining cyclic guanylate phosphatase and occludin phosphorylation and preventing apoptosis. Finally, high-dose vitamin C can augment antibacterial defense. These protective effects against overwhelming oxidative stress due to ischemia/reperfusion, sepsis or burn seems to mitigate organ injury and dysfunction, and promote recovery after cardiac revascularization and in critically ill patients, in the latter partially in combination with other antioxidants

 

 

Intravenous vitamin C in the treatment of shingles: results of a multicenter prospective cohort study, Med Sci Monit. 2012 Apr;18(4):CR215-24. M Schencking et al, https://pubmed.ncbi.nlm.nih.gov/22460093/

Mean declines of pain scores (VAS), number of affected dermatomes and efflorescences, and the presence of hemorrhagic vesicles between the baseline and follow-up assessments at 2 and 12 weeks were statistically significant

 

Vitamin C in the treatment and/or prevention of obesity and co-morbidities of obesity, J Nutr Sci Vitaminol. (Tokyo) 2014;60(6):367-79. https://pubmed.ncbi.nlm.nih.gov/25866299/

It has been observed that vitamin C intake (ascorbic acid) is negatively associated with the occurrence of several conditions such as hypertension, gallbladder disease, stroke, cancers, and atherosclerosis, and also with the onset of obesity in humans and animals.

 

---------------------------------------

Vitamin C requirement in surgical patients, Curr Opin Clin Nutr Metab Care, 2010 Nov;13(6):669-76. R Fukushima et al, https://pubmed.ncbi.nlm.nih.gov/20689415/

 

Vitamin C requirement is increased in surgical patients, and the potential advantage of supplementation is to increase the plasma and tissue levels of vitamin C and thereby reduce oxidative stress. Although some clinical benefits of high-dose vitamin C supplementation have been shown in the critically ill, the optimal dose for supplementation and the clinical benefits remain to be investigated in surgical patients.-------------------------------------

Efficacy of vitamin C for the treatment of upper respiratory tract infection. A meta-analysis in children, Eur J Clin Pharmacol , 2019 Mar;75(3):303-311.

vitamin C intake reduced the duration of URTI. 

[Effect of vitamin C on prognosis of critically ill patients: a Meta-analysis] Zhoghua wei Zhong Bing Ji Jiu Yi Xue2019 Aug;31(8):942-948. X Du et al, https://pubmed.ncbi.nlm.nih.gov/31537216/

Vit C can reduce the length of ICU stay and hospital stay. In addition, vitamin C can reduce mortality of patients with sepsis and septic shock and reduce the incidence of atrial fibrillation post operation in patients undergoing cardiac surgery.

 

 

Our data indicate that vitamin C is an important independent antioxidant in protecting cells against death from oxidative stress.

 

 

Vitamin C prevents DNA mutation induced by oxidative stress, J Biol Chem 2002 May 10;277(19):16895-9. https://pubmed.ncbi.nlm.nih.gov/11884413/

We found that vitamin C loading resulted in substantially decreased mutations induced by H(2)O(2). Depletion of glutathione led to cytotoxicity and an increase in H(2)O(2)-induced mutation frequency; however, mutation frequency was prominently decreased in depleted cells preloaded with vitamin C. The mutation results correlated with a decrease in total 8-oxo-guanine measured in genomic DNA of cells loaded with vitamin C and oxidatively stressed. These findings directly support the concept that high intracellular concentrations of vitamin C can prevent oxidation-induced mutations in human cells.

Vitamin C for DNA damage prevention, Mut Res 2012 May 1;733(1-2):39-49. https://pubmed.ncbi.nlm.nih.gov/22178550/

 

Vitamin C supplementation decreased the frequency of chromosomal aberrations in groups with insufficient dietary intake who were occupationally exposed to mutagens, and also decreased the sensitivity to mutagens as assessed using the bleomycin assay. High vitamin C levels in plasma decreased the frequency of genomic translocations in groups exposed to ionizing radiation or c-PAHs in polluted air. The frequency of micronuclei was decreased by vitamin C supplementation in smokers challenged with γ-irradiation, and higher vitamin C levels in plasma counteracted the damage induced by air pollution. The prevalence of DNA adducts inversely correlated with vitamin C levels in groups environmentally exposed to high concentrations of c-PAHs. Increased vitamin C levels decreased DNA strand breakage induced by air pollution. Oxidative damage (8-oxodG levels) was decreased by vitamin C supplementation in groups with plasma levels>50μmol/l exposed to PM2.5 and c-PAHs. Modulation of DNA repair by vitamin C supplementation was observed both in poorly nourished subjects and in groups with vitamin C plasma levels>50μmol/l exposed to higher concentrations of c-PAHs.

 

 

 

Vitamin C- Cancer Treatment

 In a 1976 study conducted by Pauling and Dr. Ewan Cameron, a Scottish surgeon, of 100 patients with terminal cancer, those treated with vitamin C had an improved quality of life and a fourfold increase in their mean survival time.9.   (Later studies done at Mayo Clinic claiming to refute these results were not similar or comparable as explained by NCI doctors.)  

Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer, E CameronL Pauling, Proc Natl Acad Sci U.S.A. 1976 Oct;73(10):3685-9 &

Intravenous ascorbic acid: protocol for its application and use, H D Riordon et al, P R Health Sci J, 2003 Sep;22(3):287-90. & High dose concentration administration of ascorbic acid inhibits tumor growth in BALB/C mice implanted with sarcoma 180 cancer cells via the restriction of angiogenesis, Chang-Hwan Yeom, et al, J Transi Med, 2009 Aug 11;7:70 & Vitamin C uncouples the Warburg metabolic switch in KRAS mutant colon cancer, O Aguilera et al, Oncotarget. 2016 Jul 26;7(30):47954-47965. https://pubmed.ncbi.nlm.nih.gov/1068480/

 

Intravenous vitamin C in the supportive care of cancer patients: a review and rational approach, Curr Oncol 2018 Apr;25(2):139-148. E Klimant et al, https://pubmed.ncbi.nlm.nih.gov/29719430/

The use of IV C is a safe supportive intervention to decrease inflammation in the patient and to improve symptoms related to antioxidant deficiency, disease processes, and side effects of standard cancer treatments.

 

Vitamin C as a Modulator of the Response to Cancer Therapy, Molecules, 2019 Jan 28;24(3):453.

Wiktoria Blaszczak et al, https://pubmed.ncbi.nlm.nih.gov/30695991/

 Experimental studies have shown the ability of pharmacological doses of vitamin C alone or in combinations with clinically used drugs to exert beneficial effects in various models of human cancers. Cytotoxicity of high doses of vitamin C in cancer cells appears to be related to excessive reactive oxygen species generation and the resulting suppression of the energy production via glycolysis. A hallmark of cancer cells is a strongly upregulated aerobic glycolysis, which elevates its relative importance as a source of ATP (Adenosine 5'-triphosphate). Aerobic glycolysis is maintained by a highly increased uptake of glucose, which is made possible by the upregulated expression of its transporters, such as GLUT-1, GLUT-3, and GLUT-4. These proteins can also transport the oxidized form of vitamin C, dehydroascorbate, permitting its preferential uptake by cancer cells with the subsequent depletion of critical cellular reducers as a result of ascorbate formation. Ascorbate also has a potential to affect other aspects of cancer cell metabolism due to its ability to promote reduction of iron(III) to iron(II) in numerous cellular metalloenzymes. Among iron-dependent dioxygenases, important targets for stimulation by vitamin C in cancer include prolyl hydroxylases targeting the hypoxia-inducible factors HIF-1/HIF-2 and histone and DNA demethylases. Altered metabolism of cancer cells by vitamin C can be beneficial by itself and can also promote activity of specific drugs.

 

Ascorbic Acid in Cancer Treatment: Let the Phoenix Fly, Cancer Cell, 2018 Nov 12;34(5):700-706.

N Shinoy et al; https://pubmed.ncbi.nlm.nih.gov/30174242/

Two mechanisms of anti-cancer activity with ascorbate have gained prominence: hydrogen peroxide-induced oxidative stress and DNA demethylation mediated by ten-eleven translocation enzyme activation. 

----------------------------------------------------------------------

The Role of Oxidative Stress Modulators (Melatonin) in Breast Cancer, Curr Med Chem 2018;25(33):4084-4101. S Suzen et al https://pubmed.ncbi.nlm.nih.gov/28699501/

Our data, in accordance with the literature, suggest an important role for melatonin in breast cancer prevention and adjuvant therapy.

 

Melatonin: the watchdog of villous trophoblast homeostasis against hypoxia/reoxygenation-induced oxidative stress and apoptosis, Mol Cell Endocrinol 2013 Dec 5;381(1-2):35-45. https://pubmed.ncbi.nlm.nih.gov/23886990/

 

This study shows that melatonin protects the villous trophoblast against H/R-induced oxidative stress and apoptosis and suggests a potential preventive and therapeutic use of this indolamine in pregnancy complications characterized by syncytiotrophoblast survival alteration.

--------------------------------------------------------------------------------------------------------------------

Does Vitamin C Influence Neurodegenerative Diseases and Psychiatric Disorders?, Nutrients 2017 Jul; 9(7): 659. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537779/         (best study I’ve seen)

Vitamin C (Vit C) is considered to be a vital antioxidant molecule in the brain. Intracellular Vit C helps maintain integrity and function of several processes in the central nervous system (CNS), including neuronal maturation and differentiation, myelin formation, synthesis of catecholamine, modulation of neurotransmission and antioxidant protection. The importance of Vit C for CNS function has been proven by the fact that targeted deletion of the sodium-vitamin C co-transporter in mice results in widespread cerebral hemorrhage and death on post-natal day one. Since neurological diseases are characterized by increased free radical generation and the highest concentrations of Vit C in the body are found in the brain and neuroendocrine tissues, it is suggested that Vit C may change the course of neurological diseases and display potential therapeutic roles

Vit C is important for proper nervous system function and its abnormal concentration in nervous tissue is thought to be accompanied with neurological disorders.

 

Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, multiple sclerosis, amyotrophic sclerosis, depression, anxiety, schizophrenia

 

 many studies have demonstrated that ROS and oxidative stress are implicated in AD disease progression. Aβ peptide was found to enhance the neuronal vulnerability to oxidative stress and cause an impairment of electron transport chain, whereas oxidative stress was shown to induce accumulation of Aβ peptide which subsequently promotes ROS production [,,].  The role of Vit C in preventing the brain against oxidative stress damage seems to be also proved by the recent study performed by Sarkar et al. []. The researchers share a view that cerebral ischemia-reperfusion-induced oxidative stress may initiate the pathogenic cascade leading eventually to neuronal loss, especially in hippocampus, with amyloid accumulation, tau protein pathology and irreversible Alzheimer’s dementia. Being the prime source of ROS generation, neuronal mitochondria are the most susceptible to damage caused by oxidative stress. The study proved it that l-ascorbic acid loaded polylactide nanocapsules exerted a protective effect on brain mitochondria against cerebral ischemia-reperfusion-induced oxidative injury []. Kennard and Harrison, in turn, evaluated the effects of a single intravenous dose of Vit C on spatial memory (using the modified Y-maze test) in APP/PSEN1 mice. The study was performed on APP/PSEN1 and wild-type (WT) mice of three age spans (3, 9 or 20 months). It was shown that APP/PSEN1 mice displayed no behavioral impairment as compared to WT controls, but memory impairment along with aging was observed in both groups. Vit C treatment (125 mg/kg, i.v.) improved performance in 9-month old APP/PSEN1 and WT mice, but improvements in short-term spatial memory did not result from changes in the neuropathological features of AD or monoamine signaling, as acute Vit C administration did not alter monoamine levels in the nucleus accumbens []. Cognitive-enhancing effects of acute intraperitoneal (i.p.) Vit C treatment in APP/PSEN1 mice (12- and 24-month-old) were investigated by Harrison et al. Vit C treatment (125 mg/kg i.p.) improved Y-maze alternation rates and swim accuracy in the water maze in both APP/PSEN1 and wild-type mice; but like in the previous study had no significant effect on the age-associated increase in Aβ deposits and oxidative stress, and did not also affect acetylcholinesterase (AChE) activity either, which was significantly reduced in APP/PSEN1 mice []. Murakami et al. [] in turn reported that 6-month-treatment with Vit C resulted in reduced Aβ oligomer formation without affecting plaque formation, a significant decrease in brain oxidative damage and Aβ42/Aβ40 ratio as well as behavioral decline in an AD mouse model. Furthermore, this restored the declined synaptophysin and reduced the phosphorylation of tau protein at Ser396. 

Besides the presented roles, Vit C has also been suggested to prevent neurodegenerative changes and cognitive decline by protecting blood–brain barrier (BBB) integrity []. meta-analysis performed by Lopes da Silva et al. proved significantly lower plasma levels of Vit C in AD patients []. It seems that the above discrepancies may result from the fact that not plasma but rather intracellular Vit C may be associated with AD.  randomized control trial involving 276 elderly participants demonstrated that 16-week-co-supplementation of vitamin E and C with β-carotene significantly improved cognitive function (particularly with higher doses of β-carotene). Furthermore, the authors suggested that such a treatment markedly reduced plasma Aβ levels and elevated plasma estradiol levels []. Vit C and E co-supplementation for more than 3 years was also shown to be associated with a reduced prevalence and incidence of AD []. Moreover, an adequate Vit C plasma level seems to be associated with less progression in carotid intima-media thickness (C-IMT)—the greater C-IMT is suggested to be a risk factor in predicting cognitive decline in the general population, in the elderly population and in patients with Alzheimer’s disease. Polidori et al. showed significant decrease (with a linear slope) in Vit C level among old individuals with no or very mild cognitive impairment from the first to the fourth C-IMT quartile [].

Parkinson’s

 there are only a few human studies considering the role of Vit C treatment in PD, the existing ones give some evidences that Vit C treatment may have beneficial effect in PD course. A cohort study involving 1036 PD patients showed that dietary Vit C intake was significantly associated with reduced PD risk. However, it was not significant in a 4-year lagged analysis []. Quiroga et al., in turn, reported a case of a 66-year-old man with PD, pleural effusion and bipolar disorder who was found to have low serum Vit C and zinc levels. Intravenous replacement of both Vit C and zinc resulted in resolution of the movement disorder in less than 24 h []. The other case report concerned 83-year-old men with dementia, diabetes mellitus, hypertension, benign prostatic hypertension, paroxysmal atrial fibrillation, congestive heart failure and suspected PD. The man was treated with Vit C (200 mg) and zinc (4 mg), which resulted in complete resolution of periungual and gingival bleeding as well as palatal petechiae. Moreover, the man’s orientation and mental status were found to be markedly improved and no further delusions or agitations were observed [].

 

Huntington’s Disease

studies performed on cell and animal models of HD appear to indicate the role of Vit C in HD course,

to the best of our knowledge, in the newest literature there exists a lack of studies considering the role of Vit C or the effect of its supplementation in HD human subjects.

MS is characterized by infiltration of immune cells (in particular T cells and macrophages), demyelination (loss of myelin sheath that surrounds and protects nerve fibers allowing them to conduct electrical impulses) and axonal pathology resulting in multiple neurological deficits, which range from motor and sensory deficits to cognitive and psychological impairment [,]  IT IS suggested that genetic predisposition associated with environmental factors can lead to expression of the envelope protein of MS-associated retrovirus (MSRV) and thus trigger the disease []. 

Oxidative/nitrosative stress and mitochondrial dysfunction are believed to contribute to the pathophysiology of MS [,,,,]. 

Having regarded the presented facts, it seems to be justified that Vit C, being a very important brain antioxidant, may affect MS course. Vit C is known to affect numerous metabolic processes directly associated with immune system. Furthermore, Vit C-dependent collagen synthesis has also been linked to formation of the myelin sheath [].

existing ones showed that MS patients displayed significantly lower Vit C level as compared to healthy individuals [,,]. Besler et al. [], in turn, observed an inverse correlation between the serum levels of Vit C and lipid peroxidation in MS patients. The authors concluded that decreased Vit C level, observed in MS patients during relapse of the disease, might be dependent on the elevated oxidative burden as reflected by increased lipid peroxidation. Hejazi et al. [],

An efficiency of antioxidant therapy in relapsing-remitting multiple sclerosis patients (n = 14) treated with complex of antioxidants and neuroprotectors with various mechanisms of action (oc-lipoic acid, nicotinamide, acetylcysteine, triovit beta-carotine, alpha-tocopheryl acetate, ascorbic acid, selenium, pentoxifylline, cerebrolysin, amantadine hydrochloride) during 1 month, 2 times a year was investigated by Odinak et al. []. The treatment resulted in significant reduction of relapse frequency, decrease of required corticosteroid courses and significantly reduced content of lipid peroxide products []. However, it should be underlined that Vit C was only one element of multicomponent treatment. However, in another study it was shown that intrahippocampal injection of Vit C (0.2, 1, 5 mg/kg, 7 days) improved memory acquisition of passive avoidance learning (PAL) in ethidium bromide-induced MS in rats. The injection of ethidium bromide caused significant deterioration of PAL, whereas treatment with Vit C at a dose of 5 mg/kg resulted in significant improvement in PAL [].

Role of Vitamin C in Psychiatric Disorders

Vit C is also believed to be involved in anxiety, stress, depression, fatigue and mood state in humans. It has been hypothesized that oral Vit C supplementation can elevate mood as well as reduce distress and anxiety. 

6.1. Depression

Depression (DP) is a mental disorder characterized by a number of basic symptoms like low mood, biological rhythm disorders, psychomotor slowdown, anxiety, somatic disorders as well other nonspecific symptoms []

believed that depression is associated with disturbances of serotonin, norepinephrine and dopamine neurotransmission

GABA level in plasma and CSF of patients suffering from depression was shown to be reduced [,] which points to its decreased synthesis in the brain. Recent data have suggested that chronic stress, via initiating changes in the hypothalamic-pituitary-adrenal axis and the immune system, acts as a trigger for the above-mentioned disturbance. For example, glucocorticoids and proinflammatory cytokines enhance the conversion of tryptophan to kynurenine thus leading to a decrease in the synthesis of brain serotonin

 

The efficacy of Vit C as an adjuvant agent in the treatment of pediatric major depressive disorder in a double-blind, placebo-controlled pilot trial was evaluated by Amr et al. []. Patients (n = 12) treated for six months with fluoxetine (10–20 mg/day) and Vit C (1000 mg/day) showed a significant decrease in depressive symptoms in comparison with the fluoxetine plus placebo group as measured by the Children’s Depression Rating Scale and Children’s Depression Inventory. No serious adverse effects were shown. Zhang et al. [] in double-blind clinical trial investigated the effect of Vit C (500 mg twice daily) on mood in non-depressed acutely hospitalized patients. The applied therapy increased plasma and mononuclear leukocyte Vit C concentrations and was associated with a 34% reduction in mood disturbance (assessed with Profile of Mood States) []. Similarly, Wang et al. found that short-term Vit C (500 mg twice daily) treatment was associated with a 71% reduction in mood disturbance (assessed with Profile of Mood States) and a 51% reduction in psychological distress (assessed with Distress Thermometer) in acutely hospitalized patients with a high prevalence of hypovitaminosis C []. Khajehnasiri et al. [] in a randomized, double-blind, placebo-controlled trial involving 136 depressed male shift workers observed, in turn, that Vit C administration (250 mg twice daily for 2 months) alone and in combination with omega-3 fatty acids significantly reduced the Beck Depression Inventory (BDI) score, however omega-3 fatty acid supplementation alone was more effective. Moreover, Vit C and omega-3 fatty acids supplementation alone (but not in combination) decreased significantly serum MDA levels. Fritz et al. [] conducted a systematic review of human and observational studies assessing the efficiency of interventional Vit C as a contentious adjunctive cancer therapy and reported that it could improve quality of life, physical function, as well as prevent some side effects of chemotherapy, including fatigue, nausea, insomnia, constipation and depression. 

 

6.2. Anxiety

 

 growing evidence, which has been recently emerged, suggests that anxiety is associated with Vit C deficit, whereas Vit C supplementation could help reduce feeling of anxiety.

 

 existing ones seem to provide promising results. 

De Oliveira et al. [] examined the effects of short-term oral Vit C supplementation (500 mg/day, 14 days) in high school students (n = 42) in a randomized, double-blind, placebo-controlled trial. The treatment led to higher plasma Vit C concentration that was associated with reduced anxiety levels evaluated with BIA (Beck Anxiety Inventory). Moreover, the Vit C supplementation had positive effect on the heart rate. Gautam et al. [] observed that patients with generalized anxiety disorder had significantly lower Vit C levels in comparison with healthy controls, whereas 6-week vitamins supplementation (vitamin C accompanied with A and E) led to a significant reduction in anxiety scores []. Mazloom et al. [], in turn, showed that short-term supplementation of Vit C (1000 mg/day) reduced anxiety levels (evaluated basing on Depression Anxiety Stress Scales 21-item) in diabetic patients. This effect was exerted through alleviating oxidative damage. Furthermore, recently performed a systematic review also showed that high-dose Vit C supplementation was effective in reducing anxiety as well as stress-induced blood pressure increase [].

6.3. Schizophrenia

Schizophrenia is a severe and complex neuropsychiatric disorder that affects 1% of the population worldwide [,,]. 

there is the increasing evidence that several physiological mechanisms such as oxidative stress, altered one carbon metabolism and atypical immune-mediated responses may be involved in schizophrenia pathomechanism [,].

Hoffer [] summarized in the review study the evidence showing that among others Vit C deficiency could worsen the symptoms of schizophrenia and that large doses of this vitamin could improve the core metabolic abnormalities predisposing some people to development of this disease. According to the author, it is probable that the pathologic process responsible for schizophrenia could increase ascorbic acid utilization. Sarandol et al. [] also noted lower levels of serum Vit C as compared to control group, but this was not regarded as a statistically significant difference. Moreover, a 6-week-long antipsychotic treatment did not modify the concentration of this vitamin. The authors explained that other factors, such as nutrition, physical activity, etc., might be the reason for the discrepancy between the results of their research and other studies. Similarly, Young et al. [] observed only a slight decrease in Vit C levels in schizophrenic group vs. control one; but interestingly, a highly significant increase in Vit C level in the control female group as compared to both control as well as schizophrenic male group was observed. The authors pointed out that this information might be relevant particularly in the light of recent reports that the risk of schizophrenia is higher in men than women. The reduced supply of Vit C with the diet in patients with schizophrenia was noted by Konarzewska et al. [].

The review of Magalhães et al. revealed that the implementation of Vit C as a low-molecular-weight antioxidant alleviated the effects of free radicals in the treatment of schizophrenia []. According to Bentsen et al. [] membrane lipid metabolism and redox regulation may be disturbed in schizophrenia. These authors conducted a study aiming at examination of the clinical effect of adding vitamins E + C to antipsychotics (D2 receptor antagonists). Patients with schizophrenia or related psychoses received Vit C (1000 mg/day) along with vitamin E (364 mg/day) for 16 weeks. Vitamins impaired the course of psychotic symptoms, especially of persecutory delusions. The authors pointed to the usefulness of supplementation of antioxidant vitamins as agents alleviating some side effects of antipsychotic drugs. This was also confirmed by the next study involving schizophrenia patients treated with haloperidol []. Classical antipsychotics like haloperidol are suggested to increase oxidative stress and oxidative cell injury in brain, which may influence the course as well as treatment effects of schizophrenia. In this study, chronic haloperidol treatment connected with supplementation of a combination of ω-3 fatty acids and vitamins E and C showed a significant beneficial effect on schizophrenia treatment as measured by SANS (Simpson Angus Scale) and BPRS (Brief Psychiatric Rating Scale) scales. BPRS total score and subscale scores as well as SANS scores were significantly improved starting from the 4th week of treatment. Moreover, in patients with schizophrenia after 16 weeks of treatment, serum Vit C levels were almost twice as high as at the beginning of the study. These results supported the hypothesis of a beneficial effect of the applied supplementation both on positive and negative symptoms of schizophrenia as well as the severity of side effects induced by haloperidol []. Heiser et al. [] also stated that reactive oxygen species (ROS) were involved in the pathophysiology of psychiatric disorders such as schizophrenia. Their research demonstrated that antipsychotics induced ROS formation in the whole blood of rats, which could be reduced by the application of vitamin C. The aim of their study was to demonstrate the effects of clozapine, olanzapine and haloperidol at different doses (18, 90 and 180 μg/mL) on the formation of ROS in the whole blood by using electron spin resonance spectroscopy. To demonstrate the protective capacity of Vit C the blood samples were incubated the highest concentration of each drug with Vit C (1 mM) for 30 min. Olanzapine caused significantly greater ROS formation vs. control under all treatment conditions, while in the case of haloperidol and clozapine only two higher concentrations resulted in significantly increased ROS formation. Vitamin C reduced the ROS production of all tested drugs, but for olanzapine the attenuating effect did not reach a significant level.

A relatively novel approach as for the role of Vit C in etiology and treatment of schizophrenia was presented by Sershen et al. []. According to the researchers, deficits in N-methyl-d-aspartate receptor (NMDAR) function are linked to persistent negative symptoms and cognitive deficits in schizophrenia. This hypothesis is supported by the fact that the flavoprotein D-amino acid oxidase (DAO) was shown to degrade the gliotransmitter D-Ser, a potent activator of N-methyl-d-aspartate-type glutamate receptors, while a lot of evidence has suggested that DAO, together with its activator, G72 protein, may play a key role in the pathophysiology of schizophrenia. Furthermore, in a postmortem study the activity of DAO was found to be two-fold higher in schizophrenia subjects []. Sershen et al. [] showed that acute ascorbic acid dose (300 mg/kg i.p.) inhibited PCP-induced and amphetamine-induced locomotor activity in mouse model, which was further attenuated in the presence of D-serine (600 mg/kg). The authors suggested that this effect could result from the Vit C-depended changes in dopamine carrier-membrane translocation and/or altered redox mechanisms that modulate NMDARs. However, this issue needs to be further investigated.

7. Conclusions

The crucial role of Vit C in neuronal maturation and functions, neurotransmitter action as well as responses to oxidative stress is well supported by the evidences presented in this review (Figure 2).

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Proteostasis is an important function critical to maintaining cellular health in the body

Normal proteostasis ensures that proteins are produced and folded appropriately before they are trafficked to precise locations. It also acts to ensure that abnormal or excess proteins are degraded to prevent the accumulation of unwanted products.4,5

Building proteins within the cell is a complex process involving protein folding. A protein must fold into a specific 3-dimensional conformation to gain proper function. Because of the critical role proteins play, incorrect folding can result in diseases such as Alzheimer's and Parkinson's.6


Protein misfolding may occur due to genetic or environmental factors and often leads to loss of function. Misfolded proteins may accumulate, form intermediate oligomers or fibrils, and, eventually, mature aggregates, all of which can be toxic to the cell.3,7

Protein misfolding underlies a large number of chronic diseases, including neurodegenerative and lysosomal storage diseases7-9

Protein misfolding

Protein aggregation

Neurodegenerative diseases

Lysosomal dysfunction

Lysosomal storage diseases

Disease definition

Heat shock proteins are the body’s natural response to protect cells, triggered when a cell is under stress

Heat shock proteins exist in normal circumstances, but their production is induced by stress—and they play a particularly important role in protecting cells exposed to stress.20

Heat shock proteins constitute part of the molecular chaperone system of the cell and play a critical role in protein-folding rescue21

Heat shock proteins are involved in several processes, such as assisting other proteins to achieve the correct conformation, and preventing protein misfolding and aggregation. When the heat shock response is activated, increased heat shock protein expression is induced.

HSP70 is a key chaperone in protein homeostasis and promotes lysosome membrane stability and integrity. HSP70 recruits and forms complexes with co-chaperones to mark proteins for degradation and to guide them to the proteasome or, for larger aggregates, to the autophagy–lysosome system.

How does HSP70 respond to cellular stress?21,22

HSP70 production is regulated by key transcription factors known as heat shock factors (HSFs). In chronic disease, the heat shock response may be insufficient to cope with prolonged exposure to a proteotoxic environment. Under times of stress, HSF-1 amplifies the transcription of HSP70 genes and the production of HSP70 proteins.

The resulting increased levels of HSP70 results in a heightened response to the stress, protecting cellular proteins from misfolding errors.

HSP70 guards cellular function and integrity during the heat shock response through 3 key mechanisms:

 

Prevents and corrects protein misfolding- This lets proteins perform their normal functions

 

Prevents and removes protein aggregates-This facilitates proper protein folding or protein degradation

 

Promotes lysosomal function

This allows lipids and other key enzymes to be chaperoned to the lysosomal membrane