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Saxena A, Prabhudesai KS, Damle A, Ramakrishnan S, Durairaj P, Kalankariyan S, Vijayalakshmi AB, Venkatesh KV. A systems biology-based mathematical model demonstrates the potential anti-stress effectiveness of a multi-nutrient botanical formulation. Sci Rep 2024; 14:9582. [PMID: 38671040 PMCID: PMC11053000 DOI: 10.1038/s41598-024-60112-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Stress is an adaptive response to the stressors that adversely affects physiological and psychological health. Stress elicits HPA axis activation, resulting in cortisol release, ultimately contributing to oxidative, inflammatory, physiological and mental stress. Nutritional supplementations with antioxidant, anti-inflammatory, and stress-relieving properties are among widely preferred complementary approaches for the stress management. However, there is limited research on the potential combined impact of vitamins, minerals and natural ingredients on stress. In the present study, we have investigated the effect of a multi-nutrient botanical formulation, Nutrilite® Daily Plus, on clinical stress parameters. The stress-modulatory effects were quantified at population level using a customized sub-clinical inflammation mathematical model. The model suggested that combined intervention of botanical and micronutrients lead to significant decline in physical stress (75% decline), mental stress (70% decline), oxidative stress (55% decline) and inflammatory stress (75% decline) as evident from reduction in key stress parameters such as ROS, TNF-α, blood pressure, cortisol levels and PSS scores at both individual and population levels. Further, at the population level, the intervention relieved stress in 85% of individuals who moved towards a healthy state. The in silico studies strongly predicts the use of Gotukola based Nutrilite® Daily Plus as promising anti-stress formulation.
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Affiliation(s)
- Abha Saxena
- MetFlux Research Private Limited, Bengaluru, India
| | | | - Aparna Damle
- Amway Global Services India Pvt. Ltd., Gurugram, India
| | | | | | | | | | - K V Venkatesh
- MetFlux Research Private Limited, Bengaluru, India.
- Department of Chemical Engineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra, India.
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Ding N, Zeng Z, Luo J, Li K. The cross-sectional relationship between vitamin C and high-sensitivity C-reactive protein levels: insights from NHANES database. Front Nutr 2023; 10:1290749. [PMID: 38024382 PMCID: PMC10675847 DOI: 10.3389/fnut.2023.1290749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Background Ascorbic acid or vitamin C has antioxidant and anti-inflammatory properties that may impact markers of inflammation like C-reactive protein (CRP). However, studies specifically on vitamin C and high-sensitivity CRP (hs-CRP) have been scarce. Methods We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey 2017-2018 dataset including 5,380 U.S. adults aged ≥20 years. Multiple regression models examined the relationship between plasma vitamin C and serum hs-CRP while adjusting for potential confounders. Stratified analyses and curve fitting assessed effect modification and nonlinearity. Results An inverse association was found between plasma vitamin C and serum hs-CRP overall (β = -0.025, 95% CI: -0.033 to -0.017, p < 0.00001) and in subgroups except for the "other Hispanic" subgroup in model II (β = -0.009, 95% CI: (-0.040, 0.023), p = 0.5885). The relationship was nonlinear, with the greatest hs-CRP reduction observed up to a plasma vitamin C level of 53.1 μmol/L. Conclusion The results showed a non-linear negative correlation between vitamin C levels and hs-CRP in adults. These results suggest vitamin C intake may reduce inflammation and cardiovascular risk, but only up to 53.1 μmol/L plasma vitamin C.
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Affiliation(s)
- Ning Ding
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China
| | - Zhao Zeng
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China
| | - Ju Luo
- Department of Geriatrics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China
| | - Keng Li
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China
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Determination of tissue-specific interaction between vitamin C and vitamin E in vivo using senescence marker protein-30 knockout mice as a vitamin C synthesis deficiency model. Br J Nutr 2022; 128:993-1003. [PMID: 34725010 PMCID: PMC9381305 DOI: 10.1017/s0007114521004384] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Vitamin E (α-tocopherol; VE) is known to be regenerated from VE radicals by vitamin C (L-ascorbic acid; VC) in vitro. However, their in vivo interaction in various tissues is still unclear. Therefore, we alternatively examined the in vivo interaction of VC and VE by measurement of their concentrations in various tissues of senescence marker protein-30 (SMP30) knockout (KO) mice as a VC synthesis deficiency model. Male SMP30-KO mice were divided into four groups (VC+/VE+, VC+/VE-, VC-/VE+ and VC-/VE-), fed diets with or without 500 mg/kg VE and given water with or without 1·5 g/l VC ad libitum. Then, VC and VE concentrations in the plasma and various tissues were determined. Further, gene expression levels of transporters associated with VC and VE, such as α-tocopherol transfer protein (α-TTP) and sodium-dependent vitamin C transporters (SVCTs), were examined. These results showed that the VE levels in the VC-depleted (VC-/VE+) group were significantly lower than those in the VC+/VE+ group in the liver and heart; the VC levels in the VE-depleted (VC+/VE-) group were significantly lower than those in the VC+/VE+ group in the kidneys. The α-TTP gene expression in the liver and kidneys was decreased by VC and/or VE depletion. Moreover, SVCT1 gene expression in the liver was decreased by both VC and VE depletion. In conclusion, these results indicate that VC spares VE mainly in the liver and heart and that VE spares VC in the kidneys of SMP30-KO mice. Thus, interaction between VC and VE is likely to be tissue specific.
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Ribeiro AM, Estevinho BN, Rocha F. The progress and application of vitamin E encapsulation – A review. Food Hydrocoll 2021. [DOI: 10.1016/j.foodhyd.2021.106998] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vitamin C in Critically Ill Patients: An Updated Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13103564. [PMID: 34684565 PMCID: PMC8539952 DOI: 10.3390/nu13103564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Vitamin C is a water-soluble antioxidant vitamin. Oxidative stress and its markers, along with inflammatory markers, are high during critical illness. Due to conflicting results of the published literature regarding the efficacy of vitamin C in critically ill patients, and especially the concerns for nephrotoxicity raised by some case reports, this meta-analysis was carried out to appraise the evidence and affirmation regarding the role of vitamin C in critically ill patients. Methods: We searched the database thoroughly to collect relevant studies that assessed intravenous vitamin C use in critically ill patients published until 25 February 2021. We included randomized controlled trials and observational studies with 20 or more critically ill patients who have received intravenous ascorbic acid (vitamin C). After screening 18,312 studies from different databases, 53 were included in our narrative synthesis, and 48 were included in the meta-analysis. We used the Covidence software for screening of the retrieved literature. Review Manager (RevMan) 5.4 was used for the pooling of data and Odds Ratios (OR) and Mean difference (MD) as measures of effects with a 95% confidence interval to assess for explanatory variables. Results: Pooling data from 33 studies for overall hospital mortality outcomes using a random-effect model showed a 19% reduction in odds of mortality among the vitamin C group (OR, 0.81; 95% CI, 0.66–0.98). Length of hospital stay (LOS), mortality at 28/30 days, ICU mortality, new-onset AKI and Renal Replacement Therapy (RRT) for AKI did not differ significantly across the two groups. Analysis of data from 30 studies reporting ICU stay disclosed 0.76 fewer ICU days in the vitamin C group than the placebo/standard of care (SOC) group (95% CI, −1.34 to −0.19). This significance for shortening ICU stay persisted even when considering RCTs only in the analysis (MD, −0.70; 95% CI, −1.39 to −0.02). Conclusion: Treatment of critically ill patients with intravenous vitamin C was relatively safe with no significant difference in adverse renal events and decreased in-hospital mortality. The use of vitamin C showed a significant reduction in the length of ICU stays in critically ill patients.
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Xing X, Xu M, Yang L, Zhang W, Niu X, Gao D. The efficacy of intravenous vitamin C in critically ill patients: A meta-analysis of randomized controlled trials. Clin Nutr 2021; 40:2630-2639. [PMID: 33933729 DOI: 10.1016/j.clnu.2021.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/18/2021] [Accepted: 03/08/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS A large number of clinical studies have shown that intravenous vitamin C supplementation is beneficial for critically ill patients, but current research conclusions are controversial. This meta-analysis included high-quality randomized controlled trials (RCTs) to evaluate the efficacy of intravenous vitamin C in critically ill patients. METHODS We searched PubMed, EMBASE and the Cochrane Library from inception to August 15, 2020 to identify published reports of RCTs evaluating the role of intravenous vitamin C in critically ill patients. Risk ratios values (RRs) and 95% confidence intervals (CIs) were calculated by random-effects meta-analysis. Trial sequential analysis (TSA), meta-regression, subgroup analyses and sensitivity analyses were also performed. RESULTS Our meta-analysis included 18 RCTs involving 2001 patients (1005 with vitamin C treatment and 996 control treatment). Intravenous vitamin C administration reduced the intensive care unit (ICU) length of stay (LOS) (MD = -0.36, 95% CI: -0.60 to -0.11, P = 0.004) and hospital LOS (MD = -1.50, 95% CI: -2.64 to -0.35, P = 0.01) but had no significant effect on the longest follow-up mortality, hospital or ICU mortality and change in Sequential Organ Failure Assessment (SOFA) score. TSAs for mortality, ICU and hospital LOS were inconclusive. CONCLUSIONS Intravenous vitamin C administration may shorten ICU LOS and hospital LOS. It had no effect on mortality and organ failure. All TSAs were inconclusive, and the value of vitamin C for critically ill patients needs to be demonstrated in more high-quality RCTs.
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Affiliation(s)
- Xin Xing
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Min Xu
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Lijun Yang
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Wenqian Zhang
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Xiaolin Niu
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China; Department of Cardiology, Meishan Brach of the Third Affiliated Hospital, Yanan University School of Medical, Meishan, Sichuan, PR China.
| | - Dengfeng Gao
- Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.
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Moussavi N, Talari H, Abedzadeh-Kalahroudi M, Khalili N, Eqtesadi R, Sehat M, Azadchehr MJ, Davoodabadi A. Implementation of an algorithm for chest imaging in blunt trauma decreases use of CT-scan: Resource management in a middle-income country. Injury 2021; 52:219-224. [PMID: 33441251 DOI: 10.1016/j.injury.2020.12.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 12/15/2020] [Accepted: 12/30/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Due to the low sensitivity of chest radiography, chest CT-scan is usually recommended for the evaluation of high-risk blunt trauma patients. Considering the radiation exposure and costs accompanying routine CT-scan, the aim of this study was to design and implement an evidence-based institutional algorithm for selective chest imaging in high energy blunt trauma patients and evaluate its effect on patient outcome and resource utilization. METHODS For this field trial, an institutional evidence-based algorithm for chest trauma imaging was designed according to existing data and expert panel. After final consent and ethic committee approval, the algorithm was integrated in the diagnostic flow sheet in the emergency department and patient data were collected from the pre- and post-implementation period. RESULTS One-hundred and sixty-five patients before algorithm implementation and 158 patients after that were included. Chest CT-scan was requested for 93% of patients in the pre-implementation group and for 73% in the post-implementation group (P<0.001). Length of stay in hospital was slightly shorter in the post-implementation group (p = 0.036), however, duration of stay in emergency room and ICU, pulmonary complications and mortality showed no significant difference. CONCLUSION Implementation of an algorithm for limiting chest CT-scan to a subgroup of patients with a higher risk of chest injuries can reduce radiation exposure and more useful distribution of resources without harming the patients. Each institution should use institutional guidelines and algorithms with respect to patient load, available resources and desired sensitivity for injury detection.
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Affiliation(s)
- Nushin Moussavi
- Assistant Professor, Trauma Research Center, Surgery Department, Kashan University of Medical Sciences, Ravandi-Street, Kashan, Iran
| | - Hamidreza Talari
- Associate Professor, Trauma Research Center, Radiology Department, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Neda Khalili
- Resident, Surgery Department, Kashan University of Medical Sciences, Kashan, Iran
| | - Razie Eqtesadi
- Assistant Professor, Trauma Research Center, Emergency Medicine Department, Kashan University of Medical Sciences, Kashan, Iran
| | - Mojtaba Sehat
- Associate Professor, Trauma Research Center, Epidemiology Department, Kashan University of Medical Sciences, Ravandi-Street, Kashan, Iran
| | - Mohammd-Javad Azadchehr
- Assistant Professor, Department of Biostatistics, Infectious Disease Research Center, Kashan University of Medical Sciences
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Hamza RZ, EL‐Megharbel SM, Altalhi T, Gobouri AA, Alrogi AA. Hypolipidemic and hepatoprotective synergistic effects of selenium nanoparticles and vitamin. E against acrylamide‐induced hepatic alterations in male albino mice. Appl Organomet Chem 2020. [DOI: 10.1002/aoc.5458] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Reham Z. Hamza
- Biology Department, Faculty of ScienceTaif University Taif 888 Saudi Arabia
- Zoology Department, Faculty of ScienceZagazig University Zagazig 44519 Egypt
| | - Samy M. EL‐Megharbel
- Chemistry Department, Faculty of ScienceZagazig University Zagazig 44519 Egypt
- Chemistry Department, Faculty of ScienceTaif University Taif 888 Saudi Arabia
| | - Tariq Altalhi
- Chemistry Department, Faculty of ScienceTaif University Taif 888 Saudi Arabia
| | - Adil A. Gobouri
- Chemistry Department, Faculty of ScienceTaif University Taif 888 Saudi Arabia
| | - Ashjan Ayad Alrogi
- Consultant medicine and adult Endocrinologist, Ministry of Health Saudi Arabia
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Hamza RZ, Al-Motaan SE, Malik N. Protective and Antioxidant Role of Selenium Nanoparticles and Vitamin C Against Acrylamide Induced Hepatotoxicity in Male Mice. INT J PHARMACOL 2019. [DOI: 10.3923/ijp.2019.664.674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Kontoghiorghes GJ, Kontoghiorghe CN. Prospects for the introduction of targeted antioxidant drugs for the prevention and treatment of diseases related to free radical pathology. Expert Opin Investig Drugs 2019; 28:593-603. [DOI: 10.1080/13543784.2019.1631284] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- George J Kontoghiorghes
- Postgraduate Research Institute of Science Technology, Environment and Medicine, Limassol, Cyprus
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Hemilä H, Chalker E. Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis. Nutrients 2019; 11:E708. [PMID: 30934660 PMCID: PMC6521194 DOI: 10.3390/nu11040708] [Citation(s) in RCA: 155] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/12/2019] [Accepted: 03/18/2019] [Indexed: 12/12/2022] Open
Abstract
A number of controlled trials have previously found that in some contexts, vitamin C can have beneficial effects on blood pressure, infections, bronchoconstriction, atrial fibrillation, and acute kidney injury. However, the practical significance of these effects is not clear. The purpose of this meta-analysis was to evaluate whether vitamin C has an effect on the practical outcomes: length of stay in the intensive care unit (ICU) and duration of mechanical ventilation. We identified 18 relevant controlled trials with a total of 2004 patients, 13 of which investigated patients undergoing elective cardiac surgery. We carried out the meta-analysis using the inverse variance, fixed effect options, using the ratio of means scale. In 12 trials with 1766 patients, vitamin C reduced the length of ICU stay on average by 7.8% (95% CI: 4.2% to 11.2%; p = 0.00003). In six trials, orally administered vitamin C in doses of 1⁻3 g/day (weighted mean 2.0 g/day) reduced the length of ICU stay by 8.6% (p = 0.003). In three trials in which patients needed mechanical ventilation for over 24 hours, vitamin C shortened the duration of mechanical ventilation by 18.2% (95% CI 7.7% to 27%; p = 0.001). Given the insignificant cost of vitamin C, even an 8% reduction in ICU stay is worth exploring. The effects of vitamin C on ICU patients should be investigated in more detail.
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Affiliation(s)
- Harri Hemilä
- Department of Public Health, University of Helsinki, POB 41, FI-00014 Helsinki, Finland.
| | - Elizabeth Chalker
- School of Public Health, University of Sydney, Sydney 2006, Australia.
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