Supplementary vitamin C does not accelerate bone healing in a rat tibia fracture model

Effect of hesperidin in the prevention of aluminum chloride-induced testicular dysfunction in rats

Hesperidin is a citrus bioflavonoid and has numerous pharmacological actions. Hesperidin's effect on testicular dysfunction has not been well researched. Hence, the present study is aims to investigate the effect of hesperidin on aluminium chloride (AlCl3)-induced testicular dysfunction in rats. Both vitamin C (200 mg/kg) and hesperidin (50, 100, and 200 mg/kg) were administered orally for 21 days. At the end of the study, the blood samples were obtained from all animals for investigation of biochemical and hematological parameters. Then, bilateral orchiectomy was carried out to remove testicles from the animals, and sperm was collected and examined under a microscope. Finally, organs such as the liver, kidney, and testicles were also collected and utilized for histopathological analysis. Part of the liver sample was used for determination of antioxidant enzymes such as reduced glutathione (GSH) and catalase (CAT) levels. The rats administered with AlCl3 showed elevated levels of biochemical and hematological parameters and a reduction in levels of sperm count, sperm motility, and oxidative stress parameters, whereas the rats administered with vitamin C/hesperidin (200 and 400 mg/kg) were able to ameliorate AlCl3-induced testicular dysfunction by attenuating AlCl3-induced changes in biochemical and hematological parameters, sperm motility, sperm count, and oxidative stress. Both vitamin C and hesperidin had significant ameliorative effects against AlCl3-induced testicular dysfunction.

Understanding Reactive Oxygen Species in Bone Regeneration: A Glance at Potential Therapeutics and Bioengineering Applications

Although the complex mechanism by which skeletal tissue heals has been well described, the role of reactive oxygen species (ROS) in skeletal tissue regeneration is less understood. It has been widely recognized that a high level of ROS is cytotoxic and inhibits normal cellular processes. However, with more recent discoveries, it is evident that ROS also play an important, positive role in skeletal tissue repair, specifically fracture healing. Thus, dampening ROS levels can potentially inhibit normal healing. On the same note, pathologically high levels of ROS cause a sharp decline in osteogenesis and promote nonunion in fracture repair. This delicate balance complicates the efforts of therapeutic and engineering approaches that aim to modulate ROS for improved tissue healing. The physiologic role of ROS is dependent on a multitude of factors, and it is important for future efforts to consider these complexities. This review first discusses how ROS influences vital signaling pathways involved in the fracture healing response, including how they affect angiogenesis and osteogenic differentiation. The latter half glances at the current approaches to control ROS for improved skeletal tissue healing, including medicinal approaches, cellular engineering, and enhanced tissue scaffolds. This review aims to provide a nuanced view of the effects of ROS on bone fracture healing which will inspire novel techniques to optimize the redox environment for skeletal tissue regeneration.

Vitamin C in orthopedic practices: Current concepts, novel ideas, and future perspectives

Vitamin C (ascorbic acid), is an important antioxidant that has been applied broadly in the field of orthopaedics. Current research on vitamin C examines the molecule's role in bone and tendon physiology, as well as joint replacement and Postoperative pain. Most laboratory and human studies associate the use of vitamin C with improved bone health and tendon healing. Recent literature moderately supports the use of vitamin C to improve functional outcomes, decreased postoperative pain, and prevent complex regional pain syndrome following orthopaedic procedures. The perioperative use of vitamin C in patients undergoing joint replacement surgery and anterior cruciate ligament reconstruction is still under investigation. Overall, there is need for high-quality human trials to confirm whether vitamin C can potentiate the outcomes of orthopaedic procedures and to determine optimal dosage and means of administration to maximize its proposed benefits. The purpose of this review was to summarize the application of vitamin C in orthopaedic practices and to identify potential areas for future study.

Effect of epigallocatechin gallate on aluminum chloride-induced changes in behavior, biochemical parameters, and spermatogenesis of Sprague-Dawley rats

Background

Epigallocatechin gallate (EGCG) acts as an antioxidant by preventing oxidative stress. The effect of EGCG on aluminum-induced testicular injury is not clear. Hence, the present study is planned to investigate the effect of EGCG on aluminum chloride (AlCl3)-induced changes in behavior, biochemical parameters, and spermatogenesis in male Sprague-Dawley rats. The rats were divided into six groups with six animals each. All the animals were administered with respective assigned treatment once daily for 28 days. The animals in groups I to VI were administered with drug vehicle, AlCl3, vitamin C, EGCG, vitamin C, and EGCG, respectively. The animals in groups V and VI were additionally challenged with AlCl3 (10 mg/kg) immediately after vitamin C and EGCG administration, respectively. Changes in behavior were measured on day 1, 14 and 28. At the end of the study, the blood sample was collected from all the animals, and the serum was separated and used for biochemical analysis. Later, the rats were subjected to bilateral orchiectomy; sperm was collected from the cauda epididymis for microscopic examination. Then, the animals were sacrificed, and the organs such as the brain, lungs, heart, liver, kidney, spleen, and testis were collected for organ weight analysis.

Results

The animal administered with AlCl3 showed a reduction in locomotor activity, grip strength, and escape latency time whereas vitamin C prevented the effect of AlCl3. But, EGCG did not show any significant changes in AlCl3-induced behavioral and biochemical changes. At the end of the study, vitamin C prevented AlCl3-induced behavioral and biochemical changes. The group of animals administered with AlCl3 showed a reduction in the number of spermatozoa whereas AlCl3 + vitamin C and AlCl3 + EGCG did not show any significant changes in the number of spermatozoa when compared to the control group.

Conclusion

EGCG prevented AlCl3-induced reduction in epididymal sperm count of male rats and did not show any significant effect on AlCl3-induced changes in behavior and biochemical parameters, whereas vitamin C had an ameliorative effect on AlCl3-induced changes in behavior, biochemical parameter, and spermatogenesis.

Graphical abstract

Histopathologic and Immunohistochemical Investigation of the Effects of Vitamin C on Bone Healing in Rats Exposed to Nicotine

PURPOSE

The aim of the present study was to perform a histopathologic and immunohistochemical investigation of the effects of vitamin C on bone healing in rats exposed to nicotine.

MATERIALS AND METHODS

A total of 52 male Sprague-Dawley rats were assigned to 4 main groups: control, vitamin C, nicotine, and nicotine plus vitamin C. The rats in the nicotine groups were injected with nicotine at 12-hour intervals for 4 weeks. At the end of 4 weeks, a tibial defect was created in all the rats. Subcutaneous injections were administered at the same intervals postoperatively, and the vitamin C groups received intraperitoneal vitamin C injections every day for the first 3 days and then every other day postoperatively. The rats were sacrificed on postoperative days 7 and 21. The blood samples collected during sacrifice were tested to determine the blood cotinine levels, and histopathological and immunohistochemical analyses were performed on tibia samples.

RESULTS

The histopathologic evaluation revealed that nicotine significantly increased the amount of necrosis and significantly decreased new bone formation and the bone healing score. The presence of necrosis in the nicotine plus vitamin C group was significantly lower on day 21 (P = .005). A statistically significant difference was observed among the new bone formation of the control, nicotine, vitamin C, and nicotine plus vitamin C groups on day 21 (P = .001). The new bone healing score of the nicotine group was significantly lower than that of the control, vitamin C, and nicotine plus vitamin C groups (P = .003, P = .001, and P = .001). The immunohistochemical evaluation showed that nicotine increased the hypoxia-inducible factor-1α and vascular endothelial growth factor levels and decreased the bone morphogenetic protein-2 levels, especially in the groups sacrificed on day 21.

CONCLUSIONS

Vitamin C did not have a significant effect on bone healing. However, vitamin C administered with nicotine decreased the metabolism of nicotine and, thus, increased nicotine excretion.

Efficacy of Vitamin C Supplementation on Collagen Synthesis and Oxidative Stress After Musculoskeletal Injuries: A Systematic Review

Background

Recent investigations on the biochemical pathways after a musculoskeletal injury have suggested that vitamin C (ascorbic acid) may be a viable supplement to enhance collagen synthesis and soft tissue healing.

Purpose

To (1) summarize vitamin C treatment protocols; (2) report on the efficacy of vitamin C in accelerating healing after bone, tendon, and ligament injuries in vivo and in vitro; and (3) report on the efficacy of vitamin C as an antioxidant protecting against fibrosis and promoting collagen synthesis.

Study Design

Systematic review; Level of evidence, 2.

Methods

A systematic review was performed, with the inclusion criteria of animal and human studies on vitamin C supplementation after a musculoskeletal injury specific to collagen cross-linking, collagen synthesis, and biologic healing of the bone, ligament, and tendon.

Results

The initial search yielded 286 articles. After applying the inclusion and exclusion criteria, 10 articles were included in the final analysis. Of the preclinical studies evaluating fracture healing, 2 studies reported significantly accelerated bone healing in the vitamin C supplementation group compared with control groups. The 2 preclinical studies evaluating tendon healing reported significant increases in type I collagen fibers and scar tissue formation with vitamin C compared with control groups. The 1 preclinical study after anterior cruciate ligament (ACL) reconstruction reported significant short-term (1-6 weeks) improvements in ACL graft incorporation in the vitamin C group compared with control groups; however, there was no long-term (42 weeks) difference. Of the clinical studies evaluating fracture healing, 1 study reported no significant differences in the rate of fracture healing at 50 days or functional outcomes at 1 year. Vitamin C supplementation was shown to decrease oxidative stress parameters by neutralizing reactive oxygen species through redox modulation in animal models. No animal or human studies reported any adverse effects of vitamin C supplementation.

Conclusion

Preclinical studies demonstrated that vitamin C has the potential to accelerate bone healing after a fracture, increase type I collagen synthesis, and reduce oxidative stress parameters. No adverse effects were reported with vitamin C supplementation in either animal models or human participants; thus, oral vitamin C appears to be a safe supplement but lacks clinical evidence compared with controls. Because of the limited number of human studies, further clinical investigations are needed before the implementation of vitamin C as a postinjury supplement.

Sequential analysis of oxidative stress markers and vitamin C status in acute bacterial osteomyelitis

In bacterial bone infections, excessively formed oxidants may result in local and systemic oxidative stress. Vitamin C is the major extracellular nonenzymatic antioxidant, also implicated in bone cells metabolism and viability. The physiological functions of vitamin C largely depend on its redox status. We sequentially assessed oxidative stress markers, hydroperoxides and malondialdehyde (MDA), total antioxidant activity (AOA), total vitamin C, ascorbic acid (Asc), and oxidized/reduced vitamin C ratio in 137 patients with acute osteomyelitis (OM). 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.). On the other side, total vitamin C levels in patients and controls were similar (P > 0.05), thereby suggesting a relative rather than absolute vitamin C deficiency in OM. During the follow-up, oxidative stress markers, AOA, and oxidizedreduced vitamin C ratio were gradually returned to normal, while there was no apparent change of total vitamin C concentrations. 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.