1
|
de Man A, Long MT, Stoppe C. Vitamin C for all? Curr Opin Crit Care 2024; 30:298-304. [PMID: 38841995 DOI: 10.1097/mcc.0000000000001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE OF REVIEW Vitamin C can be a potential adjunctive treatment option for critically ill individuals due to its pleiotropic effects as electron donor in many enzymatic reactions throughout the body. Recently, several important randomized controlled trials (RCTs) investigating vitamin C in critically ill patients have been published. RECENT FINDINGS Two recent large RCTs administering high-dose vitamin C to patients with sepsis and COVID-19 showed signs of harm. Though performed at high standard, these trials had several limitations. Recent studies in cardiac surgery and burns showed decreased cardiac enzymes and improved clinical outcomes after cardiac surgery, and decreased fluid requirements, reduced wound healing time and in-hospital mortality after burns. Vitamin C may hold benefit in the management of other ischemia/reperfusion injury populations, including postcardiac arrest patients and after solid organ transplantation. Currently, covering basal vitamin C requirements during critical illness is recommended, though the exact dose remains to be determined. SUMMARY Future work should address optimal vitamin C timing, since early versus late drug administration are likely distinct, and duration of therapy, where withdrawal-induced injury is possible. Additionally accurate assessment of body stores with determination of individual vitamin requirements is crucial to ascertain patient and subgroups most likely to benefit from vitamin C.
Collapse
Affiliation(s)
- Angelique de Man
- Amsterdam UMC, location Vrije Universiteit, Department of Intensive Care, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Amsterdam, The Netherland
| | - Micah T Long
- Departments of Anesthesiology, Internal Medicine & Emergency Medicine, University of Wisconsin Hospitals & Clinics, Madison, Wisconsin, USA
| | - Christian Stoppe
- University Hospital Wuerzburg, Department of Anaesthesiology, Intensive Care, Emergency, and Pain Medicine, Wuerzburg, Germany
- German Heart Center Charité Berlin, Department of Cardiac Anesthesiology and Intensive Care Medicine, Berlin, Germany
| |
Collapse
|
2
|
Boerenkamp LS, Gijsbers BLMG, Ververs EJ, Pijpers EMS, Spaetgens B, de Coninck A, Germeraad WTV, Wodzig WKWH, Wieten L, van Gorkom GNY, van Elssen CHMJ. Low Levels of Serum and Intracellular Vitamin C in Hospitalized COVID-19 Patients. Nutrients 2023; 15:3653. [PMID: 37630843 PMCID: PMC10458240 DOI: 10.3390/nu15163653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Vitamin C is a crucial micronutrient for human immune cell function and has potent antioxidant properties. It is hypothesized that vitamin C serum levels decline during infection. However, the precise mechanisms remain unknown. To gain deeper insights into the true role of vitamin C during infections, we aimed to evaluate the body's vitamin C storage during a SARS-CoV-2 infection. In this single-center study, we examined serum and intracellular vitamin C levels in peripheral blood mononuclear cells (PBMCs) of 70 hospitalized COVID-19 patients on the first and fifth days of hospitalization. Also, clinical COVID-19 severity was evaluated at these timepoints. Our findings revealed a high prevalence of hypovitaminosis C and vitamin C deficiency in hospitalized COVID-19 patients (36% and 15%). Moreover, patients with severe or critical disease exhibited a higher prevalence of low serum vitamin C levels than those with moderate illness. Serum vitamin C levels had a weak negative correlation with clinical COVID-19 severity classification on the day of hospitalization; however, there was no correlation with intracellular vitamin C. Intracellular vitamin C levels were decreased in this cohort as compared to a healthy cohort and showed further decline during hospitalization, while serum levels showed no relevant change. Based on this observation, it can be suggested that the reduction of intracellular vitamin C may be attributed to its antioxidative function, the need for replenishing serum levels, or enhanced turnover by immune cells. These data give an incentive to further investigate the role of intracellular vitamin C in a larger and more heterogeneous cohort as well as the underlying mechanisms.
Collapse
Affiliation(s)
- Lara S. Boerenkamp
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Birgit L. M. G. Gijsbers
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Erik-Jan Ververs
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Eva M. S. Pijpers
- Department of Internal Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Bart Spaetgens
- Department of Internal Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Aniek de Coninck
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Wilfred T. V. Germeraad
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Will K. W. H. Wodzig
- Central Diagnostic Laboratory, Department of Clinical Chemistry, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Lotte Wieten
- Department of Transplantation Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Gwendolyn N. Y. van Gorkom
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Catharina H. M. J. van Elssen
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| |
Collapse
|
3
|
Carr AC, Zawari M. Does Aging Have an Impact on Vitamin C Status and Requirements? A Scoping Review of Comparative Studies of Aging and Institutionalisation. Nutrients 2023; 15:nu15040915. [PMID: 36839273 PMCID: PMC9967583 DOI: 10.3390/nu15040915] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
The global healthcare burden of an aging population continues to increase, with nearly a quarter of the total global burden of disease attributable to people aged ≥60 years. Older people are at greater risk of micronutrient deficiencies, including immune-supportive vitamin C, which is both a contributor to and a consequence of acute and chronic illnesses. However, whether healthy aging, per se, is associated with depleted vitamin C status and increased requirements for the vitamin is less certain. A systematic scoping review was carried out to assess comparative studies that reported the vitamin C status and prevalence of deficiency in older versus younger people and in older people relative to residential status. Furthermore, vitamin C requirements were assessed through comparative studies reporting vitamin C status and pharmacokinetics in older people relative to younger people. Overall, there was limited evidence to suggest that healthy aging, per se, is related to lower vitamin C status or higher requirements for the vitamin. However, institutionalised elderly had lower vitamin C status and enhanced vitamin C requirements, primarily as a result of low intakes and/or chronic illnesses, which were not being met by hospital or residential diets. Because institutionalised elderly are vulnerable to malnutrition and micronutrient deficiencies, it is imperative that appropriate nutritional interventions are instigated to provide optimal micronutrient intake to support healthy aging.
Collapse
|
4
|
Yang J, Wu Y, Wang H, Yang W, Xu Z, Liu D, Chen HJ, Zhang D. An Improved Automated High-Throughput Efficient Microplate Reader for Rapid Colorimetric Biosensing. BIOSENSORS 2022; 12:bios12050284. [PMID: 35624585 PMCID: PMC9138432 DOI: 10.3390/bios12050284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
A high-throughput instrument to measure the full spectral properties of biochemical agents is necessary for fast screening in fields such as medical tests, environmental monitoring, and food analysis. However, this need has currently not been fully met by the commercial microplate reader (CMR). In this study, we have developed an automated high-throughput efficient microplate reader (AHTEMR) platform by combining a spectrometer and high-precision ball screw two-dimensional motion slide together, for high-throughput and full-spectrum-required biochemical assays. A two-dimensional slide working on a ball screw was driven by a stepper motor with a custom-designed master control circuit and used as a motion system of the AHTEMR platform to achieve precise positioning and fast movement of the microplate during measurements. A compact spectrometer was coupled with an in-house designed optical pathway system and used to achieve rapid capture of the full spectral properties of biochemical agents. In a performance test, the AHTEMR platform successfully measured the full spectral absorbance of bovine serum albumin (BSA) and glucose solution in multiple wells of the microplate within several minutes and presented the real-time full spectral absorbance of BSA and glucose solution. Compared with the CMR, the AHTEMR is 79 times faster in full-spectrum measurements and 2.38 times more sensitive at the optimal wavelength of 562 nm. The rapid measurement also demonstrated the great capacity of the AHTEMR platform for screening out the best colorimetric wavelengths for tests of BSA and glucose development, which will provide a promising approach to achieving high-throughput and full-spectrum-required biochemical assays.
Collapse
Affiliation(s)
- Jinhu Yang
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou 510006, China; (J.Y.); (H.W.)
| | - Yue Wu
- Research Center for Intelligent Sensing Systems, Zhejiang Laboratory, Hangzhou 311100, China; (Y.W.); (W.Y.); (Z.X.)
| | - Hao Wang
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou 510006, China; (J.Y.); (H.W.)
| | - Wenjian Yang
- Research Center for Intelligent Sensing Systems, Zhejiang Laboratory, Hangzhou 311100, China; (Y.W.); (W.Y.); (Z.X.)
| | - Zhongyuan Xu
- Research Center for Intelligent Sensing Systems, Zhejiang Laboratory, Hangzhou 311100, China; (Y.W.); (W.Y.); (Z.X.)
| | - Dong Liu
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou 510006, China; (J.Y.); (H.W.)
- Correspondence: (D.L.); (H.-J.C.); (D.Z.)
| | - Hui-Jiuan Chen
- State Key Laboratory of Optoelectronic Materials and Technologies, Guangdong Province Key Laboratory of Display Material and Technology, School of Electronics and Information Technology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou 510006, China; (J.Y.); (H.W.)
- Correspondence: (D.L.); (H.-J.C.); (D.Z.)
| | - Diming Zhang
- Research Center for Intelligent Sensing Systems, Zhejiang Laboratory, Hangzhou 311100, China; (Y.W.); (W.Y.); (Z.X.)
- Correspondence: (D.L.); (H.-J.C.); (D.Z.)
| |
Collapse
|
5
|
Helan M, Malaska J, Tomandl J, Jarkovsky J, Helanova K, Benesova K, Sitina M, Dastych M, Ondrus T, Pavkova Goldbergova M, Gal R, Lokaj P, Tomandlova M, Parenica J. Kinetics of Biomarkers of Oxidative Stress in Septic Shock: A Pilot Study. Antioxidants (Basel) 2022; 11:antiox11040640. [PMID: 35453325 PMCID: PMC9031382 DOI: 10.3390/antiox11040640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023] Open
Abstract
Septic shock is a major cause of mortality in ICU patients, its pathophysiology is complex and not properly understood. Oxidative stress seems to be one of the most important mechanisms of shock progression to multiple organ failure. In the present pilot study, we have analysed eight oxidative-stress-related biomarkers in seven consecutive time points (i.e., the first seven days) in 21 septic shock patients admitted to the ICU. Our objective was to describe the kinetics of four biomarkers related to pro-oxidative processes (nitrite/nitrate, malondialdehyde, 8-oxo-2′-deoxyguanosine, soluble endoglin) compared to four biomarkers of antioxidant processes (the ferric reducing ability of plasma, superoxide dismutase, asymmetric dimethylarginine, mid-regional pro-adrenomedullin) and four inflammatory biomarkers (CRP, IL-6, IL-10 and neopterin). Furthermore, we analysed each biomarker’s ability to predict mortality at the time of admission and 12 h after admission. Although a small number of study subjects were recruited, we have identified four promising molecules for further investigation: soluble endoglin, superoxide dismutase, asymmetric dimethylarginine and neopterin.
Collapse
Affiliation(s)
- Martin Helan
- Department of Anaesthesiology and Intensive Care, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic; (M.H.); (M.S.)
- International Clinical Research Center (ICRC), St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.M.); (K.H.); (T.O.); (R.G.); (P.L.); (J.P.)
| | - Jan Malaska
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.M.); (K.H.); (T.O.); (R.G.); (P.L.); (J.P.)
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Josef Tomandl
- Department of Biochemistry, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic;
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.J.); (K.B.)
| | - Katerina Helanova
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.M.); (K.H.); (T.O.); (R.G.); (P.L.); (J.P.)
- Department of Internal Medicine and Cardiology, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Klara Benesova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.J.); (K.B.)
| | - Michal Sitina
- Department of Anaesthesiology and Intensive Care, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic; (M.H.); (M.S.)
- International Clinical Research Center (ICRC), St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.M.); (K.H.); (T.O.); (R.G.); (P.L.); (J.P.)
| | - Milan Dastych
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic;
| | - Tomas Ondrus
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.M.); (K.H.); (T.O.); (R.G.); (P.L.); (J.P.)
- Department of Internal Medicine and Cardiology, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Monika Pavkova Goldbergova
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic;
| | - Roman Gal
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.M.); (K.H.); (T.O.); (R.G.); (P.L.); (J.P.)
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Petr Lokaj
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.M.); (K.H.); (T.O.); (R.G.); (P.L.); (J.P.)
- Department of Internal Medicine and Cardiology, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Marie Tomandlova
- Department of Biochemistry, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic;
- Correspondence:
| | - Jiri Parenica
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (J.M.); (K.H.); (T.O.); (R.G.); (P.L.); (J.P.)
- Department of Internal Medicine and Cardiology, University Hospital Brno, 625 00 Brno, Czech Republic
| |
Collapse
|