Special Issue "Vitamin C in Human Health and Disease"

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (30 September 2020).

Special Issue Editor

Prof. Dr. Dariusz Nowak
E-Mail Website
Guest Editor
Department of Clinical Physiology, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
Interests: antioxidant vitamins; plant polyphenols; exercise physiology; markers of oxidative stress; whole blood and neutrophils chemiluminescence; lung cancer; exhaled breath condensate; noninvasive markers of oxidative stress and pulmonary malignancy; dietary interventions to enhance antioxidant activity of plasma
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Special Issue Information

Dear Colleagues

Tens of thousands papers about vitamin C have been published since its discovery in 1912. Moreover, it was the first vitamin to be chemically produced and used for food fortification, as a food additive and the most common supplement. However, many questions related to the dietary intake of vitamin C and the risk of various types of cancer, prevention of cardiovascular disease, viral infections and dementia, effects on exercise performance, immune system, gene expression and cellular function still remain to be answered. Although there is a lack of sure evidence of the benefits of high intravenous doses of vitamin C in patients with late-stage cancer, thousands of them receive this treatment. Vitamin C is recognized as powerful water-soluble antioxidant. However, by reducing redox-active transition metal ions this vitamin can enhance the generation of hydroxyl and alkoxyl radicals. Whether these reactions can occur in vivo and may have physiological and clinical significance is unclear. The storage of fruits and vegetables reduces their content of vitamin C. Similarly, food processing (cooking, pasteurization, drying) decreases initial levels of this vitamin. Therefore, the optimization of these processes and the definition of their critical control points would be helpful for the prevention of vitamin C losses.

Submissions of original papers, reviews, meta-analyses, and commentaries on the afore-mentioned issues, and on other aspects of vitamin C absorption, metabolism, and elimination in the human body are welcome.

Prof. Dariusz Nowak
Guest Editor

Manuscript Submission Information

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Keywords

  • vitamin C
  • supplementation
  • cancer
  • immune system
  • anti-oxidant activity
  • pro-oxidant activity
  • exercise performance
  • viral infections
  • fruit and vegetable storage
  • food processing
  • high doses of vitamin C
  • absorption and elimination of vitamin C
  • cardiovascular disease
  • dementia
  • cellular functions

Published Papers (10 papers)

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Editorial

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Open AccessEditorial
Vitamin C in Human Health and Disease
Nutrients 2021, 13(5), 1595; https://doi.org/10.3390/nu13051595 - 11 May 2021
Viewed by 391
Abstract
Although the symptoms related to vitamin C deficiency were known in ancient Egypt and eighteenth century Scottish surgeon James Lind found that scurvy (a disease resulting from insufficient dietary ingestion of vitamin C) could be effectively treated with citrus fruit, this vitamin was [...] Read more.
Although the symptoms related to vitamin C deficiency were known in ancient Egypt and eighteenth century Scottish surgeon James Lind found that scurvy (a disease resulting from insufficient dietary ingestion of vitamin C) could be effectively treated with citrus fruit, this vitamin was discovered only in the year 1912 and then after 21 years it was chemically synthetized and introduced to the market as the first vitamin supplement [...] Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)

Research

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Open AccessArticle
A Pilot Study Examining Vitamin C Levels in Periodontal Patients
Nutrients 2020, 12(8), 2255; https://doi.org/10.3390/nu12082255 - 28 Jul 2020
Cited by 1 | Viewed by 999
Abstract
Background: Periodontal disease is the leading cause of tooth loss worldwide. Current periodontal treatment is limited by its dependency on patients learning and maintaining good dental habits, and repeated visits to oral health physicians. Vitamin C’s role in collagen synthesis and immune function [...] Read more.
Background: Periodontal disease is the leading cause of tooth loss worldwide. Current periodontal treatment is limited by its dependency on patients learning and maintaining good dental habits, and repeated visits to oral health physicians. Vitamin C’s role in collagen synthesis and immune function makes it important in wound healing and possibly periodontal healing. Therefore, if some patients are deficient, this may worsen patient outcomes. Methods: Patients were invited to participate following assessment and treatment at the Westmead Centre of Oral Health Periodontic Clinic, regardless of current disease stage or treatment. Adults were eligible if they gave informed consent and had current periodontal disease. Study involvement consisted of periodontal assessment and care followed by an interview and measurement of serum vitamin C and C-reactive protein (CRP). Results: A total of 6 out of 20 patients had vitamin C levels less than the institutional normal range, of whom 2 had levels <11.4 μmol/L and one <28 μmol/L. Low vitamin C was associated with higher periodontal disease stage (p = 0.03). Elevated CRP was found in 2/3 of people with low vitamin C and CRP was negatively correlated with vitamin C (p < 0.01). Vitamin C did not correlate with patient-reported fruit or vegetable consumption, but high processed meat intake was associated with lower vitamin C. Conclusion: Although a small study, this rate of vitamin C deficiency in the periodontal clinic is clinically important and correlations with disease severity and CRP suggests biological importance. This warrants further studies to assess vitamin C and whether supplementation improves periodontal outcomes, particularly in deficient subjects. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
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Review

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Open AccessReview
Two Faces of Vitamin C in Hemodialysis Patients: Relation to Oxidative Stress and Inflammation
Nutrients 2021, 13(3), 791; https://doi.org/10.3390/nu13030791 - 27 Feb 2021
Cited by 1 | Viewed by 743
Abstract
Hemodialysis (HD) is the most common method of renal replacement therapy. Besides toxins, it eliminates nutrients from the circulation, such as ascorbic acid (AA). HD-patients present AA deficiency more often than representatives of the general population, also due to dietary restrictions. This condition [...] Read more.
Hemodialysis (HD) is the most common method of renal replacement therapy. Besides toxins, it eliminates nutrients from the circulation, such as ascorbic acid (AA). HD-patients present AA deficiency more often than representatives of the general population, also due to dietary restrictions. This condition aggravates oxidative stress and inflammation related to uremia and extracorporeal circulation and increases cardiovascular risk followed by mortality. Supplementation of AA seems to be a promising approach in the treatment of hemodialysis patients. Many successful interventions restored plasma AA concentration in HD patients by enteral or intravenous supplementation, concomitantly inhibiting oxidative stress and inflammation. A significant number of studies reported opposite, serious pro-oxidant effects of AA. In this narrative review, we present studies, commenting on their limitations; on AA plasma or serum concentration and the influence of its supplementation on protein and lipid peroxidation, DNA damage, reactive oxygen species generation, paraoxonase activity, advanced glycation endproducts, and C-reactive protein (CRP) concentration. Moreover, in terms of safety, the possible development of oxalosis in HD patients regarding the intravenous or enteral route of AA administration is discussed. Unequivocal clinical results of recent studies on hemodialysis patients are displayed. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
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Open AccessFeature PaperReview
High-Dose Vitamin C in Advanced-Stage Cancer Patients
Nutrients 2021, 13(3), 735; https://doi.org/10.3390/nu13030735 - 26 Feb 2021
Cited by 1 | Viewed by 831
Abstract
High-dose intravenously administered vitamin C (IVC) is widely used in cancer patients by complementary and alternative medicine practitioners. The most frequent indications for IVC therapy result from the belief in its effectiveness as a potent anti-cancer agent which additionally enhances chemosensitivity of cancer [...] Read more.
High-dose intravenously administered vitamin C (IVC) is widely used in cancer patients by complementary and alternative medicine practitioners. The most frequent indications for IVC therapy result from the belief in its effectiveness as a potent anti-cancer agent which additionally enhances chemosensitivity of cancer cells and reduces chemotherapy-related toxicities and fatigue intensity. In this narrative review, we decided to deal with this issue, trying to answer the question whether there is any scientific evidence supporting the rationale for application of high-dose IVC therapy in advanced-stage cancer patients. Although results obtained from preclinical studies demonstrated that millimolar ascorbate plasma concentrations achievable only after IVC administration were cytotoxic to fast-growing malignant cells and inhibited tumor growth as well as prolonged the survival of laboratory animals, such positive effects were not found in human studies with advanced-stage cancer patients. We also have not found the rationale for the use of IVC to increase the effectiveness of chemotherapy and to reduce the chemotherapy-induced toxicity in the above mentioned group. Nevertheless, in palliative care, high-dose IVC might be considered as a therapy improving the quality of life and reducing cancer-related symptoms, such as fatigue and bone pain. However, because of the absence of placebo-controlled randomized trials on IVC efficacy in advanced-stage cancer patients, the placebo effect cannot be excluded. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
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Open AccessReview
Role of Vitamin C in Prophylaxis and Treatment of Gout—A Literature Review
Nutrients 2021, 13(2), 701; https://doi.org/10.3390/nu13020701 - 22 Feb 2021
Viewed by 846
Abstract
Gout, known as “the disease of the kings”, is the most frequent type of arthritis. It results from sustained hyperuricemia that leads to monosodium urate crystal deposition in joint structures and soft tissue. Environmental factors such as diet affect the incidence of gout; [...] Read more.
Gout, known as “the disease of the kings”, is the most frequent type of arthritis. It results from sustained hyperuricemia that leads to monosodium urate crystal deposition in joint structures and soft tissue. Environmental factors such as diet affect the incidence of gout; there is a known relationship between the occurrence of an acute attack of gout and the consumption of alcohol and meat; and a low purine diet is a widely recognized nonpharmacological method of supplementing the treatment and preventing recurrence of arthritis. This review aims to summarize the current knowledge about the role of vitamin C in prevention and treatment of gout. A PubMed/Medline database search on the role of vitamin C in purine metabolism was done. Reports from in vitro and animal studies seem to be promising and to allow explanation of the physiological relationship between vitamin C and uric acid. Most epidemiological studies indicate a significant correlation between high vitamin C intake and lower serum uric acid levels. Despite promising observations, there are few observational and interventional studies, and their results do not clearly define the benefits of a high daily intake of vitamin C in preventing the development and recurrence of gout. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
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Open AccessReview
The Role of Vitamin C in Two Distinct Physiological States: Physical Activity and Sleep
Nutrients 2020, 12(12), 3908; https://doi.org/10.3390/nu12123908 - 21 Dec 2020
Cited by 1 | Viewed by 1539
Abstract
This paper is a literature overview of the complex relationship between vitamin C and two opposing physiological states, physical activity and sleep. The evidence suggests a clinically important bidirectional association between these two phenomena mediated by different physiological mechanisms. With this in mind, [...] Read more.
This paper is a literature overview of the complex relationship between vitamin C and two opposing physiological states, physical activity and sleep. The evidence suggests a clinically important bidirectional association between these two phenomena mediated by different physiological mechanisms. With this in mind, and knowing that both states share a connection with oxidative stress, we discuss the existing body of evidence to answer the question of whether vitamin C supplementation can be beneficial in the context of sleep health and key aspects of physical activity, such as performance, metabolic changes, and antioxidant function. We analyze the effect of ascorbic acid on the main sleep components, sleep duration and quality, focusing on the most common disorders: insomnia, obstructive sleep apnea, and restless legs syndrome. Deeper understanding of those interactions has implications for both public health and clinical practice. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
Open AccessReview
Vitamin C and the Lens: New Insights into Delaying the Onset of Cataract
Nutrients 2020, 12(10), 3142; https://doi.org/10.3390/nu12103142 - 14 Oct 2020
Cited by 2 | Viewed by 1568
Abstract
Cataracts or clouding of the lens is the leading cause of blindness in the world. Age and diabetes are major risk factors, and with an increasing aging and diabetic population, the burden of cataracts will grow. Cataract surgery is an effective way to [...] Read more.
Cataracts or clouding of the lens is the leading cause of blindness in the world. Age and diabetes are major risk factors, and with an increasing aging and diabetic population, the burden of cataracts will grow. Cataract surgery is an effective way to restore vision; however, alternatives to cataract surgery are required to reduce the looming cataract epidemic. Since it is well established that oxidative damage plays a major role in the etiology of cataracts, antioxidants have been promoted as therapies to delay and/or prevent cataracts. However, many antioxidant interventions including vitamin C have produced mixed results as anti-cataract therapies. Progress has been made towards our understanding of lens physiology and the mechanisms involved in the delivery and uptake of antioxidants to the lens which may guide future studies aimed at addressing some of the inconsistencies seen in previous animal and human studies. Of interest is the potential for vitamin C based supplements in delaying the onset of cataracts post vitrectomy which occurs in up to 80% of patients within two years. These targeted approaches are required to reduce the burden of cataract on hospitals and improve the quality of life of our aging and diabetic population. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
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Open AccessReview
Role of Vitamin C in Osteoporosis Development and Treatment—A Literature Review
Nutrients 2020, 12(8), 2394; https://doi.org/10.3390/nu12082394 - 10 Aug 2020
Cited by 4 | Viewed by 1738
Abstract
Osteoporosis and associated low energy fractures are a significant clinical problem, especially in the elderly population. The occurrence of a hip fracture is associated with significant mortality and a high risk of disability. For this, apart from the treatment of osteoporosis, effective prevention [...] Read more.
Osteoporosis and associated low energy fractures are a significant clinical problem, especially in the elderly population. The occurrence of a hip fracture is associated with significant mortality and a high risk of disability. For this, apart from the treatment of osteoporosis, effective prevention of both the development of the disease and related fractures is extremely important. One aspect of osteoporosis prevention is proper dietary calcium intake and normal vitamin D3 levels. However, there is some evidence for a potential role of vitamin C in osteoporosis and fracture prevention, too. This review aims to summarize the current knowledge about the role of vitamin C in osteoporosis development, prevention and treatment. The PubMed/Medline search on the role of vitamin C in bone metabolism database was performed for articles between 2000 and May 2020. Reports from in vitro and animal studies seem promising. Epidemiological studies also indicate the positive effect of high vitamin C content in the daily diet on bone mineral density. Despite promising observations, there are still few observational and intervention studies and their results do not allow for unequivocal determination of the benefits of high daily intake of vitamin C or its long-term supplementation. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
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Open AccessReview
Vitamin C Deficiency and the Risk of Osteoporosis in Patients with an Inflammatory Bowel Disease
Nutrients 2020, 12(8), 2263; https://doi.org/10.3390/nu12082263 - 29 Jul 2020
Cited by 1 | Viewed by 1461
Abstract
Recent research studies have shown that vitamin C (ascorbic acid) may affect bone mineral density and that a deficiency of ascorbic acid leads to the development of osteoporosis. Patients suffering from an inflammatory bowel disease are at a risk of low bone mineral [...] Read more.
Recent research studies have shown that vitamin C (ascorbic acid) may affect bone mineral density and that a deficiency of ascorbic acid leads to the development of osteoporosis. Patients suffering from an inflammatory bowel disease are at a risk of low bone mineral density. It is vital to notice that patients with Crohn’s disease and ulcerative colitis also are at risk of vitamin C deficiency which is due to factors such as reduced consumption of fresh vegetables and fruits, i.e., the main sources of ascorbic acid. Additionally, some patients follow diets which may provide an insufficient amount of vitamin C. Moreover, serum vitamin C level also is dependent on genetic factors, such as SLC23A1 and SLC23A2 genes, encoding sodium-dependent vitamin C transporters and GSTM1, GSTP1 and GSTT1 genes which encode glutathione S-transferases. Furthermore, ascorbic acid may modify the composition of gut microbiota which plays a role in the pathogenesis of an inflammatory bowel disease. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
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Open AccessReview
Two Faces of Vitamin C—Antioxidative and Pro-Oxidative Agent
Nutrients 2020, 12(5), 1501; https://doi.org/10.3390/nu12051501 - 21 May 2020
Cited by 9 | Viewed by 2404
Abstract
Vitamin C has been known for decades. It is common in everyday use as an element of the diet, supplementation, and a preservative. For years, research has been conducted to precisely determine the mechanism of action of ascorbate in the cell. Available results [...] Read more.
Vitamin C has been known for decades. It is common in everyday use as an element of the diet, supplementation, and a preservative. For years, research has been conducted to precisely determine the mechanism of action of ascorbate in the cell. Available results indicate its multi-directional cellular effects. Vitamin C, which belongs to antioxidants scavenging free radicals, also has a ‘second face’—as a pro-oxidative factor. However, whether is the latter nature a defect harmful to the cell, or whether a virtue that is a source of benefit? In this review, we discuss the effects of vitamin C treatment in cancer prevention and the role of ascorbate in maintaining redox balance in the central nervous system (CNS). Finally, we discuss the effect of vitamin C supplementation on biomarkers of oxidative DNA damage and review the evidence that vitamin C has radioprotective properties. Full article
(This article belongs to the Special Issue Vitamin C in Human Health and Disease)
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