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1.
Sci Rep ; 11(1): 17648, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34480041

RESUMO

Ascorbic acid represents an appealing option for clinicians to utilize in the context of the global COVID-19 pandemic due to its proposed clinical efficacy, relative safety, and low cost. The aim of this study was to evaluate the efficacy and safety of using ascorbic acid in supplemental doses as adjunctive therapy for patients critically ill with COVID-19. This was a two-center, non-interventional, retrospective cohort study. All critically ill adult patients admitted to ICU with a confirmed COVID-19 diagnosis between March 1st and December 31st, 2020, were included in the final analysis. The study was conducted at two large governmental tertiary hospitals in Saudi Arabia. The purpose was to investigate the clinical outcomes of low-dose ascorbic acid as adjunctive therapy in COVID-19 after propensity score matching using baseline severity scores, systematic use of corticosteroids, and study centers. A number of 739 patients were included in this study, among whom 296 patients were included after propensity score matching. There was no association between the administration of ascorbic acid and in-hospital mortality or the 30-day mortality [OR (95% CI) 0.77 (0.47, 1.23), p value = 0.27 and OR (95% CI) 0.73 (0.43, 1.20), p value = 0.21, respectively]. Using ascorbic acid was associated with a lower incidence of thrombosis compared with the non-ascorbic-acid group [6.1% vs. 13% respectively; OR (95% CI) 0.42 (0.184, 0.937), p value = 0.03]. Low dose of ascorbic acid as an adjunctive therapy in COVID-19 critically ill patients was not associated with mortality benefits, but it was associated with a lower incidence of thrombosis. Further studies are required to confirm these findings.


Assuntos
Ácido Ascórbico/administração & dosagem , COVID-19 , Mortalidade Hospitalar , Hospitalização , SARS-CoV-2 , Idoso , COVID-19/tratamento farmacológico , COVID-19/mortalidade , Estado Terminal , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Estudos Retrospectivos , Arábia Saudita/epidemiologia
2.
J Cancer Res Clin Oncol ; 147(10): 3025-3042, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34402972

RESUMO

BACKGROUND: Vitamin C, also called ascorbic acid, is a water-soluble antioxidant and free radical scavenger. It is required in the body for numerous metabolic functions and is involved in the development of proteins and connective tissue. METHODS: In April 2020, a systematic search was carried out on five electronic databases (Medline, Embase, Cochrane, Cinahl, PsycINFO) to find studies on the use, efficacy and safety of a complementary therapy with vitamin C in oncological patients. RESULTS: Out of the initial 23,195 search results, 21 studies with 1961 patients were included in this review. Five of the included studies (n = 417) were randomized controlled trials (RCTs). The remaining 16 studies belonged to a lower class of evidence. The patients who were treated with vitamin C suffered from various malignant diseases, some in an advanced and palliative stage. Vitamin C was applied intravenously or orally. It was either the only treatment or was combined with chemo- or radiotherapy. Endpoints included the development of the disease-related symptoms, quality of life, mortality, progression-free survival and safety of vitamin C. The studies were of moderate quality and showed either no effect of vitamin C or a positive trend, although this has rarely been statistically proven in group comparisons. No or only slight side effects with both oral and intravenous administration of vitamin C were reported. CONCLUSION: Oral intake of vitamin C does not appear to have any effect in patients with malignancies. Data are heterogeneous for intravenous administration. There are no RCTs with statistical group comparisons.


Assuntos
Antioxidantes/administração & dosagem , Ácido Ascórbico/administração & dosagem , Neoplasias/tratamento farmacológico , Administração Oral , Humanos , Injeções Intravenosas , Prognóstico
3.
Nutrients ; 13(7)2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34371840

RESUMO

Atherosclerosis is a pro-oxidative and pro-inflammatory disease state, which is the underlying cause of most cardiovascular events, estimated to affect 5.2% of the Australian population. Diet, and specifically vitamin C, through its antioxidant properties can play a role in impeding the development and progression of atherosclerosis. This systematic review conducted comprehensive searches in Medline, Emcare, Scopus, PubMed, and Cochrane using key search terms for vitamin C, plasma vitamin C, supplementation, and cardiovascular disease (CVD). The results demonstrated that vitamin C supplementation resulted in a significant increase in vitamin C levels in populations with or without CVD, except for one study on the CVD population. It was also seen that the healthy population baseline and post-intervention vitamin C levels were high compared to the CVD population. However, further research is indicated for CVD population groups with varying baseline vitamin C levels, such as low baseline vitamin C, within a more representative elderly cohort in order to formulate and update vitamin C repletion guidelines.


Assuntos
Ácido Ascórbico/sangue , Aterosclerose/sangue , Doenças Cardiovasculares/sangue , Dieta/estatística & dados numéricos , Suplementos Nutricionais , Antioxidantes/administração & dosagem , Antioxidantes/metabolismo , Ácido Ascórbico/administração & dosagem , Aterosclerose/complicações , Aterosclerose/terapia , Doenças Cardiovasculares/etiologia , Ingestão de Alimentos/fisiologia , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional
4.
Pan Afr Med J ; 38: 318, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34285741

RESUMO

Restless leg syndrome (RLS) is a sleep disorder characterized by the sudden urge to move the lower limbs during periods of rest accompanied by an unpleasant sensation like tingling or burning in the legs. Often, this urge is partially relieved by the movement of legs. However, it causes disturbance of sleep leading to daytime fatigue. Herein, we present an unusual case of new-onset of restless leg syndrome in a COVID-19 infected patient who presented three weeks after an uncomplicated delivery via caesarean section. The patient was managed with sleep hygiene measures, oral iron and vitamin C tablets apart from general COVID-19 management medications, subsequently leading to significant improvements. Here we have discussed possible associated factors, pathophysiological mechanisms and management of RLS in the case of COVID infected individuals.


Assuntos
COVID-19/complicações , Síndrome das Pernas Inquietas/terapia , Adulto , Ácido Ascórbico/administração & dosagem , Cesárea , Feminino , Humanos , Compostos de Ferro/administração & dosagem , Gravidez , Síndrome das Pernas Inquietas/virologia , Higiene do Sono
5.
Am J Physiol Regul Integr Comp Physiol ; 321(1): R49-R61, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34075811

RESUMO

Posttraumatic stress disorder (PTSD) has been associated with an increase in risk of cardiovascular disease (CVD). The goal of this study was to determine if peripheral vascular dysfunction, a precursor to CVD, was present in young adults with PTSD, and if an acute antioxidant (AO) supplementation could modify this potential PTSD-induced vascular dysfunction. Thirteen individuals with PTSD were recruited for this investigation and were compared with 35 age- and sex-matched controls (CTRL). The PTSD group participated in two visits, consuming either a placebo (PTSD-PL) or antioxidants (PTSD-AO; vitamins C and E; α-lipoic acid) before their visits, whereas the CTRL subjects only participated in one visit. Upper and lower limb vascular functions were assessed via flow-mediated dilation and passive leg movement technique. Heart rate variability was utilized to assess autonomic nervous system modulation. The PTSD-PL condition, when compared with the CTRL group, reported lower arm and leg microvascular function as well as sympathetic nervous system (SNS) predominance. After acute AO supplementation, arm, but not leg, microvascular function was improved and SNS predominance was lowered to which the prior difference between PTSD group and CTRL was no longer significant. Young individuals with PTSD demonstrated lower arm and leg microvascular function as well as greater SNS predominance when compared with age- and sex-matched controls. Furthermore, this lower vascular/autonomic function was augmented by an acute AO supplementation to the level of the healthy controls, potentially implicating oxidative stress as a contributor to this blunted vascular/autonomic function.


Assuntos
Ácido Ascórbico/farmacologia , Sistema Nervoso Autônomo/efeitos dos fármacos , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Ácido Tióctico/farmacologia , Vitamina E/farmacologia , Adulto , Antioxidantes/administração & dosagem , Antioxidantes/farmacologia , Ácido Ascórbico/administração & dosagem , Pressão Sanguínea , Estudos de Casos e Controles , Quimioterapia Combinada , Feminino , Humanos , Masculino , Ácido Tióctico/administração & dosagem , Vitamina E/administração & dosagem , Adulto Jovem
6.
Medicine (Baltimore) ; 100(26): e26427, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190164

RESUMO

BACKGROUND: The COVID-19 pandemic has rapidly spread to other countries, causing numerous deaths and challenges for organizations and health professionals. Diet and nutrition invariably influence the competence of the immune system and determine the risk and severity of infections. Studies have already been published on the relationships through which vitamins C and D can mitigate the severity of infections such as COVID-19. In this context, this protocol describes a systematic review intended to analyze if vitamin C and D supplementation can reduce the severity of Covid-19. METHODS: This protocol was developed based on the recommendations of PRISMA-P. In order to accomplish the systematic review, we will carry out searches in the PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect databases in the quest for control case studies that analyze the supplementation and evolution of patients with COVID-19. There will be no limitations related to language or publication time. The searches will be carried out by 2 independent researchers who will select the articles, and then the duplicate studies will be removed, while the suitable ones will be selected using the Rayyan QCRI application. In order to assess the risk of bias, we will use the instrument proposed by the National Heart, Lung and Blood Institute. Moreover, we will carry out metaanalyses and subgroup analyses according to the conditions of the included data. RESULTS: This review will assess the association between vitamin C and D supplementation and the reduction in the severity of COVID-19. CONCLUSION: The findings of this systematic review will summarize the latest evidence for the association between vitamin C and D supplementation and COVID-19 through a systematic review and meta-analysis. RECORD OF SYSTEMATIC REVIEW: CRD42021255763.


Assuntos
Ácido Ascórbico/administração & dosagem , COVID-19/diagnóstico , Suplementos Nutricionais , Metanálise como Assunto , Índice de Gravidade de Doença , Revisões Sistemáticas como Assunto , Vitamina D/administração & dosagem , Humanos , Estado Nutricional , Pandemias , SARS-CoV-2
7.
J Zoo Wildl Med ; 52(2): 806-814, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34130429

RESUMO

The Milwaukee County Zoo has housed common vampire bats (Desmodus rotundus) since 1973. The bats are fed defibrinated cow's blood supplemented with a liquid pediatric multivitamin. From July 2013 to May 2014, multiple deaths occurred in colony bats, including five juveniles with multiple bone fractures and failure of endochondral ossification, three adults with cerebellar necrosis, and one adult with subcutaneous hemorrhage. In November 2013, an adult bat developed a nonhealing left wing hematoma and eventually succumbed 9 mo later. A postmortem examination revealed multifocal extensive necrohemorrhagic and suppurative ulcerative dermatitis with no underlying cause determined. From July to December 2014, five of nine adult bats in the colony developed similar hematomas along with gingival bleeding. One euthanized bat had a serum ascorbic acid level of 0.08 mg/dl and marked generalized subcutaneous hemorrhage. A therapeutic trial was initiated in which two bats received defibrinated cow's blood supplemented only with oral vitamin C, 100 mg/kg PO q24h for 3 d, and then 50 mg/kg PO q24h. Two other bats received nonsupplemented defibrinated cow's blood and were given vitamin K 3.3 mg/kg SC q12h for 3 d, and then 3.3 mg/kg SC q24h for 7 d. The bats supplemented with vitamin C improved, supporting a diagnosis of vitamin C deficiency. All bats were subsequently supplemented with vitamin C leading to resolution of all lesions within 10 d to 2 mo. Vitamin C is necessary for collagen synthesis, which is required for proper wound healing, capillary and cartilage strength, osteoid production, and pial membrane formation of the cerebellum. Several bat species cannot synthesize vitamin C and require a dietary source. This is the first report of vitamin C deficiency in a colony of vampire bats leading to severe chronic subcutaneous hemorrhage, bone fragility, microfractures, cerebellar necrosis, and death.


Assuntos
Deficiência de Ácido Ascórbico/veterinária , Ácido Ascórbico/uso terapêutico , Quirópteros , Suplementos Nutricionais , Vitaminas/uso terapêutico , Animais , Animais de Zoológico , Ácido Ascórbico/administração & dosagem , Deficiência de Ácido Ascórbico/patologia , Vitaminas/administração & dosagem
8.
BMC Infect Dis ; 21(1): 616, 2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34187382

RESUMO

BACKGROUND: Critically ill patients frequently suffer from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns, and trauma. Because of the high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia. METHODS: Eighty critically ill patients with pneumonia were enrolled in this randomized double-blinded clinical trial. Patients with a CURB-65 score > 3, one major criterion, or ≥ 3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as a continuous infusion or normal saline in the same volume correspondingly for 96 h. Serum levels of vitamin C were noted at baseline and 48 h after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO2/FiO2, and mortality rate were noted for all patients till the 28th day. Any complications related to the vitamin C administration were recorded. RESULTS: Duration of mechanical ventilation and vasopressor use were significantly lower in the intervention group (p: < 0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have a significant difference but its levels increased in the intervention group and decreased in the control group during the study period. Mortality rate insignificantly decreased in the intervention group (p = 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C. Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, duration of mechanical ventilation, and vasopressor use without any significant effect on mortality. TRIAL REGISTRATION: IRCT registration number: IRCT20190312043030N1, Registration date: 2019-08-26, Seied Hadi Saghaleini.


Assuntos
Ácido Ascórbico/administração & dosagem , Cuidados Críticos/métodos , Unidades de Terapia Intensiva , Pneumonia/tratamento farmacológico , Pneumonia/mortalidade , Índice de Gravidade de Doença , Vitaminas/administração & dosagem , Administração Intravenosa , Adulto , Idoso , Ácido Ascórbico/sangue , Estado Terminal , Método Duplo-Cego , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pneumonia/sangue , Respiração Artificial/efeitos adversos , Resultado do Tratamento
9.
Medicine (Baltimore) ; 100(19): e25876, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34106642

RESUMO

BACKGROUND: Patients infected with a virus usually lack vitamin C. High-dose vitamin C has an antiviral effect, and has been used by several researchers to treat COVID-19 by intravenous infusion, achieving good results. However, the efficacy and safety of vitamin C in the treatment of patients with COVID-19 remain unclear. Thus, the aim of the present study was to investigate the efficacy of high-dose vitamin C infusion in the treatment of patients with COVID-19. METHODS: Electronic databases were searched, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure database, Chinese Wanfang database, and Chinese Biomedical Literature database. The aim was to collect randomized controlled trials of high-dose vitamin C infusion in the treatment of patients with COVID-19, with the retrieval time being from the establishment of the database to March 2021. In accordance with the pre-designed inclusion/exclusion criteria, all data were extracted independently by 2 researchers. To assess the risk bias in the studies, the Cochrane collaboration's tool for assessing risk of bias was used to assess the risk bias in the studies, while meta-analysis was performed using Revman 5.3 software. RESULTS: In the present study, a high-quality comprehensive evaluation is provided of high-dose vitamin C infusion in the treatment of patients with COVID-19. CONCLUSION: Further convincing evidence for the clinical treatment of COVID-19 is provided, in addition to evidence-based guidance for clinical practice. PROSPERO REGISTRATION NUMBER: CRD42021246342.


Assuntos
Ácido Ascórbico/uso terapêutico , COVID-19/tratamento farmacológico , Vitaminas/uso terapêutico , Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/efeitos adversos , Relação Dose-Resposta a Droga , Humanos , Infusões Intravenosas , Interleucina-6/sangue , Tempo de Internação , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Respiração Artificial/estatística & dados numéricos , SARS-CoV-2 , Vitaminas/administração & dosagem , Vitaminas/efeitos adversos
10.
Fish Shellfish Immunol ; 114: 20-27, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33857621

RESUMO

To search immune defense proteins in skin mucus of Japanese flounder fed with a diet containing high concentration of ascorbic acid, we carried out 2D-PAGE and compared the resolved pattern of proteins between control group that fed commercial diet and ascorbic acid supplemented group (AsA group) fed a diet supplemented with high concentration of ascorbic acid (2,000 mg/kg) for 7 days. The results revealed that there were many proteins exhibited distinct increase in AsA group. Among them, 6 regions that showed a dramatic elevation were chosen for protein identification using LC-MS/MS analysis and Mascot database search. Six proteins were identified, i.e. serotransferrin (Sero), transferrin (Trans), warm temperature acclimation-related 65 kDa protein (Wap65), complement component c3 (C3), hemoglobin beta-A chain (Hbß) and apolipoprotein A-1 (Apo). Quantitative RT-PCR analysis showed that the mRNA level of Hbß in epidermis of AsA group gave much higher increase (11.6 folds) than control group; the levels of Sero/Trans, Wap65, C3 and Apo showed no apparent difference between the two groups. The mRNA levels of wap65 and c3 in the liver and Apo in the kidney of AsA group exhibited significant increase in comparison to control group. In the case of secreted immunoglobulin M (IgM) and lysozyme (lyz), no difference of the mRNA levels of IgM in epidermis, gill, kidney, spleen and intestine, and lyz in epidermis, gill, spleen and intestine, was observed. The results of in situ hybridization confirmed the elevation of Hbß mRNA level in the epidermis tissue of AsA group. Our present study provided additional evidence showing the effectiveness of AsA in activating innate immune defense system in skin mucosal tissue of fish.


Assuntos
Ácido Ascórbico/farmacologia , Proteínas de Peixes/metabolismo , Linguado/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Muco/metabolismo , Animais , Ácido Ascórbico/administração & dosagem , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Proteínas de Peixes/imunologia , Regulação da Expressão Gênica/imunologia , Fígado/química , Fígado/metabolismo
11.
Nutrients ; 13(4)2021 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-33801745

RESUMO

Vitamin C (ascorbic acid) is a normal liver metabolite in most animals, with humans being a notable exception due to random genetic mutations that have occurred during our evolution [...].


Assuntos
Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/farmacologia , Ácido Ascórbico/farmacocinética , Infecções Bacterianas/tratamento farmacológico , COVID-19/tratamento farmacológico , COVID-19/virologia , Epigênese Genética , Humanos , Neoplasias/tratamento farmacológico , SARS-CoV-2 , Sepse/tratamento farmacológico
12.
Nutrients ; 13(4)2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33807280

RESUMO

Fatigue is common not only in cancer patients but also after viral and other infections. Effective treatment options are still very rare. Therefore, the present knowledge on the pathophysiology of fatigue and the potential positive impact of treatment with vitamin C is illustrated. Additionally, the effectiveness of high-dose IV vitamin C in fatigue resulting from various diseases was assessed by a systematic literature review in order to assess the feasibility of vitamin C in post-viral, especially in long COVID, fatigue. Nine clinical studies with 720 participants were identified. Three of the four controlled trials observed a significant decrease in fatigue scores in the vitamin C group compared to the control group. Four of the five observational or before-and-after studies observed a significant reduction in pre-post levels of fatigue. Attendant symptoms of fatigue such as sleep disturbances, lack of concentration, depression, and pain were also frequently alleviated. Oxidative stress, inflammation, and circulatory disorders, which are important contributors to fatigue, are also discussed in long COVID fatigue. Thus, the antioxidant, anti-inflammatory, endothelial-restoring, and immunomodulatory effects of high-dose IV vitamin C might be a suitable treatment option.


Assuntos
Ácido Ascórbico/uso terapêutico , COVID-19/complicações , Fadiga/tratamento farmacológico , Fadiga/etiologia , SARS-CoV-2 , Ácido Ascórbico/administração & dosagem , COVID-19/patologia , Estudos de Viabilidade , Humanos , Injeções Intravenosas
13.
Nutr Hosp ; 38(3): 622-630, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-33829849

RESUMO

Introduction: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Compared with adults, children with SARS-CoV-2 infection may have fewer and less severe symptoms. Gastrointestinal symptoms are commonly reported in children, sometimes as the only manifestation of the disease, and most often manifest as anorexia, diarrhea, nausea and vomiting, or abdominal pain. Although most children have asymptomatic or mild disease, 10 % of those infected may experience serious or critical disease, or even death. Multisystem inflammatory syndrome is a rare but serious condition recently reported in children with COVID-19. Studies indicate that children with obesity are at higher risk of developing severe COVID-19, and inflammation associated with obesity could be one of the factors that worsens COVID-19 symptoms due to an increased inflammatory response involving molecules such as interleukin 6, tumor necrosis factor alpha, and monocyte chemoattractant protein. On the other hand, evidence has been reported of a higher protein expression of ACE2 in the visceral adipose tissue of obese and malnourished humans, and this could be associated with complications and severity of COVID-19. Therefore, regulation of the intake of macronutrients or micronutrients could be used as a strategy to reduce the consequences of COVID-19. Diet in general and bioactive compounds could play an important role in the prevention of the inflammatory cascade. The micronutrients with the most evidence suggesting a role in immune support are vitamins C and D, zinc, and polyphenols.


Assuntos
COVID-19/complicações , Gastroenteropatias/etiologia , Obesidade Pediátrica/complicações , Dor Abdominal/etiologia , Enzima de Conversão de Angiotensina 2/metabolismo , Anorexia/etiologia , Ácido Ascórbico/administração & dosagem , COVID-19/etiologia , COVID-19/metabolismo , Criança , Diarreia/etiologia , Feminino , Humanos , Inflamação/complicações , Masculino , Náusea/etiologia , Sobrepeso/complicações , Estresse Oxidativo , Obesidade Pediátrica/metabolismo , Polifenóis/administração & dosagem , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Magreza/complicações , Magreza/metabolismo , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Vômito/etiologia , Zinco/administração & dosagem , Zinco/deficiência
14.
Nutrients ; 13(4)2021 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-33921297

RESUMO

More than one year has passed since the first cases of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome (SARS)-CoV-2 coronavirus were reported in Wuhan (China), rapidly evolving into a global pandemic. This infectious disease has become a major public health challenge in the world. Unfortunately, to date, no specific antivirals have been proven to be effective against COVID-19, and although a few vaccines are available, the mortality rate is not decreasing but is still increasing. One therapeutic strategy has been focused on infection prevention and control measures. In this regard, the use of nutraceutical supports may play a role against some aspect of the infection, particularly the inflammatory state and the immune system function of patients, thus representing a strategy to control the worst outcomes of this pandemic. For this reason, we performed an overview including meta-analyses and systematic reviews to assess the association among melatonin, vitamin C, vitamin D, zinc supplementation and inflammatory markers using three databases, namely, MEDLINE, PubMed Central and the Cochrane Library of Systematic Reviews. According to the evidence available, an intake of 50,000 IU/month of vitamin D showed efficacy in CRP. An amount of 1 to 2 g per day of vitamin C demonstrated efficacy both in CRP and endothelial function, and a dosage of melatonin ranging from 5 to 25 mg /day showed good evidence of efficacy in CRP, TNF and IL6. A dose of 50 mg/day of elemental zinc supplementation showed positive results in CRP. Based on the data reported in this review, the public health system could consider whether it is possible to supplement the current limited preventive measures through targeted nutraceutical large-scale administration.


Assuntos
Ácido Ascórbico/administração & dosagem , COVID-19/tratamento farmacológico , Suplementos Nutricionais , Melatonina/administração & dosagem , Vitamina D/administração & dosagem , Zinco/administração & dosagem , Proteína C-Reativa/análise , COVID-19/prevenção & controle , Humanos , Sistema Imunitário/efeitos dos fármacos , Inflamação/tratamento farmacológico , Metanálise como Assunto , SARS-CoV-2 , Oligoelementos/administração & dosagem , Vitaminas/administração & dosagem
15.
Nutrients ; 13(4)2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33916257

RESUMO

Vitamin C is an essential nutrient that serves as antioxidant and plays a major role as co-factor and modulator of various pathways of the immune system. Its therapeutic effect during infections has been a matter of debate, with conflicting results in studies of respiratory infections and in critically ill patients. This comprehensive review aimed to summarize the current evidence regarding the use of vitamin C in the prevention or treatment of patients with SARS-CoV2 infection, based on available publications between January 2020 and February 2021. Overall, 21 publications were included in this review, consisting of case-reports and case-series, observational studies, and some clinical trials. In many of the publications, data were incomplete, and in most clinical trials the results are still pending. No studies regarding prevention of COVID-19 with vitamin C supplementation were found. Although some clinical observations reported improved medical condition of patients with COVID-19 treated with vitamin C, available data from controlled studies are scarce and inconclusive. Based on the theoretical background presented in this article, and some preliminary encouraging studies, the role of vitamin C in the treatment of patients with SARS-CoV-2 infection should be further investigated.


Assuntos
Ácido Ascórbico/uso terapêutico , COVID-19/tratamento farmacológico , Vitaminas/uso terapêutico , Adulto , Idoso , Antioxidantes/administração & dosagem , Antioxidantes/uso terapêutico , Ácido Ascórbico/administração & dosagem , Criança , Ensaios Clínicos como Assunto , Suplementos Nutricionais , Vias de Administração de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Índice de Gravidade de Doença , Resultado do Tratamento , Vitaminas/administração & dosagem
16.
Theranostics ; 11(8): 3552-3564, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33664847

RESUMO

Rationale: The clinical use of PI3K inhibitors, such as buparlisib, has been plagued with toxicity at effective doses. The aim of this study is to determine if vitamin C, a potent epigenetic regulator, can improve the therapeutic outcome and reduce the dose of buparlisib in treating PIK3CA-mutated triple negative breast cancer (TNBC). Methods: The response of TNBC cells to buparlisib was assessed by EC50 measurements, apoptosis assay, clonogenic assay, and xenograft assay in mice. Molecular approaches including Western blot, immunofluorescence, RNA sequencing, and gene silencing were utilized as experimental tools. Results: Treatment with buparlisib at lower doses, along with vitamin C, induced apoptosis and inhibited the growth of TNBC cells in vitro. Vitamin C via oral delivery rendered a sub-therapeutic dose of buparlisib able to inhibit TNBC xenograft growth and to markedly block metastasis in mice. We discovered that buparlisib and vitamin C coordinately reduced histone H3K4 methylation by enhancing the nuclear translocation of demethylase, KDM5, and by serving as a cofactor to promote KDM5-mediated H3K4 demethylation. The expression of genes in the PI3K pathway, such as AKT2 and mTOR, was suppressed by vitamin C in a KDM5-dependent manner. Vitamin C and buparlisib cooperatively blocked AKT phosphorylation. Inhibition of KDM5 largely abolished the effect of vitamin C on the response of TNBC cells to buparlisib. Additionally, vitamin C and buparlisib co-treatment changed the expression of genes, including PCNA and FILIP1L, which are critical to cancer growth and metastasis. Conclusion: Vitamin C can be used to reduce the dosage of buparlisib needed to produce a therapeutic effect, which could potentially ease the dose-dependent side effects in patients.


Assuntos
Ácido Ascórbico/administração & dosagem , Inibidores de Fosfoinositídeo-3 Quinase/administração & dosagem , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Aminopiridinas/administração & dosagem , Animais , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Sinergismo Farmacológico , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Código das Histonas/efeitos dos fármacos , Humanos , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Terapia de Alvo Molecular , Morfolinas/administração & dosagem , Medicina de Precisão , Neoplasias de Mama Triplo Negativas/metabolismo , Neoplasias de Mama Triplo Negativas/patologia , Ensaios Antitumorais Modelo de Xenoenxerto
17.
J Int Soc Sports Nutr ; 18(1): 19, 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653365

RESUMO

BACKGROUND: In this study, we investigated the effects of supplementation and exercise on the expression of genes associated with inflammation like CCL2, CRP, IL1, IL6, IL10 mRNA in elderly women. METHODS: Twenty four participants divided randomly into two groups were subjected to 6 weeks of the same health training program (three times per week). SUP group (supplemented, n = 12, mean age 72.8 ± 5.26 years and mean body mass 68.1 ± 8.3 kg) received 1000 mg of Vitamin C/day during the training period, while CON group (control, n = 12, mean age 72.4 ± 5.5 years and body mass 67.7 ± 7.5 kg) received placebo. RESULTS: No significant changes in IL-1, IL-6, IL-10 and CRP mRNA were observed within and between groups. However, there was a clear tendency of a decrease in IL-6 (two-way ANOVA, significant between investigated time points) and an increase in IL-10 mRNA noted in the supplemented group. A significant decrease in CCL2 mRNA was observed only in the CON group (from 2^0.2 to 2^0.1, p = 0.01). CONCLUSIONS: It can be concluded, that 6 weeks of supplementation and exercise was too short to obtain significant changes in gene expression in leukocytes, but supplementation of 1000 mg vitamin C positively affected IL-6 and IL-10 expression - which are key changes in the adaptation to training. However, changes in body mass, IL1 and CCL2 were positive in CON group. It is possible that Vitamin C during 6 weeks of supplementation could have different effects on the expression of individual genes involved in the immune response. TRIAL REGISTRATION: Retrospectively registered.


Assuntos
Ácido Ascórbico/administração & dosagem , Expressão Gênica , Imunidade/genética , Condicionamento Físico Humano/fisiologia , Vitaminas/administração & dosagem , Idoso , Ácido Ascórbico/sangue , Composição Corporal , Índice de Massa Corporal , Quimiocina CCL2/sangue , Quimiocina CCL2/genética , Feminino , Humanos , Interleucina-1/sangue , Interleucina-1/genética , Interleucina-10/sangue , Interleucina-10/genética , Interleucina-6/sangue , Interleucina-6/genética , Estresse Oxidativo , Consumo de Oxigênio , RNA Mensageiro/sangue , Receptores Imunológicos/sangue , Receptores Imunológicos/genética , Fatores de Tempo , Vitaminas/sangue
18.
BMC Nephrol ; 22(1): 91, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33722190

RESUMO

BACKGROUND: COVID-19 infection in kidney transplant recipients often lead to allograft dysfunction. The allograft injury has various histopathological manifestations. Our case illustrates the unusual combination of allograft rejection, acute kidney injury secondary to oxalate nephropathy and SARS CoV-2 nephropathy as the cause of irreversible allograft failure. CASE PRESENTATION: A 56 year old renal allograft recipient presented with a history of fever and diarrhoea for the preceding 4 weeks, tested positive for Sars-CoV2 on nasal swab and was found to have severe allograft dysfunction, necessitating haemodialysis. He subsequently underwent an allograft biopsy, which demonstrated antibody mediated rejection along with the presence of extensive oxalate deposition in the tubules. Ultrastructural examination demonstrated spherical spiked particles in the glomerular capillary endothelium and the presence of tubulo-reticular inclusions suggestive of an active COVID-19 infection within the kidney. The intra-tubular oxalate deposition was considered to be the result of high dose, supplemental Vitamin C used as an immune booster in many patients with COVID - 19 infection in India. CONCLUSIONS: This case highlights the complex pathology that may be seen in following COVID-19 disease and the need for kidney biopsies in these patients to better understand the aetiology of disease.


Assuntos
Ácido Ascórbico/efeitos adversos , COVID-19/complicações , Rejeição de Enxerto/etiologia , Hiperoxalúria/complicações , Transplante de Rim , Disfunção Primária do Enxerto/etiologia , Injúria Renal Aguda/etiologia , Ácido Ascórbico/administração & dosagem , COVID-19/diagnóstico , Evolução Fatal , Humanos , Nefropatias/complicações , Nefropatias/patologia , Masculino , Pessoa de Meia-Idade , Disfunção Primária do Enxerto/patologia , Disfunção Primária do Enxerto/virologia
19.
Nutrients ; 13(3)2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33673687

RESUMO

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.


Assuntos
Ácido Ascórbico/farmacologia , Inflamação , Estresse Oxidativo , Diálise Renal , Vitaminas/farmacologia , Ácido Ascórbico/administração & dosagem , Humanos , Vitaminas/administração & dosagem
20.
J Infect Dev Ctries ; 15(2): 209-213, 2021 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-33690202

RESUMO

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is declared as pandemic by the World Health Orgnazation (WHO) on March 2020. One of the heavily utilized measures during this pandemic is vitamin C (aka ascorbic acid). Unfortunately, vitamin C has been associated with glucose measurement interference and thus this study highlights the elevated levels of blood glucose correlated with the presence of vitamin C interference. METHODOLOGY: Thirty samples were selected randomly and the blood glucose were measured prior and post the addition of spiked standard concentrations of vitamin C. The interference of vitamin C with glucose readings in COVID-19 pandemic were evaluated and observed employing the Auto Chemistry Analyzer machine. RESULTS: The addition of ascorbic acid (vitamin C) standards (spikes) into the isolated samples shows a correlated increment in the reading measures. Thereafter, the increments of Random Blood Sugar (RBS) readings after being spiked with the vitamin C standards shows a logarithmic correlation with good interesting R-squared (R2 = 0.9921). CONCLUSIONS: The authors find that the presence of vitamin C in blood actively and significantly alters the glucose level readings especially with the highly consumption of vitamin C during the COVID-19 pandemic.


Assuntos
Ácido Ascórbico/sangue , Glicemia/análise , Ácido Ascórbico/administração & dosagem , COVID-19 , Humanos
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