Liliana Mititelu-Tartau
Maria Bogdan
Manuela Ciocoiu- 1Department of Pharmacology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2Department of Pharmacology, Faculty of Pharmacy, University of Medicine and Pharmacy, Craiova, Romania
- 3Department of Pathophysiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
Editorial on the Research Topic
Vitamin C from bench to bedside
Vitamin C, also known as ascorbic acid, has long held a place in the pantheon of essential nutrients (1, 2). From its discovery in the early 20th century to its ubiquitous presence in health food stores today, its journey from bench to bedside has been one of intrigue, controversy, and groundbreaking discovery (3, 4). Vitamin C serves as a potent antioxidant, scavenging free radicals and protecting cells from oxidative damage (5, 6). Also, it contributes to the reduction of tiredness and fatigue, to normal functioning of the nervous system, to the regeneration of the reduced form of vitamin E, and increases iron absorption.1 Moreover, it plays a crucial role in collagen synthesis, wound healing, and immune function (7–10). These fundamental discoveries have laid the groundwork for understanding the broader implications of vitamin C in human health.
Experimental studies have illuminated the potential therapeutic effects of vitamin C in various diseases (11–13). From its purported anti-cancer properties to its role in mitigating the symptoms of the common cold, researchers have delved deep into the biological pathways through which vitamin C exerts its effects (14). Furthermore, emerging evidence suggests that vitamin C may play a role in combating inflammation, cardiovascular disease, and neurodegenerative disorders (15–18). In recent years, the field of nutritional psychiatry has emerged as a promising avenue for understanding the complex interplay between diet and mental health (Chen et al.) (19).
In infectious diseases, vitamin C has been the subject of intense scrutiny, particularly in the context of the common cold and more recently, the COVID-19 pandemic (20, 21). Various researches suggest that adequate vitamin C intake may lower the risk of developing certain acute and chronic diseases by supporting immune function and reducing inflammation (22). Considering the COVID-19 pandemic, interest in the potential role of vitamin C in bolstering immune health has surged (23, 24).
In this Research Topic there are seven papers published, covering the above-mentioned aspects.
Luo et al. conducted a meta-analysis of randomized controlled trials to investigate the impact of intravenous vitamin C as an adjunctive therapy in patients with sepsis. Their analysis incorporated ten studies comprising 1,426 patients. The findings revealed that the administration of vitamin C to sepsis patients did not lead to a significant reduction in short-term mortality, length of Intensive Care Unit (ICU) stay, or the Sequential Organ Failure Assessment (SOFA) score. However, it was noted that vitamin C could decrease the duration of vasopressor usage, with potential greater benefits observed in sepsis patients from developing countries compared to those from developed nations.
A noteworthy case report by Lu et al. described a rare occurrence involving a 25-year-old male patient without underlying health conditions. The patient presented with progressively severe pain and ecchymoses in both lower extremities over a three-week period during the COVID-19 pandemic and was subsequently diagnosed with scurvy. Given the challenge of diagnosing scurvy due to its nonspecific clinical manifestations, early recognition and prompt treatment are crucial to prevent life-threatening complications in the advanced stages of the disease. This case report emphasizes the importance of being alert for nutritional deficiencies.
Sun et al. devised a protocol for a prospective, randomized, double-blinded, placebo-controlled study aimed at investigating the impact of high-dose intravenous vitamin C treatment on the prognosis of patients with moderately severe and severe acute pancreatitis.
Ding et al. conducted a cross-sectional analysis utilizing the National Health and Nutrition Examination Survey 2017–2018 dataset. Their study involved 5,380 adults from the USA aged ≥20 years and examined the association between vitamin C levels and hs-CRP. Through multiple regression models, stratified analysis, and curve fitting, they assessed the linear and nonlinear relationship between plasma vitamin C and serum hs-CRP. The findings suggested potential cardioprotective and anti-inflammatory effects associated with optimal vitamin C intake, as well as a non-linear negative correlation between vitamin C levels and hs-CRP in adults. Nonetheless, further investigation is warranted to better understand the underlying mechanisms.
Chiscano-Camón et al. conducted a prospective observational study at a single center, involving 43 patients diagnosed with severe COVID-19 pneumonia. They assessed the plasma levels of vitamin C on days 1, 5, and 10 following admission to ICU. The study revealed that vitamin C concentrations were undetectable upon ICU admission in 86% of patients, and this trend persisted throughout the observation period.
Chen et al. explored the relationship between serum vitamin C concentration and the prevalence of depression among adults in the United States. Their research utilized data from the National Health and Nutrition Examination Survey 2017–2018, encompassing 3,404 participants. The results unveiled a negative correlation between serum vitamin C levels and depression, underscoring a noteworthy association between higher levels of serum vitamin C and a reduced prevalence of depressive symptoms.
The case-control pilot study by Noronha et al. analyzed CpG sites related both to the relative abundance of specific bacteria phyla and vitamin C ingestion, in 6 women aged 30.8 ± 2.2. Their analysis revealed that increased vitamin C intake corresponded to a higher relative abundance of Actinobacteria, showing a positive correlation between these factors. Among participants with elevated vitamin C intake, 207 CpG sites were consistently associated with both vitamin C consumption and Actinobacteria abundance. Hypomethylated sites were linked to glucose homeostasis and general cellular metabolism, while immune function was associated with both hypo- and hypermethylated sites. These findings provide deeper insights into the complex interaction among microbiota, nutrients, DNA methylation, and immune response.
From the laboratory bench to the patient's bedside, the journey of vitamin C has been marked by both triumphs and challenges. While its therapeutic potential in various diseases continues to be investigated, the importance of maintaining adequate vitamin C levels for overall health and wellbeing cannot be overstated. As we navigate the complex interplay between diet, supplementation, and disease prevention, it is essential to approach the role of vitamin C with scientific rigor and an open mind. By embracing the potential of vitamin C and leveraging the insights gleaned from bench research, we can pave the way for innovative approaches to healthcare that prioritize prevention, personalized medicine, and holistic wellbeing.
Author contributions
LM-T: Writing – original draft. MB: Writing – original draft. MC: Writing – review & editing.
Funding
The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Footnotes
1. ^https://ec.europa.eu/food/food-feed-portal/screen/health-claims/eu-register (accessed 31 March, 2024).
References
1. Abdullah M, Jamil RT, Attia FN. Vitamin C (Ascorbic Acid). In: StatPearls. Treasure Island (FL): StatPearls Publishing. (2024). Available online at: https://www.ncbi.nlm.nih.gov/books/NBK499877/ (accessed May 3, 2023).
2. Khalife R, Grieco A, Khamisa K, Tinmouh A, McCudden C, Saidenberg E. Scurvy, an old story in a new time: the hematologist's experience. Blood Cells Mol Dis. (2019) 76:40–4. doi: 10.1016/j.bcmd.2019.01.004
3. Ashor AW, Brown R, Keenan PD, Willis ND, Siervo M, Mathers JC. Limited evidence for a beneficial effect of vitamin C supplementation on biomarkers of cardiovascular diseases: an umbrella review of systematic reviews and meta-analyses. Nutr Res. (2019) 61:1–12. doi: 10.1016/j.nutres.2018.08.005
4. Yussif NM. Vitamin C. In: LeBlanc JG, , editor. Vitamin C: An Update on Current Uses and Functions. London: IntechOpen (2019). doi: 10.5772/intechopen.81783
5. Pehlivan FE. Vitamin C: an antioxidant agent. In: Hamza A, , editor. Vitamin C. London: IntechOpen. (2017). doi: 10.5772/intechopen.69660
6. Jaros-Sajda A, Budzisz E, Erkiert-Polguj A. Ascorbic acid treatments as effective and safe anti-aging therapies for sensitive skin. Antioxidants. (2024) 13:174. doi: 10.3390/antiox13020174
7. Bogdan M, Meca AD, Boldeanu MV, Gheorghe DN, Turcu-Stiolica A, Subtirelu M-S, et al. Possible involvement of vitamin c in periodontal disease-diabetes mellitus association. Nutrients. (2020) 12:553. doi: 10.3390/nu12020553
8. Moritz B, Schmitz AE, Rodrigues ALS, Dafre AL, Cunha MP. The role of vitamin C in stress-related disorders. J Nutr Biochem. (2020) 85:108459. doi: 10.1016/j.jnutbio.2020.108459
9. Sasidharan Nair V, Huehn J. Impact of vitamin C on the development, differentiation and functional properties of T cells. Eur J Microbiol Immunol (Bp). (2024) 6:1–8. doi: 10.1556/1886.2024.00017
10. Carr AC, Maggini S. Vitamin C and immune function. Nutrients. (2017) 9:1211. doi: 10.3390/nu9111211
11. Langlois PL, Manzanares W, Adhikari NKJ, Lamontagne F, Stoppe C, Hill A, et al. Vitamin C Administration to the critically ill: a systematic review and meta-analysis. JPEN J Parenter Enteral Nutr. (2019) 43:335–46. doi: 10.1002/jpen.1471
12. Ghalibaf MHE, Kianian F, Beigoli S, Behrouz S, Marefati N, Boskabady M, et al. The effects of vitamin C on respiratory, allergic and immunological diseases: an experimental and clinical-based review. Inflammopharmacology. (2023) 31:653–72. doi: 10.1007/s10787-023-01169-1
13. Wong SK, Chin KY, Ima-Nirwana S. Vitamin C: a review on its role in the management of metabolic syndrome. Int J Med Sci. (2020) 17:1625–38. doi: 10.7150/ijms.47103
14. de Carvalho Melo-Cavalcante AA, da Rocha Sousa L, Alencar MVOB, de Oliveira Santos JV, da Mata AMO, Paz MFCJ, et al. Sousaa JM. Retinol palmitate and ascorbic acid: Role in oncological prevention and therapy. Biomed Pharmacother. (2019) 109:1394–405. doi: 10.1016/j.biopha.2018.10.115
15. Gegotek A, Skrzydlewska E. Antioxidative and anti-inflammatory activity of ascorbic acid. Antioxidants (Basel). (2022) 11:1993. doi: 10.3390/antiox11101993
16. Roth-Walter F, Berni Canani R, O'Mahony L, Peroni D, Sokolowska M, Vassilopoulou E, et al. Nutrition in chronic inflammatory conditions: bypassing the mucosal block for micronutrients. Allergy. (2024) 79:353–83. doi: 10.1111/all.15972
17. Morelli MB, Gambardella J, Castellanos V, Trimarco V, Santulli G. Vitamin C and cardiovascular disease: an update. Antioxidants (Basel). (2020) 9:1227. doi: 10.3390/antiox9121227
18. Zhu N, Huang B, Jiang W. Targets of vitamin C with therapeutic potential for cardiovascular disease and underlying mechanisms: a study of network pharmacology. Front Pharmacol. (2021) 11:591337. doi: 10.3389/fphar.2020.591337
19. Sim M, Hong S, Jung S, Kim JS, Goo YT, Chun WY, et al. Vitamin C supplementation promotes mental vitality in healthy young adults: results from a cross-sectional analysis and a randomized, double-blind, placebo-controlled trial. Eur J Nutr. (2022) 61:447–59. doi: 10.1007/s00394-021-02656-3
20. Hemilä H, Chalker E. Vitamin C reduces the severity of common colds: a meta-analysis. BMC Public Health. (2023) 23:2468. doi: 10.1186/s12889-023-17229-8
21. Cerullo G, Negro M, Parimbelli M, Pecoraro M, Perna S, Liguori G, et al. The long history of vitamin C: from prevention of the common cold to potential aid in the treatment of COVID-19. Front Immunol. (2020) 11:574029. doi: 10.3389/fimmu.2020.574029
22. Moore A, Khanna D. The role of vitamin C in human immunity and its treatment potential against COVID-19: a review article. Cureus. (2023) 15:e33740. doi: 10.7759/cureus.33740
23. McKenzie C, Moore L, Borthwick M. Vitamin C for patients hospitalized with COVID-19. JAMA. (2024) 331:886. doi: 10.1001/jama.2024.0452
Keywords: vitamin C, immunity, antioxidant, inflammation, dietary supplements
Citation: Mititelu-Tartau L, Bogdan M and Ciocoiu M (2024) Editorial: Vitamin C from bench to bedside. Front. Nutr. 11:1406342. doi: 10.3389/fnut.2024.1406342
Received: 24 March 2024; Accepted: 09 April 2024;
Published: 29 April 2024.
Edited by:
Diego A. Moreno, Spanish National Research Council (CSIC), SpainReviewed by:
Bojana B. Vidovic, University of Belgrade, SerbiaRonan Lordan, University of Pennsylvania, United States
Ashok Kumar Pandurangan, B. S. Abdur Rahman Crescent Institute of Science and Technology, India
Francisco Pérez García, University of Barcelona, Spain
Copyright © 2024 Mititelu-Tartau, Bogdan and Ciocoiu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Maria Bogdan, bogdanfmaria81@yahoo.com