- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Vitamin-C promising therapeutic agent in sepsis, meta-analysis reveals
USA: The largest meta-analysis conducted by S. Sattar and colleagues provides strong evidence of Vitamin-C as a therapeutic agent in sepsis. The researchers reported that vitamin C either in enteral or IV form, in monotherapy as well as combined therapy continues to demonstrate a promising reduction in hospital length of stay, mortality, duration of mechanical ventilation, ICU length of stay, and vasopressor requirement compared to control.
"We strongly encourage conducting further large pivotal studies to establish vitamin C as a standard of care in sepsis to reduce mortality given its low cost and fewer adverse effects," Sattar et al. wrote in their study.
The study findings were presented at the American Thoracic Society (ATS) 2022 International Conference held from May 13-18, 2022; in San Francisco, CA.
The mortality rate of sepsis remains very high with an overall very poor prognosis despite all the advancements in critical care. From a pathophysiology point of view, it is known that endotoxins of bacterial cell walls stimulate macrophages to produce pro-inflammatory cytokines. Activated macrophages also release high mobility group box 1 (HMGB1), which is an essential mediator of sepsis. Extracellular HMGB1 is the culprit for triggering a lethal cascade of cytokines and inflammatory proteins. Ascorbic acid (AscA) induces heme oxygenase (HO)-1 which inhibits the release of HMGB1 in lipopolysaccharide (LPS)-stimulated cells and increases survival in sepsis. As HO-1 is one of the rate-limiting enzymes in heme catabolism.
Pharmacological studies have shown that parenteral high-dose vitamin C inhibits endotoxin-induced endothelial dysfunction and vasohyporeactivity in humans, normalized physiological functions that attenuated the development of multiple organ dysfunction syndrome in sepsis, and significantly reduced pro-inflammatory biomarkers in severe sepsis patients. AscA induces the expression of HO-1 protein via Nrf-2/Keap-1 pathways. Indeed, Nrf-2 is a ubiquitous master transcription factor regulating a complex cellular stress response network that functions to lessen stress signaling.
For the study, a systemic review search was conducted on PubMed, Embase, and Central Cochrane Registry. For analysis, the selection of 21 prospective randomized clinical trials with Vitamin C as an intervention in the septic adult patient population was done.
Standardized mean difference (SMD) was used for continuous variables and the odds ratio (OR) was used for discrete variables.
RCTs showed that in the patient population with a sample size of 2548 (n=2548), treated with vitamin C there was a statistically significant reduction in mortality, OR=0.788, SOFA score, -0.333, days on mechanical ventilation SMD=-0.732, days on pressors SMD=-0.637, and ICU length of stay, SMD= -0.351.
Reference:
Sattar S, Jahangir A, Kassem A, et al. Efficacy of vitamin C in septic patient population: A Systematic Review and Metanalysis: Presented at: the American Thoracic Society (ATS) 2022 International Conference; May 13-18, 2022; San Francisco, CA. Abstract P530.
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751