Chang Chia-Yu, Chen Jen-Yin, Chen Sheng-Hsien, Cheng Tain-Junn, Lin Mao-Tsun, Hu Miao-Lin
Department of Neurology, Chi Mei Medical Center, 901 Chung-Hwa Road, Yong kang, Tainan, Taiwan; Department of Food Science and Applied Biotechnology, National Chung-Hsing University, 250 Kuo-Kuang Road, Taichung 402, Taiwan; Center for General Education, Southern Taiwan University of Science and Technology, 1 Nan-Tai Street, Yong kang, Tainan, Taiwan.
Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
Free Radic Biol Med. 2016 Apr;93:84-93. doi: 10.1016/j.freeradbiomed.2015.12.017. Epub 2015 Dec 15.
The impact of ascorbate on oxidative stress-related diseases is moderate because of its limited oral bioavailability and rapid clearance. However, recent evidence of the clinical benefit of parenteral vitamin C administration has emerged, especially in critical care. Heatstroke is defined as a form of excessive hyperthermia associated with a systemic inflammatory response that results in multiple organ dysfunctions in which central nervous system disorders such as delirium, convulsions, and coma are predominant. The thermoregulatory, immune, coagulation and tissue injury responses of heatstroke closely resemble those observed during sepsis and are likely mediated by similar cellular mechanisms. This study was performed by using the characteristic high lethality rate and sepsis-mimic systemic inflammatory response of a murine model of heat stroke to test our hypothesis that supra-physiological doses of ascorbate may have therapeutic use in critical care. We demonstrated that parenteral administration of ascorbate abrogated the lethality and thermoregulatory dysfunction in murine model of heat stroke by attenuating heat stroke-induced accelerated systemic inflammatory, coagulation responses and the resultant multiple organ injury, especially in hypothalamus. Overall, our findings support the hypothesis and notion that supra-physiological doses of ascorbate may have therapeutic use in critical care.
由于口服生物利用度有限且清除迅速,抗坏血酸对氧化应激相关疾病的影响较为适度。然而,近期出现了关于肠外给予维生素C临床益处的证据,尤其是在重症监护中。中暑被定义为一种与全身炎症反应相关的过度高热形式,可导致多器官功能障碍,其中以谵妄、惊厥和昏迷等中枢神经系统紊乱为主。中暑的体温调节、免疫、凝血和组织损伤反应与脓毒症期间观察到的反应极为相似,且可能由相似的细胞机制介导。本研究利用中暑小鼠模型的高致死率和类似脓毒症的全身炎症反应这一特性,来检验我们的假设,即超生理剂量的抗坏血酸可能在重症监护中具有治疗作用。我们证明,通过减轻中暑诱导的加速全身炎症、凝血反应以及由此导致的多器官损伤,尤其是下丘脑的损伤,肠外给予抗坏血酸可消除中暑小鼠模型的致死率和体温调节功能障碍。总体而言,我们的研究结果支持超生理剂量的抗坏血酸可能在重症监护中具有治疗作用这一假设和观点。