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大剂量维生素 C 逆转脓毒症和 COVID-19 器官功能障碍的治疗潜力。

Therapeutic potential of megadose vitamin C to reverse organ dysfunction in sepsis and COVID-19.

机构信息

Preclinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia.

Department of Critical Care, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia.

出版信息

Br J Pharmacol. 2021 Oct;178(19):3864-3868. doi: 10.1111/bph.15579. Epub 2021 Jun 24.

Abstract

Sepsis induced by bacteria or viruses can result in multiorgan dysfunction, which is a major cause of death in intensive care units. Current treatments are only supportive, and there are no treatments that reverse the pathophysiological effects of sepsis. Vitamin C has antioxidant, anti-inflammatory, anticoagulant and immune modulatory actions, so it is a rational treatment for sepsis. Here, we summarise data that support the use of megadose vitamin C as a treatment for sepsis and COVID-19. Megadose intravenous sodium ascorbate (150 g per 40 kg over 7 h) dramatically improved the clinical state and cardiovascular, pulmonary, hepatic and renal function and decreased body temperature, in a clinically relevant ovine model of Gram-negative bacteria-induced sepsis. In a critically ill COVID-19 patient, intravenous sodium ascorbate (60 g) restored arterial pressure, improved renal function and increased arterial blood oxygen levels. These findings suggest that megadose vitamin C should be trialled as a treatment for sepsis and COVID-19.

摘要

细菌或病毒引起的败血症会导致多器官功能障碍,这是重症监护病房死亡的主要原因。目前的治疗方法只是支持性的,没有治疗方法可以逆转败血症的病理生理效应。维生素 C 具有抗氧化、抗炎、抗凝和免疫调节作用,因此是治疗败血症的合理选择。在这里,我们总结了支持大剂量维生素 C 治疗败血症和 COVID-19 的数据。在革兰氏阴性菌诱导的败血症的临床相关绵羊模型中,大剂量静脉注射抗坏血酸钠(40kg 体重给予 150g,持续 7 小时)显著改善了临床状态以及心血管、肺、肝和肾功能,并降低了体温。在一名危重症 COVID-19 患者中,静脉注射抗坏血酸钠(60g)恢复了动脉血压,改善了肾功能并提高了动脉血氧水平。这些发现表明,应尝试将大剂量维生素 C 作为败血症和 COVID-19 的治疗方法。

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