Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
Center of Preclinical Research, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
Clin Nutr. 2022 Jun;41(6):1244-1255. doi: 10.1016/j.clnu.2022.04.004. Epub 2022 Apr 12.
Ischemia/reperfusion (I/R) injury plays a pivotal role in the development of graft dysfunction and allograft rejection after transplantation. Excessive free radical production and massive consumption of endogenous antioxidants are common mechanisms underlying I/R injury and are implicated in posttransplant organ damage and reduced graft viability. Ascorbic Acid (AA) is an essential micronutrient involved in several biological processes, from antioxidative response to the modulation of apoptosis and inflammation. These properties, combined to the safety profile, low cost, and ease of administration and measurement, make AA a potential bullet for reducing I/R damage in the setting of solid organ transplantation. Although multiple preclinical and clinical studies have been performed to investigate the effectiveness of AA administration in reducing I/R injury during transplantation, its therapeutic potential remains controversial as well as the optimal dosage, timing, and combination with other antioxidants. In this review, we summarize the AA modulated metabolic pathways, focusing on its potential role in the treatment of solid organ (kidney, liver, lung, heart, and pancreas) transplantation.
缺血/再灌注（I/R）损伤在移植后移植物功能障碍和同种异体排斥反应的发展中起着关键作用。过量自由基的产生和内源性抗氧化剂的大量消耗是 I/R 损伤的常见机制，并与移植后器官损伤和移植物活力降低有关。抗坏血酸（AA）是一种必需的微量营养素，参与多种生物过程，从抗氧化反应到调节细胞凋亡和炎症。这些特性，加上安全性、低成本、易于管理和测量，使 AA 成为减少实体器官移植中 I/R 损伤的潜在药物。尽管已经进行了多项临床前和临床研究来研究 AA 给药在减少移植过程中 I/R 损伤的有效性，但它的治疗潜力仍然存在争议，包括最佳剂量、时间和与其他抗氧化剂的联合应用。在这篇综述中，我们总结了 AA 调节的代谢途径，重点讨论了其在治疗实体器官（肾、肝、肺、心和胰腺）移植中的潜在作用。
