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维生素C在预防和控制心脏移植排斥反应及心脏移植血管病变中的治疗潜在作用。值得考虑。

Therapeutic potential role of vitamin C in prevention and control of heart transplant rejection and cardiac allograft vasculopathy. A need for consideration.

作者信息

Kenedy Idd J, Kabuhaya Jaynes F, Mashauri Harold L

机构信息

Department of General Surgery Kilimanjaro Christian Medical University College Moshi Tanzania.

Department of Epidemiology and Biostatistics Institute of Public Health, Kilimanjaro Christian Medical University College Moshi Tanzania.

出版信息

Health Sci Rep. 2023 Nov 5;6(11):e1687. doi: 10.1002/hsr2.1687. eCollection 2023 Nov.

DOI:10.1002/hsr2.1687
PMID:37936616
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10626049/
Abstract

The burden of cardiovascular diseases is rising rapidly globally. Heart transplant is one of the most last resort medical option for patients with heart failure. Unfortunately, this surgical intervention is associated with several serious complications including heart transplant rejection (HTR) and Cardiac Allograft Vasculopathy (CAV) which can manifest just within few years' posttransplant. These complications affect significantly the prognosis and quality of life among postheart transplant patients. Several medications including immunosuppressant, antibiotics, antihypertensive, and statins have been used during posttransplant care so as to address such complications. Unfortunately, most of those drugs are expensive and pose a number of serious side effects to the patients enough to compromise patients' quality of life too. Several studies on Vitamin C are therapeutically suggestive that it can be used during postheart transplant care with more cost-effective benefits with less and minimized side effects compared to the current drugs in place. It should be considered pharmacologically that Vitamin C has a great potential role clinically in prevention and control of HTR and CAV development. On the light of such findings as described above, we recommend more studies especially clinical trials and molecular studies to determine whether Vitamin C can be repositioned to replace or to be used along the current drug regimens used in postheart transplant care for prevention and control of HTR and CAV.

摘要

心血管疾病的负担在全球范围内正在迅速上升。心脏移植是心力衰竭患者最后的医疗选择之一。不幸的是,这种外科手术干预会引发多种严重并发症,包括心脏移植排斥反应(HTR)和心脏移植血管病变(CAV),这些并发症可能在移植后短短几年内就会出现。这些并发症严重影响心脏移植术后患者的预后和生活质量。在移植后护理期间,人们使用了多种药物,包括免疫抑制剂、抗生素、抗高血压药和他汀类药物,以应对此类并发症。不幸的是,这些药物大多价格昂贵,并且会给患者带来一些严重的副作用,足以影响患者的生活质量。一些关于维生素C的研究表明,与目前使用的药物相比,在心脏移植术后护理中使用维生素C具有更高的性价比,副作用更少且最小化。从药理学角度来看,维生素C在预防和控制HTR和CAV发展方面具有巨大的临床潜力。鉴于上述这些发现,我们建议开展更多研究,尤其是临床试验和分子研究,以确定维生素C是否可以重新定位,以取代或与目前用于心脏移植术后护理的药物方案一起使用,用于预防和控制HTR和CAV。

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2
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本文引用的文献

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The dawn of repurposing vitamins as potential novel antimicrobial agents: A call for global emergency response amidst AMR crisis.将维生素重新用作潜在新型抗菌剂的曙光:在抗菌药物耐药性危机中呼吁全球紧急应对。
Health Sci Rep. 2023 May 20;6(5):e1276. doi: 10.1002/hsr2.1276. eCollection 2023 May.
2
Vitamin C intake potentially lowers total cholesterol to improve endothelial function in diabetic patients at increased risk of cardiovascular disease: A systematic review of randomized controlled trials.维生素C摄入量可能会降低总胆固醇,以改善心血管疾病风险增加的糖尿病患者的内皮功能:一项随机对照试验的系统评价。
Front Nutr. 2022 Oct 31;9:1011002. doi: 10.3389/fnut.2022.1011002. eCollection 2022.
3
High-Dose Vitamin C for Cancer Therapy.大剂量维生素C用于癌症治疗
Pharmaceuticals (Basel). 2022 Jun 3;15(6):711. doi: 10.3390/ph15060711.
4
Bactericidal, anti-biofilm, and anti-virulence activity of vitamin C against carbapenem-resistant hypervirulent .维生素C对耐碳青霉烯类高毒力菌的杀菌、抗生物膜及抗毒力活性
iScience. 2022 Feb 8;25(3):103894. doi: 10.1016/j.isci.2022.103894. eCollection 2022 Mar 18.
5
High-dose intravenous vitamin C, a promising multi-targeting agent in the treatment of cancer.大剂量静脉注射维生素 C,一种有前途的癌症多靶点治疗药物。
J Exp Clin Cancer Res. 2021 Oct 30;40(1):343. doi: 10.1186/s13046-021-02134-y.
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Cardiac allograft vasculopathy: current review and future research directions.心脏移植后血管病:当前综述与未来研究方向。
Cardiovasc Res. 2021 Nov 22;117(13):2624-2638. doi: 10.1093/cvr/cvab259.
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Front Cell Dev Biol. 2021 May 11;9:639944. doi: 10.3389/fcell.2021.639944. eCollection 2021.
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Antioxidants (Basel). 2020 Nov 26;9(12):1182. doi: 10.3390/antiox9121182.
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Cardiology. 2020;145(11):693-702. doi: 10.1159/000509630. Epub 2020 Sep 4.
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