Li Runze, Guan Liangchao, Liu Yue, Hu Zongyi, Liu Junyu, Li Cheng, Min Hui
Second Clinical College, China Medical University, Shenyang, Liaoning, China.
Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning, China.
Nutrition. 2025 Jun;134:112733. doi: 10.1016/j.nut.2025.112733. Epub 2025 Mar 1.
Vitamin C is a versatile nutrient with essential antioxidant properties and roles in amino acid metabolism, collagen promotion, and hormone synthesis. It has long been regarded as benefitting infectious disease management, although its specific roles remain uncertain. The dominant view is that this efficacy not only stems from its redox regulation in the body but also from its profound impact on the immune system. This review provides a comprehensive overview of Vitamin C's effects on redox regulation and shows how the vitamin influences various immune cells and cell-intrinsic innate immunity signaling pathways, thereby updating and expanding our previous perspectives. Clinically, though some studies and case series have suggested potential benefits of Vitamin C in preventing and (or) treating respiratory tract infections and sepsis and septic shock, the evidence remains controversial. The current data is insufficient to support the routine clinical use of Vitamin C in managing these diseases and requires further rigorous evaluation to establish definitive efficacy and safety profiles. This review thoroughly examines current clinical research progress on Vitamin C, summarizes the primary controversies and their underlying causes, and proposes directions for future clinical research. Furthermore, preclinical evidence shows potential roles for Vitamin C in the supplementary treatment of the "Big Three" infectious diseases: acquired immunodeficiency syndrome (AIDS), tuberculosis, and malaria; however, systematic clinical studies in these areas are lacking. We examine related in vitro and animal studies, as well as clinical trials, and discuss potential roles for Vitamin C as a treatment and (or) adjuvant therapy.
维生素C是一种多功能营养素，具有重要的抗氧化特性，在氨基酸代谢、胶原蛋白生成和激素合成中发挥作用。长期以来，人们一直认为它对传染病管理有益，但其具体作用仍不明确。主流观点认为，这种功效不仅源于其在体内的氧化还原调节，还源于其对免疫系统的深远影响。本综述全面概述了维生素C对氧化还原调节的作用，并展示了该维生素如何影响各种免疫细胞和细胞内在的先天免疫信号通路，从而更新和扩展了我们之前的观点。临床上，尽管一些研究和病例系列表明维生素C在预防和（或）治疗呼吸道感染、败血症和感染性休克方面可能有益，但证据仍存在争议。目前的数据不足以支持维生素C在这些疾病管理中的常规临床应用，需要进一步严格评估以确定其确切疗效和安全性。本综述深入研究了维生素C目前的临床研究进展，总结了主要争议及其潜在原因，并提出了未来临床研究的方向。此外，临床前证据表明维生素C在“三大”传染病（获得性免疫缺陷综合征（艾滋病）、结核病和疟疾）的辅助治疗中可能发挥作用；然而，这些领域缺乏系统的临床研究。我们研究了相关的体外和动物研究以及临床试验，并讨论了维生素C作为治疗和（或）辅助治疗的潜在作用。
