title: Therapeutic efficacy of high-dose vitamin C on acute pancreatitis and its potential mechanisms.
abstract: OBJECTIVE
  To observe the therapeutic efficacy of high-dose Vitamin C (Vit. C) on acute pancreatitis (AP), and to explore its potential mechanisms.
  
  
  METHODS
  Eighty-four AP patients were divided into treatment group and control group, 40 healthy subjects were taken as a normal group. In the treatment group, Vit. C (10 g/day) was given intravenously for 5 days, whereas in the control group, Vit. C (1 g/day) was given intravenously for 5 days. Symptoms, physical signs, duration of hospitalization, complications and mortality rate were monitored. Meanwhile, serum amylase, urine amylase and leukocyte counts were also determined. The concentration of plasma vitamin C (P-VC), plasma lipid peroxide (P-LPO), plasma vitamin E (P-VE), plasma beta-carotene (P-beta-CAR), whole blood glutathione (WB-GSH) and the activity of erythrocyte surperoxide dimutase (E-SOD) and erythrocyte catalase (E-CAT) as well as T lymphocyte phenotype were measured by spectrophotometry in the normal group and before and after treatment with Vit. C in the treatment and the control group.
  
  
  RESULTS
  Compared with the normal group, the average values of P-VC, P-VE, P-beta-CAR, WB-GSH and the activity of E-SOD and E-CAT in AP patients were significantly decreased and the average value of P-LPO was significantly increased, especially in severe acute pancreatitis (SAP) patients (P<0.05. P-VC, P=0.045; P-VE, P=0.038; P=0.041; P-beta-CAR, P=0.046; WB-GSH, P=0.039; E-SOD, P=0.019; E-CAT, P=0.020; P-LPO, P=0.038). Compared with the normal group, CD3 and CD4 positive cells in AP patients were significantly decreased. The ratio of CD4/CD8 and CD4 positive cells were decreased, especially in SAP patients (P<0.05. CD4/CD8, P=0.041; CD4, P =0.019). Fever and vomiting disappeared, and leukocyte counts and amylase in urine and blood become normal quicker in the treatment group than in the control group. Moreover, patients in treatment group also had a higher cure rate, a lower complication rate and a shorter in-ward days compared with those in he control group. After treatment, the average value of P-VC was significantly higher and the values of SIL-2R, TNF-alpha, IL-6 and IL-8 were significantly lower in the treatment group than in the control group (P<0.05 P-VC, P=0.045; SIL-2R, P=0.012; TNF-alpha, P=0.030; IL-6, P=0.015; and IL-8, P=0.043). In addition, the ratio of CD4/CD8 and CD4 positive cells in the patients of treatment group were significantly higher than that of the control group after treatment (P<0.05. CD4/CD8, P=0.039; CD4, P=0.024).
  
  
  CONCLUSIONS
  High-dose vitamin C has therapeutic efficacy on acute pancreatitis. The potential mechanisms include promotion of anti-oxidizing ability of AP patients, blocking of lipid peroxidation in the plasma and improvement of cellular immune function.
authors: Department of Surgery, Huadong Hospital, Shanghai 200040, China. duzhuyi@sh163.net
authors: Wei-Dong
authors: WD
authors: Du
authors: Zu-Rong
authors: ZR
authors: Yuan
authors: Jian
authors: J
authors: Sun
authors: Jian-Xiong
authors: JX
authors: Tang
authors: Ai-Qun
authors: AQ
authors: Cheng
authors: Da-Ming
authors: DM
authors: Shen
authors: Chun-Jin
authors: CJ
authors: Huang
authors: Xiao-Hua
authors: XH
authors: Song
authors: Xiao-Feng
authors: XF
authors: Yu
authors: Song-Bai
authors: SB
authors: Zheng
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007275:Injections, Intravenous; D015227:Lipid Peroxidation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism*
chemical_list: D000975:Antioxidants; D016207:Cytokines; D001205:Ascorbic Acid