Letter: Vitamins and oral contraceptives.
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The effect of oral vitamin C has been examined in elderly long-stay inpatients known to have low levels of vitamin C in their plasma and leucocytes. 1 g of vitamin C given daily for 28 days was shown to be associated with slight, but significant, clinical improvement and weight-gain when compared with placebo therapy.
Scurvy is caused by a deficiency of ascorbic acid. We describe a 31-year-old Hispanic man who had perifollicular hemorrhages, follicular hyperkeratosis, corkscrew hairs, and gingival hemorrhage after consuming a peculiar and restricted diet for 1 year. A diagnosis of scurvy was made and the patient's disease resolved after treatment with vitamin C.
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The ability of rainbow trout liver and kidney preparations to produce L-ascorbic acid with an added source of L-gulono-gamma-lactone oxidase (GLO) and the absence of their own GLO activity suggested that the reason for the absence of L-ascorbic acid biosynthesis in fish and in guinea pig, a scurvy-prone mammal, can be similar. Nevertheless, results of rat GLO cDNA expression in guinea pig cells and in rainbow trout proved different. In guinea pig cells, rat GLO was expressed in a functional form. Regardless of recombinant GLO transcripts detected in rainbow trout embryos, alevins and in juvenile fish, neither GLO protein nor GLO activity were found. Furthermore, production of L-ascorbic acid in transgenic rainbow trout was not revealed in feeding tests with vitamin C-free diets or after direct administration of L-gulono-gamma-lactone. These results indicate that conditions required for translation or stability of rat GLO are absent in rainbow trout tissues.
The classical form of Barlow's disease or infantile scurvy, with bruises, broken bones and sores that will not heal, is rarely seen today, but it seems to be reappearing under a different guise, when infants with borderline vitamin C depletion are assaulted with too many inoculations at one time.Moreover, it is now sometimes mistakenly diagnosed as child abuse.
It has been previously theorized that free-radical reactions led to the first life on Earth, and their ability to randomly cause mutations may have subsequently led to the evolution of life. One of the most efficient free-radical quenchers is ascorbate, which most animals manufacture endogenously. It is generally believed that, approximately 25 million years ago, an ancestor of the Anthropoidea primate suborder, which includes Homo sapiens, lost the ability to produce its own ascorbate, and all descending species inherited this genetic defect. The first of three hypotheses presented here proposes that a genetic defect, caused by either free radicals or a virus, deleted the gene needed by Anthropoidea to manufacture endogenous ascorbate. The second hypothesis proposes that this evolutionary accident permitted large numbers of free radicals to remain metabolically unquenched. The third hypothesis proposes that the presence of these excessive free radicals increased the likelihood of free-radical-induced genetic mutations, and these mutations propelled the evolution of Anthropoidea, leading to Homo sapiens.
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Gulonolactone oxidase (GLO) is the enzyme responsible for the last step of ascorbic acid biosynthesis. The aim of this study was to investigate the effect of dietary alpha-tocopherol and ascorbic acid on GLO activity in a lower vertebrate, the white sturgeon (Acipenser transmontanus). Both alpha-tocopherol and ascorbic acid modulated renal GLO activity. The increase of dietary levels of alpha-tocopherol and/or ascorbic acid significantly raised the liver concentrations of these two antioxidants and concomitantly lowered kidney's GLO activity. The results suggest that the enzyme of ascorbic acid synthetic pathway responded to the animal's antioxidant status and that its activity was downregulated by alpha-tocopherol. This is the first record of alpha-tocopherol being involved in the regulation of ascorbic acid synthesis. This new observation may provide a hypothesis for the evolutionary loss of GLO expression in teleost fishes.
An account of the journey around the world by the Austrian ship's doctor Eduard Schwarz on a sailing ship from 1857 to 1859, his successful cure of nightblindness among the sailors, and how he was maligned by some of the Viennese medical press for his view that nightblindness is a nutritional disorder.
The incidence of cardiovascular disease is increased in diabetic nephropathy. Increased oxidative stress in diabetes is believed to play an important role in the pathogenesis of atherosclerosis in diabetes. Since antioxidant vitamins, such as ascorbic acid, often are reduced in diabetes, we hypothesized that the renal clearance of ascorbic acid is increased in patients with diabetic nephropathy. Thirty-seven subjects with diabetic nephropathy were studies: 18 had microalbuminuria (30-300 mg/day albuminuria); the remainder had clinical nephropathy (> 300 mg/day albuminuria). Indices of glycemic control (glucose, hemoglobin A1C) and renal function (albuminuria and creatinine clearance) were measured in addition to serum and urinary ascorbic acid levels. Results showed that subjects with clinical nephropathy had lower mean plasma ascorbic acid (p=0.0009) and higher renal clearance of ascorbic acid (p=0.005) than those with microalbuminuria. Bivariate analysis revealed an inverse correlation between creatinine clearance and AA clearance (r=-0.42, p=0.009). There was a significant linear association between the quantity of albuminuria and ascorbic acid clearance (r=0.49, p=0.002). Thus, patients with diabetic nephropathy have reduced ascorbic acid levels due to increased ascorbic acid clearance. The decrease in antioxidant defense that arises from the low levels of vitamin C may contribute to the increased cardiovascular morbidity and mortality observed in this population.
1. Dietary histories covering 1 week were obtained from 212 men and 263 women, aged 62--90 years, who formed a random sample of the older people living in a defined area of Edinburgh. The histories were validated by 2 d weighed-diet records for 219 of the subjects. 2. Nutrient intakes are given as mean values and standard deviations, and as percentage distributions of intake relative to the recommended intakes of nutrients. Intakes are also related to factors which might affect diet adversely. 3. Mean values obtained suggested that intakes were less than recommended intakes for more nutrients for women than for men, particularly values for energy and vitamin D. Values for percentage distributions indicated that a substantial proportion of all subjects had low intakes of ascorbic acid and vitamin D, that the energy intake of many women was low and that for most nutrients a greater proportion of men than of women had the recommended intake. Factors assocIATED With significant proportions of subjects with less than the recommended intakes were mental illness in women and deafness and severe dyspnoea in men. 4. Possible action to improve the diet of the elderly is discussed.