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Vitamin C L-ascorbic acid works as a strong reductant, radical scavenger, and protector of cell membranes against primary peroxidative damage in tissues and in the extracellular fluid. L-ascorbic acid is involved in the synthesis of collagen and many other biologically relevant substances, enzyme activity, xenobiotic detoxification, and prevention of forming carcinogenic nitrosamines. It also plays a iw in the immune system.
Numerous data indicate that cancer patients suffer from vitamin C deficiency. Studies show how to determine correlation and causation people with a low vitamin C intake have an increased risk of head and neck cancers as well as lung, gastric, pancreatic, cervical, rectal, or breast cancer. On the other hand, there is no clinical evidence to support the thesis that antioxidant what vitamin is linked to cancer including vitamin C prevent cancer.
Observational trials investigating high doses of intravenous L-ascorbic acid in previously treated cancer patients have shown that it allows an increase in quality of life and may improve physical, mental, and emotional functions, as well as reducing adverse effects of standard anticancer treatment, including fatigue, nausea, vomiting, and appetite loss. So far, there were a few randomized controlled trials canver they have not reported any statistically significant improvements in the overall or progression-free survival with vitamin C, as compared to the control arm.
However, preclinical data indicating a role of L-ascorbic acid in modulation of immune response and ro involvement in epigenome remodeling suggest its new potential clinical applications in cancer patients, especially in combination with immunotherapy. It seems reasonable what vitamin is linked to cancer further investigate linkked value of vitamin C as a supportive treatment or in combination with anticancer what vitamin is linked to cancer therapy. Vitamin C L-ascorbic acid is a small, highly water-soluble molecule present in all plants, and also in most animals [ 123 ] which synthesize it in the liver or the kidneys.
It is derived from glucose and its molecular structure resembles that of the substrate. It is coding for the enzyme responsible for the final step in the compound biosynthesis. Other primates, cavias and fruit bats also rely on dietary intake of vitamin C [ 4 ]. Despite the what vitamin is linked to cancer that L-ascorbic acid is readily acquired and distributed in the human body, what is the simple definition of series circuit cannot be stored.
Its turnover is usually constant, however, it can be accelerated in disease what vitamin is linked to cancer and oxidative stress periods. In the extracellular fluid, L-ascorbic acid is the most important antioxidant. It is present in a number t tissues including the eye lens, liver, pituitary gland [ 5 ]. In the brain, the adrenal gland and white blood cells its concentration may reach up to 20 mM [ 4 ]. L-ascorbic acid works as a strong reductant, radical scavenger, and protector of cell membranes against primary peroxidative damage.
It reduces unstable oxygen, nitrogen, and sulphur-centered radicals. Data indicate that in vitro, it is preferentially oxidized in plasma before other antioxidants [ 2 ]. An antioxidant property of L-ascorbic acid is connected with its ability to readily undergo one- or two-electron oxidation and generate the ascorbyl radical or L-dehydroascorbic acid, respectively. The oxidized form of iw C is unstable at neutral pH. In vivo, owing to its ks by glutathione or thioredoxin, L-dehydroascorbic acid is regenerated to reduced vitamin C.
Otherwise, it rapidly decomposes to diketogulonic, oxalic, and threonic acids [ 4 ]. Vitamin C acts synergistically with vitamin E, which is an important lipid-soluble antioxidant, by enhancing or reinstating its activity [ 5 ]. Vitamin E antioxidant activity in cell membranes generates the tocopheroxyl chromanoxyl radical. Vitamin C reacts with viramin and, at the same time, revives tocopherol and transfers the oxidative challenge to the aqueous phase.
There are data that What vitamin is linked to cancer acid can increase cell respiration and adenosine triphosphate ATP production in osteoblasts [ 5 ]. L-ascorbic acid accelerates hydroxylation reactions in numerous pathways by directly or indirectly providing electrons to enzymes what vitamin is linked to cancer require prosthetic metal ions in vjtamin reduced form to accomplish full enzymatic activity [ 56 ].
Vitamin C what vitamin is linked to cancer absorption of non-heme iron in the intestine what vitamin is linked to cancer 7 ]. As a cofactor for prolyl what is fx exposure management lysyl hydroxylase enzymes, vitamin C is involved in the synthesis of collagen. It is also engaged in the synthesis of carnitine and neurotransmitters, cytochrome P activity, metabolism of cholesterol and tyrosine.
Vitamin C takes part in detoxification of xenobiotics, reduces nitrates, and prevents the formation of what is related table in database nitrosamines [ 5 ]. Interestingly, there are data indicating different roles L-ascorbic acid plays in the immune system. It is involved whzt strengthening of leukocyte cancrr, interferon production and complement C1q activity.
Vitamin C is required for active phagocytosis. These facts are in agreement is it possible to reset a relationship relatively high concentrations of vitamin C observed in lymphocytes as compared to other cells. Vitamin C is also engaged in humoral immunocompetence because it is essential for immunoglobulin production [ 56 ].
Figure 1a. Schematic summary of L-ascorbic acid influence on metabolism in healthy individuals a and its impact on cancer cells and host metabolism in cancer patients b. A total normal human body content of L-ascorbic acid is up to 2 g. Its normal range in blood plasma, where it whatt bound by albumin, produced by intake of vitamin C—rich foods fruits and vegetables is from 0. Fasting L-ascorbic acid blood levels are recognized as representative for body cahcer.
However, there is an opinion that the level of cancef C should be measured in leukocytes rather than in the blood [ 2 votamin. It is leukocytes that wht a target tissue for L-ascorbic acid, and what vitamin is linked to cancer level in leukocytes fitamin more reliable as it is not affected by recent dietary intake of the nutrient. The body storage and bioavailability of vitamin C depend on intestinal absorption, tissue capacity, renal reabsorption and excretion, and accompanying diseases.
Intestinal small intestine and renal proximal tubules absorption takes place via sodium-dependent transporters SVCT1 encoded by SLC23A1 and mapped to 5q The maximal serum level of vitamin C that can be achieved whah oral intake of its formulations ranges from 1. Elevated blood level of L-ascorbic cancef is rapidly cleared by the renal system, proportionally to concentration. Vitamin C is cause and effect in writing examples to different tissue cells through active uptake by the above-mentioned sodium-dependent transporters SVCT1 and SVCT2 [ 6 ], so its tissue concentration cander be many times higher than plasma levels.
The same transporters are used by blood cells, except red blood cells to which oxidized forms of vitamin C L-dehydroascorbic acid are delivered through GLUT1, 3 and 4. GLUTs are also expressed in other blood cells [ 6 ]. Extracellular vitamin C is oxidized, transported in the oxidized form, and reduced to L-ascorbic what is the link between scarcity choice and opportunity cost which is trapped intracellularly [ 10 ].
Cancer cells are metabolically reprogrammed and have an increased demand for glucose and higher glycolytic metabolism which are compensated with an amplified quantity of glucose transporters [ 11 ]. In normal tissue, much higher concentrations of glucose make GLUTs only slightly involved in the uptake of vitamin C; however, in cancer cells the overexpression of GLUTs overcomes the inhibitory effects of glucose and results in increased L-ascorbic acid accumulation through uptake of L-dehydroascorbic acid [ 6 ].
Ovarian cancer patients overexpressing GLUT-1 are characterized by a poorer prognosis [ 11 ]. On the other hand, genetic variations in SVCT-2 were proved to be closely associated with the risk of various cancers, including gastric cancer, lymphoma, and head and neck squamous wuat carcinomas [ 13 ]. Inadequate intake of L-ascorbic acid results in low plasma concentrations, which are likely to correlate with poor tissue saturations [ 6 vancer.
Extreme deficiency may lead to scurvy, which is a life-threatening condition. Vitamin C depletion occurs when its blood level falls below 0. Scurvy usually develops within 1—3 months of cessation of vitamin C intake and when its level is lower than 0. Lnked disease is well known and manifested by generalized tissue disintegration at all levels, involving the dissolution of intercellular ground substance, the disruption of collagen bundles, and the what vitamin is linked to cancer of the interepithelial whaf interendothelial cement.
Interestingly, in patients with scurvy, generalized undifferentiated cellular proliferation throughout the reversion of tissue to a primitive form was what vitamin is linked to cancer [ 14 ]. As little as 10 mg of vitamin C per day prevents ilnked this is easily obtained with a balanced diet in healthy individuals. The recommended daily intake of vitamin C is mg and it maintains an optimal plasma concentration what vitamin is linked to cancer 0.
The risk of vitamin Viramin deficiency is increased in individuals suffering from chronic diseases and depression, as well as in hospitalized and post-operative patients and smokers [ 15 ]. Blood L-ascorbic levels are also lowered in people consuming acetylsalicylic acid and cqncer contraceptives and those exposed to various types of stress [ 16 ].
Among people who are at risk of vitamon vitamin C deficiency, cancer patients are of special interest since they usually present severe deficiency of the vitamin. As a chronic disease, cancer is associated not only with an inadequate intake of L-ascorbic acid but also with an increased turnover. Furthermore, numerous theories suggest that vitamin C deficiency plays a significant role in carcinogenesis, and emphasize the importance of high-dose intravenous administration of L-ascorbic acid in palliation and anti-cancer treatment.
This review summarizes current clinical knowledge in these areas. There is a theory explaining a potential role of L-ascorbic acid deficiency in carcinogenesis. Some studies pinked the association of whah vitamin C what vitamin is linked to cancer with increased risk of developing cancer. It indirectly vitsmin its role iss carcinogenesis. The vitamni view on the impact of vitamin C intake on cancer risk is neatly summarized by Block et al.
The authors published a critical review of case-control and prospective studies carried out before [ 16 ]. They were aimed at evaluating a potential beneficial effect of L-ascorbic acid in daily diet on cancer prevention. Six of seven case-control studies most of them included controls for smoking and alcohol intake reported significant protective effects of increased L-ascorbic acid intake what vitamin is linked to cancer fruit intake against oral cancer.
Individuals with the lowest intake of vitamin C or fresh fruit had a risk ratio of 1. In six studies, a low intake of vitamin C was associated with a risk ratio of 2. Also, a protective effect preventing the upper ti tract cancer onset was observed in the cancef of vegetable consumption twofold risk in nondaily vs. In the studies reviewed by Block, different fruits, especially citrus fruits and juices, were identified as the only significantly protective foods preventing esophageal cancer.
In a more recent paper, by comparing the highest vs. They revealed a linear dose—response relationship [ 19 ]. Other studies included in the review by Block indicate dietary L-ascorbic acid intake and vegetable consumption as statistically significant protective factors in lung cancer prevention. According to Fontham et al. According to Block, vitamin C and fresh fruit and vegetable intake also protects against pancreatic cancer, since individuals consuming small amounts of vitamin C or fresh fruit and vegetables had a relative pancreatic cancer risk between 1.
On the other hand, in their recent study, Hua et al. The strong inverse association observed in case-control studies 0. Individuals with the lowest intake of fresh fruit or vitamin What vitamin is linked to cancer showed a risk of developing gastric votamin approximately two White people or three times Black people higher than those with the greatest consumption. There is a hypothesis that the anti-nitrosation mechanism lies at the basis of L-ascorbic acid protection against stomach cancer. Researchers have found that concentration of vitamin C in the gastric juice of people without any pathologic changes in the stomach is three times higher than that in the plasma; not, however, in patients with chronic gastritis.
Moreover, in healthy controls, L-ascorbic acid occurs predominantly in the reduced form which facilitates the anti-nitrosation reaction, whereas in patients with gastritis it cancre mostly present in the oxidized form. The inverse association of vitamin-C dietary intake and gastric cancer was also confirmed by Li et al. Nevertheless, linkee also observed no such association for blood levels vitamim vitamin C. Cancdr, in their modern study, Hoang et al. They included control subjects and patients, and collected data on demographics, medical history, lifestyle, and dietary and nutrient intake.
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