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Kassa HL, Singh S, Douglas-Jones M, Schermbrucker G, De Lange J, Phoya F, Butters C, Hlela C, Coetzee A, Banderker E, Webb K. Scurvy masquerading as IgA vasculitis. Pediatr Rheumatol Online J 2024; 22:56. [PMID: 38760753 PMCID: PMC11102241 DOI: 10.1186/s12969-024-00992-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Vitamin C deficiency, or scurvy, is rare but poses risks for children with poor diets, limited resources, or malabsorption issues. It may also be common in children with restrictive or selective dietary habits in children with global developmental delay, autism spectrum disorder, and physical disabilities. Symptoms include fatigue, irritability, joint and muscle pain, joint swellings, edema, swollen gums, easy bruising, and delayed wound healing. Early recognition and prompt intervention are essential to prevent the progression of symptomatic vitamin C deficiency in children. CASE PRESENTATION We present a case of a 13-year-old boy with developmental delay secondary to Lennox Gastaut syndrome referred for suspected recurrent, severe, and atypical IgA vasculitis. He presented with irritability, loss of appetite, petechial and ecchymotic lower limb lesions, unilateral gum swelling, severe arthritis, peripheral oedema, severe weight loss, anaemia, and raised inflammatory markers. Multiple investigations were performed before the diagnosis of scurvy was made. A surgical finding of friable gingival tissue with multiple loose teeth, a skin biopsy with follicular hyperkeratosis and extravasated perifollicular red blood cells, and a typical X-ray finding led to the diagnosis of scurvy. CONCLUSION Scurvy should be given careful consideration as a differential diagnosis in patients presenting with musculoskeletal issues, mucocutaneous complaints, and constitutional symptoms such as malaise, asthenia, irritability, and loss of appetite. A focused and detailed dietary history looking for a lack of good sources of vitamin C can be an easy indicator of this differential. Imaging studies revealing the typical features can also help make the diagnosis. Pathology of the skin revealing pathognomonic features can add to the certainty of the diagnosis. In the absence of all else, the rapid response to treatment with an appropriate dose of vitamin C has a diagnostic and therapeutic role.
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Affiliation(s)
- Hanna L Kassa
- Department of Pediatric Rheumatology, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.
| | - S Singh
- National Health Laboratory Service, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - M Douglas-Jones
- Department of Maxillofacial and Oral Surgery, Groote Schuur and Red Cross Children's Hospital, University of the Western Cape, Cape Town, South Africa
| | | | - J De Lange
- Department of Maxillofacial and Oral Surgery, Groote Schuur and Red Cross Children's Hospital, University of the Western Cape, Cape Town, South Africa
| | - Frank Phoya
- Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Claire Butters
- Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Carol Hlela
- Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Ashton Coetzee
- Department of Paediatric Nephrology, Red Cross Childrens Hospital, University of Cape Town, Cape Town, South Africa
| | - Ebrahim Banderker
- Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Kate Webb
- Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa
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2
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Du T, Kulkarni A. Scurvy in an Adolescent: A Case Report. Cureus 2024; 16:e58782. [PMID: 38784361 PMCID: PMC11112398 DOI: 10.7759/cureus.58782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Scurvy is a rare condition characterized by a deficiency in dietary vitamin C. Historically a disease taught in the context of long ocean voyages with limited vitamin intake, it is now rare in developed nations. The classical physical exam findings include gingival bleeding, perifollicular hemorrhages, and corkscrew hairs. We discuss the case of a 15-year-old female with scurvy whose initial presentation suggested more common diagnoses seen in the emergency department setting. Her course was complicated by a prior history of anorexia nervosa and a restrictive diet that lacked necessary vitamins. Once the patient's dietary habits were identified, a detailed physical exam revealed the characteristic findings. She was subsequently discharged with oral vitamin C supplements and was scheduled for outpatient follow-up to monitor symptoms.
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Affiliation(s)
- Tony Du
- Pediatric Emergency Medicine, Baylor College of Medicine, Houston, USA
| | - Abhay Kulkarni
- Pediatric Emergency Medicine, Baylor College of Medicine, Houston, USA
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3
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Arora SK, Jana M, Seth R. Unusual case of 'scorbutic proptosis'. BMJ Case Rep 2024; 17:e253380. [PMID: 38296501 PMCID: PMC10831456 DOI: 10.1136/bcr-2022-253380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024] Open
Abstract
Proptosis is a frequent presenting symptom/sign of many paediatric malignancies. Acute-onset proptosis is an ophthalmic emergency that can endanger vision if not treated promptly. Appropriate treatment must be instituted only after investigating for the underlying aetiology. Here, we report a developmentally delayed boy in middle childhood who presented with recent onset bilateral proptosis. Clinical examination followed by radiological evaluation suggested scurvy to be the underlying cause and vitamin C supplementation led to prompt reversal of proptosis. The relevant literature has been reviewed and presented here to apprise the paediatric oncologists about this rare but easily treatable cause of proptosis.
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Affiliation(s)
- Shilpa Khanna Arora
- Pediatrics, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Manisha Jana
- Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), NewDelhi, India
| | - Rachna Seth
- Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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De Luca F, Pasini A, Scianò F, Zedda N, Guarnieri C, Masotti S, Bramanti B, Gualdi-Russo E, Rinaldo N. "Heal the sick": Health status and caregiving during the 17th-18th century in Northern Italy (St. Biagio cemetery, Ravenna). AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 183:125-140. [PMID: 37830270 DOI: 10.1002/ajpa.24861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/16/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE The study of health-related care provision in archeology gives important indications on the culture and community organization of past populations. This study aims to assess the health status of the skeletal assemblage recovered from the burial site of St. Biagio (Ravenna, 17th-18th Centuries); next, we identified likely instances of need for and receipt of caregiving in response to the condition, to examine evidence of community attitudes toward disease and disability. MATERIALS AND METHODS The skeletal assemblage is composed of 133 individuals in a generally good state of preservation. Sex and age-at-death were estimated through classical anthropological methods. Health status was inferred through the biological index of frailty (BIF) and paleopathological analysis was performed through macroscopic and radiographic investigations. The "bioarcheology of care" approach was applied to individuals who showed evidence of impairment and disability. RESULTS The skeletal assemblage of St. Biagio was equally represented by males and females (50% males), with a higher percentage of adults (83.4%) than subadults (10.5%), and this is reflected in the high life expectancy at birth (40.3 years). No significant differences in health status emerged between age groups and sexes, with a generally high percentage of joint diseases, antemortem trauma, and infectious diseases. Evidence of care and compassion was found in some individuals with a high degree of impairment or disability, as in the case of probable Angelman syndrome. DISCUSSION This study provided important insights into the biological and social aspects of an Early Modern population in Northern Italy, showing that people with functional and/or visible abnormalities were probably cared for in life and were presumably considered full members of the society.
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Affiliation(s)
- Federica De Luca
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Alba Pasini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Filippo Scianò
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- UOC Gastroenterologia, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Nicoletta Zedda
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Chiara Guarnieri
- Archaeological Heritage Office, Superintendence SABAP Bologna, Modena, Reggio Emilia, Ferrara, Bologna, Italy
| | - Sabrina Masotti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Barbara Bramanti
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Emanuela Gualdi-Russo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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5
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Shen J, Fan Z. Ce 4+/Ce 3+ as the switch of AIE-copper nanoclusters for highly selective detection of ascorbic acid in soft drinks. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 302:123070. [PMID: 37390716 DOI: 10.1016/j.saa.2023.123070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023]
Abstract
An ultrasimple "turn-on" sensor for indirectly detecting ascorbic acid (AA) was prepared using N-acetyl-L-cysteine stabilized copper nanoclusters (NAC-CuNCs) via the AIE (aggregation-induced emission) effect controlled by Ce4+/Ce3+ redox reaction. This sensor fully utilizes the different properties of Ce4+ and Ce3+. Non-emissive NAC-CuNCs were synthesized by a facile reduction method. NAC-CuNCs easily aggregate in the presence of Ce3+ due to AIE, resulting in fluorescence enhancement. However, this phenomenon cannot be observed in the presence of Ce4+. Ce4+ possesses strong oxidizing ability and produces Ce3+ by reacting with AA via a redox reaction, followed by switching on the luminescence of NAC-CuNCs. Moreover, the fluorescence intensity (FI) of NAC-CuNCs increases with the concentration of AA in the range of 4-60 µM, with the limit of detection (LOD) as low as 0.26 µM. This probe with excellent sensitivity and selectivity was successfully used in the determination of AA in soft drinks.
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Affiliation(s)
- Jingxiang Shen
- School of Chemistry and Material Science, Shanxi Normal University, Taiyuan 030000, People's Republic of China; Department of Chemistry, Changzhi University, Changzhi 046011, People's Republic of China
| | - Zhefeng Fan
- School of Chemistry and Material Science, Shanxi Normal University, Taiyuan 030000, People's Republic of China.
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6
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Kinlin LM, Weinstein M. Scurvy: old disease, new lessons. Paediatr Int Child Health 2023; 43:83-94. [PMID: 37795755 DOI: 10.1080/20469047.2023.2262787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
Scurvy, the condition associated with severe vitamin C deficiency, is believed to be one of the oldest diseases in human history. It was particularly prevalent during the Age of Sail, when long sea voyages without access to fresh food resulted in an epidemic which claimed millions of lives; however, scurvy has existed across time and geography, occurring whenever and wherever diets are devoid of vitamin C. Young children, specifically, were affected by the emergence of 'infantile scurvy' in the 19th century owing to the use of heated milk and manufactured infant foods of poor nutritional quality. Scurvy continues to occur in at-risk groups. In children and youths, it is primarily observed in the context of autism spectrum disorder and feeding problems such as a limited food repertoire and high-frequency single food intake. Diagnosis may be delayed and invasive testing undertaken owing to clinicians' lack of familiarity with the disease, or the mistaken assumption that it is exclusively a disease of the past. The aetiology, clinical manifestations and treatment of scurvy are described. Its long history and current epidemiology are also reviewed, demonstrating that scurvy is very much a disease of the present. It is suggested that future efforts should focus on (i) anticipatory guidance and early nutritional intervention, informed by an understanding of scurvy's epidemiology, with the aim of preventing the disease in those at risk, and (ii) prompt recognition and treatment to minimise morbidity and healthcare costs.Abbreviations: ASD: autism spectrum disorder.
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Affiliation(s)
- Laura M Kinlin
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael Weinstein
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
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7
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Robin CJ, Robin KJ, Maier MA, Stevens ES. A Rare Presentation of Scurvy in a Well-Nourished Patient. Cureus 2023; 15:e46379. [PMID: 37927702 PMCID: PMC10620061 DOI: 10.7759/cureus.46379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 11/07/2023] Open
Abstract
Vitamin C deficiency, otherwise known as scurvy, is a rare diagnosis among populations with adequate nutritional resources. We present a 37-year-old female patient with bilateral lower extremity edema, episodic anasarca, petechiae, and easy bruising who was diagnosed with scurvy. Given the clinical presentation, a broad differential was investigated with no findings suggestive of hematologic or cardiovascular pathology. Initial laboratory studies were unremarkable. Progression of cutaneous symptoms and subsequent laboratory findings demonstrating low vitamin C levels supported a diagnosis of scurvy. Classical symptoms of scurvy include mucocutaneous petechiae, poor wound healing, ecchymosis, hyperkeratosis, corkscrew hair, gingival swelling, and bleeding gums. Following standard enteral supplementation of vitamin C, repeat vitamin C levels failed to adequately respond with the patient remaining to be symptomatic. Given a lack of insufficient nutritional intake or known systemic illness, gastrointestinal malabsorptive etiology was suspected. Though rare in the United States, scurvy should be considered in patients with manifestations of a bleeding disorder. A gastrointestinal workup may be indicated if other nutritional deficiencies are identified, or a source of inadequate intake cannot be established.
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Affiliation(s)
- Connor J Robin
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
| | - Kaleb J Robin
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
| | - Mark A Maier
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
| | - Elyse S Stevens
- Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
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8
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Sánchez-Velázquez OA, Luna-Vital DA, Morales-Hernandez N, Contreras J, Villaseñor-Tapia EC, Fragoso-Medina JA, Mojica L. Nutritional, bioactive components and health properties of the milpa triad system seeds (corn, common bean and pumpkin). Front Nutr 2023; 10:1169675. [PMID: 37538927 PMCID: PMC10395131 DOI: 10.3389/fnut.2023.1169675] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 06/13/2023] [Indexed: 08/05/2023] Open
Abstract
The milpa system is a biocultural polyculture technique. Heritage of Mesoamerican civilizations that offers a wide variety of plants for food purposes. Corn, common beans, and pumpkins are the main crops in this agroecosystem, which are important for people's nutritional and food security. Moreover, milpa system seeds have great potential for preventing and ameliorating noncommunicable diseases, such as obesity, dyslipidemia, type 2 diabetes, among others. This work reviews and analyzes the nutritional and health benefits of milpa system seeds assessed by recent preclinical and clinical trials. Milpa seeds protein quality, vitamins and minerals, and phytochemical composition are also reviewed. Evidence suggests that regular consumption of milpa seeds combination could exert complementing effect to control nutritional deficiencies. Moreover, the combination of phytochemicals and nutritional components of the milpa seed could potentialize their individual health benefits. Milpa system seeds could be considered functional foods to fight nutritional deficiencies and prevent and control noncommunicable diseases.
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Affiliation(s)
- Oscar Abel Sánchez-Velázquez
- Tecnología Alimentaria, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Zapopan, Mexico
| | | | - Norma Morales-Hernandez
- Tecnología Alimentaria, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Zapopan, Mexico
| | - Jonhatan Contreras
- Tecnología Alimentaria, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Zapopan, Mexico
| | - Elda Cristina Villaseñor-Tapia
- Tecnología Alimentaria, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Zapopan, Mexico
| | | | - Luis Mojica
- Tecnología Alimentaria, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Zapopan, Mexico
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9
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Musa M, Zeppieri M, Atuanya GN, Enaholo ES, Topah EK, Ojo OM, Salati C. Nutritional Factors: Benefits in Glaucoma and Ophthalmologic Pathologies. Life (Basel) 2023; 13:life13051120. [PMID: 37240765 DOI: 10.3390/life13051120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/19/2023] Open
Abstract
Glaucoma is a chronic optic neuropathy that can lead to irreversible functional and morphological damage if left untreated. The gold standard therapeutic approaches in managing patients with glaucoma and limiting progression include local drops, laser, and/or surgery, which are all geared at reducing intraocular pressure (IOP). Nutrients, antioxidants, vitamins, organic compounds, and micronutrients have been gaining increasing interest in the past decade as integrative IOP-independent strategies to delay or halt glaucomatous retinal ganglion cell degeneration. In our minireview, we examine the various nutrients and compounds proposed in the current literature for the management of ophthalmology diseases, especially for glaucoma. With respect to each substance considered, this minireview reports the molecular and biological characteristics, neuroprotective activities, antioxidant properties, beneficial mechanisms, and clinical studies published in the past decade in the field of general medicine. This study highlights the potential benefits of these substances in glaucoma and other ophthalmologic pathologies. Nutritional supplementation can thus be useful as integrative IOP-independent strategies in the management of glaucoma and in other ophthalmologic pathologies. Large multicenter clinical trials based on functional and morphologic data collected over long follow-up periods in patients with IOP-independent treatments can pave the way for alternative and/or coadjutant therapeutic options in the management of glaucoma and other ocular pathologies.
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Affiliation(s)
- Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Edo State, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | | | | | - Efioshiomoshi Kings Topah
- Department of Optometry, Faculty of Allied Health Sciences, College of Health Sciences Bayero University, Kano 700006, Kano State, Nigeria
| | - Oluwasola Michael Ojo
- School of Optometry and Vision Sciences, College of Health Sciences, University of Ilorin, Ilorin 240003, Kwara State, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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10
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Jones R, Shafiq L, Idowu B, Radhakrishnan NS, Fromm J. Abdominal Ecchymosis: Emergency, or Urgen-C? Cureus 2023; 15:e38091. [PMID: 37252579 PMCID: PMC10209748 DOI: 10.7759/cureus.38091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/31/2023] Open
Abstract
Scurvy is a multisystem disease caused by vitamin C deficiency, historically associated with lethargy, gingivitis, ecchymosis, edema, and death if left untreated. Contemporary socioeconomic risk factors for scurvy include smoking, alcohol abuse, fad diets, mental health conditions, social isolation, and economic marginalization. Food insecurity is also a risk factor. This report describes a case of a man in his 70s who presented with unexplained dyspnea, abdominal pain, and abdominal ecchymosis. His plasma vitamin C level was undetectable, and he improved with vitamin C supplementation. This case highlights the significance of awareness of these risk factors and emphasizes the need for a comprehensive social and dietary history to enable the timely treatment of this rare but potentially fatal disease.
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Affiliation(s)
- Riley Jones
- Medicine, University of Florida College of Medicine, Gainesville, USA
| | - Leila Shafiq
- Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Benmichael Idowu
- Medicine, University of Florida College of Medicine, Gainesville, USA
| | | | - Jason Fromm
- Medicine, University of Florida College of Medicine, Gainesville, USA
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11
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Wang M, He J, Li S, Cai Q, Zhang K, She J. Structural basis of vitamin C recognition and transport by mammalian SVCT1 transporter. Nat Commun 2023; 14:1361. [PMID: 36914666 PMCID: PMC10011568 DOI: 10.1038/s41467-023-37037-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/28/2023] [Indexed: 03/15/2023] Open
Abstract
Vitamin C (L-ascorbic acid) is an essential nutrient for human health, and its deficiency has long been known to cause scurvy. Sodium-dependent vitamin C transporters (SVCTs) are responsible for vitamin C uptake and tissue distribution in mammals. Here, we present cryogenic electron microscopy structures of mouse SVCT1 in both the apo and substrate-bound states. Mouse SVCT1 forms a homodimer with each protomer containing a core domain and a gate domain. The tightly packed extracellular interfaces between the core domain and gate domain stabilize the protein in an inward-open conformation for both the apo and substrate-bound structures. Vitamin C binds at the core domain of each subunit, and two potential sodium ions are identified near the binding site. The coordination of sodium ions by vitamin C explains their coupling transport. SVCTs probably deliver substrate through an elevator mechanism in combination with local structural arrangements. Altogether, our results reveal the molecular mechanism by which SVCTs recognize vitamin C and lay a foundation for further mechanistic studies on SVCT substrate transport.
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Affiliation(s)
- Mingxing Wang
- MOE Key Laboratory for Cellular Dynamics, Hefei National Research Center for Interdisciplinary Sciences at the Microscale, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
- Center for Advanced Interdisciplinary Science and Biomedicine of IHM, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
- Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, 230026, China
| | - Jin He
- MOE Key Laboratory for Cellular Dynamics, Hefei National Research Center for Interdisciplinary Sciences at the Microscale, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
- Center for Advanced Interdisciplinary Science and Biomedicine of IHM, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
- Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, 230026, China
| | - Shanshan Li
- MOE Key Laboratory for Cellular Dynamics, Hefei National Research Center for Interdisciplinary Sciences at the Microscale, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
- Center for Advanced Interdisciplinary Science and Biomedicine of IHM, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
- Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, 230026, China
| | - Qianwen Cai
- MOE Key Laboratory for Cellular Dynamics, Hefei National Research Center for Interdisciplinary Sciences at the Microscale, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Kaiming Zhang
- MOE Key Laboratory for Cellular Dynamics, Hefei National Research Center for Interdisciplinary Sciences at the Microscale, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China.
- Center for Advanced Interdisciplinary Science and Biomedicine of IHM, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China.
- Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, 230026, China.
| | - Ji She
- MOE Key Laboratory for Cellular Dynamics, Hefei National Research Center for Interdisciplinary Sciences at the Microscale, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China.
- Center for Advanced Interdisciplinary Science and Biomedicine of IHM, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China.
- Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, 230026, China.
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12
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Adil S, Jana AH, Mehta BM, Darji VB. Value addition to frozen yoghurt through the use of orange peel solids as flavour adjunct. INT J DAIRY TECHNOL 2022. [DOI: 10.1111/1471-0307.12930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Shaikh Adil
- Dairy Technology Department Parul Institute of Technology, Parul University 391 760 Gujarat Vadodara India
| | - Atanu H Jana
- Principal, SMC College of Dairy Science Kamdhenu University 388 110 Gujarat Anand India
| | - Bhavbhuti M Mehta
- Dairy Chemistry Department, SMC College of Dairy Science Kamdhenu University 388 110 Gujarat Anand India
| | - V B Darji
- Department of Agriculture Science, College of AIT Anand Agricultural University 388 110 Gujarat Anand India
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13
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Muacevic A, Adler JR, Turney K, Driscoll M. Scurvy: A Diagnosis Not to Be Missed. Cureus 2022; 14:e33050. [PMID: 36721542 PMCID: PMC9881687 DOI: 10.7759/cureus.33050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/29/2022] Open
Abstract
Vitamin C deficiency, one of the oldest-known nutritional disorders, is now uncommon in high-income countries. Recently, however, there has been an increase in cases of vitamin C deficiency, also known as scurvy. We report three adult patients with histories of homelessness, food insecurity, and poor nutrition, making them particularly vulnerable to restrictive diets and at increased risk for scurvy. After proper diagnosis and treatment, favorable outcomes can be rapidly obtained. This case series emphasizes the importance of keeping a broad differential diagnosis and inquiring about nutritional history in patients presenting with purpura, gingival bleeding, and body hair changes.
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14
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Uttam Gawas R, Thakuri A, Acharya R, Banerjee M, Chatterjee A. Amplification of AIE-effect of tetraphenylethylene on solid support: Formation of a sensitive fluorescent nanosensor for turn-on detection of Cu2+ and successive sensing of ascorbate ions. Inorganica Chim Acta 2022. [DOI: 10.1016/j.ica.2022.121097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Determination of tissue-specific interaction between vitamin C and vitamin E in vivo using senescence marker protein-30 knockout mice as a vitamin C synthesis deficiency model. Br J Nutr 2022; 128:993-1003. [PMID: 34725010 PMCID: PMC9381305 DOI: 10.1017/s0007114521004384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Vitamin E (α-tocopherol; VE) is known to be regenerated from VE radicals by vitamin C (L-ascorbic acid; VC) in vitro. However, their in vivo interaction in various tissues is still unclear. Therefore, we alternatively examined the in vivo interaction of VC and VE by measurement of their concentrations in various tissues of senescence marker protein-30 (SMP30) knockout (KO) mice as a VC synthesis deficiency model. Male SMP30-KO mice were divided into four groups (VC+/VE+, VC+/VE-, VC-/VE+ and VC-/VE-), fed diets with or without 500 mg/kg VE and given water with or without 1·5 g/l VC ad libitum. Then, VC and VE concentrations in the plasma and various tissues were determined. Further, gene expression levels of transporters associated with VC and VE, such as α-tocopherol transfer protein (α-TTP) and sodium-dependent vitamin C transporters (SVCTs), were examined. These results showed that the VE levels in the VC-depleted (VC-/VE+) group were significantly lower than those in the VC+/VE+ group in the liver and heart; the VC levels in the VE-depleted (VC+/VE-) group were significantly lower than those in the VC+/VE+ group in the kidneys. The α-TTP gene expression in the liver and kidneys was decreased by VC and/or VE depletion. Moreover, SVCT1 gene expression in the liver was decreased by both VC and VE depletion. In conclusion, these results indicate that VC spares VE mainly in the liver and heart and that VE spares VC in the kidneys of SMP30-KO mice. Thus, interaction between VC and VE is likely to be tissue specific.
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Affiliation(s)
- K Ishizuka
- Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa 216-8511, Japan
| | - Y Ohira
- Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa 216-8511, Japan.
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17
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The Impact of Chronic Kidney Disease on Nutritional Status and Its Possible Relation with Oral Diseases. Nutrients 2022; 14:nu14102002. [PMID: 35631140 PMCID: PMC9143067 DOI: 10.3390/nu14102002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/02/2022] [Accepted: 05/07/2022] [Indexed: 02/01/2023] Open
Abstract
Several studies have demonstrated a strong relation between periodontal diseases and chronic kidney disease (CKD). The main mechanisms at the base of this link are malnutrition, vitamin dysregulation, especially of B-group vitamins and of C and D vitamins, oxidative stress, metabolic acidosis and low-grade inflammation. In particular, in hemodialysis (HD) adult patients, an impairment of nutritional status has been observed, induced not only by the HD procedures themselves, but also due to numerous CKD-related comorbidities. The alteration of nutritional assessment induces systemic manifestations that have repercussions on oral health, like oral microbiota dysbiosis, slow healing of wounds related to hypovitaminosis C, and an alteration of the supporting bone structures of the oral cavity related to metabolic acidosis and vitamin D deficiency. Low-grade inflammation has been observed to characterize periodontal diseases locally and, in a systemic manner, CKD contributes to the amplification of the pathological process, bidirectionally. Therefore, CKD and oral disease patients should be managed by a multidisciplinary professional team that can evaluate the possible co-presence of these two pathological conditions, that negatively influence each other, and set up therapeutic strategies to treat them. Once these patients have been identified, they should be included in a follow-up program, characterized by periodic checks in order to manage these pathological conditions.
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Rauf A, Shariati MA, Imran M, Bashir K, Khan SA, Mitra S, Emran TB, Badalova K, Uddin MS, Mubarak MS, Aljohani ASM, Alhumaydhi FA, Derkho M, Korpayev S, Zengin G. Comprehensive review on naringenin and naringin polyphenols as a potent anticancer agent. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:31025-31041. [PMID: 35119637 DOI: 10.1007/s11356-022-18754-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
Though the incidence of several cancers in Western societies is regulated wisely, some cancers such as breast, lung, and colorectal cancer are currently rising in many low- and middle-income countries due to increased risk factors triggered by societal and development problems. Surgery, chemotherapy, hormone, radiation, and targeted therapies are examples of traditional cancer treatment approaches. However, multiple short- and long-term adverse effects may also significantly affect patient prognosis depending on treatment-associated clinical factors. More and more research has been carried out to find new therapeutic agents in natural products, among which the bioactive compounds derived from plants have been increasingly studied. Naringin and naringenin are abundantly found in citrus fruits, such as oranges and grapefruits. A variety of cell signaling pathways mediates their anti-carcinogenic properties. Naringin and naringenin were also documented to overcome multidrug resistance, one of the major challenges to clinical practice due to multiple defense mechanisms in cancer. The effective parameters underlying the anticancer effects of naringenin and naringin include GSK3β inactivation, suppression of the gene and protein activation of NF-kB and COX-2, JAK2/STAT3 downregulation, downregulation of intracellular adhesion molecules-1, upregulation of Notch1 and tyrocite-specific genes, and activation of p38/MAPK and caspase-3. Thus, this review outlines the potential of naringin and naringenin in managing different types of cancers.
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Affiliation(s)
- Abdur Rauf
- Department of Chemistry, University of Swabi, Anbar, Swabi, 23561, Khyber Pakhtunkhwa, Pakistan
| | - Mohammad Ali Shariati
- K.G. Razumovsky Moscow State University of Technologies and Management, The First Cossack University), 73 Zemlyanoy Val, Moscow, 109004, Russia
| | - Muhammad Imran
- Department of food science and technology, University of Narowal-Pakistan, Pakistan
- Food, nutrition and lifestyle Unit, King Fahed Medical Research Center, Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
| | - Kashif Bashir
- Department of Microbiology and Biotechnology, Abasyan University Peshawar, Peshawar, Pakistan
| | - Shahid Ali Khan
- Department of Chemistry, University of Swabi, Anbar, Swabi, 23561, Khyber Pakhtunkhwa, Pakistan
| | - Saikat Mitra
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh
| | - Kamala Badalova
- General Toxicological Chemistry Department, Azerbaijan Medical University Azerbaijan, Baku, Azerbaijan
| | - Md Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
| | | | - Abdullah S M Aljohani
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Fahad A Alhumaydhi
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Marina Derkho
- Institute of Veterinary Medicine, South-Ural State Agrarian University, Chelyabinsk Region, 13 Gagarin St, Troitsk, 454700, Russian Federation
| | - Serdar Korpayev
- Biotechnology Institute, Ankara University, 06135, Ankara, Turkey
| | - Gokhan Zengin
- Department of Biology, Science Faculty, Selcuk University, Konya, Turkey.
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20
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Frank HER, Amato K, Trautwein M, Maia P, Liman ER, Nichols LM, Schwenk K, Breslin PAS, Dunn RR. The evolution of sour taste. Proc Biol Sci 2022; 289:20211918. [PMID: 35135352 PMCID: PMC8826303 DOI: 10.1098/rspb.2021.1918] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The evolutionary history of sour taste has been little studied. Through a combination of literature review and trait mapping on the vertebrate phylogenetic tree, we consider the origin of sour taste, potential cases of the loss of sour taste, and those factors that might have favoured changes in the valence of sour taste-from aversive to appealing. We reconstruct sour taste as having evolved in ancient fish. By contrast to other tastes, sour taste does not appear to have been lost in any major vertebrate taxa. For most species, sour taste is aversive. Animals, including humans, that enjoy the sour taste triggered by acidic foods are exceptional. We conclude by considering why sour taste evolved, why it might have persisted as vertebrates made the transition to land and what factors might have favoured the preference for sour-tasting, acidic foods, particularly in hominins, such as humans.
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Affiliation(s)
- Hannah E. R. Frank
- Department of Crop and Soil Sciences North Carolina State University, Raleigh, USA
| | - Katie Amato
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Michelle Trautwein
- Entomology Department, Institute for Biodiversity Science and Sustainability, California Academy of Sciences, San Francisco, USA
| | - Paula Maia
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Emily R. Liman
- Department of Biological Sciences, Section of Neurobiology, University of Southern California, Los Angeles, CA, USA
| | - Lauren M. Nichols
- Department of Applied Ecology, North Carolina State University, Raleigh, USA
| | - Kurt Schwenk
- Department of Ecology and Evolutionary Biology, University of Connecticut, Storrs, CT, USA
| | - Paul A. S. Breslin
- Department of Nutritional Sciences, Rutgers The State University of New Jersey, New Brunswick, NJ, USA,Monell Chemical Senses Center, Philadelphia, PA, USA
| | - Robert R. Dunn
- Department of Applied Ecology, North Carolina State University, Raleigh, USA,Center for Evolutionary Hologenomics, University of Copenhagen, Copenhagen, Denmark
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21
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Doherty A, Wall A, Khaldi N, Kussmann M. Artificial Intelligence in Functional Food Ingredient Discovery and Characterisation: A Focus on Bioactive Plant and Food Peptides. Front Genet 2021; 12:768979. [PMID: 34868255 PMCID: PMC8640466 DOI: 10.3389/fgene.2021.768979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/28/2021] [Indexed: 12/12/2022] Open
Abstract
Scientific research consistently demonstrates that diseases may be delayed, treated, or even prevented and, thereby, health may be maintained with health-promoting functional food ingredients (FFIs). Consumers are increasingly demanding sound information about food, nutrition, nutrients, and their associated health benefits. Consequently, a nutrition industry is being formed around natural foods and FFIs, the economic growth of which is increasingly driven by consumer decisions. Information technology, in particular artificial intelligence (AI), is primed to vastly expand the pool of characterised and annotated FFIs available to consumers, by systematically discovering and characterising natural, efficacious, and safe bioactive ingredients (bioactives) that address specific health needs. However, FFI-producing companies are lagging in adopting AI technology for their ingredient development pipelines for several reasons, resulting in a lack of efficient means for large-scale and high-throughput molecular and functional ingredient characterisation. The arrival of the AI-led technological revolution allows for the comprehensive characterisation and understanding of the universe of FFI molecules, enabling the mining of the food and natural product space in an unprecedented manner. In turn, this expansion of bioactives dramatically increases the repertoire of FFIs available to the consumer, ultimately resulting in bioactives being specifically developed to target unmet health needs.
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22
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Borah N, Kalita AJ, Guha AK, Das MR, Tamuly C. Dual colorimetric sensing of ascorbic acid and thyroxine using Ag-EGCG-CTAB via a DFT approach. RSC Adv 2021; 11:36698-36706. [PMID: 35494345 PMCID: PMC9043532 DOI: 10.1039/d1ra04204a] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/19/2021] [Indexed: 01/06/2023] Open
Abstract
In this work, a colorimetric approach for the detection of ascorbic acid (AA) and thyroxine (TH) was developed by synthesizing cost-effective silver nanoparticles (AgNPs) decorated with epigallocatechin gallate (EGCG) and CTAB. EGCG is the major bioactive chemical constituent that played a significant role in this study. The environment around the nanoparticle (NP) was controlled by adding CTAB surfactants. The synthesized NPs were characterized by different advanced techniques including XRD, XPS, SEM, and TEM. UV-visible spectra were thoroughly analyzed for sensing of AA and TH and the colour change of the solution can be visually monitored. The change in the localized surface plasmon resonance (LSPR) properties was used as an asset for the detection of AA and TH. A good linear relationship was obtained in both the sensing schemes with a limit of detection (LoD) of 0.67 μM and 0.33 μM for AA and TH respectively. Furthermore, the nanoparticles (NP) were implemented for real-sample analysis (pharmaceutical tablets). A cost-effective filter paper strip-based method coupled with smartphone scanning sensing was developed for the detection of AA. The interaction of AA and TH with the probe was depicted by a density functional theory (DFT) analysis. The synthesized NPs show tremendous selectivity towards AA and TH and excellent potential for practical applications.
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Affiliation(s)
- Nirangkush Borah
- Natural Product Chemistry Section, CSIR-North East Institute of Science and Technology, Branch Itanagar Arunachal Pradesh-791110 India
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad-201002 India
| | | | - Ankur Kanti Guha
- Department of Chemistry, Cotton University Guwahati Assam-781001 India
| | - Manash R Das
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad-201002 India
- Material Science & Technology Division, CSIR-North East Institute of Science & Technology Jorhat Assam-785006 India
| | - Chandan Tamuly
- Natural Product Chemistry Section, CSIR-North East Institute of Science and Technology, Branch Itanagar Arunachal Pradesh-791110 India
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad-201002 India
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23
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Zhitkovich A. Ascorbate: antioxidant and biochemical activities and their importance for in vitro models. Arch Toxicol 2021; 95:3623-3631. [PMID: 34596731 DOI: 10.1007/s00204-021-03167-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/16/2021] [Indexed: 12/19/2022]
Abstract
Ascorbate has many biological activities that involve fundamental cellular functions such as gene expression, differentiation, and redox homeostasis. Biochemically, it serves as a cofactor for a large family of dioxygenases (> 60 members) which control transcription, formation of extracellular matrix, and epigenetic processes of histone and DNA demethylation. Ascorbate is also a major antioxidant acting as a very effective scavenger of primary reactive oxygen species. Reduction of Fe(III) by ascorbate is important for cellular uptake of iron via DMT1. Cell culture models are extensively used in toxicology and pharmacology for mechanistic studies of nutrients, drugs and other xenobiotics. High-throughput screens in vitro, such as a large-scale Tox21 program in the US, offers opportunities to assess hazardous properties of a vast and growing number of industrial chemicals. However, cells in typical cultures are severely deficient in ascorbate, raising concerns about their ability to accurately recapitulate toxic and other responses in vivo. Scarcity of ascorbate and a frequently unrecognized use of media with its thiol substitute alters stress sensitivity of cells in different directions. Remediation of ascorbate deficiency in tissue culture restores the physiological state of many cellular processes and it should improve a currently limited toxicity predictability of in vitro bioassays.
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Affiliation(s)
- Anatoly Zhitkovich
- Department of Pathology and Laboratory Medicine, Brown University, 70 Ship Street, Room 507, Providence, RI, 02912, USA.
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24
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Affiliation(s)
- Cayla Pichan
- From the University of Michigan Medical School (C.P.), the Department of Internal Medicine, University of Michigan Medical School (A.C., S.S., N.H.), the Veterans Affairs Ann Arbor Healthcare System Medicine Service (A.C., S.S., N.H.), and the Department of Veterans Affairs Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Department of Medicine, University of California San Francisco, and the San Francisco Veterans Affairs Medical Center - both in San Francisco (G.D.)
| | - Gurpreet Dhaliwal
- From the University of Michigan Medical School (C.P.), the Department of Internal Medicine, University of Michigan Medical School (A.C., S.S., N.H.), the Veterans Affairs Ann Arbor Healthcare System Medicine Service (A.C., S.S., N.H.), and the Department of Veterans Affairs Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Department of Medicine, University of California San Francisco, and the San Francisco Veterans Affairs Medical Center - both in San Francisco (G.D.)
| | - Alice Cusick
- From the University of Michigan Medical School (C.P.), the Department of Internal Medicine, University of Michigan Medical School (A.C., S.S., N.H.), the Veterans Affairs Ann Arbor Healthcare System Medicine Service (A.C., S.S., N.H.), and the Department of Veterans Affairs Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Department of Medicine, University of California San Francisco, and the San Francisco Veterans Affairs Medical Center - both in San Francisco (G.D.)
| | - Sanjay Saint
- From the University of Michigan Medical School (C.P.), the Department of Internal Medicine, University of Michigan Medical School (A.C., S.S., N.H.), the Veterans Affairs Ann Arbor Healthcare System Medicine Service (A.C., S.S., N.H.), and the Department of Veterans Affairs Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Department of Medicine, University of California San Francisco, and the San Francisco Veterans Affairs Medical Center - both in San Francisco (G.D.)
| | - Nathan Houchens
- From the University of Michigan Medical School (C.P.), the Department of Internal Medicine, University of Michigan Medical School (A.C., S.S., N.H.), the Veterans Affairs Ann Arbor Healthcare System Medicine Service (A.C., S.S., N.H.), and the Department of Veterans Affairs Health Services Research and Development Center of Excellence (S.S.) - all in Ann Arbor; and the Department of Medicine, University of California San Francisco, and the San Francisco Veterans Affairs Medical Center - both in San Francisco (G.D.)
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25
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Harve‐Rytsälä H, Paal P, Kurola J. To the Moon and beyond-Pushing boundaries in critical emergency medicine. Acta Anaesthesiol Scand 2021; 65:717-718. [PMID: 33638867 DOI: 10.1111/aas.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Heini Harve‐Rytsälä
- Departments of Emergency Medicine & Services Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Peter Paal
- Department of Anaesthesiology and Intensive Care Medicine Hospitallers Brothers HospitalParacelsus Medical University Salzburg Austria
| | - Jouni Kurola
- Prehospital Emergency Medicine University of Eastern Finland and Centre for Prehospital Emergency CareKuopio University Hospital. Kuopio Finland
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26
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Knapik JJ, Farina EK, Fulgoni VL, Lieberman HR. Clinically-diagnosed vitamin deficiencies and disorders in the entire United States military population, 1997-2015. Nutr J 2021; 20:55. [PMID: 34130698 PMCID: PMC8207601 DOI: 10.1186/s12937-021-00708-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 05/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background This study examined incidence rates, temporal trends, and demographic factors associated with vitamin deficiencies/disorders in all United States military personnel from 1997 to 2015 (mean N = 1,382,266/year). Methods Employing an ecological study design, the Defense Medical Epidemiological Database and specific International Classification of Diseases codes were used to determine incidence rates for clinically-diagnosed vitamin deficiencies/disorders. Associations with demographic factors were examined. Results The overall incidence rate of vitamin deficiencies/disorders was 92.7 cases/100,000 person-years (p-yr). Highest rates were for vitamin D (53.7 cases/100,000 p-yr), other B-complex vitamins (20.2 cases, 100,000 p-yr), vitamin B12 anemia (7.6 cases/100,000 p-yr), deficiencies of “other vitamins” (5.9 cases/100,000 p-yr), and vitamin A (2.5 cases/100,000 p-yr). Thiamin, riboflavin, niacin, pyridoxine, folate, vitamin C, and vitamin K deficiencies and hypervitaminoses A and D had < 1 case/100,000 p-yr. Rates for vitamin D, other B-complex, “other vitamin”, and thiamin deficiencies increased over time, while vitamin A and C deficiencies decreased. Women had higher incidence rates for all examined deficiencies/ disorders except niacin and vitamin C. Incidence rates rose with age in 8 of 15 deficiency/disorder categories and blacks had higher incidence rates in 9 of 15 deficiency/disorder categories. Conclusions The overall rate of clinically-diagnosed vitamin deficiencies and disorders was low but higher in women and minority subgroups. As for most illnesses, the diagnosed incidence of such disorders may be an underestimate of the actual incidence. These findings can guide clinical decision making with regard to testing for nutritional deficiencies and delivering public health information to at risk populations. Clinical trial registration (No. ISRCTN58987177). Registration date 9 October 2019.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - Emily K Farina
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Victor L Fulgoni
- Nutrition Impact, LLC, 9725 D Drive North, Battle Creek, MI, 49014, USA
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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Mellidou I, Koukounaras A, Kostas S, Patelou E, Kanellis AK. Regulation of Vitamin C Accumulation for Improved Tomato Fruit Quality and Alleviation of Abiotic Stress. Genes (Basel) 2021; 12:genes12050694. [PMID: 34066421 PMCID: PMC8148108 DOI: 10.3390/genes12050694] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/01/2021] [Accepted: 05/02/2021] [Indexed: 12/23/2022] Open
Abstract
Ascorbic acid (AsA) is an essential multifaceted phytonutrient for both the human diet and plant growth. Optimum levels of AsA accumulation combined with balanced redox homeostasis are required for normal plant development and defense response to adverse environmental stimuli. Notwithstanding its moderate AsA levels, tomatoes constitute a good source of vitamin C in the human diet. Therefore, the enhancement of AsA levels in tomato fruit attracts considerable attention, not only to improve its nutritional value but also to stimulate stress tolerance. Genetic regulation of AsA concentrations in plants can be achieved through the fine-tuning of biosynthetic, recycling, and transport mechanisms; it is also linked to changes in the whole fruit metabolism. Emerging evidence suggests that tomato synthesizes AsA mainly through the l-galactose pathway, but alternative pathways through d-galacturonate or myo-inositol, or seemingly unrelated transcription and regulatory factors, can be also relevant in certain developmental stages or in response to abiotic factors. Considering the recent advances in our understanding of AsA regulation in model and other non-model species, this review attempts to link the current consensus with novel technologies to provide a comprehensive strategy for AsA enhancement in tomatoes, without any detrimental effect on plant growth or fruit development.
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Affiliation(s)
- Ifigeneia Mellidou
- Institute of Plant Breeding and Genetic Resources, Hao Elgo-Demeter, 57001 Thessaloniki, Greece
- Correspondence: (I.M.); (A.K.K.)
| | - Athanasios Koukounaras
- Department of Horticulture, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (S.K.)
| | - Stefanos Kostas
- Department of Horticulture, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (S.K.)
| | - Efstathia Patelou
- Laboratory of Pharmacognosy, Group of Biotechnology of Pharmaceutical Plants, Department of Pharmaceutical Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Angelos K. Kanellis
- Laboratory of Pharmacognosy, Group of Biotechnology of Pharmaceutical Plants, Department of Pharmaceutical Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Correspondence: (I.M.); (A.K.K.)
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Dunleavy KA, Ungaro RC, Manning L, Gold S, Novak J, Colombel JF. Vitamin C Deficiency in Inflammatory Bowel Disease: The Forgotten Micronutrient. CROHN'S & COLITIS 360 2021; 3:otab009. [PMID: 34222863 PMCID: PMC8248877 DOI: 10.1093/crocol/otab009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Micronutrient deficiencies are common in patients with inflammatory bowel disease (IBD). To date, the literature has focused on vitamin D, vitamin B12, and iron deficiencies. METHODS We report a case series of 20 patients with IBD and vitamin C deficiency treated at a single tertiary care center. RESULTS Sixteen (80%) patients had symptoms of clinical scurvy, including arthralgia, dry brittle hair, pigmented rash, gingivitis, easy bruising, and/or brittle nails. Eighteen patients underwent a nutritional assessment, 10 (56%) patients reported complete avoidance of fruits and vegetables, and 3 (17%) reported reduced intake of fruits and vegetables. CONCLUSIONS Vitamin C deficiency should be considered in IBD patients, particularly those with reduced fruit/vegetable intake, as it can lead to significant signs and symptoms.
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Affiliation(s)
- Katie A Dunleavy
- Address correspondence to: Katie A. Dunleavy, MBBChBAO, 1 Gustave Levy Place, New York, NY 10029, USA ()
| | - Ryan C Ungaro
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Laura Manning
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stephanie Gold
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joshua Novak
- Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jean-Frederic Colombel
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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29
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Esteves A, Teixeira da Silva F, Carvalho J, Felgueiras P, Laranjeira P. Scurvy, Starvation, and Flea Infestation - A Case Report From 21st Century Europe. Cureus 2021; 13:e13158. [PMID: 33728161 PMCID: PMC7935234 DOI: 10.7759/cureus.13158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Scurvy is a disease caused by vitamin C deficiency, historically associated with long sea voyages, periods of famine and war. Currently, it is often misdiagnosed and underreported, as physicians tend to consider it a disease of the past. We present the case of a 79-year-old female who was admitted to the Emergency Department complaining of pruritus. The patient lived alone and in poor hygiene conditions. Diet was scarce. One week before admission she was in contact with flea-ridden stray dogs. Sometime later she noted several fleas and multiple pruritic small papules, crusts, and excoriations on her torso, limbs, palms, soles, and scalp. Physical examination showed the patient to be pale, emaciated, and poorly groomed. Laboratory analysis showed microcytic anemia. Flea bites were treated with oral antihistamines and prednisolone. Follow-up one month later showed weight gain and partial resolution of skin lesions. However, multiple small ecchymosis on both lower and upper limbs, and occasional perifollicular petechias on her lower extremities, were noted. Additional workup showed undetectable serum vitamin C levels. A diagnosis of scurvy was made. The patient was treated with 1000 mg per day of oral vitamin C for one month leading to complete recovery. We present this case to remind that early recognition of vitamin C deficiency and appropriate supplementation are essential in patients with scurvy. Physicians should be aware of classic signs, symptoms, and social factors associated with this forgotten disease.
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Affiliation(s)
- Alexandra Esteves
- Internal Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | | | - José Carvalho
- Internal Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | - Paula Felgueiras
- Internal Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | - Paulo Laranjeira
- Department of Safety, Health and Environment, School of Management and Technology, Polytechnic Institute of Porto, Porto, PRT
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30
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Villarreal-Paúl G, Ordieres-Ortega L, Galeano-Valle F, Del Toro-Cervera J, Demelo-Rodríguez P. The cobbler's children have no shoes: scurvy in a farmer. Int J Dermatol 2021; 60:761-762. [PMID: 33393090 DOI: 10.1111/ijd.15402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/08/2020] [Accepted: 12/11/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Gracia Villarreal-Paúl
- Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Lucía Ordieres-Ortega
- Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Francisco Galeano-Valle
- Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Gregorio Marañón Research Institute, Madrid, Spain
| | - Jorge Del Toro-Cervera
- Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Gregorio Marañón Research Institute, Madrid, Spain
| | - Pablo Demelo-Rodríguez
- Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Gregorio Marañón Research Institute, Madrid, Spain
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Montalto M, Porceddu E, Pero E, Lupascu A, Gallo A, De Simone C, Nucera E, Aruanno A, Giarretta I, Pola R, Landolfi R. Scurvy: A Disease not to be Forgotten. Nutr Clin Pract 2020; 36:1063-1067. [PMID: 33368529 DOI: 10.1002/ncp.10616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
An 18-year-old man presented to our hospital with muscular pain, diffuse petechiae, spontaneous thigh ecchymosis, edema and pain of the right knee, bilateral pretibial subcutaneous nodules, and gingival hypertrophy and hemorrhage. His history was positive for a mixed anxiety-depressive disorder and a restrictive diet caused by self-diagnosed food allergies. Skin lesions appeared like hyperkeratotic papules with coiled hairs and perifollicular hemorrhages. A diagnosis of scurvy was made upon demonstration of low serum levels of ascorbic acid. An allergy evaluation found cross-reactivity between pollens and food, related to the presence of panallergens. Moreover, we found that our patient was also affected by celiac disease. In conclusion, scurvy should be considered in the differential diagnosis of patients with petechiae and ecchymosis, especially when food restriction, malabsorption, or psychiatric disorders are present.
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Affiliation(s)
- Massimo Montalto
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Enrica Porceddu
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Erika Pero
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Andrea Lupascu
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Antonella Gallo
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Clara De Simone
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Eleonora Nucera
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Arianna Aruanno
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Igor Giarretta
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Roberto Pola
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Raffaele Landolfi
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico - Università Cattolica del Sacro Cuore, Roma, Italy
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Abstract
![]()
Vitamin
C (ascorbic acid) is a water-soluble antioxidant and a
cofactor for a large number of enzymes. It is present in all tissues
and especially abundant in corneal epithelium, stem cells, and neurons.
Although similar to thiols in its ability to react with many reactive
oxygen species (ROS), ascorbate is much better (>100× faster)
than glutathione at scavenging of primary ROS (superoxide radical
and singlet oxygen). Ascorbate appears to be especially important
for elimination of O2•– in the
nucleus which contains little or no SOD activity. Cofactor functions
of ascorbate involve the maintenance of activity of Fe(II)/2-oxoglutarate-dependent
dioxygenases via reduction of Fe(III). The most prominent activity
of ascorbate-dependent dioxygenases in the cytoplasm is hydroxylation
of prolines in proteins involved in the formation of extracellular
matrix and regulation of metabolism and hypoxia responses. In the
nucleus, ascorbate is important for oxidative demethylation of 5-methylcytosine
in DNA (by TET proteins) and removal of methyl groups from histone
lysines (by JmjC demethylases). Differentiation and other cellular
reprograming processes involving DNA demethylation are especially
sensitive to ascorbate insufficiency. High doses of vitamin C alone
or in combinations with drugs produced cancer-suppressive effects
which involved redox, immune, and epigenetic mechanisms. Solutions
to vitamin C deficiency in cultured cells are discussed to improve
the physiological relevance of in vitro models. An
abundance of vitamin C in rodents limits their ability to fully recapitulate
human sensitivity to adverse health effects of malnutrition and xenobiotics,
including neurotoxicity, lung injury, and intergenerational and other
epigenetic effects.
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Affiliation(s)
- Anatoly Zhitkovich
- Department of Pathology and Laboratory Medicine, Brown University, 70 Ship Street, Providence, Rhode Island 02912, United States
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33
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Bhattacharyya P, Giannoutsos J, Eslick GD, Fuller SJ. Scurvy: An Unrecognized and Emerging Public Health Issue in Developed Economies. Mayo Clin Proc 2019; 94:2594-2597. [PMID: 31806112 DOI: 10.1016/j.mayocp.2019.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/26/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Puja Bhattacharyya
- Department of Medicine, Faculty of Medicine and Health, Nepean Clinical School, The University of Sydney, Nepean Hospital, Kingswood, Australia
| | - John Giannoutsos
- Department of Medicine, Faculty of Medicine and Health, The University of Sydney, Nepean Hospital, Kingswood, Australia
| | - Guy D Eslick
- The Whiteley-Martin Research Centre, The University of Sydney, Penrith, New South Wales, Australia
| | - Stephen J Fuller
- Department of Medicine, Faculty of Medicine and Health, The University of Sydney, Nepean Hospital, Kingswood, Australia
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34
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Puddy AC, Hughes JL, Joffe AL, Khanna PC, Thornburg CD, Mubarak SJ. Scurvy Findings in a Child with Jacobsen Syndrome: A Case Report. JBJS Case Connect 2019; 9:e0352. [PMID: 31584905 DOI: 10.2106/jbjs.cc.18.00352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We describe the first reported case of scurvy developing secondary to behavioral traits of Jacobsen syndrome. The diagnosis of scurvy was significantly delayed because bleeding symptoms were initially attributed to baseline thrombocytopenia and platelet dysfunction associated with Jacobsen syndrome and patient's medication. Following vitamin C supplementation, signs and symptoms of the patient's disease quickly resolved. CONCLUSIONS We aim to reinforce the need to consider nutritional deficiencies in patients with complex medical histories and behavioral issues, especially when presenting with new complaints.
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Affiliation(s)
- Alan C Puddy
- United States Air Force Medical Corps, San Antonio Military Medical Center, Fort Sam Houston, Texas
| | - Jessica L Hughes
- Department of Orthopedic Surgery, Baylor Scott and White, Temple, Texas
| | - Avrum L Joffe
- North Jersey Pediatric Orthopedics, Ridgewood, New Jersey
| | - Paritosh C Khanna
- Division of Radiology, Rady Children's Hospital-San Diego, San Diego, California
| | - Courtney D Thornburg
- Division of Hematology-Oncology, Rady Children's Hospital-San Diego, San Diego, California
| | - Scott J Mubarak
- Division of Orthopedic Surgery, Rady Children's Hospital-San Diego, San Diego, California
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35
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Wong VCK, Yung G, Russo R, Sumpton D, Mansberg R. Scurvy: a rare cause of arthralgia in a young woman. Intern Med J 2019; 49:1189-1190. [PMID: 31507047 DOI: 10.1111/imj.14427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/03/2019] [Accepted: 03/11/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Veronica C K Wong
- Department of Nuclear Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Grace Yung
- Department of Nuclear Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Robert Russo
- Department of Nuclear Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Sumpton
- Department of Rheumatology, Concord Hospital, Sydney, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Robert Mansberg
- Department of Nuclear Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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36
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Abstract
While scurvy is considered to be a rare disease in the modern era, the disease still presents in certain populations with nutritional deficiencies such as those with poor nutritional absorption secondary to gastrointestinal disorders and in patients with poor nutritional intake. We present a case of scurvy in a patient who had eosinophilic oesophagitis which limited his oral intake. He presented with the classic symptoms of scurvy including a perifollicular rash, arthralgia, gingivitis and anaemia. He was treated with intravenous vitamin C initially followed by an oral course after which he showed improvement. This case demonstrates that it is important to consider vitamin C deficiency in patients with who present with anaemia and bleeding stigmata specifically in those who have poor nutritional intake. Furthermore, additional consideration should be given to patients with malnutrition as part of the preoperative evaluation.
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Affiliation(s)
- Kristina Weitzel
- Internal Medicine, University of Florida, Gainesville, Florida, USA
| | - Nabeel Moon
- Internal Medicine, University of Florida, Gainesville, Florida, USA
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37
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Lund RM, Becker ML, Shapiro S, Allison T, Harris JG. Scurvy presenting with limp and weakness: a case report. BMC Pediatr 2019; 19:228. [PMID: 31279337 PMCID: PMC6612164 DOI: 10.1186/s12887-019-1605-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 06/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background Scurvy is one of the oldest diseases known to mankind. Although presently rare in the developed world, scurvy was a common potentially fatal disease. In recent times, the most common risk factors for scurvy include alcoholism, low socioeconomic status, and severely poor nutrition or dietary restriction secondary to psychiatric illness or developmental disorders. Our case demonstrates the importance of having a high index of clinical suspicion of an uncommon disease in developed countries and emphasizes the necessity of a dietary screening that could potentially reduce extensive work-up in patients with nonspecific complaints. Case presentation We report a case of a 3-year-old previously healthy female originally seen in the rheumatology clinic for limp. She developed weakness and was admitted to the hospital for further evaluation. She underwent extensive diagnostic testing including blood work, magnetic resonance imaging, lumbar puncture, electromyogram, and nerve conduction studies. Ultimately, her vitamin C level returned undetectable. She had immediate and complete improvement upon starting vitamin C supplementation. Conclusions Despite being developmentally appropriate, our patient’s refusal to eat fruits or vegetables had limited her diet, emphasizing the importance of obtaining a diet history in a child presenting with an unknown diagnosis. In addition, our patient had no other characteristic features of scurvy, which further supports the need to consider this diagnosis in a child presenting with lower extremity weakness or abnormal gait.
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Affiliation(s)
- Robin M Lund
- University of Louisville School of Medicine, 571 S. Floyd Street, Suite 412, Louisville, KY, 40202, USA
| | - Mara L Becker
- Duke Clinical Research Institute, 200 Morris Street, Durham, North Carolina, 27701, USA
| | - Steven Shapiro
- Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA
| | - Tyler Allison
- Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA
| | - Julia G Harris
- Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
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38
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[Paroxystic acrosyndrome highlighting a vitamin C deficiency]. Presse Med 2019; 48:715-718. [PMID: 31133340 DOI: 10.1016/j.lpm.2019.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/17/2018] [Accepted: 05/07/2019] [Indexed: 11/23/2022] Open
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39
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Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis. Nutrients 2019; 11:nu11040708. [PMID: 30934660 PMCID: PMC6521194 DOI: 10.3390/nu11040708] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/12/2019] [Accepted: 03/18/2019] [Indexed: 12/12/2022] Open
Abstract
A number of controlled trials have previously found that in some contexts, vitamin C can have beneficial effects on blood pressure, infections, bronchoconstriction, atrial fibrillation, and acute kidney injury. However, the practical significance of these effects is not clear. The purpose of this meta-analysis was to evaluate whether vitamin C has an effect on the practical outcomes: length of stay in the intensive care unit (ICU) and duration of mechanical ventilation. We identified 18 relevant controlled trials with a total of 2004 patients, 13 of which investigated patients undergoing elective cardiac surgery. We carried out the meta-analysis using the inverse variance, fixed effect options, using the ratio of means scale. In 12 trials with 1766 patients, vitamin C reduced the length of ICU stay on average by 7.8% (95% CI: 4.2% to 11.2%; p = 0.00003). In six trials, orally administered vitamin C in doses of 1⁻3 g/day (weighted mean 2.0 g/day) reduced the length of ICU stay by 8.6% (p = 0.003). In three trials in which patients needed mechanical ventilation for over 24 hours, vitamin C shortened the duration of mechanical ventilation by 18.2% (95% CI 7.7% to 27%; p = 0.001). Given the insignificant cost of vitamin C, even an 8% reduction in ICU stay is worth exploring. The effects of vitamin C on ICU patients should be investigated in more detail.
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40
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41
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Takahashi K, Yanai S, Takisawa S, Kono N, Arai H, Nishida Y, Yokota T, Endo S, Ishigami A. Vitamin C and vitamin E double-deficiency increased neuroinflammation and impaired conditioned fear memory. Arch Biochem Biophys 2019; 663:120-128. [DOI: 10.1016/j.abb.2019.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/25/2018] [Accepted: 01/05/2019] [Indexed: 12/15/2022]
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42
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Casacchia T, Occhiuzzi MA, Grande F, Rizzuti B, Granieri MC, Rocca C, Gattuso A, Garofalo A, Angelone T, Statti G. A pilot study on the nutraceutical properties of the Citrus hybrid Tacle® as a dietary source of polyphenols for supplementation in metabolic disorders. J Funct Foods 2019. [DOI: 10.1016/j.jff.2018.11.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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43
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Chen L, Lin M, Yang P. Reproducible mesoporous silica-coated gold@silver nanoprobes for the bright colorimetric sensing of ascorbic acid. NEW J CHEM 2019. [DOI: 10.1039/c9nj02310k] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Herein, a colorimetric approach for the detection of ascorbic acid (AA) was developed by controlling the surface chemistry of silica-coated gold nanorod@silver nanoparticles (AuNR@Ag@mSiO2).
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Affiliation(s)
- Ling Chen
- School of Materials Science and Engineering
- University of Jinan
- Jinan 250022
- China
| | - Meng Lin
- Key Laboratory for Colloid and Interface Chemistry of State Education Ministry
- School of Chemistry and Chemical Engineering
- Shandong University
- Jinan 250100
- China
| | - Ping Yang
- School of Materials Science and Engineering
- University of Jinan
- Jinan 250022
- China
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44
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Armstrong E, Jamieson R, Porter J. Food cooking methods contribute to the reduced vitamin C content of foods prepared in hospitals and care facilities: a systematic review. Int J Food Sci Technol 2018. [DOI: 10.1111/ijfs.13979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Emma Armstrong
- Clinical Dietitian; Eastern Health; Box Hill Vic. 3128 Australia
| | - Rachel Jamieson
- Clinical Dietitian; Eastern Health; Box Hill Vic. 3128 Australia
| | - Judi Porter
- Clinical Dietitian; Eastern Health; Box Hill Vic. 3128 Australia
- Department of Nutrition; Dietetics & Food, Monash University; Ferntree Gully road Notting Hill Vic. 3168 Australia
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45
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Xu W, Chen J, Sun S, Tang Z, Jiang K, Song L, Wang Y, Liu C, Lin H. Fluorescent and photoacoustic bifunctional probe for the detection of ascorbic acid in biological fluids, living cells and in vivo. NANOSCALE 2018; 10:17834-17841. [PMID: 30221263 DOI: 10.1039/c8nr03435d] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Photoacoustic imaging (PAI) has emerged as a promising clinical technology, thanks to its high-resolution in deep tissues. However, the lack of specificity towards analytes limits further application of the PA probe in molecular imaging. To this end, we herein report a PA and fluorescence (FL) dual-modal probe for the selective detection of ascorbic acid (AA). To realize this design, cobalt oxyhydroxide (CoOOH) was adopted as a multifunctional platform (PA contrast agent, FL quencher and specific oxidant to AA) and hybridized with red-emissive carbon dots (RCDs). In the presence of AA, CoOOH is reduced to Co2+ and meanwhile releases RCDs, resulting in the decrease of PA and recovery of FL signals. We demonstrated the AA detection capabilities of the probe in complicated biological fluids (human serum and urine), living cells, and dual-modal FL/PA imaging in vivo. This work revealed the PAI capacity of CoOOH for the first time, which may inspire researchers to design other CoOOH-based PA probes and further employ RCDs in biology and the clinic.
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Affiliation(s)
- Wenxiang Xu
- Key Laboratory of Graphene Technologies and Applications of Zhejiang Province, Ningbo Institute of Materials Technology & Engineering, Chinese Academy of Sciences, Ningbo 315201, P. R. China.
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46
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Gogtay NJ. Research methodology workshops: A small step towards practice of evidence-based medicine. Perspect Clin Res 2018; 9:59-60. [PMID: 29862196 PMCID: PMC5950610 DOI: 10.4103/picr.picr_28_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Nithya Jaideep Gogtay
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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47
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Brandy-García AM, Cabezas-Rodríguez I, Caravia-Durán D, Caminal-Montero L. Hemarthrosis and scurvy. REUMATOLOGIA CLINICA 2017; 13:364-365. [PMID: 28433625 DOI: 10.1016/j.reuma.2017.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/02/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Anahy M Brandy-García
- Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
| | - Iván Cabezas-Rodríguez
- Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Daniel Caravia-Durán
- Unidad de Enfermedades Autoinmunes Sistémicas, Unidad de Gestión Clínica de Medicina Interna, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Luis Caminal-Montero
- Unidad de Enfermedades Autoinmunes Sistémicas, Unidad de Gestión Clínica de Medicina Interna, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
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48
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Bonsall A. Never surprise a patient with scurvy. Int J Dermatol 2017; 56:1488-1489. [PMID: 28833056 DOI: 10.1111/ijd.13723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 06/20/2017] [Accepted: 07/21/2017] [Indexed: 11/28/2022]
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49
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Fong JFY, Chin SF, Ng SM. A unique “turn-on” fluorescence signalling strategy for highly specific detection of ascorbic acid using carbon dots as sensing probe. Biosens Bioelectron 2016; 85:844-852. [DOI: 10.1016/j.bios.2016.05.087] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/27/2016] [Accepted: 05/30/2016] [Indexed: 11/15/2022]
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50
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Pedroza-Tobías A, Hernández-Barrera L, López-Olmedo N, García-Guerra A, Rodríguez-Ramírez S, Ramírez-Silva I, Villalpando S, Carriquiry A, Rivera JA. Usual Vitamin Intakes by Mexican Populations. J Nutr 2016; 146:1866S-73S. [PMID: 27511936 DOI: 10.3945/jn.115.219162] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 03/11/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In the past several years, the consumption of high-energy, nutrient-poor foods has increased globally. Dietary intake data collected by the National Health and Nutrition Survey (ENSANUT) 2012 provide information to assess the quality of the Mexican diet and to guide food and nutrition policy. OBJECTIVE The aim was to describe the usual intake and the prevalence of inadequate intakes of vitamins for the overall Mexican population and by subgroups defined by sex, age, region, urban or rural areas, and socioeconomic status (SES). METHODS ENSANUT 2012 is a cross-sectional probabilistic survey representative of the Mexican population. Dietary information was collected by using the 24-h recall automated multiple-pass method (n = 10,096) with a repeated measurement on a subsample (n = 889) to permit adjustment for intraindividual variability with the use of the Iowa State University method. Mean usual intakes and the prevalence of inadequate intakes of thiamin, riboflavin, niacin, folate, and vitamins A, D, E, C, B-6, and B-12 were calculated for children aged 1-4 y (CH1-4y), children aged 5-11 y (CH5-11y), adolescents aged 12-19 y, and adults aged ≥20 y. RESULTS In all of the age groups, prevalences of inadequate intakes of vitamins D and E were the highest (77-99% of adults and adolescents and 53-95% of CH5-11y and CH1-4y) and those of folate and vitamin A were intermediate (47-70% of adults and adolescents, 15-23% of CH5-11y and 8-13% of CH1-4y), whereas those of thiamin, riboflavin, niacin, and vitamins B-6, B-12, and C were the lowest (0-37% of adults, 1-27% of adolescents, and 0-2.4% of CH5-11y and CH1-4y). With few exceptions, the highest prevalences of inadequate intakes for vitamins were observed in the poorest populations (rural South region and the lowest tertile of SES). CONCLUSIONS The intake of vitamins among Mexicans is inadequate overall. Information collected by ENSANUT can help target food assistance programs and develop strategies to prevent vitamin deficiencies.
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Affiliation(s)
- Andrea Pedroza-Tobías
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; and
| | - Lucía Hernández-Barrera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; and
| | - Nancy López-Olmedo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; and
| | - Armando García-Guerra
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; and
| | - Sonia Rodríguez-Ramírez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; and
| | - Ivonne Ramírez-Silva
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; and
| | - Salvador Villalpando
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; and
| | | | - Juan A Rivera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; and
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