Effect of vitamin C on collagen structure of cardinal and uterosacral ligaments during pregnancy

Fortifying the foundation: assessing the role of uterine ligament integrity in uterine prolapse and beyond

BACKGROUND

Pelvic floor stability is influenced by various biomechanical, anatomical, and physiological factors. Understanding these dynamics is crucial for improving the treatment of pelvic organ prolapse (POP) and related conditions.

OBJECTIVE

To analyze the key factors affecting pelvic floor integrity and explore both non-surgical and surgical interventions to enhance stability and treatment outcomes.

METHODS

This review draws from biomechanical research to assess the role of the uterosacral ligament in pelvic support, while also examining the potential of both traditional and emerging therapeutic approaches, including non-surgical interventions like vitamin C supplementation.

RESULTS

- The uterosacral ligament demonstrates superior strength and stiffness, making it essential for structural support of pelvic organs. - Non-surgical interventions, such as vitamin C supplementation, show potential in improving ligament integrity and preventing pelvic floor disorders. - Emerging surgical techniques, including tendon-based procedures and injectable fibrous hydrogel composites, offer promising improvements in outcomes for patients with pelvic organ prolapse. - Additional factors such as muscle strength and neural deficiencies contribute to the complexity of pelvic floor biomechanics, indicating the need for multifaceted treatment approaches.

CONCLUSION

This analysis provides a comprehensive framework for understanding and managing pelvic floor stability by integrating biomechanical, physiological, and anatomical insights. The findings highlight the potential for personalized treatment strategies to improve patient outcomes in pelvic floor disorders.

Can Stria Gravidarum Predict Surgical Fluid Loss in Cesarean Section?

INTRODUCTION

Alterations in collagen subtypes and matrix can potentially cause fluid loss in surgery which is important in terms of liquid loss.

OBJECTIVES

The study aimed to analyze stria gravidarum (SG) and its severity in pregnant women who had undergone cesarean section (CS) and to evaluate surgical fluid loss (SFL) that occurred during CS operation.

METHODS

The research was designed as a prospective clinical cohort study to compare the amount of SFL in the second cesarean section with the severity of SG at 34-37 weeks pregnant (N 308). The severity of SG was evaluated in the preoperative period using the Davey scoring. All patients were defined none, mild stria and severe stria. The SFL was calculated by weighing the pre-and post-operative weights of the sponges.

RESULTS

The weight gain (P = 0.008) and body mass index (BMI, P = 0.017) gradually increased toward severe SG. In correlation analysis of SFL, a positive correlation was found with Davey (r=0.791; P = 0.0001), weight gained during pregnancy (r=0.328; P = 0.0001), BMI (r=0.453; P = 0.001) and newborn weight (r=0.139; P = 0.003). In the receiver operating characteristic for the predictability of SG severity on SFL, severe SG showed a potential for SFL with 95.1% specificity and 93.2% sensitivity at 791 cut-offs (area under the curve:0.987; P = 0.00001; 95% confidence interval: 0.977-0.997).

CONCLUSIONS

The SG severity and SFL showed a very strong relationship, which was a very important finding that would affect the approach of the surgeons to the patients with SG in terms of fluid loss in CS.

Development, Validation, and Use of 1H-NMR Spectroscopy for Evaluating the Quality of Acerola-Based Food Supplements and Quantifying Ascorbic Acid

Acerola (Malpighia emarginata D.C.) is an exotic fruit with high agro-industrial potential due to its high content of ascorbic acid (AA), phenolic compounds, and carotenoid pigments. Acerola fruit is processed into concentrated juice or powder to be incorporated into food supplements. The ascorbic acid content of concentrated juice or powders must be controlled and well assessed. Therefore, the development of optimal methods and procedures for the rapid and accurate determination of the ascorbic acid content in juice concentrate and juice powder remains of considerable commercial interest. NMR spectroscopy is currently a powerful spectroscopic tool for the qualitative and quantitative analysis of molecules of all types and sizes. Firstly, this article presents the NMR-based metabolomic profiling of acerola juice and concentrate powder to describe and compare their composition. Thirty-six metabolites were identified. The AA over choline ratio and the NMR metabolomic profiles could be used for authentication in the future. Secondly, a rapid (8 min), reliable, and non-destructive method for the quantification of ascorbic acid by 1D ¹H-NMR spectroscopy was developed and validated. The LOD and LOQ were 0.05 and 0.15 mg/mL, respectively. These two approaches could be combined to better characterize ingredients derived from acerola and incorporated into food supplements.

Is there an association between pelvic organ prolapse and oxidative stress? A systematic review

Introduction and hypothesis

The pathophysiology of pelvic organ prolapse (POP) has not been fully elucidated, although accumulating evidence suggests that oxidative stress is involved. The present systematic review comprehensively discusses this topic.

Methods

The PubMed/Medline, Scopus, and Web of Science databases were searched for relevant studies published up to May 2021. This systematic review was registered in the PROSPERO database (registration number CRD42021242240). Two independent researchers screened and selected articles that fulfilled predefined inclusion criteria, performed a quality assessment, and extracted the relevant data. Of 901 original articles retrieved, 8 fulfilled the selection criteria and were included in the review.

Results

Elevated levels of markers of oxidative stress, such as advanced glycation end products, hydroxynonenal and hydroxydeoxyguanosine, were found in various parts of the pelvic floor of patients with POP. Accordingly, the levels of glutathione peroxidase and superoxide dismutase, known as major antioxidant enzymes, were reduced, compared to those in healthy controls. Levels of two other markers (mitofusin 2 and nuclear factor erythroid derived 2) also support hypotheses suggesting the involvement of oxidative stress in POP.

Conclusions

In the literature available, an association between oxidative stress and pelvic organ prolapse was confirmed.

Mechanics of Uterosacral Ligaments: Current Knowledge, Existing Gaps, and Future Directions

The uterosacral ligaments (USLs) are important anatomical structures that support the uterus and apical vagina within the pelvis. As these structures are over-stretched, become weak, and exhibit laxity, pelvic floor disorders such as pelvic organ prolapse occur. Although several surgical procedures to treat pelvic floor disorders are directed toward the USLs, there is still a lot that is unknown about their function. This manuscript presents a review of the current knowledge on the mechanical properties of the USLs. The anatomy, microstructure, and clinical significance of the USLs are first reviewed. Then, the results of published experimental studies on the in vivo and ex vivo, uniaxial and biaxial tensile tests are compiled. Based on the existing findings, research gaps are identified and future research directions are discussed. The purpose of this exhaustive review is to help new researchers navigate scientific literature on the mechanical properties of the USLs. The use of these structures remains very popular in reconstructive surgeries that restore and augment the support of pelvic organs, especially as synthetic surgical mesh implants continue to be highly controversial.

Vitamin C: A stem cell promoter in cancer metastasis and immunotherapy

Vitamin C is an electron donor and is involved in a variety of biochemical reactions in stem cell and cancer stem cell, as well as collagen synthesis and the regulation of hypoxia-inducible factor synthesis, which two affect extracellular matrix remodelling and hence cancer metastasis. Specific doses of vitamin C can stop cancer cell glycolysis and block nitroso synthesis, indicating the potential of vitamin C in cancer treatment. Recent studies preliminary revealed Vitamin C enhance the cancer's immune response to anti PD-L1 therapy through multiple indirect approaches. Herein we reviewed the recent function of vitamin C for further research in sequential aspects of cancer stem cell, extracellular matrix remodeling, cancer metastasis and cancer immunotherapy.

Vitamin C stability in acerola and camu-camu powder obtained by spray drying

Abstract Acerola and camu-camu fruits possess high vitamin C content. However, since these fruits are little consumed in their fresh form, it is important to consider that vitamin C can be oxidized depending on storage conditions. Thus, this study aimed to produce acerola and camu-camu powders by spray drying to maintain the stability of their vitamin C content during storage. Acerola and camu-camu powders were characterized in relation to their physicochemical characteristics, antioxidant activity, and vitamin C concentration and stability under different storage conditions (30 °C and 40 °C, 75% relative humidity). In general, the powders were proven to be stable, with low water activity (< 0.40) and humidity (< 4.0 g/100 g powder), as well as high vitamin C concentrations (1593.2 and 6690.4 mg/100 g of powder for acerola and camu-camu, respectively). Furthermore, we observed a high antioxidant activity by ABTS●+, DPPH• and FRAP assays. The powders stored at lower temperature (30 °C) showed higher vitamin C stability. In conclusion, acerola and camu-camu powders produced by spray drying are potential sources of vitamin C and active compounds and are therefore suitable for several food industry applications.

Role of a combination dietary supplement containing mucopolysaccharides, vitamin C, and collagen on tendon healing in rats

Objective

The aim of this study was to investigate the effect of mucopolysaccharide, vitamin C, and collagen supplementation on the healing of Achilles tendon in rats.

Methods

Sixteen rats were separated into 2 groups. Both Achilles tendons of all rats were transected 5 mm above the insertion and repaired using a Kessler suture. After the surgical repair, the study group received the daily recommended amount of the supplement by gastric gavage, while the control group received a placebo. At the end of the third week, the animals were sacrificed. The biomechanical properties of the groups were compared with ultimate tensile strength and stiffness tests. The biological properties of the 2 groups were assessed with a histomorphometric comparison to determine the amount of collagen type I (COL1), proliferating cell nuclear antigen (PCNA), and transforming growth factor β1 (TGF-β1) expression in 3 different tissue subgroups (collagen matrix, tenocytes, and endotenon fibroblasts).

Results

Analysis of histomorphometric results revealed that the rats receiving dietary supplements demonstrated a significant increase in PCNA (mean value of 86 in the control group and 168.85 in the trial group; p < 0.05) and TGF-β1 (mean value of 87.57 in the control group and 161.85 in the trial group; p < 0.05) in the endotenon fibroblasts of the repair site. However, there was no difference between the groups in PCNA or TGF-β1 when the collagen matrix and the tenocytes of the repair site were examined. Furthermore, no significant difference could be found between groups in COL1 in any of the 3 tissue subgroups (collagen matrix, tenocytes, and endotenon fibroblasts). The statistical analysis also indicated that the rats receiving supplements did not demonstrate a significant increase in the ultimate tendon tensile strength or stiffness.

Conclusion

The results of this study revealed no advantage to the oral administration of the trial supplement in collagen synthesis or biomechanical properties in rats after 3 weeks using the presented study design. However, the increased expression of PCNA and TGFβ1 seen in the endotenon fibroblasts of the repair site might play a role in the continuum of tendon healing.

The Roles of Vitamin C in Skin Health

The primary function of the skin is to act as a barrier against insults from the environment, and its unique structure reflects this. The skin is composed of two layers: the epidermal outer layer is highly cellular and provides the barrier function, and the inner dermal layer ensures strength and elasticity and gives nutritional support to the epidermis. Normal skin contains high concentrations of vitamin C, which supports important and well-known functions, stimulating collagen synthesis and assisting in antioxidant protection against UV-induced photodamage. This knowledge is often used as a rationale for the addition of vitamin C to topical applications, but the efficacy of such treatment, as opposed to optimising dietary vitamin C intake, is poorly understood. This review discusses the potential roles for vitamin C in skin health and summarises the in vitro and in vivo research to date. We compare the efficacy of nutritional intake of vitamin C versus topical application, identify the areas where lack of evidence limits our understanding of the potential benefits of vitamin C on skin health, and suggest which skin properties are most likely to benefit from improved nutritional vitamin C intake.