Effect of ascorbic acid on plasma alcohol clearance

Vitamin Supplements as a Nutritional Strategy against Chronic Alcohol Consumption? An Updated Review

Several studies have shown that blood vitamin levels are low in alcoholic patients. In effect, alcohol use abuse is considered a chronic disease that promotes the pathogenesis of many fatal diseases, such as cancer and liver cirrhosis. The alcohol effects in the liver can be prevented by antioxidant mechanisms, which induces enzymatic as well as other nonenzymatic pathways. The effectiveness of several antioxidants has been evaluated. However, these studies have been accompanied by uncertainty as mixed results were reported. Thus, the aim of the present review article was to examine the current knowledge on vitamin deficiency and its role in chronic liver disease. Our review found that deficiencies in nutritional vitamins could develop rapidly during chronic liver disease due to diminished hepatic storage and that inadequate vitamins intake and alcohol consumption may interact to deplete vitamin levels. Numerous studies have described that vitamin supplementation could reduce hepatotoxicity. However, further studies with reference to the changes in vitamin status and the nutritional management of chronic liver disease are in demand.

Nutrition in alcohol-related liver disease: Physiopathology and management

Malnutrition encompassing both macro- and micro-nutrient deficiency, remains one of the most frequent complications of alcohol-related liver disease (ArLD). Protein-energy malnutrition can cause significant complications including sarcopenia, frailty and immunodepression in cirrhotic patients. Malnutrition reduces patient’s survival and negatively affects the quality of life of individuals with ArLD. Moreover, nutritional deficit increases the likelihood of hepatic decompensation in cirrhosis. Prompt recognition of at-risk individuals, early diagnosis and treatment of malnutrition remains a key component of ArLD management. In this review, we describe the pathophysiology of malnutrition in ArLD, review the screening tools available for nutritional assessment and discuss nutritional management strategies relevant to the different stages of ArLD, ranging from acute alcoholic hepatitis through to decompensated end stage liver disease.

Adding an orange to the banana bag: vitamin C deficiency is common in alcohol use disorders

BACKGROUND

At least a third of the world's population consumes alcohol regularly. Patients with alcohol use disorders (AUDs) are frequently hospitalized for both alcohol-related and unrelated medical conditions. It is well recognized that patients with an AUD are thiamine deficient with thiamine replacement therapy being considered the standard of care. However, the incidence of vitamin C deficiency in this patient population has been poorly defined.

METHODS

In this retrospective, observational study, we recorded the admission vitamin C level in patients with an AUD admitted to our medical intensive care unit (MICU) over a 1-year period. In addition, we recorded relevant clinical and laboratory data including the day 2 and day 3 vitamin C level following empiric treatment with vitamin C. Septic patients were excluded from this study.

RESULTS

Sixty-nine patients met the inclusion criteria for this study. The patients' mean age was 53 ± 14 years; 52 patients (75%) were males. Severe alcohol withdrawal syndrome was the commonest admitting diagnosis (46%). Eighteen patients (26%) had cirrhosis as the admitting diagnosis with 18 (13%) patients admitted due to alcohol/drug intoxication. Forty-six patients (67%) had evidence of acute alcoholic hepatitis. The mean admission vitamin C level was 17.0 ± 18.1 μmol/l (normal 40-60 μmol/l). Sixty-one (88%) patients had a level less than 40 μmol/l (subnormal) while 52 patients (75%) had hypovitaminosis C (level < 23 μmol/l). None of the variables recorded predicted the vitamin C level. Various vitamin C replacement dosing strategies were used. A 1.5-g loading dose, followed by 500-mg PO q 6, was effective in restoring blood levels to normal by day 2.

CONCLUSION

Our results suggest that hypovitaminosis C is exceedingly common in patients with an AUD admitted to an intensive care unit and that all such patients should receive supplementation with vitamin C in addition to thiamine. Additional studies are required to confirm the findings of our observational study and to determine the optimal vitamin C dosing strategy.

Anti-alcoholic effects of honeys from different floral origins and their correlation with honey chemical compositions

The effects of honeys from different floral origins on alcohol metabolism were compared, and the correlation between their chemical compositions and antialcholic effects was analyzed. The results demonstrated that the five types of investigated honeys from different floral origins had different effects on alcohol metabolism, and the blood alcohol removal rate by these honeys ranged from 18.01% to 49.17%. Ziziphus jujuba honey exhibited the best blood alcohol removal effect, and meanwhile significantly enhanced the activity of alcohol-metabolizing enzymes including alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). Chemical composition analysis also showed that honeys from different floral origins were considerably different in the contents of sugars, minerals, ascorbic acid and phenolics. Ziziphus jujuba honey had the highest fructose/glucose ratio, ascorbic acid and phenolics contents, and higher contents of minerals, especially K, Ca, Mg, Fe, Cu, Zn and Mn. This chemical composition might contribute to its better anti-alcoholic effect.

Potentiation of ethanol-induced loss of the righting reflex by ascorbic acid in mice: interaction with dopamine antagonists

The present investigation was carried out to determine the effect of ascorbic acid on ethanol-induced loss of the righting reflex (LORR) and the interactions between ascorbic acid and dopamine receptor antagonists in affecting this action of ethanol in mice. To test the effect of each drug on ethanol-induced LORR, ascorbic acid (31.25, 62.5, 125, 250, 500, 1000 mg/kg intraperitoneally [IP]) and dopamine receptor antagonists (haloperidol 0.5, 1.0 mg/kg; L-sulpiride 20, 40, 80 mg/kg; clozapine 0.625, 1.25, 2.5 mg/kg; SCH 23390 0.5, 1.0, 2.0 mg/kg subcutaneously [SC]) were administered, respectively, 30 min before ethanol (4.0 g/kg IP) administration. Ascorbic acid, at the dose of 1000 mg/kg, significantly potentiated ethanol-induced LORR in mice. Dopamine D(2) antagonists haloperidol (0.5, 1.0 mg/kg SC), and L-sulpiride (80 mg/kg SC) also significantly prolonged the duration of LORR induced by ethanol. Clozapine and SCH 23390, at the doses used, did not affect ethanol-induced LORR. In the interaction study, the synergistic effect of ascorbic acid (1000 mg/kg IP) on ethanol-induced LORR was significantly enhanced by dopamine D(2) antagonists haloperidol, L-sulpiride, and clozapine, and the highest dose of dopamine D(1) antagonist SCH 23390. These results suggest that ascorbic acid may potentiate ethanol-induced LORR partially via a mechanism mainly linked to blockade of dopamine D(2) receptors.

Ascorbic acid antagonizes ethanol-induced locomotor activity in the open-field

It has been reported that ascorbic acid (AA) antagonizes the physiological and behavioral effects of dopamine (DA). AA reduces locomotor activity induced by dopaminergic agonist drugs. Also, AA amplifies the action of antidopaminergic drugs. Ethanol, like other drugs, produces a release of DA in the mesolimbic pathway, and at some doses, induces locomotor activity in mice. The ethanol-induced locomotor activity could be dopamine-dependent because it can be reduced by antidopaminergic drugs. In the present study, we investigated whether an acute administration of AA reduces ethanol-induced locomotor behavior. AA, at doses (0.0, 21.85, 87.5, 175, 350. and 1400 mg/kg) was injected i.p. into mice, 0, 30, 60, or 90 min before an i.p. injection of ethanol (0.0, 0.8, 1.6, 2.4, and 3.2 g/kg). Locomotor activity was evaluated in open-field chambers. Our results showed that AA (350 and 1400 mg/kg) reduced ethanol-induced locomotor activity when injected 30 min before ethanol treatment. This effect was lost when ethanol was administered 90 min after AA injection. AA also reduced locomotor activity produced by d-amphetamine and methanol. The results support a pro-dopaminergic action of ethanol, and suggest a common dopaminergic pathway for the drugs of abuse in locomotor activity.

NMDA receptor antagonist CPP inhibits ethanol-evoked ascorbate release in the brain of freely moving rats

The effect of the N-methyl-D-aspartate (NMDA) receptor antagonist, 3-(2-carboxypiperazin-4-yl)propyl-1-phosphonic acid (CPP), on the ethanol-evoked release of brain ascorbate (AA) was investigated in freely moving rats using an in vivo voltammetry technique. Ethanol (1.0 g/kg, intraperitoneal injection, i.p.) increased the release of brain AA in the nucleus accumbens and striatum. Pretreatment with CPP (1 nmol, intracerebroventricular injection, i.c.v.) not only completely reversed the ethanol-evoked AA release but also reduced the concentration of extracellular AA and kept it at low level 80 min after the ethanol administration in both brain areas. However, 80 min after the treatment with CPP per se only the level of AA in the nucleus accumbens was decreased. The results suggest that ethanol-evoked release of AA probably is a self-protective mechanism against the neurotoxicity induced by ethanol in the brain, and the NMDA receptor may play an important role in this mechanism.