Intravenous Vitamin C Research Articles

Modulation of Cytokines in Cancer Patients by Intravenous Ascorbate Therapy.

BackgroundCytokines play an important role in tumor angiogenesis and inflammation. There is evidence in the literature that high doses of ascorbate can reduce inflammatory cytokine levels in cancer patients. The objective of this study was to investigate the effect of treatment by intravenous vitamin C (IVC) on cytokines and tumor markers.Material/MethodsWith the availability of protein array kits allowing assessment of many cytokines in a single sample, we measured 174 cytokines and additional 54 proteins and tumor markers in 12 cancer patients before and after a series of IVC treatments.ResultsPresented results show for our 12 patients the effect of treatment resulted in normalization of many cytokine levels. Cytokines that were most consistently elevated prior to treatments included M-CSF-R, Leptin, EGF, FGF-6, TNF-α, β, TARC, MCP-1,4, MIP, IL-4, 10, IL-4, and TGF-β. Cytokine levels tended to decrease during the course of treatment. These include mitogens (EGF, Fit-3 ligand, HGF, IGF-1, IL-21R) and chemo-attractants (CTAC, Eotaxin, E-selectin, Lymphotactin, MIP-1, MCP-1, TARC, SDF-1), as well as inflammation and angiogenesis factors (FGF-6, IL-1β, TGF-1).ConclusionsWe are able to show that average z-scores for several inflammatory and angiogenesis promoting cytokines are positive, indicating that they are higher than averages for healthy controls, and that their levels decreased over the course of treatment. In addition, serum concentrations of tumor markers decreased during the time period of IVC treatment and there were reductions in cMyc and Ras, 2 proteins implicated in being upregulated in cancer.

Intravenous Vitamin C and Cancer

Intravenous vitamin C (IVC) is a contentious adjunctive cancer therapy, widely used in naturopathic and integrative oncology settings. We conducted a systematic review of human interventional and observational studies assessing IVC for use in cancer patients. We searched MEDLINE, EMBASE, The Cochrane Library, CINAHL, and AMED from inception to April 2013 for human studies examining the safety, effectiveness, or pharmacokinetics of IVC use in cancer patients. Of 897 records, a total of 39 reports of 37 studies were included: 2 randomized controlled trials (RCTs), 15 uncontrolled trials, 6 observational studies, and 14 case reports. IVC dosing ranged from 1 g to more than 200 g ascorbic acid per infusion, typically administered 2 to 3 times weekly. IVC does not appear to increase toxicity or interfere with antitumor effects of gemcitabine/erlotinib therapy or paclitaxel and carboplatin. Based on 1 RCT and data from uncontrolled human trials, IVC may improve time to relapse and possibly enhance reductions in tumor mass and improve survival in combination with chemotherapy. IVC may improve quality of life, physical function, and toxicities associated with chemotherapy, including fatigue, nausea, insomnia, constipation, and depression. Case reports document several instances of tumor regression and long-term disease-free survival associated with use of IVC. There is limited high-quality clinical evidence on the safety and effectiveness of IVC. The existing evidence is preliminary and cannot be considered conclusive but is suggestive of a good safety profile and potentially important antitumor activity; however, more rigorous evidence is needed to conclusively demonstrate these effects. IVC may improve the quality of life and symptom severity of patients with cancer, and several cases of cancer remission have been reported. Well-designed, controlled studies of IVC therapy are needed.

High-dose intravenous vitamin C improves quality of life in cancer patients

High-dose intravenous vitamin C (IVC) therapy has been safely employed for at least 30 years as one form of complementary alternative medical treatments for cancer. We prospectively examined the effects of IVC on the quality of life (QOL) in cancer patients in a multicenter observational study. This study involved 60 patients with newly diagnosed cancer who visited participating institutions in Japan between June and December 2010 for IVC as an adjuvant cancer therapy. Using the QOL questionnaire developed by the European Organization of Research and Treatment of Cancer (EORTC), EORTC-QLQ C30, QOL was assessed before, and at 2 and 4 weeks of IVC therapy. The global health/QOL score significantly improved from 44.6 ± 27.8 to 53.2 ± 26.5 (p < 0.05) at 2 weeks and to 61.4 ± 24.3 (p < 0.01) at 4 weeks. Patients also showed significant increases in physical, role, emotional, cognitive, and social functioning at 4 weeks after IVC (p < 0.05). In the symptom scale, significant relief was observed, especially in the score of fatigue, pain, insomnia, constipation, and financial difficulties. According to the Clinical Global Impression of Change (CGIC), attending physicians evaluated the QOL of their patients as minimally to much improved in 46.7% (28/60) and 60.0% (30/60) at 2 and 4 weeks after IVC, respectively. Only 2 patients at 2 weeks and 3 patients at 4 weeks were evaluated as minimally worse. Moreover, all adverse events were mild, and none of the patients discontinued the therapy because of adverse reactions to IVC. IVC can safely improve the QOL of cancer patients. These results warrant the conduct of prospective comparative studies to evaluate the usefulness of IVC for patients with advanced cancer.

Effect of high dose intravenous ascorbic acid on the level of inflammation in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) is a major inflammatory joint disease that causes cartilage destruction, bone erosions, and joint destruction. Oxidative stress is elevated in RA patients implying reactive oxygen species (ROS) are possible mediators of tissue damage. ROS trigger a cascade of events through nuclear factors’ activation (NF-kappa B), which up-regulates gene expression of pro-inflammatory cytokines that mediate the immune responses causing inflammation. As ascorbic acid can reduce oxidative stress, decrease production of pro-inflammatory cytokines, and suppress the activation of NF-kappa B, we suggest that millimolar concentration of ascorbic acid may be useful in RA treatment. In our study we analyzed the effect of intravenous vitamin C (IVC) treatment on eleven subjects with RA. Our data suggest that IVC therapy with dosages of 7.5 g - 50 g can reduce inflammation. The level of inflammation as measured by C-reactive protein levels was decreased on average by 44%. Based on our pilot study, we hypothesize that IVC therapy can be a useful strategy in treating RA.

472 A phase II trial of oral combination chemotherapy with capecitabine and cyclophosphamide (XC) in metastatic breast cancer

High-dose intravenous vitamin C (IVC) therapy has been safely employed for at least 30 years as one form of complementary alternative medical treatments for cancer. We prospectively examined the effects of IVC on the quality of life (QOL) in cancer patients in a multicenter observational study.This study involved 60 patients with newly diagnosed cancer who visited participating institutions in Japan between June and December 2010 for IVC as an adjuvant cancer therapy. Using the QOL questionnaire developed by the European Organization of Research and Treatment of Cancer (EORTC), EORTC-QLQ C30, QOL was assessed before, and at 2 and 4 weeks of IVC therapy.The global health/QOL score significantly improved from 44.6 ± 27.8 to 53.2 ± 26.5 (p < 0.05) at 2 weeks and to 61.4 ± 24.3 (p < 0.01) at 4 weeks. Patients also showed significant increases in physical, role, emotional, cognitive, and social functioning at 4 weeks after IVC (p < 0.05). In the symptom scale, significant relief was observed, especially in the score of fatigue, pain, insomnia, constipation, and financial difficulties.According to the Clinical Global Impression of Change (CGIC), attending physicians evaluated the QOL of their patients as minimally to much improved in 46.7% (28/60) and 60.0% (30/60) at 2 and 4 weeks after IVC, respectively. Only 2 patients at 2 weeks and 3 patients at 4 weeks were evaluated as minimally worse. Moreover, all adverse events were mild, and none of the patients discontinued the therapy because of adverse reactions to IVC.IVC can safely improve the QOL of cancer patients. These results warrant the conduct of prospective comparative studies to evaluate the usefulness of IVC for patients with advanced cancer.

Effects of vitamin C infusion and vitamin E-coated membrane on hemodialysis-induced oxidative stress

Chronic hemodialysis (HD) patients manifest anemia and atherosclerosis with associated oxidative stress. We explored whether intravenous infusion of vitamin C (VC) and/or use of vitamin E (VE)-coated dialysis membrane could palliate HD-evoked oxidative stress. Eighty patients undergoing chronic HD were enrolled and randomly assigned into four groups: HD with intravenous VC (n=20), HD with VE-coated dialyzer (n=20), HD with both (n=20), and HD with neither (n=20). We evaluated oxidative stress in blood and plasma, erythrocyte methemoglobin/ferricyanide reductase (red blood cells (RBC)-MFR) activity, plasma methemoglobin, and pro-inflammatory cytokines in these patients. All patients showed marked increases (14-fold) in blood reactive oxygen species (ROS) after HD. The types of ROS were mostly hydrogen peroxide, and in lesser amounts, O2*- and HOCl. HD resulted in decreased plasma VC, total antioxidant status, and RBC-MFR activity and increased plasma and erythrocyte levels of phosphatidylcholine hydroperoxide (PCOOH) and methemoglobin. Intravenous VC significantly palliated HD-induced oxidative stress, plasma and RBC levels of PCOOH, and plasma methemoglobin levels and preserved RBC-MFR activity. The VE-coated dialyzer effectively prevented RBCs from oxidative stress, although it showed a partial effect on the reduction of total ROS activity in whole blood. In conclusion, intravenous VC plus a VE-coated dialyzer is effective in palliating HD-evoked oxidative stress, as indicated by hemolysis and lipid peroxidation, and by overexpression of proinflammation cytokines in HD patients. Using VE-coated dialyzer per se is, however, effective in reducing lipid peroxidation and oxidative damage to RBCs.