gracelive

AUTHOR: SEOK WOO YANG, MD & PhD

CONTACT: E mail: soplab@outlook.kr

DATE: 2020.03.17

CONTENT:

 In the pulmonary cases of COVID-19, Xu et al found the cytotoxic T cells with cytolytic activity which is associated with Th17 CD4 T cells polarized by IL-6 and TGF-β. This immunopathology led to diffuse alveolar and interstitial damage with pulmonary edema, pathologically and subsequent acute respiratory distress syndrome(ARDS) and secondary pneumonia, clinically.[1]   

 As a nutritional candidate to modulate both IL-6 and TGF-β, vitamin D can be considered. 

 Dalvi et al reported that the serum level of IL-6 was significantly increased and vitamin D3 decreased in tuberculosis multidrug-resistant group. Conversely, we can expect that the elevated serum level of vitamin D may reduce that of IL-6.[2]

 Hu et al mentioned the protecting role of vitamin D in diabetic nephropathy. One of the mechanisms to suppress pro-inflammatory responses was to inhibit production of TGF-β.[3]

 In conclusion, because the problematic immunopathology in the lung injury by COVID-19 is the elevated serum levels of IL-6 and TGF-β, we can infer that vitamin D to counteract these inflammatory responses may play a role somewhat in ameliorating the lung injury by COVID-19. About this, further studies will be necessary. 

REFERENCE:

[1] Xu Z, Shi L, Wang Y, Zhang J, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;S2213-2600(20)30076-X.

[2] Dalvi SM, Ramraje NN, Patil VW, Hegde R, Yeram N. Study of IL-6 and vitamin D3 in patients of pulmonary tuberculosis. Indian J Tuberc. 2019 Jul;66(3):337-345.

[3] Hu X, Liu W, Yan Y, Liu H, Huang Q, Xiao Y, Gong Z, Du J. Vitamin D protects against diabetic nephropathy: Evidence-based effectiveness and mechanism. Eur J Pharmacol. 2019 Feb 15;845:91-98. 

AUTHOR: SEOK WOO YANG, MD & PhD

CONTACT: E.mail; soplab@outlook.kr

DATE: 2020.03.17

CONTENT:

 About the usefulness of megadose vitamin C in common colds or flu-like symptoms, there have been many debates.

 With the high potency of the antioxidant effect in vitamin C, vitamin C seems to be a healthful nutrient to suppress the inflammatory reaction in cancer or infection, including viral respiratory diseases.

 Gorton & Jarvis reported that vitamin C use in the early phase of virus-induced respiratory infections can be helpful to prevent further disease progression or to relieve symptoms of common colds or flu-like symptoms.[1]   

 In contrast, Douglas et al analyzed that vitamin C plays some role in respiratory defense mechanisms, but vitamin C at the onset of common colds did not show clinically significant benefit.[2] 

 In summary, the beneficial role of vitamin C in common colds or virus-induced respiratory infections has not been clearly established.

 But Oudemans-van Straaten et al commented that vitamin C can restore vascular responsiveness to vasoconstrictors, preserve endothelial barrier by maintaining cyclic guanylate phosphatase and occludin phosphorylation and preventing apoptosis. Furthermore, they mentioned the role of high-dose vitamin C in augmenting antibacterial defense. With this context, they argued that vitamin C can be applied for ischemia/reperfusion injury and sepsis.[3] 

 Although there are many conflicting reports on the beneficial role of vitamin C in common colds, at least vitamin C can be used as an antioxidant to maintain vascular integrity and plausibly to prevent aggravation of secondary bacterial infection.

REFERENCE:

1. Gorton HC, Jarvis K. The effectiveness of vitamin C in preventing and
relieving the symptoms of virus-induced respiratory infections. J Manipulative
Physiol Ther. 1999 Oct;22(8):530-3. 

2. Douglas RM, Hemila H, D'Souza R, Chalker EB, Treacy B. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2004 Oct
18;(4):CD000980. 

3. Oudemans-van Straaten HM, Spoelstra-de Man AM, de Waard MC. Vitamin C
revisited. Crit Care. 2014 Aug 6;18(4):460.