The Protection Potential of Antioxidant Vitamins Against Acute Respiratory Distress Syndrome: a Rat Trial

Abstract

Acute respiratory distress syndrome (ARDS) is a fatal disease that includes inflammation formed by septic and non-septic causes. Reactive oxygen radicals (ROS) play a key role in ARDS pathophysiology and constitute the base of damage process. Antioxidant vitamins are used for inhibiting hazardous effects of radicals. Therefore, effects of antioxidant vitamins such as α-lipoic acid (ALA), vitamin E (VITE), and C (VITC) were investigated on oleic acid (OA)-induced ARDS rat model. Furthermore, high and low dose of methylprednisolone (HDMP, LDMP) was used for comparing effects of the vitamins. In this study, 42 male rats were divided to seven groups named control, OA, ALA, VITE, VITC, LDMP, and HDMP. OA was intravenously administered to all groups except control group and other compounds were orally administered (ALA, VITE, and VITC: 100 mg/kg, LDMP: 5 mg/kg, HDMP: 50 mg/kg) after OA injections. OA increased MDA level in lung tissue and TNF-α and IL-1β cytokine levels in serum. ALA, VITE, VITC, and both dose of MP significantly decreased the cytokine levels. Although OA reduced SOD, CAT, and GSH levels in lung tissue, the vitamins and LDMP markedly enhanced the levels except for HDMP. Furthermore, OA showed thickening in bronchi and alveolar septum, hyperemia in vessels, and inflammatory cell infiltrations in lung tissue histopathological examinations. Antioxidant vitamins may be useful for premedication of ARDS and similar disorders. However, methylprednisolone was not found sufficient for being a therapeutic agent for ARDS.

General Adaptation in Critical Illness: Glucocorticoid Receptor-alpha Master Regulator of Homeostatic Corrections

“…The inclusion or exclusion of fludrocortisone, as a cointervention with hydrocortisone, may partly explain the differences reported in outcomes of some RCTs (see explanation for Figure 7 below) (292,298). Other potential co-interventions directed at increasing glucocorticoid receptor expression, such as statins (299), melatonin (300), beta-blockers (301), calcium channel blockers (301), or directed at improving mitochondrial function (194,302,303) have not been investigated in association with glucocorticoid treatment in acute illness or alone in chronic critical illness.…”

COVID-19: Up to 87% Critically Ill Patients Had Low Vitamin C Values.

“…Animal studies support a bene cial role of vitamin C. These positive effects include increased resistance of chick embryo tracheal organ cultures to infection and protecting broiler chicks against avian coronavirus [5,6]. Vitamin C had been shown to signi cantly decrease serum TNFα and IL-1β levels and increased superoxide dismutase, catalase, and glutathione levels in a rat ARDS model supporting its antioxidant effect [7]. Additionally, vitamin C also enhances lung epithelial barrier function by promoting epigenetic and transcriptional expression of protein channels at the alveolar capillary membrane that regulate alveolar uid clearance, which include aquaporin-5, cystic brosis transmembrane conductance regulator, epithelial sodium channel, and the Na+/K+-ATPase pump [8].…”

Redox signaling and antioxidant therapies in acute respiratory distress syndrome

“…It has been proven that redox signaling system is closely related with the development of ARDS. In response to the various in ammatory stimuli, lung endothelial cells, alveolar cells, airway epithelial cells, alveolar macrophages, as well as recruited leukocytes produce ROS and RNS [14]. An imbalance of oxidant-antioxidant arises when the antioxidant defenses are depleted or when free radicals are overproduced.…”

“…During the development of ARDS, a variety of leukocytes such as neutrophils and macrophages, are recruited to the injured site in the lung. Subsequently, these in ammatory cells as well as lung endothelial cells, alveolar cells, and epithelial cells generate free radicals that lead to oxidative stress [14]. Oxidative stress which is mainly caused by reactive oxygen species (ROS) and reactive nitrogen species (RNS) plays an important role in lung injury and progression of ARDS.…”