Vitamin C supplementation for the treatment of osteoarthritis: perspectives on the past, present, and future

Abstract

According to the US Centers for Disease Control and Prevention (CDC), an estimated 14% of adults in the United States have either been diagnosed with osteoarthritis (OA) or have symptoms suggestive of the disease. The CDC also points out that the incidence of OA has been gradually increasing over the past 30 years. What is more worrisome is that this trend is going to accelerate due to the aging demographics of the United States and the increasing prevalence of obesity seen in the country. The need for better preventive treatments and efficacious therapeutics are direly needed to combat this public health crisis. Among the possible treatments being hypothesized, antioxidant supplementation has become one of the most widely studied over the past decade due to its ability to attenuate reactive oxygen species (ROS) formation within chondrocytes, a critical step in the pathogenesis of this disease. Vitamin C has emerged as among the most promising of the antioxidant group, with many animal and human studies having been conducted in recent years. Although many of the studies have shown encouraging results in terms of preventing OA, others have reached opposite conclusions, thus making the data controversial. However, after reviewing several of these studies, we hypothesize that certain parameters may not have been properly considered during data collection. In the end, more randomized placebo-controlled trials in humans are desperately needed in order to fully understand whether vitamin C therapy is efficacious in treating and/or preventing OA.

Genetic liability for diet-derived circulating antioxidants, oxidative stress, and risk of osteoarthritis: a Mendelian randomization study

“…The current state of research on the association between antioxidants and OA yields conflicting results. Several studies and reviews analyze the potential protective effects of nutrients, including vitamins D, E, and C, on cartilage metabolism and the development of OA ( 8 , 9 ). However, some studies have not reported the protective effects of the preceding antioxidants on OA ( 10 , 11 ).…”

Association between Dietary total antioxidant capacity and knee osteoarthritis: a case-control study in the Iranian Population

“…Vitamin E may be a powerful antioxidant causes preventing reactive oxygen species from oxidizing cell membranes. Furthermore, the protective role of vitamin E against chondrocyte-derived lipid peroxidation-mediated collagen degradation, have been well documented [ 29 , 64 , 65 ]. However, we didn’t find any significant difference between the case and control and between DTAC quartiles in dietary intake of vitamin E. On the other hand, we observed that people with KOA consumed significantly lower amounts of fiber compared to the control group.…”

“…Oxidative stress and inflammation have been shown to play a significant role in the etiology of KOA [ 17 , 23 , 24 ]. Therefore, this hypothesis has been examined in many studies to see whether dietary patterns with high levels of inflammatory foods can increase the risk of osteoarthritis and vice versa and whether foods with antioxidant and anti-inflammatory properties can reduce the risk and symptoms [ 25 – 29 ].…”

Drug Delivery Strategies and Nanozyme Technologies to Overcome Limitations for Targeting Oxidative Stress in Osteoarthritis

“…In a comprehensive review of vitamin C as an OA therapy, Dunlap et al found conflicting results for pre-clinical and clinical trials of vitamin C supplementation. While the therapeutic effects of vitamin C supplementation are unclear, there is a consensus that overdosing vitamin C is detrimental to both the development and progression of OA [ 52 ]. In comparison, vitamins D and E, both membrane-bound antioxidants, have been investigated as potential OA therapeutics.…”