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<meta name="description" content="Vitamin C (Ascorbic Acid), the antiscorbutic vitamin, cannot be synthesized by humans and other primates, and has to be obtained from diet. Ascorbic acid is an electron donor and acts as a cofactor for fifteen mammalian enzymes. Two sodium-dependent transporters are specific for ascorbic acid, and i …"><meta name="keywords" content="pmid:26808119, PMC4959991, doi:10.1111/odi.12446, Review, S J Padayatty, M Levine, Ascorbic Acid / metabolism, Ascorbic Acid / physiology*, Humans, In Vitro Techniques, Oral Health, Recommended Dietary Allowances, PubMed Abstract, NIH, NLM, NCBI, National Institutes of Health, National Center for Biotechnology Information, National Library of Medicine, MEDLINE"><meta name="robots" content="index,nofollow,noarchive"><meta property="og:title" content="Vitamin C: the known and the unknown and Goldilocks - PubMed"><meta property="og:url" content="https://pubmed.ncbi.nlm.nih.gov/26808119/"><meta property="og:description" content="Vitamin C (Ascorbic Acid), the antiscorbutic vitamin, cannot be synthesized by humans and other primates, and has to be obtained from diet. Ascorbic acid is an electron donor and acts as a cofactor for fifteen mammalian enzymes. Two sodium-dependent transporters are specific for ascorbic acid, and i …"><meta property="og:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:image:secure_url" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:type" content="website"><meta property="og:site_name" content="PubMed"><meta name="twitter:domain" content="pubmed.ncbi.nlm.nih.gov"><meta name="twitter:card" content="summary_large_image"><meta name="twitter:title" content="Vitamin C: the known and the unknown and Goldilocks - PubMed"><meta name="twitter:url" content="https://pubmed.ncbi.nlm.nih.gov/26808119/"><meta name="twitter:description" content="Vitamin C (Ascorbic Acid), the antiscorbutic vitamin, cannot be synthesized by humans and other primates, and has to be obtained from diet. Ascorbic acid is an electron donor and acts as a cofactor for fifteen mammalian enzymes. Two sodium-dependent transporters are specific for ascorbic acid, and i …"><meta name="twitter:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg">
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</div>
<div class="include-supplemental-container">
<input type="checkbox" aria-label="Include MeSH and other data" name="include-supplemental" id="email-include-supplemental" class="email-include-supplemental">
<label for="email-include-supplemental" class="email-include-supplemental-label">MeSH and other data</label>
</div>
<div class="form-field recaptcha ">
<div class="g-recaptcha" id="id-recaptcha" data-sitekey="6LfsWHMdAAAAAClKbtOpjQ2pMjgsGxvv7NdZW9uI"></div>
</div>
<div id="captcha-error-message" class="usa-input-error-message captcha-validation-message" role="alert"></div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Sending..."
data-ga-category="save_share"
data-ga-action="email"
data-ga-label="send">
Send email
</button>
<button class="action-panel-cancel"
aria-label="Close 'Email citations' panel"
ref="linksrc=close_email_panel"
aria-controls="email-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="email"
data-ga-label="cancel">
Cancel
</button>
</div>
<input type="hidden" name="email-search-details" value="" />
<input type="hidden" name="email-search-details-hash" value="0e42663a6c3bd85498fcb88798998fed7bfdc45d457db35281e41afe13cc0524" />
</form>
</div>
</div>
<div id="collections-action-panel"
class="collections-action-panel action-panel in-progress-dots-panel"
aria-hidden="true"
data-collections-open-panel-enabled="false"
data-collections-open-panel-url-hash="#open-collections-panel">
<div class="inner-wrap">
<h3 class="action-panel-heading">
Add to Collections
</h3>
<form id="collections-action-panel-form"
class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-existing-collections-url="/list-existing-collections/"
data-add-to-existing-collection-url="/add-to-existing-collection/"
data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/"
data-get-article-ids-by-search-url="/get-article-ids-by-search/"
data-myncbi-max-collection-name-length="100"
data-add-to-collection-max-amount="1000"
data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/">
<input type="hidden" name="csrfmiddlewaretoken" value="Bw6JkrJrwS68dS7VEzE3coKmx6ibyJNmSjQOXhcN6tTC7jdLhSh5Gwg05a0nrklG">
<div class="choice-group" role="radiogroup">
<ul class="radio-group-items">
<li>
<input type="radio"
id="collections-action-panel-new"
class="collections-new"
name="collections"
value="new"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="collections_radio_new">
<label for="collections-action-panel-new">Create a new collection</label>
</li>
<li>
<input type="radio"
id="collections-action-panel-existing"
class="collections-existing"
name="collections"
value="existing"
checked="true"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="collections_radio_existing">
<label for="collections-action-panel-existing">Add to an existing collection</label>
</li>
</ul>
</div>
<div class="controls-wrapper">
<div class="action-panel-control-wrap new-collections-controls">
<label for="collections-action-panel-add-to-new" class="action-panel-label required-field-asterisk">
Name your collection:
</label>
<input
type="text"
name="add-to-new-collection"
id="collections-action-panel-add-to-new"
class="collections-action-add-to-new"
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/"
maxlength="100"
data-ga-category="save_share"
data-ga-action="create_collection"
data-ga-label="non_favorties_collection">
<div class="collections-new-name-too-long usa-input-error-message selection-validation-message">
Name must be less than 100 characters
</div>
</div>
<div class="action-panel-control-wrap existing-collections-controls">
<label for="collections-action-panel-add-to-existing" class="action-panel-label">
Choose a collection:
</label>
<select id="collections-action-panel-add-to-existing"
class="action-panel-selector collections-action-add-to-existing"
data-ga-category="save_share"
data-ga-action="select_collection"
data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'">
</select>
<div class="collections-retry-load-on-error usa-input-error-message selection-validation-message">
Unable to load your collection due to an error<br>
<a href="#">Please try again</a>
</div>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Adding..."
data-pinger-ignore
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="add">
Add
</button>
<button class="action-panel-cancel"
aria-label="Close 'Add to Collections' panel"
ref="linksrc=close_collections_panel"
aria-controls="collections-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="bibliography-action-panel"
class="bibliography-action-panel action-panel in-progress-dots-panel"
aria-hidden="true"
data-bibliography-open-panel-enabled="false"
data-bibliography-open-panel-url-hash="#open-bibliography-panel">
<div class="inner-wrap">
<h3 class="action-panel-heading">
Add to My Bibliography
</h3>
<form id="bibliography-action-panel-form"
class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-add-to-bibliography-max-amount="100"
data-add-to-bibliography-batch-size="10"
data-bibliography-delegates-url="/list-bibliography-delegates/"
data-add-to-bibliography-url="/add-to-bibliography/"
data-get-article-ids-by-search-url="/get-article-ids-by-search/"
data-mybib-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/mybibliography/">
<input type="hidden" name="csrfmiddlewaretoken" value="Bw6JkrJrwS68dS7VEzE3coKmx6ibyJNmSjQOXhcN6tTC7jdLhSh5Gwg05a0nrklG">
<div class="action-panel-control-wrap bibliographies-controls">
<div class="choice-group">
<ul class="bibliographies-action-add radio-group-items">
<li>
<input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/>
<label for="my-bibliography">My Bibliography</label>
</li>
</ul>
</div>
</div>
<div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message">
Unable to load your delegates due to an error<br>
<a href="#">Please try again</a>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Adding..."
data-pinger-ignore>
Add
</button>
<button class="action-panel-cancel"
aria-label="Close 'Add to bibliography' panel"
ref="linksrc=close_bibliography_panel"
aria-controls="bibliography-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="mybib"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true"
data-saved-search-open-panel-enabled="false"
data-saved-search-open-panel-url-hash="#open-saved-search-panel">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Your saved search
</h2>
<form id="saved-search-action-panel-form"
class="saved-search-action-panel-form action-panel-content action-form"
data-create-saved-search-url="/create-saved-search/"
data-try-search-terms-url="/try-search-term/"
data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/">
<input type="hidden" name="csrfmiddlewaretoken" value="Bw6JkrJrwS68dS7VEzE3coKmx6ibyJNmSjQOXhcN6tTC7jdLhSh5Gwg05a0nrklG">
<div class="action-panel-control-wrap">
<label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk">
Name of saved search:
</label>
<input maxlength="200"
type="text"
name="saved-search-name"
id="saved-search-name"
class="saved-search-name"
value=""
required
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/">
</div>
<div class="action-panel-control-wrap">
<label for="saved-search-term" class="action-panel-label required-field-asterisk">
Search terms:
</label>
<textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea>
</div>
<div class="test-search-term-wrap">
<a href="#" class="try-search-term">Test search terms</a>
</div>
<div class="choice-group action-panel-extra-margin-top">
<span class="action-panel-label" id="fieldset-label">
Would you like email updates of new search results?
</span>
<fieldset id="saved-search-alert" aria-describedby="fieldset-label">
<legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend>
<ul class="radio-group-items">
<li>
<input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked>
<label for="saved-search-alert-yes" class="action-panel-label">Yes</label>
</li>
<li>
<input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no">
<label for="saved-search-alert-no" class="action-panel-label">No</label>
</li>
</ul>
</fieldset>
</div>
<div class="alert-schedule-wrap">
<div class="action-panel-control-wrap">
<label class="action-panel-label">
Email:
</label>
<span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span>
</div>
<div class="action-panel-control-wrap action-panel-extra-margin-top">
<label for="saved-search-frequency" class="action-panel-label">
Frequency:
</label>
<select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency">
<option value="monthly">Monthly</option>
<option value="weekly">Weekly</option>
<option value="daily">Daily</option>
</select>
</div>
<div class="action-panel-control-wrap saved-search-monthly-additional">
<label for="saved-search-monthly-on-day" class="action-panel-label">
Which day?
</label>
<select id="saved-search-monthly-on-day" class="no-border-panel-selector">
<option value="Sunday">The first Sunday</option>
<option value="Monday">The first Monday</option>
<option value="Tuesday">The first Tuesday</option>
<option value="Wednesday">The first Wednesday</option>
<option value="Thursday">The first Thursday</option>
<option value="Friday">The first Friday</option>
<option value="Saturday">The first Saturday</option>
<option value="day">The first day</option>
<option value="weekday">The first weekday</option>
</select>
</div>
<div class="action-panel-control-wrap saved-search-weekly-additional">
<label for="saved-search-weekly-on-day" class="action-panel-label">
Which day?
</label>
<select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day">
<option value="Sunday">Sunday</option>
<option value="Monday">Monday</option>
<option value="Tuesday">Tuesday</option>
<option value="Wednesday">Wednesday</option>
<option value="Thursday">Thursday</option>
<option value="Friday">Friday</option>
<option value="Saturday">Saturday</option>
</select>
</div>
<div class="action-panel-control-wrap">
<label for="saved-search-report" class="action-panel-label">
Report format:
</label>
<select id="saved-search-report" class="no-border-panel-selector saved-search-report">
<option value="DocSum">Summary</option>
<option value="DocSumText">Summary (text)</option>
<option value="Abstract">Abstract</option>
<option value="AbstractText">Abstract (text)</option>
<option value="MEDLINE">PubMed</option>
</select>
</div>
<div class="action-panel-control-wrap">
<label for="saved-search-amount" class="action-panel-label">
Send at most:
</label>
<select id="saved-search-amount" class="no-border-panel-selector saved-search-amount">
<option value="1">1 item</option>
<option value="5" selected>5 items</option>
<option value="10">10 items</option>
<option value="20">20 items</option>
<option value="50">50 items</option>
<option value="100">100 items</option>
<option value="200">200 items</option>
</select>
</div>
<div>
<input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result">
<label for="saved-search-send-if-no-result" class="action-panel-label smaller-checkbox">
Send even when there aren't any new results
</label>
</div>
<div class="action-panel-control-wrap option-text-in-email-wrap">
<label for="saved-search-email-text" class="action-panel-label">
Optional text in email:
</label>
<textarea name="saved-search-email-text"
id="saved-search-email-text"
class="saved-search-email-text"></textarea>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Saving..."
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="save">
Save
</button>
<button class="action-panel-cancel"
aria-label="Close 'Your saved search' panel"
ref="linksrc=close_saved_search_panel"
aria-controls="saved-search-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Create a file for external citation management software
</h2>
<form id="citation-manager-action-panel-form"
class="action-panel-content action-form"
action="/results-export-ids/"
data-by-search-action="/results-export-search-data/"
data-by-ids-action="/results-export-ids/"
method="post"
data-by-search-method="post"
data-by-ids-method="post">
<input type="hidden" name="csrfmiddlewaretoken" value="Bw6JkrJrwS68dS7VEzE3coKmx6ibyJNmSjQOXhcN6tTC7jdLhSh5Gwg05a0nrklG">
<input name="results-format" type="hidden" value="pubmed"/>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Sending..."
data-ga-category="save_share"
data-ga-action="citation_manager"
data-ga-label="save">
Create file
</button>
<button class="action-panel-cancel"
aria-label="Close 'Send citations to citation manager' panel"
ref="linksrc=close_citation_manager_panel"
aria-controls="citation-manager-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="citation_manager"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Your RSS Feed
</h2>
<form id="rss-action-panel-form"
class="rss-action-panel-form action-panel-content action-form"
data-create-rss-feed-url="/create-rss-feed-url/"
data-search-form-term-value="">
<input type="hidden" name="csrfmiddlewaretoken" value="Bw6JkrJrwS68dS7VEzE3coKmx6ibyJNmSjQOXhcN6tTC7jdLhSh5Gwg05a0nrklG">
<div class="action-panel-control-wrap">
<label for="rss-name" class="action-panel-label required-field-asterisk">
Name of RSS Feed:
</label>
<input maxlength="200"
placeholder="Name"
type="text"
name="rss-name"
id="rss-name"
class="rss-name"
value=''
required
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/">
</div>
<div class="rss-limit-wrap">
<div class="action-panel-control-wrap action-panel-extra-margin-top">
<label for="rss-limit" class="action-panel-label">
Number of items displayed:
</label>
<select id="rss-limit" class="no-border-panel-selector rss-limit">
<option value="5">5</option>
<option value="10">10</option>
<option value="15" selected="selected">15</option>
<option value="20">20</option>
<option value="50">50</option>
<option value="100">100</option>
</select>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Creating..."
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="save">
Create RSS
</button>
<button class="action-panel-cancel"
aria-label="Close 'Your RSS' panel"
ref="linksrc=close_rss_panel"
aria-controls="rss-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="cancel">
Cancel
</button>
</div>
<div class="action-panel-control-wrap rss-link-copy-wrap">
<label for="rss-link" class="usa-sr-only">RSS Link</label>
<input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link">
<button
type="button"
disabled
class="rss-link-copy-button disabled"
data-ga-category="save_share"
data-ga-action="rss"
data-ga-label="copy">
Copy
</button>
</div>
</form>
</div>
</div>
</div>
</div>
<div class="article-page" id="article-page" data-article-pmid="26808119">
<aside class="page-sidebar">
<div class="inner-wrap">
<div class="full-text-links">
<div class="full-view">
<h3 class="title">
Full text links
</h3>
<div class="full-text-links-list">
<a class="link-item
dialog-focus"
href="https://doi.org/10.1111/odi.12446"
target="_blank"
rel="noopener"
ref="linksrc=fulltextorjournal_fulltext&amp;is_pmc=False&amp;PrId=3058&amp;itool=Abstract-def&amp;log$=linkouticon&amp;uid=26808119&amp;db=pubmed&amp;nlmid=9508565"
title="See full text options at Wiley"
data-ga-category="full_text"
data-ga-action="Wiley"
data-ga-label="26808119"
><img src="https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--media.wiley.com-assets-7388-69-wiley-full-text.png" alt="Wiley full text link"><span class="text">
Wiley
</span></a><a class="link-item
pmc
"
href="https://pmc.ncbi.nlm.nih.gov/articles/pmid/26808119/"
target="_blank"
rel="noopener"
ref="linksrc=fulltextorjournal_fulltext&amp;is_pmc=True&amp;PrId=3494&amp;itool=Abstract-def&amp;log$=linkouticon&amp;uid=26808119&amp;db=pubmed&amp;nlmid=9508565"
title="Free full text at PubMed Central"
data-ga-category="full_text"
data-ga-action="PMC"
data-ga-label="26808119"
><span class="text">
Free PMC article
</span></a>
</div>
</div>
<div class="short-view">
<a href="#" class="full-text-links-button full-text-links-dialog-trigger">
Full text links
</a>
</div>
</div>
<div class="actions-buttons sidebar"><h3 class="title">Actions</h3><div class="inner-wrap"><button class="citation-button citation-dialog-trigger"
aria-label="Open dialog with citation text in different styles"
data-ga-category="save_share"
data-ga-action="cite"
data-ga-label="open"
data-all-citations-url="/26808119/citations/"
data-citation-style="nlm"
data-pubmed-format-link="/26808119/export/"><span class="button-label">Cite</span></button><link type="text/css" href="ncbi-overlay-block/src/overlay-block.css"><div class="collections-button-container" data-article-id="26808119" data-article-db="pubmed"><button class="collections-button collections-dialog-trigger"
aria-label="Save article in MyNCBI collections."
data-ga-category="collections_button"
data-ga-action="click"
data-ga-label="collections_button"
data-collections-open-dialog-enabled="false"
data-collections-open-dialog-url="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F26808119%2F%23open-collections-dialog"
data-in-collections="false"><span class="button-label">Collections</span></button><div class="overlay" role="dialog"><div id="collections-action-dialog"
class="dialog collections-dialog"
aria-hidden="true"><div class="title">Add to Collections</div><div class="collections-action-panel action-panel"><form id="collections-action-dialog-form"
class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-existing-collections-url="/list-existing-collections/"
data-add-to-existing-collection-url="/add-to-existing-collection/"
data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/"
data-myncbi-max-collection-name-length="100"
data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/"><input type="hidden" name="csrfmiddlewaretoken" value="Bw6JkrJrwS68dS7VEzE3coKmx6ibyJNmSjQOXhcN6tTC7jdLhSh5Gwg05a0nrklG"><div class="choice-group" role="radiogroup"><ul class="radio-group-items"><li><input type="radio"
id="collections-action-dialog-new"
class="collections-new"
name="collections"
value="new"
data-ga-category="collections_button"
data-ga-action="click"
data-ga-label="collections_radio_new"><label for="collections-action-dialog-new">Create a new collection</label></li><li><input type="radio"
id="collections-action-dialog-existing"
class="collections-existing"
name="collections"
value="existing"
checked="true"
data-ga-category="collections_button"
data-ga-action="click"
data-ga-label="collections_radio_existing"><label for="collections-action-dialog-existing">Add to an existing collection</label></li></ul></div><div class="controls-wrapper"><div class="action-panel-control-wrap new-collections-controls"><label for="collections-action-dialog-add-to-new" class="action-panel-label required-field-asterisk">
Name your collection:
</label><input
type="text"
name="add-to-new-collection"
id="collections-action-dialog-add-to-new"
class="collections-action-add-to-new"
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/"
maxlength="100"
data-ga-category="collections_button"
data-ga-action="create_collection"
data-ga-label="non_favorties_collection"><div class="collections-new-name-too-long usa-input-error-message selection-validation-message">
Name must be less than 100 characters
</div></div><div class="action-panel-control-wrap existing-collections-controls"><label for="collections-action-dialog-add-to-existing" class="action-panel-label">
Choose a collection:
</label><select id="collections-action-dialog-add-to-existing"
class="action-panel-selector collections-action-add-to-existing"
data-ga-category="collections_button"
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<p>
Vitamin C (Ascorbic Acid), the antiscorbutic vitamin, cannot be synthesized by humans and other primates, and has to be obtained from diet. Ascorbic acid is an electron donor and acts as a cofactor for fifteen mammalian enzymes. Two sodium-dependent transporters are specific for ascorbic acid, and its oxidation product dehydroascorbic acid is transported by glucose transporters. Ascorbic acid is differentially accumulated by most tissues and body fluids. Plasma and tissue vitamin C concentrations are dependent on amount consumed, bioavailability, renal excretion, and utilization. To be biologically meaningful or to be clinically relevant, in vitro and in vivo studies of vitamin C actions have to take into account physiologic concentrations of the vitamin. In this paper, we review vitamin C physiology; the many phenomena involving vitamin C where new knowledge has accrued or where understanding remains limited; raise questions about the vitamin that remain to be answered; and explore lines of investigations that are likely to be fruitful.
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dehydroascorbic acid; dose-concentration relationship; recommended dietary allowance; scurvy; vitamin C; vitamin C transport.
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<p> Figure 1. Ascorbic acid metabolism </p>
</strong>
<div class="figure-caption-contents"><p> Ascorbic acid… </p></div>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 1. Ascorbic acid metabolism </p>
</strong>
<div class="figure-caption-contents"><p> Ascorbic acid metabolism and halogenated analogues of ascorbic acid. Vitamin… </p></div>
</div>
<figcaption id="figure-caption-0" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 1. Ascorbic acid metabolism
</strong>
<div class="figure-caption-contents">Ascorbic acid metabolism and halogenated analogues of ascorbic acid. Vitamin C
(ascorbic acid) under physiological conditions is >99% in the form of
ascorbate anion (shown in bold)(Beuttner &
Schafer, 2004). It can sequentially donate two electrons from the
double bond between carbons two and three. Loss of the first electron
(oxidation) produces the free radical ascorbate radical (semidehydroascorbic
acid). Some reactive free radicals produced by biological processes can be
harmful because of their highly reactive nature. These can be reduced by
ascorbic acid but in the process ascorbic acid is itself is converted (oxidized)
into ascorbate radical. Ascorbate radical has a half-life of
10<sup>3</sup> seconds to several minutes, depending on the presence
of oxygen and metals. Under physiologic conditions, ascorbate radical is
comparatively unreactive compared to other free radicals. Ascorbate radical can
be reduced back to vitamin C. Alternately, it can lose a second electron
(oxidized) to form dehydroascorbic acid. Thus, because vitamin C loses
electrons, it acts as an antioxidant or free radical scavenger (Buettner, 1993). Dehydroascorbic acid is also unstable with a half-life of several minutes (Lewin, 1976). While dehydroascorbic acid
exists in different forms, the dominant form <i>in vivo</i> is likely
to be a hydrated hemiketal (Lewin, 1976,
Corpe et al., 2005). Dehydroascorbic
acid undergoes hydrolysis, with irreversible ring rupture to form 2,
3diketogulonic acid, whose metabolic products include oxalate,
threonate, and possibly xylose, xylonic acid, and lynxonic acid (Lewin, 1976). Oxalic acid is the
clinically significant metabolic product in humans (bold). In some animals,
products of vitamin C catabolism may enter the pentose phosphate pathway or
other pathways of carbohydrate metabolism (Banhegyi &amp; Loewus, 2004). Dehydroascorbic acid may be reduced
back sequentially to ascorbate radical and ascorbic acid by glutathione or
directly to ascorbic acid by enzyme dependent mechanisms (Linster &amp; Van Schaftingen, 2007). Under suitable
conditions (millimolar concentrations of ascorbic acid, presence of metal ions),
hydrogen peroxide may be formed. Analogues of vitamin C have been synthesized by
replacing the OH group at carbon 6 with bromine or iodine. These halogenated
analogues of vitamin C (shown in box) can be oxidized to bromo dehydroascorbic
acid and iodo dehydroascorbic acid respectively. However, oxidized halogen
ascorbate analogues cannot form a cyclized hydrated hemiketal (Fig. 2). Note that many of the reactions
above have been shown only <i>in vitro</i> or in animals and not under
physiological conditions <i>in vivo</i> or in humans. From (Washko et al., 1992). Modified and
reproduced with permission of Analytical Biochemistry.</div>
</figcaption>
</figure>
<figure class="figure-item "
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="1"
data-label-slug="figure-2">
<a class="figure-link"
href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/26bb7227997e/nihms-754526-f0002.jpg"
itemprop="contentUrl"
aria-describedby="figure-caption-1"
role="button"
data-image-width="625"
data-image-height="628"
data-image-alt="Figure 2"
data-pmc-id="PMC4959991"
data-figure-id="F2">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-1"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/9e8d4214c9c4/nihms-754526-f0002.gif"
alt="Figure 2" />
</a>
<meta itemprop="width" itemtype="http://schema.org/ImageObject" content="625">
<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="628">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 2. Vitamin C transporters </p>
</strong>
<div class="figure-caption-contents"><p> Distribution of… </p></div>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 2. Vitamin C transporters </p>
</strong>
<div class="figure-caption-contents"><p> Distribution of vitamin C transporters in human tissues. Sodium Vitamin… </p></div>
</div>
<figcaption id="figure-caption-1" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 2. Vitamin C transporters
</strong>
<div class="figure-caption-contents">Distribution of vitamin C transporters in human tissues. Sodium Vitamin C
Transporters (SVCTs) are mainly responsible for vitamin C transport into cells
in humans and other mammals. SVCT1 is primarily expressed in absorptive tissues,
including the intestinal epithelium and the proximal convoluted tubules and the
descending part of the loop of Henle in the kidney. SVCT 1 is also expressed in
liver. SVCT2 is expressed in most body tissues, as are Glucose Transporters
(GLUTs). SVCT 1 and 2 transport ascorbic acid but not dehydroascorbic acid into
cells. GLUTs 1, 2, 3, 4 and 8 (but not other GLUTS) (Corpe et al., 2013, Rumsey
et al., 2000a, Rumsey et al.,
1998, Burzle & Hediger,
2012), transport dehydroascorbic acid but not ascorbic acid into
cells. Some GLUTs have a higher affinity for DHA than for glucose. The
transporter responsible for exporting ascorbic acid from cells into the
extracellular fluid or plasma has not been identified. The only ascorbate
containing cell known to lack an SVCT is the mature red blood cell. The red
blood cell obtains its ascorbate by transporting dehydroascorbic acid and
immediately reducing it internally. Dehydroascorbic acid is transported into
human red blood cells by GLUT1, and into mouse red blood cells by GLUT 3 and/or
4 (Tu et al., 2015). D-Glucose closely
resembles the ring form (hydrated hemiketal form) of dehydroascorbic acid, which
is likely to account for its transport by some GLUTs. When bromo ascorbic acid
is oxidized to form bromo dehydroascorbic acid, this compound is not transported
by GLUTs. SVCT distribution was inferred by the presence of specific mRNA for
SVCT1 and 2, and in some cases by antibodies. Figure based on data from: (Tsukaguchi et al., 1999, Savini et al., 2008) (Daruwala et al., 1999, Wang et al., 1999, Wang et al., 2000).</div>
</figcaption>
</figure>
<figure class="figure-item "
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="2"
data-label-slug="figure-3">
<a class="figure-link"
href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/a5cb00038b24/nihms-754526-f0003.jpg"
itemprop="contentUrl"
aria-describedby="figure-caption-2"
role="button"
data-image-width="500"
data-image-height="625"
data-image-alt="Figure 3"
data-pmc-id="PMC4959991"
data-figure-id="F3">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-2"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/5272a5ea6b0d/nihms-754526-f0003.gif"
alt="Figure 3" />
</a>
<meta itemprop="width" itemtype="http://schema.org/ImageObject" content="500">
<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="625">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 3. Vitamin C concentrations in human… </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 3. Vitamin C concentrations in human and rat tissues and fluids </p>
</strong>
<div class="figure-caption-contents"><p> Concentration of vitamin… </p></div>
</div>
<figcaption id="figure-caption-2" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 3. Vitamin C concentrations in human and rat tissues and fluids
</strong>
<div class="figure-caption-contents">Concentration of vitamin C in body tissues and body fluids are shown in
µM. Ascorbic acid concentrations are much higher in tissues than in
plasma. Tissues and body fluids are shown in separate concentration dependent
color schemes. Organs that are uncolored (white) indicate that data on vitamin C
concentrations are unavailable. For clarity, some organs shown are slightly
displaced from their correct anatomical positions. Vitamin C concentrations
shown are derived from published reports. Values for white blood cells and
urinary vitamin C concentrations were obtained from depletion repletion studies
in young healthy women, at the study phase when they were at steady state for
vitamin C intake of 100 mg per day (Levine et
al., 2001b), which is close to the recommended dietary allowance for
vitamin C. Note that the red blood cell is the only cell with internal
concentrations of vitamin C that are below those in plasma (values less than
plasma are shown in red). Of body fluids, only saliva has a vitamin C
concentration lower than that of plasma. Putative functions of vitamin C as a
cofactor for enzymes are indicated, as are selected clinical or experimental
observations of phenomenon involving vitamin C. Values shown should be
considered approximate as they were obtained from tissues collected under non
uniform conditions including clinical and post mortem samples. Some vitamin C
concentrations shown are the mean values of results from two or more studies.
Further, the dietary intake or plasma concentrations of vitamin C were not known
in many cases and the methods used in sample collection and storage, and for
vitamin C assays, varied widely. Values may also vary with age and possibly in
disease states. Data obtained from (Hornig,
1975, Voigt et al.,
2002)(Dostalova, 1982, Koliakos et al., 2002, Vobecky et al., 1982, Evans et al., 1982, Omaye et al., 1987, Berger
et al., 1996, Taylor et al.,
1997, Rathbone et al., 1989,
Sobala et al., 1989, Levine et al., 2001b, Jacob et al., 1987). Reported salivary
vitamin C concentrations varied widely. Salivary vitamin C concentration shown
(median 0.6 µM, range 0.2-19 µM) in nonsmokers was measured by
HPLC. Corresponding median plasma vitamin C concentration was 53 µM
(range 16 µM-89 µM)(Schock et
al., 2004). Note that tissue vitamin C concentrations shown for the
rat are much higher than for humans. Explanations are that fresh tissue samples
can be obtained from animals (while many human tissue samples were obtained post
mortem), or that there are true species differences. Compared to other tissues,
AA concentrations in the rat pituitary and adrenal glands are higher, and
therefore they are shown in arbitrary colors (and not according to the
concentration dependent color scale) (Hornig,
1975). Vitamin C concentration data for mice are similar to that of
the rat (Sotiriou et al., 2002, Corpe et al., 2010).</div>
</figcaption>
</figure>
<figure class="figure-item "
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="3"
data-label-slug="figure-4">
<a class="figure-link"
href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/173be3e32309/nihms-754526-f0004.jpg"
itemprop="contentUrl"
aria-describedby="figure-caption-3"
role="button"
data-image-width="635"
data-image-height="371"
data-image-alt="Figure 4"
data-pmc-id="PMC4959991"
data-figure-id="F4">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-3"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/37fd2ede5624/nihms-754526-f0004.gif"
alt="Figure 4" />
</a>
<meta itemprop="width" itemtype="http://schema.org/ImageObject" content="635">
<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="371">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 4. Vitamin C dose concentration relationship </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 4. Vitamin C dose concentration relationship </p>
</strong>
<div class="figure-caption-contents"><p> Vitamin C concentrations in plasma and circulating cells… </p></div>
</div>
<figcaption id="figure-caption-3" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 4. Vitamin C dose concentration relationship
</strong>
<div class="figure-caption-contents">Vitamin C concentrations in plasma and circulating cells were studied in young
healthy men (Levine et al., 1996b) and
women (Levine et al., 2001b) each of
whom were given six to seven different doses of the vitamin in two
depletion-repletion studies. Seven healthy men (<b>4A</b>) and fifteen
healthy women (<b>4B</b>), all nonsmokers, age 19-27 years were studied as
inpatients. To decrease hospitalization time, outpatient subjects prior to
admission were instructed to consume a diet containing &lt; 60 mg of vitamin
C. When inpatients, throughout hospitalization they consumed a defined diet
containing less than 5 mg of vitamin C daily (King et al., 1997). Deficiencies of other nutrients were prevented
by supplementation. When plasma vitamin C concentrations achieved nadir of
&lt;10 µM, vitamin C in solution was administered at 15 mg orally in
the fasted state twice daily (30 mg total per day) until steady state for the
dose was achieved. Vitamin C dose was increased to 30 mg twice daily (60 mg
total per day) until steady state was achieved for this dose. In this way
subjects received the following doses in mg/day: 30, 60, 100, 200, 400, 1000,
and 2500. Vitamin C was measured by HPLC with coulometric electrochemical
detection. Doses are indicated at the top of the figure. Each symbol represents
a different subject. There is a one-day gap between all doses for
bioavailability sampling. Each vertical line represents the start of a new dose.
Some subjects reached steady state concentrations earlier than others; the
duration shown is longest time taken by a subject to reach steady state. Two
subjects were studied at one time and the graphs show data collated at the end
of all studies. Modified and reproduced with permission from Biofactors (Levine et al., 2001a) and The Proceedings
of the National Academy of Sciences (Levine et
al., 2001b).</div>
</figcaption>
</figure>
<figure class="figure-item "
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="4"
data-label-slug="figure-4">
<a class="figure-link"
href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/66c8622a927d/nihms-754526-f0005.jpg"
itemprop="contentUrl"
aria-describedby="figure-caption-4"
role="button"
data-image-width="647"
data-image-height="449"
data-image-alt="Figure 4"
data-pmc-id="PMC4959991"
data-figure-id="F4">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-4"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/37fd2ede5624/nihms-754526-f0004.gif"
alt="Figure 4" />
</a>
<meta itemprop="width" itemtype="http://schema.org/ImageObject" content="647">
<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="449">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 4. Vitamin C dose concentration relationship </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 4. Vitamin C dose concentration relationship </p>
</strong>
<div class="figure-caption-contents"><p> Vitamin C concentrations in plasma and circulating cells… </p></div>
</div>
<figcaption id="figure-caption-4" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 4. Vitamin C dose concentration relationship
</strong>
<div class="figure-caption-contents">Vitamin C concentrations in plasma and circulating cells were studied in young
healthy men (Levine et al., 1996b) and
women (Levine et al., 2001b) each of
whom were given six to seven different doses of the vitamin in two
depletion-repletion studies. Seven healthy men (<b>4A</b>) and fifteen
healthy women (<b>4B</b>), all nonsmokers, age 19-27 years were studied as
inpatients. To decrease hospitalization time, outpatient subjects prior to
admission were instructed to consume a diet containing &lt; 60 mg of vitamin
C. When inpatients, throughout hospitalization they consumed a defined diet
containing less than 5 mg of vitamin C daily (King et al., 1997). Deficiencies of other nutrients were prevented
by supplementation. When plasma vitamin C concentrations achieved nadir of
&lt;10 µM, vitamin C in solution was administered at 15 mg orally in
the fasted state twice daily (30 mg total per day) until steady state for the
dose was achieved. Vitamin C dose was increased to 30 mg twice daily (60 mg
total per day) until steady state was achieved for this dose. In this way
subjects received the following doses in mg/day: 30, 60, 100, 200, 400, 1000,
and 2500. Vitamin C was measured by HPLC with coulometric electrochemical
detection. Doses are indicated at the top of the figure. Each symbol represents
a different subject. There is a one-day gap between all doses for
bioavailability sampling. Each vertical line represents the start of a new dose.
Some subjects reached steady state concentrations earlier than others; the
duration shown is longest time taken by a subject to reach steady state. Two
subjects were studied at one time and the graphs show data collated at the end
of all studies. Modified and reproduced with permission from Biofactors (Levine et al., 2001a) and The Proceedings
of the National Academy of Sciences (Levine et
al., 2001b).</div>
</figcaption>
</figure>
<figure class="figure-item "
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="5"
data-label-slug="figure-5">
<a class="figure-link"
href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/5cbf05bbbee4/nihms-754526-f0006.jpg"
itemprop="contentUrl"
aria-describedby="figure-caption-5"
role="button"
data-image-width="524"
data-image-height="624"
data-image-alt="Figure 5"
data-pmc-id="PMC4959991"
data-figure-id="F5">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-5"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/b00dcd1ade61/nihms-754526-f0006.gif"
alt="Figure 5" />
</a>
<meta itemprop="width" itemtype="http://schema.org/ImageObject" content="524">
<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="624">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 5. Ascorbate flux in humans </p>
</strong>
<div class="figure-caption-contents"><p> The… </p></div>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 5. Ascorbate flux in humans </p>
</strong>
<div class="figure-caption-contents"><p> The relationship between the daily intake of known doses… </p></div>
</div>
<figcaption id="figure-caption-5" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 5. Ascorbate flux in humans
</strong>
<div class="figure-caption-contents">The relationship between the daily intake of known doses of vitamin C and its
absorption, distribution and excretion are shown for four different daily
intakes of vitamin C. Data were obtained from studies in seven healthy young men
(Levine et al., 1996b) detailed in
Fig 4. Ascorbate flux is shown in four
panels. The upper part of each panel shows the relationship between an oral dose
of vitamin C and: bioavailability; amount absorbed by the gastrointestinal
tract; peak plasma concentrations reached; and the amount of the vitamin
excreted in urine. Bioavailability studies were performed when patients were at
steady-state for that dose (with some modifications, see below). Following each
bioavailability study, subjects were given twice daily doses of the vitamin
until they reached steady state for that dose. The lower part of each panel
shows the steady-state condition for a specific dose. The panels for 50 and 100
mg doses can be taken as examples. When subjects were at steady-state for
vitamin C intake of 50 mg twice daily (100mg total daily dose), fasting plasma
vitamin C concentrations were 56µM, and neutrophil and lymphocyte vitamin
C concentrations were 1250 µM and 3100 µM respectively. At this
stage, bioavailability was studied in part by using a test dose of 100mg by
mouth (labelled “test dose”). Urine excretion data (25 mg) are
shown for this oral dose. Not shown are data for the same dose administered
intravenously, to permit bioavailability to be calculated. Bioavailability for
the 100 mg test dose was 80%: 80 mg of vitamin C was absorbed, and the resultant
peak plasma vitamin C concentration attained was 78 µM. 25 mg of vitamin
C was excreted in the urine in the following 24 hours. The upper part of each of
the four panels shows bioavailability doses of 15, 50, 100 or 500 mg. The lower
part of the four panels show steady state for vitamin C intake of 30 mg/day, 100
mg/day (close to the recommended dietary allowance), 200 mg/day (the approximate
amount provided by five servings of fruits and vegetables per day), or
1000mg/day (a dose that is used as a dietary supplement). Data shown are mean
values for all patients studied. Amount absorbed was calculated from
bioavailability data (Graumlich et al.,
1997, Levine et al., 1996b).
Separate color schemes, for which the intensity of color is related to the
amount or concentration of vitamin C, are used for test doses; amounts absorbed
and excreted in the urine; and for fasting steady state intracellular vitamin C
concentrations. Bioavailability studies were performed as follows: bioavailability for 15 mg dose
at the end of depletion phase, for 50 mg when the subjects were at steady state
for 60 mg, for 100 mg when the subjects were at steady state for 100 mg, and for
500 mg when the subjects were at steady state for 400 mg. Note that the end of
the depletion phase was not a true steady-state. Mean fasting plasma vitamin C
concentration at the end of depletion was 7.62 +/ 1.64 µM.
Fasting steady state plasma vitamin C concentrations at the time of oral
bioavailability tests were: for 50 mg dose, 24.8 µM +/ 14.1; for
100 mg dose, 56 µM +/ 4.5; and for 500 mg dose, 70 µM
+/ 6.9. Each subject received a total of seven different doses of
vitamin C but only data from four bioavailability studies and for four steady
state conditions are shown. Details of methods used were previously published
(King et al., 1997, Graumlich et al., 1997, Levine et al., 1996b, Levine et al., 2001b).</div>
</figcaption>
</figure>
<figure class="figure-item tail"
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="6"
data-label-slug="figure-6">
<a class="figure-link"
href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/6617740a5133/nihms-754526-f0007.jpg"
itemprop="contentUrl"
aria-describedby="figure-caption-6"
role="button"
data-image-width="625"
data-image-height="605"
data-image-alt="Figure 6"
data-pmc-id="PMC4959991"
data-figure-id="F6">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-6"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/0d96b85d2d20/nihms-754526-f0007.gif"
alt="Figure 6" />
</a>
<meta itemprop="width" itemtype="http://schema.org/ImageObject" content="625">
<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="605">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 6. Ascorbic acid recycling in Human… </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 6. Ascorbic acid recycling in Human Neutrophils </p>
</strong>
<div class="figure-caption-contents"><p> Ascorbic acid (AA) and dehydroascorbic acid (DHA)… </p></div>
</div>
<figcaption id="figure-caption-6" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 6. Ascorbic acid recycling in Human Neutrophils
</strong>
<div class="figure-caption-contents">Ascorbic acid (AA) and dehydroascorbic acid (DHA) transport and recycling in
human neutrophils <i>in vitro</i> (Stankova et al., 1975) (Bigley &amp;
Stankova, 1974) (Hemila et al.,
1984) (Anderson &amp; Lukey,
1987, Wang et al., 1997).
When normal human neutrophils <i>in vitro</i> were activated by
pathogens (E coli, Enterococcus faecalis, Moraxella catarrhlis, Klebsiella
oxytoca, Acinetobacter baumanii or <i>C. albicans</i>) (Wang et al., 1997), neutrophils
accumulated ascorbic acid. Intracellular vitamin C concentrations increased from
~ 1.3mM to 8mM, and vitamin C in the culture media decreased to
undetectable concentrations from 50µM. These findings did not occur when
neutrophils were used from patients with Chronic Granulomatous Disease (Wang et al., 1997). Patients with this
condition are unable to make superoxide, and have dysfunctional neutrophils that
cannot kill certain pathogens. The observed <i>in vitro</i> phenomena
can be accounted for by the proposed model described below. Normal human
neutrophils maintain internal vitamin C concentrations of about ~ 1.3mM
by uptake of AA by sodium-dependent vitamin C transporter 2 (SVCT2). Activated
neutrophils secrete reactive oxygen species because membrane associated NADPH
oxidase is able to transfer electrons across the cell membrane, using NADPH in
the process. H<sub>2</sub>O<sub>2</sub> is formed, which is a precursor for
production of reactive oxygen species (ROS and RNOS). These oxidize
extracellular AA to DHA. Neutrophil activation with oxidant formation and its
consequent results are shown in red. DHA is rapidly transported into the
neutrophil by glucose transporters, probably GLUT1 and GLUT3, and immediately
reduced to AA by glutaredoxin, producing a 4 to10-fold increase in neutrophil
internal AA concentration. When bacteria are engulfed by the neutrophil, a
phagolysosome is formed. Myeloperoxidase containing vesicles fuse with the
phagolysosome, such that the oxidant generating reactions occur in a sequestered
space. Although superoxide cannot cross the plasma membrane,
H<sub>2</sub>O<sub>2</sub> can readily diffuse into the cell. Oxidants
generated by H2O2 can be reduced by internal AA. Glutathione (GSH), used by
glutaredoxin during DHA reduction, is regenerated from glutathione disulfide
(GSSG) by glutathione reductase (GRD) and NADPH. NADPH essential for these
reactions is derived predominantly from the pentose phosphate pathway. Two
molecules of NADPH are produced by the oxidative phase of pentose phosphate
pathway (shown in green) when glucose 6 phosphate is converted to ribulose 6
phosphate (shown in green). Ribulose 6 phosphate undergoes further metabolism in
the non-oxidative phase of the pentose phosphate pathway. As NADPH is oxidized
to NADP, electrons are transferred to GRD so it can reduce GSSG to GSH. Modified
and reproduced from (Rumsey &amp; Levine,
1998), with permission of the Journal of Nutritional
Biochemistry.</div>
</figcaption>
</figure>
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itemprop="associatedMedia"
data-slide-index="7"
data-label-slug="figure-7">
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href="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/718384a1d0f5/nihms-754526-f0008.jpg"
itemprop="contentUrl"
aria-describedby="figure-caption-7"
role="button"
data-image-width="600"
data-image-height="452"
data-image-alt="Figure 7"
data-pmc-id="PMC4959991"
data-figure-id="F7">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-7"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/5cdb892d5d64/nihms-754526-f0008.gif"
alt="Figure 7" />
</a>
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<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="452">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 7. Vitamin C secretion by human… </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 7. Vitamin C secretion by human adrenal glands </p>
</strong>
<div class="figure-caption-contents"><p> Vitamin C concentrations were measured in… </p></div>
</div>
<figcaption id="figure-caption-7" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 7. Vitamin C secretion by human adrenal glands
</strong>
<div class="figure-caption-contents">Vitamin C concentrations were measured in the adrenal and peripheral veins of 26
patients with primary hyperaldosteronism. Under radiographic guidance, catheters
were placed in both adrenal veins, and blood samples were taken after
stimulation with adrenocorticotrophic hormone (ACTH). Vitamin C concentrations
in each of the adrenal (<i>n</i> = 47) and peripheral
(<i>n</i> = 26) veins sampled are shown. In 5 patients, blood
samples were obtained from only one adrenal vein because of unusual venous
anatomy or difficulties with adrenal vein catheterization. In the adrenal veins,
peak vitamin C concentrations (Mean ± SD: 176 ± 71 µmol/L)
were reached between 1 and 4 min, and were significantly (<i>P</i>
&lt; 0.0001, paired <i>t</i> test) higher than corresponding
peripheral plasma vitamin C concentrations (35 ± 15 µmol/L). In
patients in whom adrenal vein vitamin C concentration could be measured in only
one adrenal gland, that single value was used in the calculation. In patients in
whom both adrenals were successfully sampled, the mean of the two adrenal vein
vitamin C concentrations was used for calculation, but all values are shown.
Modified and reproduced from (Padayatty et al.,
2007), with permission from American Journal of Clinical
Nutrition.</div>
</figcaption>
</figure>
<figure class="figure-item tail"
itemscope itemtype="http://schema.org/ImageObject"
itemprop="associatedMedia"
data-slide-index="8"
data-label-slug="figure-8">
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itemprop="contentUrl"
aria-describedby="figure-caption-8"
role="button"
data-image-width="625"
data-image-height="562"
data-image-alt="Figure 8"
data-pmc-id="PMC4959991"
data-figure-id="F8">
<img class="figure-thumb" itemprop="thumbnail"
id="article-image-8"
src="https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5863/4959991/b23b461af375/nihms-754526-f0009.gif"
alt="Figure 8" />
</a>
<meta itemprop="width" itemtype="http://schema.org/ImageObject" content="625">
<meta itemprop="height" itemtype="http://schema.org/ImageObject" content="562">
<div class="figure-caption figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="caption" aria-hidden="true">
<div class="caption-wrap">
<strong class="figure-label">
<p> Figure 8. Ascorbate radical formation <i> in vivo </i> </p>
</strong>
</div>
</div>
<div class="figure-caption-medium figure-caption-text" aria-hidden="true">
<strong class="figure-label">
<p> Figure 8. Ascorbate radical formation <i> in vivo </i> </p>
</strong>
<div class="figure-caption-contents"><p> Concentrations of ascorbate, ascorbate radical (Asc <sup> • −… </sup> </p></div>
</div>
<figcaption id="figure-caption-8" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
<strong class="figure-label">
Figure 8. Ascorbate radical formation <i>in vivo</i>
</strong>
<div class="figure-caption-contents">Concentrations of ascorbate, ascorbate radical (Asc<sup></sup>)
(radical is denoted by a superscript dot) and H<sub>2</sub>O<sub>2</sub> in
blood and extracellular space, and proposed mechanisms that result in measurable
Asc<sup></sup> and H<sub>2</sub>O<sub>2</sub> in
extracellular fluid but not in blood. Whether given by oral or parenteral
routes, ascorbate rapidly equilibrates between blood and extracellular fluid,
possibly through intercellular junctions. When pharmacological doses are
administered parenterally, blood and extracellular fluid ascorbate
concentrations reached 10 to 20 mM. Concentrations of Asc<sup>
</sup> in blood reached 10-30 nM but H<sub>2</sub>O<sub>2</sub> was
not detectable in blood. Asc<sup></sup> and
H<sub>2</sub>O<sub>2</sub> reached concentrations of 250-300 nM and 150
µM respectively in extracellular fluid. A proposed scheme that accounts
for these observations are as follows: In extracellular fluid, ascorbate loses
one electron to form Asc<sup></sup> (solid lines). The electron
reduces a protein-centered metal, for example Fe<sup>3+</sup> to
Fe<sup>2+</sup>. Candidate proteins may be either in extracellular fluid, or on
cell membranes facing outward. Fe<sup>2+</sup> donates an electron to oxygen,
forming superoxide (O<sub>2</sub>
<sup></sup>) which undergoes dismutation to form
H<sub>2</sub>O<sub>2</sub> (Qian &amp;
Buettner, 1999). In blood, these reactions are damped or inhibited
(dashed lines), or the resultant products diffuse into red blood cells where
they are rapidly extinguished/reduced. In blood, the formation of
Asc<sup></sup> may be inhibited by red blood cell membrane
bound reducing proteins (May et al.,
2001) and/or by large plasma proteins that do not distribute into the
extracellular space. H<sub>2</sub>O<sub>2</sub> that is formed in blood will be
immediately destroyed by plasma catalase and red blood cell GSH peroxidase, so
that no H<sub>2</sub>O<sub>2</sub> is detectable (Chen et al., 2007, Gaetani
et al., 1996, Johnson et al.,
2005) (Chen et al., 2005). The
identities of the metal-centered proteins are not known.
H<sub>2</sub>O<sub>2</sub> that diffuses into the blood or tissues from
extracellular fluid is inactivated by reducing substances in these compartments.
Ascorbate was measured by HPLC, Asc<sup></sup> by Electron
Paramagnetic Resonance (EPR) and H<sub>2</sub>O<sub>2</sub> by fluorescence
(Chen et al., 2007). The values shown
are approximations from measurements in animals given ascorbate by the intra
peritoneal or intravenous routes (Chen et al.,
2007)(Chen et al., 2005, Chen et al., 2008). Modified and reproduced
from (Chen et al., 2007), with permission
from the National Academy of Sciences.</div>
</figcaption>
</figure>
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