How Does Vitamin C Support The Immune System

Review

doi: 10.3390/nu9111211.

Vitamin C and Immune Function

Affiliations

  • PMID: 29099763
  • PMCID: PMC5707683
  • DOI: 10.3390/nu9111211

Free PMC article

Review

Vitamin C and Immune Function

Anitra C Carr  et al. Nutrients. .

Free PMC article

Abstract

Vitamin C is an essential micronutrient for humans, with pleiotropic functions related to its ability to donate electrons. It is a potent antioxidant and a cofactor for a family of biosynthetic and gene regulatory enzymes. Vitamin C contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. Vitamin C supports epithelial barrier function against pathogens and promotes the oxidant scavenging activity of the skin, thereby potentially protecting against environmental oxidative stress. Vitamin C accumulates in phagocytic cells, such as neutrophils, and can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately microbial killing. It is also needed for apoptosis and clearance of the spent neutrophils from sites of infection by macrophages, thereby decreasing necrosis/NETosis and potential tissue damage. The role of vitamin C in lymphocytes is less clear, but it has been shown to enhance differentiation and proliferation of B- and T-cells, likely due to its gene regulating effects. Vitamin C deficiency results in impaired immunity and higher susceptibility to infections. In turn, infections significantly impact on vitamin C levels due to enhanced inflammation and metabolic requirements. Furthermore, supplementation with vitamin C appears to be able to both prevent and treat respiratory and systemic infections. Prophylactic prevention of infection requires dietary vitamin C intakes that provide at least adequate, if not saturating plasma levels (i.e., 100-200 mg/day), which optimize cell and tissue levels. In contrast, treatment of established infections requires significantly higher (gram) doses of the vitamin to compensate for the increased inflammatory response and metabolic demand.

Keywords: ascorbate; ascorbic acid; immune system; immunity; infection; lymphocytes; microbial killing; neutrophil function; vitamin C.

Conflict of interest statement

S.M. is employed by Bayer Consumer Care Ltd., a manufacturer of multivitamins, and wrote the section on 'Vitamin C insufficiency conditions'. A.C.C. has received funding, as a Key Opinion Leader, from Bayer Consumer Care Ltd.

Figures

Figure 1
Figure 1

The enzyme cofactor activities of vitamin C. Vitamin C is a cofactor of a family of biosynthetic and gene regulatory monooxygenase and dioxygenase enzymes. These enzymes are involved in the synthesis of collagen, carnitine, catecholamine hormones, e.g., norepinephrine, and amidated peptide hormones, e.g., vasopressin. These enzymes also hydroxylate transcription factors, e.g., hypoxia-inducible factor 1α, and methylated DNA and histones, thus playing a role in gene transcription and epigenetic regulation. ↑ indicates an increase and ↓ indicates a decrease.

Figure 2
Figure 2

Role of vitamin C in phagocyte function. Vitamin C has been shown to: (a) enhance neutrophil migration in response to chemoattractants (chemotaxis), (b) enhance engulfment (phagocytosis) of microbes, and (c) stimulate reactive oxygen species (ROS) generation and killing of microbes. (d) Vitamin C supports caspase-dependent apoptosis, enhancing uptake and clearance by macrophages, and inhibits necrosis, including NETosis, thus supporting resolution of the inflammatory response and attenuating tissue damage.

Similar articles

  • Micronutrients at the interface between inflammation and infection--ascorbic acid and calciferol: part 1, general overview with a focus on ascorbic acid.

    Ströhle A, Wolters M, Hahn A. Ströhle A, et al. Inflamm Allergy Drug Targets. 2011 Feb;10(1):54-63. doi: 10.2174/187152811794352105. Inflamm Allergy Drug Targets. 2011. PMID: 21184650 Review.

  • Enhanced human neutrophil vitamin C status, chemotaxis and oxidant generation following dietary supplementation with vitamin C-rich SunGold kiwifruit.

    Bozonet SM, Carr AC, Pullar JM, Vissers MC. Bozonet SM, et al. Nutrients. 2015 Apr 9;7(4):2574-88. doi: 10.3390/nu7042574. Nutrients. 2015. PMID: 25912037 Free PMC article.

  • Dietary vitamin C deficiency depressed the gill physical barriers and immune barriers referring to Nrf2, apoptosis, MLCK, NF-κB and TOR signaling in grass carp (Ctenopharyngodon idella) under infection of Flavobacterium columnare.

    Xu HJ, Jiang WD, Feng L, Liu Y, Wu P, Jiang J, Kuang SY, Tang L, Tang WN, Zhang YA, Zhou XQ. Xu HJ, et al. Fish Shellfish Immunol. 2016 Nov;58:177-192. doi: 10.1016/j.fsi.2016.09.029. Epub 2016 Sep 15. Fish Shellfish Immunol. 2016. PMID: 27640333

  • Dietary vitamin C deficiency depresses the growth, head kidney and spleen immunity and structural integrity by regulating NF-κB, TOR, Nrf2, apoptosis and MLCK signaling in young grass carp (Ctenopharyngodon idella).

    Xu HJ, Jiang WD, Feng L, Liu Y, Wu P, Jiang J, Kuang SY, Tang L, Tang WN, Zhang YA, Zhou XQ. Xu HJ, et al. Fish Shellfish Immunol. 2016 May;52:111-38. doi: 10.1016/j.fsi.2016.02.033. Epub 2016 Mar 2. Fish Shellfish Immunol. 2016. PMID: 26944716

  • Immune-enhancing role of vitamin C and zinc and effect on clinical conditions.

    Wintergerst ES, Maggini S, Hornig DH. Wintergerst ES, et al. Ann Nutr Metab. 2006;50(2):85-94. doi: 10.1159/000090495. Epub 2005 Dec 21. Ann Nutr Metab. 2006. PMID: 16373990 Review.

Cited by 257 articles

  • Nutritional risk factors for SARS-CoV-2 infection: a prospective study within the NutriNet-Santé cohort.

    Deschasaux-Tanguy M, Srour B, Bourhis L, Arnault N, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Allègre J, Allès B, Andreeva VA, Baudry J, Fezeu LK, Galan P, Julia C, Kesse-Guyot E, Péneau S, Hercberg S, Bajos N, Severi G, Zins M, de Lamballerie X, Carrat F, Touvier M; SAPRIS-SERO study group. Deschasaux-Tanguy M, et al. BMC Med. 2021 Nov 30;19(1):290. doi: 10.1186/s12916-021-02168-1. BMC Med. 2021. PMID: 34844606 Free PMC article.

  • Microwave and convective drying kinetics and thermal properties of orange slices and effect of drying on some phytochemical parameters.

    Alibas I, Yilmaz A. Alibas I, et al. J Therm Anal Calorim. 2021 Nov 21:1-21. doi: 10.1007/s10973-021-11108-3. Online ahead of print. J Therm Anal Calorim. 2021. PMID: 34840521 Free PMC article.

  • Beneficial Effects of Vitamins, Minerals, and Bioactive Peptides on Strengthening the Immune System Against COVID-19 and the Role of Cow's Milk in the Supply of These Nutrients.

    Ahvanooei MRR, Norouzian MA, Vahmani P. Ahvanooei MRR, et al. Biol Trace Elem Res. 2021 Nov 27:1-14. doi: 10.1007/s12011-021-03045-x. Online ahead of print. Biol Trace Elem Res. 2021. PMID: 34837602 Free PMC article. Review.

  • Insufficient Vitamin C Levels among Adults in the United States: Results from the NHANES Surveys, 2003-2006.

    Crook J, Horgas A, Yoon SJ, Grundmann O, Johnson-Mallard V. Crook J, et al. Nutrients. 2021 Oct 30;13(11):3910. doi: 10.3390/nu13113910. Nutrients. 2021. PMID: 34836166 Free PMC article.

  • Dietary Diversity and Nutrient Intake of Han and Dongxiang Smallholder Farmers in Poverty Areas of Northwest China.

    Wang Z, Chen Y, Tang S, Chen S, Gong S, Jiang X, Wang L, Zhang Y. Wang Z, et al. Nutrients. 2021 Oct 30;13(11):3908. doi: 10.3390/nu13113908. Nutrients. 2021. PMID: 34836163 Free PMC article.

References

    1. Parkin J., Cohen B. An overview of the immune system. Lancet. 2001;357:1777–1789. doi: 10.1016/S0140-6736(00)04904-7. - DOI - PubMed
    1. Maggini S., Wintergerst E.S., Beveridge S., Hornig D.H. Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses. Br. J. Nutr. 2007;98:S29–S35. doi: 10.1017/S0007114507832971. - DOI - PubMed
    1. Webb A.L., Villamor E. Update: Effects of antioxidant and non-antioxidant vitamin supplementation on immune function. Nutr. Rev. 2007;65:181. doi: 10.1111/j.1753-4887.2007.tb00298.x. - DOI - PubMed
    1. Burns J.J. Missing step in man, monkey and guinea pig required for the biosynthesis of l-ascorbic acid. Nature. 1957;180:553. doi: 10.1038/180553a0. - DOI - PubMed
    1. Nishikimi M., Fukuyama R., Minoshima S., Shimizu N., Yagi K. Cloning and chromosomal mapping of the human nonfunctional gene for l-gulono-gamma-lactone oxidase, the enzyme for l-ascorbic acid biosynthesis missing in man. J. Biol. Chem. 1994;269:13685–13688. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources

  • Full Text Sources

    • Europe PubMed Central
    • Multidisciplinary Digital Publishing Institute (MDPI)
    • PubMed Central
  • Other Literature Sources

    • scite Smart Citations
  • Medical

    • ClinicalTrials.gov
    • MedlinePlus Health Information

How Does Vitamin C Support The Immune System

Source: https://pubmed.ncbi.nlm.nih.gov/29099763/