The role of inflammation and oxidative stress in the pathophysiology of depressions: time to consider vitamin C deficiency

C. Vollbracht, Marc Werner
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Abstract

Depression is on the rise and medication does not always provide satisfactory relief. This raises the question of a treatment gap that has not yet been (sufficiently) addressed. Inflammation and oxidative stress play an important pathophysiological role, which also leads to a deficiency of antioxidants such as vitamin C. This perspective mini-review reflects the results of a PubMed search combining the search terms depression with inflammation, oxidative stress and vitamin C. Vitamin C is an important antioxidant and co-factor for many neuronal metabolic and epigenetic pathways, and a deficiency is associated with depression and cognitive disorders. Inadequate vitamin C blood levels that do not yet result in somatic symptoms may induce neuropsychiatric scurvy, which is associated with increased neuroinflammation and characterized by depression and cognitive impairment. Experimental studies show that vitamin C has multifactorial effects on metabolic pathways relevant to depression. Treatment of vitamin C deficiency, which is more common than appreciated, should be considered in the management of depressed patients. Further studies should investigate whether the pharmacological administration of vitamin C has additional effects beyond the correction of deficiency.
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炎症和氧化应激在抑郁症病理生理学中的作用:是时候考虑维生素 C 缺乏症了
抑郁症呈上升趋势,而药物治疗并不总能提供令人满意的缓解。这就提出了一个尚未(充分)解决的治疗缺口问题。炎症和氧化应激起着重要的病理生理学作用,同时也会导致维生素 C 等抗氧化剂的缺乏。本视角小综述反映了 PubMed 搜索结果,该搜索结合了抑郁症、炎症、氧化应激和维生素 C 等关键词。血液中维生素 C 含量不足但尚未导致躯体症状,可能会诱发神经精神坏血病,这与神经炎症加重有关,并以抑郁和认知障碍为特征。实验研究表明,维生素 C 对与抑郁症相关的代谢途径具有多因素影响。在治疗抑郁症患者时,应考虑治疗维生素 C 缺乏症,因为维生素 C 缺乏症比人们想象的更为常见。进一步的研究应探讨维生素 C 的药理作用是否超出了纠正缺乏症的范围。
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