Current role of high dose vitamin C in sepsis management: A concise review

Table 1 Biological effects of vitamin C

Biological effects of vitamin C	Mechanisms of action
Antioxidant properties	Reduced production of reactive oxygen species; Reduced production of endothelial nitric oxide
Prevention of mitochondrial dysfunction	Reduction of oxidation injury; Reduces apoptosis
Prevention of septic cardiomyopathy	Reduction of oxidation injury; Increased carnitine synthesis; Reduces apoptosis
Prevention of micro and macro vascular dysfunction	Acts as a co-factor for synthesis of catecholamines (epinephrine, norepinephrine) and vasopressin; Inhibition of iNOS expression
Anti-inflammatory effects	Supresses activation of nuclear factor kappa-B (NF-κB); Inhibits tumor necrosis factor-α; Reduces pro-inflammatory cytokines like high mobility group box-1; Lowers histamine levels
Immune enhancing effects	T-cell maturation and modulation; Improves neutrophil chemotaxis and phagocytosis; Enhances oxidative killing; Promotes proliferation of lymphocytes; Stimulates interferon production; Increased antibody production