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The Role of Vitamin C in Gastric Health and Disease Prevention
Vitamin C and Gastric Cancer Risk Reduction
Plasma Vitamin C and Gastric Adenocarcinoma
Research indicates that higher levels of plasma vitamin C are associated with a reduced risk of gastric adenocarcinoma (GA). A study conducted in China found that each 20-μmol/L increase in plasma vitamin C was linked to a 14% decrease in the risk of GA1. Additionally, individuals with normal plasma vitamin C concentrations had a 27% reduced risk of GA compared to those with low concentrations1. A meta-analysis further supported these findings, showing a 31% lower risk of incident GA among those with the highest plasma vitamin C levels1.
Vitamin C Supplementation and Gastric Mucosal Health
Vitamin C supplementation has been shown to protect against the progression of gastric mucosal atrophy, a precursor to gastric cancer. A five-year randomized controlled trial in Japan demonstrated that high-dose vitamin C supplementation significantly improved serum pepsinogen levels, indicating a protective effect on the gastric mucosa2. This suggests that vitamin C may help maintain the integrity of the gastric lining and prevent atrophic changes that can lead to cancer.
Vitamin C and Gastric Protection Mechanisms
Antioxidant Properties and Heme Oxygenase-1
Vitamin C's gastroprotective effects are partly due to its ability to induce heme oxygenase-1 (HO-1) expression, which has antioxidant and vasodilative properties. Studies on gastric epithelial cells have shown that vitamin C increases HO-1 mRNA and protein expression, thereby enhancing the cells' resistance to oxidative damage3. This mechanism helps mitigate the harmful effects of free radicals on the gastric mucosa.
Reduction of Mutagenic Activity in Gastric Juice
Oral supplementation of vitamin C has been found to reduce the mutagenic activity of gastric juice. In a study involving patients with chronic gastritis, vitamin C supplementation significantly decreased mutagenic activity and increased intragastric ascorbate levels without altering gastric pH4. This reduction in mutagenic activity is crucial for preventing DNA damage and subsequent cancer development.
Vitamin C and Helicobacter pylori Infection
Impact on Gastric Vitamin C Levels
Helicobacter pylori (H. pylori) infection is known to reduce intragastric concentrations of vitamin C. Patients infected with H. pylori have significantly lower levels of gastric juice ascorbic acid compared to uninfected individuals8. The severity of gastritis and the presence of CagA antibodies further exacerbate this reduction8. This suggests that maintaining adequate vitamin C levels could be particularly important for individuals with H. pylori infection to counteract the infection's negative impact on gastric health.
Protective Effects Against Gastric Mucosal DNA Damage
Vitamin C supplementation has been shown to decrease gastric mucosal DNA damage in patients with chronic atrophic gastritis. A study involving 43 patients found that vitamin C treatment elevated intragastric ascorbate levels and reduced DNA damage in the gastric mucosa5. This supports the hypothesis that vitamin C can protect against the genotoxic effects of chronic inflammation and infection in the stomach.
Conclusion
Vitamin C plays a crucial role in maintaining gastric health and preventing gastric cancer. Its antioxidant properties, ability to induce protective enzymes, and capacity to reduce mutagenic activity in gastric juice all contribute to its protective effects. Additionally, vitamin C supplementation can mitigate the adverse effects of H. pylori infection and chronic gastritis on the gastric mucosa. These findings underscore the importance of adequate vitamin C intake for gastric cancer prevention and overall gastric health.
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Most relevant research papers on this topic
Prediagnostic plasma vitamin C and risk of gastric adenocarcinoma and esophageal squamous cell carcinoma in a Chinese population.
Higher circulating vitamin C is associated with a reduced risk of gastric adenocarcinoma, but no association was found for esophageal squamous cell carcinoma.
Meta-Analysis
Very Rigorous JournalThe effect of 5‐year vitamin C supplementation on serum pepsinogen level and Helicobacter pylori infection
Vitamin C supplementation may protect against progression of gastric mucosal atrophy.
RCT
Large Human TrialGastroprotection by vitamin C--a heme oxygenase-1-dependent mechanism?
Vitamin C reduces gastric toxicity of acetyl-salicylic acid by transforming mRNA into active protein, offering antioxidant and vasodilative properties.
Effect of increased intake of vitamin C on the mutagenic activity of gastric juice and intragastric concentrations of ascorbic acid.
Oral vitamin C supplements significantly reduce mutagenic activity in gastric juice and increase intragastric ascorbic acid levels, potentially aiding in the chemoprevention of gastric cancer.
Non-RCTEffect of vitamin C supplementation on gastric mucosal DNA damage.
Vitamin C supplementation may have a protective effect against gastric cancer by decreasing gastric mucosal DNA damage in 28 out of 43 patients with chronic atrophic gastritis.
Non-RCTVitamin C in the human stomach: relation to gastric pH, gastroduodenal disease, and possible sources.
Low fasting vitamin C levels in hypochlorhydric gastric juice may be caused by chemical instability and may be secreted by the human stomach.
Observational Study
Highly CitedPlasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST).
High plasma vitamin C levels are associated with a decreased risk of gastric cancer, with a stronger inverse association observed in individuals consuming higher levels of red and processed meats.
Observational StudyHighly CitedThe relation between gastric vitamin C concentrations, mucosal histology, and CagA seropositivity in the human stomach
Reduction in gastric vitamin C concentrations is related to gastric juice pH, severity of gastritis, H pylori infection, and CagA antibody status, potentially impacting H pylori-associated carcinogenesis.
Observational StudyHighly CitedVitamin C modulates adrenaline-augmented gastric injury via cardiac troponin/creatine kinase pathway in Wistar rats
Vitamin C pretreatment reduces excessive gastric secretions, ulcer scores, and attenuates cardio-inflammatory responses in adrenaline-induced myocardial injury in rats.
RCT
Animal StudyFormation of self-assembled polyelectrolyte complex hydrogel derived from salecan and chitosan for sustained release of Vitamin C.
The novel polyelectrolyte complex hydrogel, derived from salecan and chitosan, effectively protects vitamin C from gastric fluid and sustainably releases it in the intestine, improving its assimilation and health benefits.
Highly Cited