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249 Pages·1989·38.569 MB·English
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Vitamin C Volume II Author C. Alan B. Clemetson Professor Tulane University School of Medicine New Orleans, Louisiana Boca Raton London New York CRC Press, Inc. CRC Press is an imprint of the Taylor &B Foracnaci sR Garotuop,n an, Finlfoorrmiada b usiness First published 1989 by CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 Reissued 2018 by CRC Press © 1989 by CRC Press, Inc. CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright. com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Clemetson, C. Alan B. Vitamin C / C. Alan B. Clemetson. p. cm. Includes bibliographies and index. ISBN 0-8493-4841-2 (v. 1) ISBN 0-8493-4842-0 (v. 2) ISBN 0-8493-4843-9 (v. 3) 1. Vitamin C deficiency. 2. Vitamin C--Metabolism. I. Title. RC627.S36C53 1989 616 3’9--dc19 88-14735 A Library of Congress record exists under LC control number: 88014735 Publisher’s Note The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original copies may be apparent. Disclaimer The publisher has made every effort to trace copyright holders and welcomes correspondence from those they have been unable to contact. ISBN 13: 978-1-315-89847-6 (hbk) ISBN 13: 978-1-351-07757-6 (ebk) Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com FOREWORD While frank scurvy is rare nowadays, subclinical vitamin C deficiency is common and is now known to be associated with elevated blood histamine levels, which rapidly return to normal when ascorbic acid is administered. Epidemiological and experimental evidence suggests that our common metabolic defect, the inability to synthesize ascorbic acid from simple sugars, may be largely responsible for the development of subendothelial hemorrhage, thrombosis, atheroma, and degenerative vascular disease. This book is more concerned with factors affecting ascorbic acid metabolism, such as aging, smoking, infection, trauma, surgery, hormone administration, heavy metals, pregnancy, hemolysis, ionizing radiation, aspirin, alcohol, and other drugs which cause a disturbance of ascorbic acid metabolism and may thereby lead to vascular disease, than it is with simple dietary deficiency of ascorbic acid. The clinical, pathological, and chemical changes observed in ascorbic acid deficiency are discussed in detail; several diseases and disorders associated with abnormalities of ascorbic acid metabolism are described. Possible toxic effects resulting from the oxidation of ascorbic acid are noted, and reasons for the use of D-catechin or other chelating fiber to prevent or minimize the release of ascorbate free radical are detailed. PREFACE About 60 years ago, and before the isolation of ascorbic acid, Mme. L. Randoin (1923)* found the number of research studies on the antiscorbutic vitamin so great as to make it impossible for her to review them all . a • '}a! maintenant parler des recherches de toute Now I must speak of all kinds of studies of the nature faites sur le facteur ant1scorbut1que. La tache antiscorbutic factor It is a thankless task because est bien mgrate, car le nombre de ces recherches the number of research studies is so great that it 1s est si grand qu' il m' est eVldemment impossible de clearly impossible to review them all; moreover, by les passer toutes en revue et, au surplus, elles pre- failure of agreement, they present such gaps that it sentent, par defaut de convergence, de telles la- is truly difficult to present a consistent thesis. cunes, qu' il est vraiment diffie~le d' en donner une idee d' ensemble." Today, the profusion of the literature on this subject is even more overwhelming. It is growing so fast that it is impossible to do justice to all the work that had been done in this field. Moreover, having written 57 chapters in 36 months, it is inevitable that the chapters written first will not be as up-to-date as those written last. Undoubtedly, some important works have been omitted, either because they have escaped my notice or because they were written in a language that I cannot read. Any workers whose contributions have been omitted must accept my assurance that it was not by intent. It is hoped that this book presents a consistent thesis and that its main message is clear. It does not so much concern the amount of vitamin C in the diet, as it does the factors affecting ascorbic acid metabolism, the diseases that may result from abnormalities of ascorbic acid metabolism, and some suggestions as to what we may be able to do to prevent them. Although the title of this book is Vitamin C, it could equally well have been entitled Vitamin C, Heavy Metals, and Chelating Fiber. C. Alan B. Clemetson, M.D. Pineville, Louisiana February, 1987 THE AUTHOR C. Alan B. Clemetson, M.D., was born in England. He attended the King's School, Canterbury, Magdalen College, Oxford, and Oxford University School of Medicine, grad- uating as a physician (B.M., B.Ch.) in 1948. He is an obstetrician and gynecologist, with fellowships in British, Canadian, and American colleges (F.R.C.O.G., F.R.C.S.C., and F.A.C.O.G.), but he has devoted most of his life to research and has published papers on many diverse subjects. His career has included academic positions at London University, the University of Sas- katchewan, the University of California at San Francisco, the State University of New York, and at Tulane University in Louisiana, where he is currently Professor at the School of Medicine. He has challenged many conventional ideas and believes that, "certainty of knowledge is the antithesis of progress." Thus, every statement in this book is backed by reference to experiments and observations in the literature; contrary findings are cited, weighed, and given due credence. VITAMIN C Volume I Vitamin C Deficiency Classical Scurvy: A Historical Review Chronic Subclinical Ascorbic Acid Deficiency Factors Affecting the Economy of Ascorbic Acid Inadequate Ascorbic Acid Intake Smoking Aging Sex Menstrual Cycle, Estrus Cycle, Ovulation Infection Trauma, Surgery, and Bums Heavy Metals, Water Supplies: Copper, Iron, Manganese, Mercury, and Cobalt Bioflavonoids Dietary Protein Hormone Administration: Birth Control Pills Pregnancy Hemolysis Stress and the Pituitary-Adrenal System Lack of Sleep Time of Day Season Achlorhydria Ionizing Radiation Aspirin and Salicylates Alcohol Other Factors Affecting Ascorbic Acid Needs Volume II Clinical and Pathological Findings in Ascorbic Acid Deficiency Vascular Changes Diabetes Mellitus Anemia Defective Wound Healing Bone Changes Joint Lesions Dental and Periodontal Changes Atherosclerosis Mental Depression Amyloid Venous Thrombosis Decreased Resistance to Infection Liver, Bile, and Gallstones Volume III Chemical Changes Associated with Vitamin C Deficiency Histamine Metabolism Proline and Lysine Metabolism Carbohydrate Metabolism Folic Acid Metabolism Cholesterol Metabolism Tyrosine and Phenylalanine Metabolism Tryptophan Metabolism Adrenal Corticoid Metabolism Uric Acid Clearance Clinical Conditions Associated with Disorders of Ascorbic Acid Metabolism Rheumatic Fever Menorrhagia Wound Dehiscence Habitual Abortion Abruptio Placentae Prematurity and Premature Rupture of the Fetal Membranes Megaloblastic Anemia of Infancy, Pregnancy, and Steatorrhea Gastrointestinal Ulcers and Hemorrhage Ocular Lesions Cerebral Hemorrhage and Thrombosis Coronary Thrombosis and Myocardial Infarction TABLE OF CONTENTS CLINICAL AND PATHOLOGICAL FINDINGS IN ASCORBIC ACID DEFICIENCY Chapter I Vascular Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I. Clinical Signs ..................................................................... 1 II. Microvascular Fragility ........................................................... 1 III. Microvascular Pathology .......................................................... 5 IV. Histamine Effects ................................................................. 9 V. Peripheral Vasodilation, Congestion, and Stasis ................................. 10 VI. Loss of Vasoconstrictor Response ............................................... 10 VII. Arterial and Venous Pathology ................................................... 12 VIII. Aortic Endothelial Pathology .................................................... 12 IX. Aortic Wall Chemistry ........................................................... 15 X. Summary and Conclusion ........................................................ 16 References ............................................................................... 18 Chapter 2 Diabetes Mellitus ....................................................................... 23 I. Review ........................................................................... 23 II. Conclusions ...................................................................... 37 References ............................................................................... 38 Chapter 3 Anemia ................................................................................. 41 I. Human Observations ............................................................. 41 II. Animal Studies .................................................................. 44 III. In Vitro Studies .................................................................. 45 IV. Megaloblastic Anemia of Infancy ................................................ 45 V. Megaloblastic Anemia of Pregnancy ............................................. 46 VI. Iron Deficiency Anemia ......................................................... 47 VII. The Anemia of Hemosiderosis ................................................... 49 VIII. The Anemia of Adult Scurvy in Temperate Regions ............................. 50 IX. Conclusions ...................................................................... 51 References ............................................................................... 51 Chapter 4 Defective Wound Healing .............................................................. 55 References ............................................................................... 68 Chapter 5 Bone Changes .......................................................................... 71 I. Introduction ...................................................................... 71 II. Human Observations ............................................................. 71 Ill. X-Ray Findings .................................................................. 76 IV. Guinea Pig Studies ............................................................... 79 V. Studies of Other Animals ........................................................ 87 VI. Conclusions ...................................................................... 88 References ............................................................................... 88 Chapter 6 Joint Lesions ........................................................................... 93 I. Introduction ...................................................................... 93 II. Ascorbic Acid Deficiency in Animals ............................................ 93 III. Experimental Human Scurvy .................................................... 103 IV. Relevant Laboratory Studies .................................................... 105 V. Infantile Scurvy ................................................................. 110 VI. Adult Scurvy and Arthritis ...................................................... 111 VII. Conclusions ..................................................................... 115 References .............................................................................. 115 Chapter 7 Dental and Periodontal Changes ..................................................... 119 I. Introduction ..................................................................... 119 II. Animal Studies ................................................................. 119 Ill. Human Observations ............................................................ 129 IV. Conclusions ..................................................................... 141 References .............................................................................. 142 Chapter 8 Atherosclerosis ........................................................................ 147 References .............................................................................. 161 Chapter 9 Mental Depression .................................................................... 165 I. Observations in Humans ........................................................ 165 II. Observations in Monkeys ....................................................... 170 Ill. Observations in Guinea Pigs .................................................... 170 IV. In Vitro Findings ................................................................ 171 V. Conclusions ..................................................................... 171 References .............................................................................. 171 Chapter 10 Amyloid ................................................................................ 173 References .............................................................................. 178 Chapter 11 Venous Thrombosis ................................................................... 179 References .............................................................................. 184 Chapter 12 Decreased Resistance to Infection .................................................... 187 I. The Vicious Cycle .............................................................. 187 II. Increased Susceptibility to Bacterial Toxins ..................................... 188 Ill. Decreased Localization of Bacterial Infections .................................. 188 IV. Increased Capillary Permeability to Viruses ..................................... 189 V. Increased Susceptibility to Plasmodial Infection ................................ 189 VI. Increased Susceptibility to Fungal Infection ..................................... 189 VII. Impaired Leukocyte Metabolism ................................................ 189 VIII. Increased Plasma Cortisol Levels ............................................... 191 IX. Altered General Metabolism .................................................... 191

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