There should be studies of low vitamin D levels in people under chronic stress, for example.
Where as both types of allostasis are associated with increased release of cortisol and , catecholamine’s, they differentially affect thyroid homeostasis: Concentrations of the thyroid hormone triiodothyromine are decreased in type 1 allostasis, but elevated in type 2 allostasis.
Dehydroascorbic acid is transported via the GLUT1 transporter into mitochondria, where it converted to ascorbic acid and acts as a potent antioxidant limiting mitochondrial oxidant injury. Considering that the mitochondrial respiratory chain is a main source of ROS in live cells and mitochondrial dysfunction plays a prominent role in sepsis pathogenesis, antioxidants targeting the intra-mitochondrial environment could be pivotal role in the treatment of sepsis.
Vitamin C suppresses activation of NF-κB by inhibiting tumor necrosis factor-α (TNFα) induced phosphorylation of inhibitory kappa-B kinase (IκB kinase)
“If this study shows promising results for the combination therapy of vitamin C, thiamine, and corticosteroids in sepsis, it has the potential to impact millions of lives both in the United States and worldwide,” Dr. Nugent said. “Such a combination carries fewer risks and is more widely available than previously studied ancillary therapies, increasing its possible influence over this widespread, deadly, and costly public health crisis.”
The double-blind, placebo-controlled, adaptive randomized clinical trial will enroll as many as 2000 patients with sepsis to receive either the combination therapy or a placebo along with standard intensive medical treatment for sepsis, which includes high doses of antibiotics. The primary outcome for the study is vasopressor and ventilator-free days at 30 days (+/-3 days) after randomization, which will be determined by recording all start and stop days of these measures, according to the trial description.
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