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      Unraveling the potential of vitamins C and D as adjuvants in depression treatment with escitalopram in an LPS animal model

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          Abstract

          Depression is linked with oxidative stress and inflammation, where key players include nitric oxide (NO), nuclear factor erythroid 2-related factor 2 (Nrf2), Brain-Derived Neurotrophic Factor (BDNF), and Heme Oxidase-1 (HO-1). Augmenting the efficacy of antidepressants represents a compelling avenue of exploration. We explored the potential of vitamins C and D as adjuncts to escitalopram (Esc) in a lipopolysaccharide (LPS)-induced depression model focusing on the aforementioned biomarkers. Male Swiss albino mice were stratified into distinct groups: control, LPS, LPS + Esc, LPS + Esc + Vit C, LPS + Esc + Vit D, and LPS + Esc + Vit C + Vit D. After a 7-day treatment period, a single LPS dose (2 mg/kg), was administered, followed by comprehensive assessments of behavior and biochemical parameters. Notably, a statistically significant ( p < 0.05) alleviation of depressive symptoms was discerned in the Esc + Vit C + Vit D group versus the LPS group, albeit with concomitant pronounced sedation evident in all LPS-treated groups ( p < 0.05). Within the cortex, LPS reduced ( p < 0.05) the expression levels of NO x , Nrf2, BDNF, and HO-1, with only HO-1 being reinstated to baseline in the LPS + Esc + Vit D and the LPS + Esc + Vit C + Vit D groups. Conversely, the hippocampal NO x , Nrf2, and HO-1 levels remained unaltered following LPS administration. Notably, the combination of Esc, Vit C, and Vit D effectively restored hippocampal BDNF levels, which had been diminished by Esc alone. In conclusion, vitamins C and D enhance the therapeutic effects of escitalopram through a mechanism independent of Nrf2. These findings underscore the imperative need for in-depth investigations.

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          Curcumin activates the haem oxygenase-1 gene via regulation of Nrf2 and the antioxidant-responsive element.

          The transcription factor Nrf2, which normally exists in an inactive state as a consequence of binding to a cytoskeleton-associated protein Keap1, can be activated by redox-dependent stimuli. Alteration of the Nrf2-Keap1 interaction enables Nrf2 to translocate to the nucleus, bind to the antioxidant-responsive element (ARE) and initiate the transcription of genes coding for detoxifying enzymes and cytoprotective proteins. This response is also triggered by a class of electrophilic compounds including polyphenols and plant-derived constituents. Recently, the natural antioxidants curcumin and caffeic acid phenethyl ester (CAPE) have been identified as potent inducers of haem oxygenase-1 (HO-1), a redox-sensitive inducible protein that provides protection against various forms of stress. Here, we show that in renal epithelial cells both curcumin and CAPE stimulate the expression of Nrf2 in a concentration- and time-dependent manner. This effect was associated with a significant increase in HO-1 protein expression and haem oxygenase activity. From several lines of investigation we also report that curcumin (and, by inference, CAPE) stimulates ho-1 gene activity by promoting inactivation of the Nrf2-Keap1 complex, leading to increased Nrf2 binding to the resident ho-1 AREs. Moreover, using antibodies and specific inhibitors of the mitogen-activated protein kinase (MAPK) pathways, we provide data implicating p38 MAPK in curcumin-mediated ho-1 induction. Taken together, these results demonstrate that induction of HO-1 by curcumin and CAPE requires the activation of the Nrf2/ARE pathway.
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            Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism.

            Serotonin and vitamin D have been proposed to play a role in autism; however, no causal mechanism has been established. Here, we present evidence that vitamin D hormone (calcitriol) activates the transcription of the serotonin-synthesizing gene tryptophan hydroxylase 2 (TPH2) in the brain at a vitamin D response element (VDRE) and represses the transcription of TPH1 in tissues outside the blood-brain barrier at a distinct VDRE. The proposed mechanism explains 4 major characteristics associated with autism: the low concentrations of serotonin in the brain and its elevated concentrations in tissues outside the blood-brain barrier; the low concentrations of the vitamin D hormone precursor 25-hydroxyvitamin D [25(OH)D3]; the high male prevalence of autism; and the presence of maternal antibodies against fetal brain tissue. Two peptide hormones, oxytocin and vasopressin, are also associated with autism and genes encoding the oxytocin-neurophysin I preproprotein, the oxytocin receptor, and the arginine vasopressin receptor contain VDREs for activation. Supplementation with vitamin D and tryptophan is a practical and affordable solution to help prevent autism and possibly ameliorate some symptoms of the disorder. © FASEB.
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              Vitamin C—An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19

              There are limited proven therapies for COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19. This literature review focuses on vitamin C deficiency in respiratory infections, including COVID-19, and the mechanisms of action in infectious disease, including support of the stress response, its role in preventing and treating colds and pneumonia, and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2–8 g/day) may reduce the incidence and duration of respiratory infections and intravenous vitamin C (6–24 g/day) has been shown to reduce mortality, intensive care unit (ICU) and hospital stays, and time on mechanical ventilation for severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and the frequency of vitamin C deficiency in respiratory infections, it may be worthwhile testing patients’ vitamin C status and treating them accordingly with intravenous administration within ICUs and oral administration in hospitalised persons with COVID-19.
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                Author and article information

                Contributors
                omar.gammoh@yu.edu.jo
                mtambuwala@lincoln.ac.uk
                Journal
                Inflammopharmacology
                Inflammopharmacology
                Inflammopharmacology
                Springer International Publishing (Cham )
                0925-4692
                1568-5608
                5 January 2024
                5 January 2024
                2024
                : 32
                : 2
                : 1147-1157
                Affiliations
                [1 ]Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Al Yarmouk University, ( https://ror.org/004mbaj56) Irbid, Jordan
                [2 ]Department of Nutrition and Dietetics, Faculty of Health Sciences, American University of Madaba, ( https://ror.org/04tgeej53) Madaba, Jordan
                [3 ]Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University, ( https://ror.org/00rs6vg23) Columbus, OH USA
                [4 ]Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, ( https://ror.org/04a1r5z94) Zarqa, Jordan
                [5 ]Department of Medical Laboratory Sciences, Faculty of Allied Science, Zarqa University, ( https://ror.org/01wf1es90) Zarqa, 13133 Jordan
                [6 ]Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm AI­Qura University, ( https://ror.org/01xjqrm90) Mecca, Kingdom of Saudi Arabia
                [7 ]Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, ( https://ror.org/04a1r5z94) Zarqa, Jordan
                [8 ]Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Yarmouk University, ( https://ror.org/004mbaj56) Irbid, 21163 Jordan
                [9 ]Lincoln Medical School, University of Lincoln, ( https://ror.org/03yeq9x20) Brayford Pool Campus, Lincoln, LN6 7TS UK
                Author information
                http://orcid.org/0000-0001-8499-9891
                Article
                1404
                10.1007/s10787-023-01404-9
                11006785
                38180676
                7288fb21-4d09-4ad7-8001-b6252cd4260c
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 19 September 2023
                : 25 November 2023
                Categories
                Original Article
                Custom metadata
                © Springer Nature Switzerland AG 2024

                Pharmacology & Pharmaceutical medicine
                vitamins c and d,escitalopram,depression treatment,nrf2 pathway,bdnf modulation,hippocampal response,chronic lps model

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