Vitamin C Pharmacology in Disease Prevention and Treatment

Vitamin C (L-ascorbic acid) is an essential water-soluble micronutrient renowned for its antioxidant capacity and its integral role as an electron donor in diverse enzymatic reactions. It serves as a cofactor for collagen prolyl and lysyl hydroxylases, supports carnitine and neurotransmitter biosynthesis and regulates epigenetic modifiers such as ten-eleven translocation enzymes and Jumonji domain histone demethylases. Tissue uptake and plasma distribution are governed by sodium-dependent vitamin C transporters (SVCTs), which impart dose-dependent pharmacokinetic properties that shift from zero to first-order kinetics at pharmacological concentrations. At physiological doses, vitamin C maintains redox homeostasis, bolsters epithelial and immune barrier function, and scavenges reactive oxygen species. Suboptimal intake or impaired transport results in scurvy, compromised immunity and heightened susceptibility to infections and chronic diseases. In contrast, high-dose intravenous administration achieves millimolar plasma levels exploited in adjunctive cancer therapy, sepsis management and treatment of severe infections. Recent insights into transporter structure, metal-catalysed oxidation and dose–concentration relationships have underscored the necessity for personalised dosing regimens, particularly in populations with elevated body mass or increased inflammatory demand. Collectively, contemporary pharmacological research seeks to refine recommendations for dietary requirements, elucidate molecular transport and redox mechanisms and harness vitamin C’s multifaceted functions for disease prevention and targeted therapies.

Research from Nature Portfolio

Structural studies using cryogenic electron microscopy have resolved the architecture of SVCT1 in both substrate-free and ascorbate-bound states, revealing a homodimeric assembly in an inward-open conformation. These data elucidate how vitamin C and two sodium ions coordinate within the core domain, supporting an elevator-like transport mechanism that underpins high-affinity uptake and offers a template for rational design of transporter modulators.

A comprehensive chemical kinetics model has been developed to reconcile disparate literature on ascorbate oxidation by iron(III) and copper(II). Experimental constraints define unit stoichiometries and rate constants for metal-catalysed ascorbate turnover, demonstrating that trace metal reactions, rather than reactive oxygen species alone, constitute the principal sink for vitamin C in tissues. This kinetic framework advances understanding of antioxidant capacity under oxidative stress and informs dosing strategies for pulmonary and systemic exposure.

Vitamin C Pharmacology in Disease Prevention and Treatment publication trend

The graph below shows the total number of articles in vitamin c pharmacology in disease prevention and treatment across all publications each year (not limited to Nature Index journals).

Technical terms

Sodium-dependent vitamin C transporters (SVCTs): Membrane proteins responsible for active uptake of ascorbate into cells, exhibiting saturable kinetics and tissue-specific expression.

Pharmacokinetics: The study of absorption, distribution, metabolism and excretion of a compound, delineating dose–concentration relationships over time.

Dehydroascorbic acid (DHA): The oxidised form of vitamin C that can traverse cell membranes via glucose transporters and regenerate intracellular ascorbate.

Reactive oxygen species (ROS): Chemically reactive molecules derived from oxygen, including hydrogen peroxide and hydroxyl radicals, which can cause oxidative damage.

Redox disequilibrium: A disruption of the cellular balance between oxidants and antioxidants, often exploited in targeted cancer therapies.

References

1. The pharmacology of vitamin C. Pharmacological Reviews (2025).
2. Structural basis of vitamin C recognition and transport by mammalian SVCT1 transporter. Nature Communications (2023).
3. A Bioinspired Flexible Sensor for Electrochemical Probing of Dynamic Redox Disequilibrium in Cancer Cells. Advanced Science (2023).
4. An increasing proportion of the population is not covered by the current RDA for vitamin C – interrogation of EPIC-Norfolk and NHANES 2017/2018 cohorts. Critical Reviews in Food Science and Nutrition (2024).
5. The Pharmacokinetics of Vitamin C. Nutrients (2019).
6. Ascorbate oxidation by iron, copper and reactive oxygen species: review, model development, and derivation of key rate constants. Scientific Reports (2021).