The result that pharmacological ascorbic acid concentration in blood releases hydrogen peroxide and ascorbyl radicals when ascorbic acid is transferred into interstitial fluids is reviewed. The hydrogen peroxide concentration in some interstitial fluids (liver, gut, pancreas, kidneys) may be responsible for some killing activity of neoplastic cells deprived of antioxidant defences. However a real anti-tumour effect limited to some neoplasms remains an open problem not explored here. On the other hand reactive oxygen species (ROS) may induce peroxidation of lipids and, in this case, peroxidation compounds and alkenals returning into the general circulation may represent a moderate oxidative stress able to activate and free nuclear related factor 2 (Nrf2), which, after binding to antioxidant response elements (ARE), switch on the upregulation of the innate antioxidant system. This situation can be achieved by repeated intravenous infusion of ascorbic acid at the dose of 0.36-0.64 g/kg in patients with chronic cardiovascular diseases, macular degeneration (dry form), type 2 diabetes and chronic infectious diseases where, in spite of effective orthodox drugs, the diseases are complicated by a chronic oxidative stress. Consequently a prolonged orthodox therapy integrated by repeated ascorbic acid infusions may lead to a real improvement due to the combined approach proposed in this paper.
Alkenals; Antioxidant response elements; Ascorbic acid; Hydrogen peroxide; Integrative medicine; Reactive oxygen species