ascorbic-acid and Endometriosis

This study aimed to clarify the effect of antioxidant vitamins supplementation on endometriosis-related pain.. A systematic search of PubMed, Web of Science, Cochrane Library, Scopus, and China National Knowledge Infrastructure (CNK) databases was conducted to identify relevant studies published in English and Chinese up to 16 March 2023. The search terms used were "endometriosis" OR "endometrioma" OR "endometrium" AND "antioxidant" OR "Vitamin C" OR "Vitamin E" OR "Vitamin D" OR "25-OHD" OR "25(OH)D" OR "25-hydroxyvitamin D". Eligible studies were randomized controlled trials (RCTs) that assessed pain scores using the Visual Analogue Scale (VAS). Mean differences or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the effect of antioxidant vitamins supplementation on endometriosis. The quality of the included studies was assessed using the Cochrane Risk of Bias Tool. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.. A total of 13 RCTs involving 589 patients were included in this meta-analysis. We identified 11 studies that evaluated the effect of antioxidant vitamins supplementation on endometriosis-related pain. The results indicated that the supplementation of antioxidant vitamins can effectively alleviate endometriosis-related pain. Subgroup analysis showed that the supplementation of vitamin E (with or without vitamin C) had a positive effect on improving clinical pelvic pain in patients with chronic pelvic pain. Conversely, supplementation of vitamin D was associated with a reduction in pelvic pain in endometriosis patients, but the difference was not statistically significant compared to the placebo. Additionally, we observed changes in oxidative stress markers following vitamin supplementation. Plasma malondialdehyde (MDA) concentration decreased in patients with endometriosis after antioxidant vitamin supplementation, and the plasma MDA level was inversely correlated with the time and dose of vitamin E and C supplementation. Furthermore, the inflammatory markers in peritoneal fluid, including RANTES, interleukin-6, and monocyte chemoattractant protein-1, significantly decreased after antioxidant therapy. These findings suggest that antioxidant vitamins may alleviate pain in endometriosis patients by reducing inflammation.. The included studies support the potential role of antioxidant vitamins in the management of endometriosis. Supplementation with antioxidant vitamins effectively reduced the severity of dysmenorrhea, improved dyspareunia and pelvic pain, and enhanced quality of life in these patients. Therefore, antioxidant vitamin therapy could be considered as an alternative treatment method, either alone or in combination with other approaches, for endometriosis-related pain.. PROSPERO registration number: CRD42023415198.

Topics: Antioxidants; Ascorbic Acid; Dietary Supplements; Endometriosis; Female; Humans; Pelvic Pain; Vitamin A; Vitamin K; Vitamins

Endometriosis is a chronic, painful, estrogen-related inflammatory disease that affects approximately 10% of the female population. Endometriosis has a significant negative impact on quality of life. Nutrition may be involved in the development and severity of endometriosis. The purpose of this paper is to discuss in detail the nutritional recommendations for patients with endometriosis. This article discusses the importance of nutrients such as polyphenols, vitamins C, D and E, PUFAs, and iron in the development of endometriosis. Alternative diets, such as the Mediterranean, anti-inflammatory, vegetarian, low-nickel and low-FODMAP diets, have also been presented in the context of their potential beneficial effects on the course of endometriosis.

Topics: Ascorbic Acid; Chronic Disease; Diet; Endometriosis; Female; Humans; Quality of Life; Vitamins

This study was performed to investigate the effect of vitamin C (VitC) supplementation on the outcomes of in vitro fertilization-embryo transfer (IVF-ET) in patients with endometriosis (EMs).. A total of 280 patients with EMs underwent IVF-ET (VitC treatment group, n=160; VitC non-treatment group, n=120). An additional 150 patients who did not have EMs but underwent IVF-ET (control group) were also enrolled in this study. Superoxide dismutase (SOD), total antioxidant capacity (TAC), malondialdehyde (MDA) and reactive oxygen species (ROS) were measured to determine the role of VitC on oxidative stress markers in serum and follicular fluid (FF).. In total, 245 patients with EMs and 132 patients without EMs underwent successful IVF-ET and follow-up. The serum or FF levels of VitC, SOD, and TAC were lower in the EMs than control group; however, the MDA and ROS levels in serum or FF were higher in the EMs than control group. After 2 months of VitC treatment, the serum VitC levels in serum and FF were significantly increased, while oxidative stress markers were unaffected.. Treatment with VitC oral formulation improved the serum and FF levels of VitC but did not affect oxidative stress markers in patients with EMs.

Topics: Adult; Ascorbic Acid; Biomarkers; Embryo Transfer; Endometriosis; Female; Fertilization in Vitro; Follicular Fluid; Humans; Oxidative Stress; Pregnancy; Pregnancy Outcome

We previously suggested that women with endometriosis have increased oxidative stress in the peritoneal cavity. To assess whether antioxidant supplementation would ameliorate endometriosis-associated symptoms, we performed a randomized, placebo-controlled trial of antioxidant vitamins (vitamins E and C) in women with pelvic pain and endometriosis. Fifty-nine women, ages 19 to 41 years, with pelvic pain and history of endometriosis or infertility were recruited for this study. Patients were randomly assigned to 2 groups: vitamin E (1200 IU) and vitamin C (1000 mg) combination or placebo daily for 8 weeks before surgery. Pain scales were administered at baseline and biweekly. Inflammatory markers were measured in the peritoneal fluid obtained from both groups of patients at the end of therapy. Our results indicated that after treatment with antioxidants, chronic pain ("everyday pain") improved in 43% of patients in the antioxidant treatment group (P = 0.0055) compared with the placebo group. In the same group, dysmenorrhea ("pain associated with menstruation") and dyspareunia ("pain with sex") decreased in 37% and 24% patients, respectively. In the placebo group, dysmenorrhea-associated pain decreased in 4 patients and no change was seen in chronic pain or dyspareunia. There was a significant decrease in peritoneal fluid inflammatory markers, regulated upon activation, normal T-cell expressed and secreted (P ≤ 0.002), interleukin-6 (P ≤ 0.056), and monocyte chemotactic protein-1 (P ≤ 0.016) after antioxidant therapy compared with patients not taking antioxidants. The results of this clinical trial show that administration of antioxidants reduces chronic pelvic pain in women with endometriosis and inflammatory markers in the peritoneal fluid.

Topics: Adult; Antioxidants; Ascitic Fluid; Ascorbic Acid; Chemokine CCL2; Chemokine CCL5; Dysmenorrhea; Dyspareunia; Endometriosis; Female; Humans; Inflammation Mediators; Interleukin-6; Oxidative Stress; Pain Measurement; Pelvic Pain; Translational Research, Biomedical; Vitamin E; Young Adult

To determine whether vitamins C and E supplementation lowers oxidative stress marker levels and improves pregnancy rate in women with endometriosis.. Thirty-four women with endometriosis received a bar containing vitamins C and E (343 mg and 84 mg, respectively) or placebo for 6 months. Plasma and peritoneal fluid levels of malondialdehyde (MDA) and lipid hydroperoxides (LOOHs) were measured for all women and compared between the 2 groups. Data were analyzed by the t test or 1-way analysis of variance for parametric data and the Mann-Whitney rank sum test or Kruskall-Wallis test for nonparametric data. The Fisher exact test was used to compare pregnancy rates.. After 4 months, the study group had lower levels of MDA and LOOHs than the control group, and the difference became statistically significant in the fourth month for MDA levels and in the sixth month for LOOH levels. The postintervention pregnancy rates were 19% and 12% in the supplementation and placebo groups, respectively, but the difference was not significant.. Vitamins C and E supplementation was associated with a decrease in the concentration of oxidative stress markers in women with endometriosis. The pregnancy rate, however, did not improve during or after the intervention.

Topics: Adult; Antioxidants; Ascorbic Acid; Biomarkers; Double-Blind Method; Endometriosis; Female; Humans; Lipid Peroxidation; Oxidative Stress; Pregnancy; Pregnancy Rate; Vitamin E

Apoptosis and antioxidant mechanisms are pathways for the treatment of endometriosis (Endo). Rutin (Rtn) is an antioxidant flavonol that induces apoptosis. This study, for first time, was conducted to evaluate the effects of rutin on Endo through apoptosis and antioxidant mechanisms. The experimental Endo was induced in 24 rats and then the animals were subdivided into Endo-sole, 3000 and 6000 µg/kg rutin (Rtn-3000 and Rtn-6000) and vitamin C groups. After 4 weeks, the expression of Bcl2, Bax, anti Pro Caspase-9, cleaved Caspase-9, pro PARP, pro Cleaved PARP, Pro PARP, pro mTOR and mTOR were assessed by western blotting technique. The protein concentrations of malondialdehyde (MDA), total antioxidant capacity, and super oxide dismutase and gutathione peroxidase were also evaluated. TUNEL staining was also used for the detection of apoptosis. Caspase-9 and concentration of antioxidants were higher in the treated groups compared to Endo-sole group (P < 0.05). The results also showed that rutin decreased the expression of Bcl2 and MDA concentration (P < 0.05). The results for TUNEL staining showed that the animals treated with Rtn-6000 and vitamin C showed higher apoptosis. Rutin induces apoptosis by the expression of Bcl-2, Bax and caspase and also antioxidant activity by increasing antioxidants concentrations.

Topics: Administration, Oral; Animals; Antioxidants; Apoptosis; Ascorbic Acid; Cell Survival; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Endometriosis; Female; Humans; Oxidative Stress; Rats; Rutin

Endometriosis is an extremely heterogeneous disease and affects about ten percent of the female population during their reproductive years. Recent studies showed that endometriosis is an angiogenesis-dependent disease. Peritoneal macrophages are a well-characterised source of vascular endothelial growth factor (VEGF). The aim of this study was to determine the

Topics: Adult; Ascitic Fluid; Ascorbic Acid; Dietary Supplements; Endometriosis; Female; Gene Expression; Humans; Macrophages, Peritoneal; RNA, Messenger; Vascular Endothelial Growth Factors; Vitamin E

Endometriosis is a chronic inflammatory disease pathologically defined as the presence of endometrial-like tissue outside the uterine cavity. It is one of the most important diseases affecting women of reproductive age. The process of endometriotic implant growth is mediated by many complex interactions of immunologic, hormonal, genetic, and environmental mediators. Vitamin C (ascorbic acid), besides playing a role in preventing invasion and metastasis, is an antioxidant having anti-inflammatory and -angiogenic effects. In this study, we aimed to investigate the effect of vitamin C on the prevention and regression of endometriotic implants in a rat model of endometriosis.. This was a prospective, comparative, experimental animal study. After endometriotic implants were induced simultaneously, rats were divided into three groups. Group A was given 500 mg/kg of intravenous vitamin C every 2 days, starting immediately after implantation (n = 11). All rats had a second operation 21 days after the initial one and had the lesion volumes measured. Group B was given 500 mg/kg of intravenous vitamin C every 2 days, starting 21 days after this operation (n = 11). All rats were sacrificed 21 days after the third operation. Implant volume, weight measurements, and histopathological evaluation of the lesions were carried out. Group A received vitamin C throughout the study, while Group C (n = 11) was not given any medication. The findings in the three groups were compared.. At the second laparotomy after the induction, Group A had the smallest implant volume with a statistically significant difference compared to Group B (p = 0.012). The end-of-study volumes of endometriotic implants of group B were significantly smaller than the first volumes (p < 0.05).. Intravenous vitamin C treatment might have a suppressive effect on the prevention of endometriotic implant induction and regression of endometriotic implant volumes.

Topics: Animals; Antioxidants; Ascorbic Acid; Disease Models, Animal; Endometriosis; Female; Prospective Studies; Rats; Rats, Wistar

The aim of this study was to investigate the effect of vitamin C on the growth of experimental endometriotic cysts.. The endometrium of the uterine horn wall (diameter, 4 mm) was implanted onto the inner surface of the anterior abdominal wall of 40 Wistar albino adult female rats, by laparotomy. The day after the implantation, the rats were randomly assigned into four groups (control group and experimental groups [V1, V2, and V3]) comprising 10 rats each. For 6 weeks, the control group (Group C) received 1 mL distilled water, whereas the experimental groups (Groups V1, V2, and V3) received 0.5 mg, 1.25 mg, and 2.5 mg of vitamin C in 1 mL of distilled water, respectively. The doses were given via oral gavage once per day. At the end of the administration, a second laparotomy was performed and endometriotic cyst volumes and weights of rats among the groups were compared. In addition, the stromal and glandular tissue and the natural killer cell contents of the cysts were compared among the groups.. The cyst volume in Group V3 and the cyst weights in Groups V2 and V3 were significantly lower than those in Group C. The natural killer cell content in Groups V1, V2, and V3 was significantly lower than that in Group C. Stromal and glandular tissue contents of the groups were not significantly different.. The dose-dependent vitamin C supplementation significantly reduced the volumes and weights of the endometriotic cysts.

Topics: Abdominal Wall; Animals; Antioxidants; Ascorbic Acid; Cysts; Dietary Supplements; Disease Models, Animal; Disease Progression; Endometriosis; Female; Pilot Projects; Random Allocation; Rats; Rats, Wistar

To study the levels of four markers of oxidative stress in follicular fluid (FF) and plasma of patients with infertility related to endometriosis and controls.. Experimental study.. University-affiliated hospital and infertility center.. Ninety-one infertile women were included in the study (23 infertile women with endometriosis and 68 controls including infertile women due to tubal factor, male factor, or healthy egg donors).. Blood was obtained at the time of egg retrieval, and FF from the mature follicles of each ovary was centrifuged and frozen until analysis.. Vitamin C and E, malondialdehyde, and superoxide dismutase concentrations in plasma and follicular fluid.. Women with endometriosis showed a lower vitamin C concentration in FF (12.7 ± 5.9 vs. 9.7 ± 6.9 μg/mL) and lower superoxide dismutase concentration in plasma (0.9 ± 1.4 vs. 0.5 ± 0.7 U/mL) compared with controls. Vitamin E plasma levels were significantly higher in women with endometriosis (8.1 ± 3.8 vs. 5.2 ± 3.2 μg/mL). A nonsignificant trend toward a lower plasma concentration of malondialdehyde was found in women with endometriosis.. These findings suggest a lower antioxidant capacity in infertile women with endometriosis. Although a certain level of reactive oxygen species is required under physiological conditions, an altered balance between pro-oxidant and antioxidant activities may have an impact on folliculogenesis and adequate embryo development.

Topics: Adult; Ascorbic Acid; Biomarkers; Case-Control Studies; Endometriosis; Female; Follicular Fluid; Humans; Infertility, Female; Male; Ovarian Diseases; Oxidative Stress; Superoxide Dismutase; Superoxide Dismutase-1

To assess immunological variables, T-cell apoptosis and oxidative stress markers in the peripheral blood and peritoneal fluid of women with (WEN) and without (WWE) endometriosis.. Observational and transverse case-control study.. National Institute of Perinatology, Mexico City, Mexico.. Peripheral blood and peritoneal fluid obtained from 30 WWE and 32 WEN.. Blood was drawn before surgery and peritoneal fluid was collected during surgery but before any surgical procedure had been carried out. Flow cytometry, spectrophotometry, high-performance liquid chromatography and multiplex immunoassay analyses were performed. MAIN OUTCOME MEASURES  Peripheral and peritoneal lymphocyte subpopulations (CD3(+), CD4(+) CD3(+), CD8(+) CD3(+), CD16(+) CD56(+), human leucocyte antigen-DR(+) CD3(+) and CD19(+)), intracellular CD4(+) CD3(+) and CD8(+) CD3(+) cytokine synthesis (interleukin-2 [IL-2] and interferon-γ [IFN-γ]), CD3(+) apoptosis, malondialdehyde and ascorbate concentrations and peritoneal cytokine concentrations.. No differences were found in peripheral and peritoneal lymphocyte subsets between the groups. Peritoneal T lymphocytes from WEN produced less IL-2 and IFN-γ than those from WWE. Peritoneal malondialdehyde concentrations were higher and ascorbate concentrations were lower in WEN than in WWE. Higher peritoneal concentrations of pro-inflammatory cytokines (IL-1β, tumour necrosis factor-α and IL-6) and chemokines (IL-10, IL-8, eotaxin, vascular endothelial growth factor, monocyte chemotactic protein-1 and regulated upon activation, normal T-cell expressed, and secreted) and lower concentrations of IFN-γ, IL-1 receptor antagonist and IL-15 were found in WEN. No statistical differences were found in IL-2, IL-4, IL-12 and IL-13 concentrations.. The alterations observed in WEN were associated with a diminished peritoneal T helper type 1 immune response. Pro-inflammatory, chemotactic, angiogenic and oxidative stress markers were altered in the peritoneal milieu of WEN. These changes appeared to contribute to the peritoneal immune alterations found.

Topics: Adult; Apoptosis; Ascorbic Acid; Case-Control Studies; Cytokines; Endometriosis; Female; Flow Cytometry; Humans; Immunity, Cellular; Immunoassay; Malondialdehyde; Oxidative Stress; T-Lymphocyte Subsets; T-Lymphocytes, Helper-Inducer

To evaluate the antioxidant intake and the lipoperoxidation status in plasma and peritoneal fluid of women with endometriosis.. The study was carried out in 48 women with endometriosis obtained at the Sterility Clinic from the National Institute of Perinatology. The antioxidant intake was evaluated applying the Questionnaire Assessment of Antioxidants and Retinol Intakes in Mexican women validated by the National Institute of Public Health. The lipoperoxidation status was determined in plasma and peritoneal fluid with the malondyaldehyde method. Results were analyzed by ANOVA of Kruskal-Wallis.. The antioxidant intake (vitamin C, vitamin E, selenium and zinc) of women with endometriosis showed a significative statistical difference when data was compared with the control group, including total group and those stratified in pathology stages. The lipoperoxidation status in plasma and peritoneal fluid of women with endometriosis, analyzed in group, did not show statistical difference versus healthy women. When data was stratified according to the pathology severity, the percentage of lipoperoxidation status increased in plasma in the severe grade of endometriosis and in peritoneal fluid in the moderate and severe grades.. The antioxidant intake in women with endometriosis showed an inverse correlation with the pathology intensity. As endometriosis severity intensifies, a less intake of antioxidants is present. There is a positive association between the pathology development and the lipoperoxidation status.

Topics: Adult; Antioxidants; Ascitic Fluid; Ascorbic Acid; Endometriosis; Female; Humans; Lipid Peroxidation; Oxidative Stress; Selenium; Vitamin E; Zinc