Anitra Carr, PhD

Principal Investigator and Senior Research Fellow
Department of Pathology
University of Otago
Christchurch, New Zealand

image of Dr. Anitra Carr
Abstract: Patients with severe infections, such as pneumonia, can develop sepsis, an uncontrolled inflammatory response to the initial infection. This can result in organ failure and septic shock, the major cause of death of critically ill patients in intensive care. We and others have found that critically ill patients have severely depleted vitamin C levels despite recommended intakes via liquid nutrition. One study has shown that critically ill patients require parenteral vitamin C at levels that are 30-fold higher than recommended intakes. Patients with sepsis have dysregulated immune function, including compromised leukocyte function. Neutrophils are the primary responders to infection and these cells are known to accumulate high levels of vitamin C, suggesting an important role for the vitamin in immune cell function. We and others have shown that vitamin C can enhance neutrophil chemotaxis, oxidant production, apoptosis and clearance by macrophages. Vitamin C is an important cofactor for numerous biosynthetic and regulatory enzymes in the body. Because vitamin C is a cofactor for the enzymes that synthesize noradrenaline and vasopressin, we hypothesized that vitamin C administration to patients with severe sepsis and septic shock may decrease the need for exogenous administration of these vasopressors. Support for the vitamin C and vasopressor hypothesis comes from recent clinical trials which showed decreased vasopressor requirements in patients who received intravenous vitamin C. We are currently implementing a clinical trial in Christchurch Hospital ICU to assess the outcomes and mechanisms of action of intravenous vitamin C in severe sepsis.