Assistant Attending Physician, Long Island College,
Associate Physician, Greenpoint Hospital and Brooklyn Cancer Hospitals.
Gastroscopist Beth Moses Hospital, Brooklyn, New York.
Brooklyn, New York
The effect of Vitamin C on adverse reactions to drugs is extremely interesting. The effect of ascorbic acid on the sensitivity to neoarsphenamine is well known, and has been repeatedly described. 1, 5, 9 It is unknown whether the patients exhibiting these actions are deficient in Vitamin C, or whether Vitamin C detoxifies the neoarsphenamine in a well-saturated patient. Recently, I described a case of rheumatic fever that rapidly became intolerant to salicylates and had a low ascorbic acid content of the serum, this patient was quickly relieved of his disability by adequate intake of Vitamin C. 6 This was also shown to be true for several cases exhibiting intolerance to sulfonamides, and more recently to stilbestrol. 8 These experiments have largely been verified. 4
Holmes 3 recently published evidence that hay fever patients may be relieved of their disability in great measure by giving Vitamin C in large doses, on the average of about 500 mg. per day. More recently, also, he has shown that Vitamin C will also protect against food allergies. 2
This short communication is concerned with the protection of an extremely sensitive ragweed patient against adverse reactions to pollen injections.
The patient, a woman thirty-five years of age, was markedly sensitive to ragweed pollen, and was given pre-seasonal treatment with pollen antigen (Lederle). When 200 pollen units were given, the patient developed hives all over her body, swelling of the eyes and tongue and marked wheezing. This reaction was relieved in about fifteen minutes by epinephrine. Attempts to increase this amount slightly brought forth increasingly severe reactions.
The following week the 410 pollen units of ragweed were given along with ½ c.c. of sodium ascorbate, (100 mg. in 2 c.c.) in the same syringe. No reaction occurred. Thereafter, at two-day intervals, increasing doses of ragweed pollen were given with ½ c.c. of sodium ascorbate. In addition, 100 mg. of ascorbic acid were given three times a day by mouth.
The patient volunteered that she had not had citrus fruits for many years because of sensitivity to orange and grapefruit. Finally, a dose of 1500 units of ragweed pollen antigen combined with ½ c.c. of sodium ascorbate was given without incident.
Ascorbic acid was thus able to reduce the exquisite sensitivity to ragweed pollen antigen in this patient. It was thought desirable to find out whether this phenomenon was a local effect of ascorbic acid on the pollen antigen. On a ragweed-sensitive patient, the following skin tests were carried out by intradermal injection:
Ragweed .02 c.c.; ragweed .02 c.c. plus .05 c.c. of sodium ascorbate (described above); histamine hydrochloride 1/1000 solution, .02 c.c.; histamine hydrochloride (1/1000 solution) .02 c.c. plus .05 c.c. of sodium ascorbate. There was no observable difference between ragweed and ragweed with sodium ascorbate or between histamine and histamine with sodium ascorbate. Thus, whatever detoxification occurs is not local in nature.
The liver is the site of detoxification for most noxious substances in the body. Usually they are rendered harmless by conjugation in the liver cells. It is certainly by design that the liver, next to the adrenal glands, contains the most ascorbic acid of any organ in the body. The ascorbic acid is undoubtedly one of the substances concerned with detoxification.
REFERENCES
From Annals of Allergy, May-June 1944, Volume 2, Number 3 pp. 231-232
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