Topical Vitamin C
Vitamin C (ascorbic acid) is an important water soluble micronutrient
that plays several roles in the human body. It is an antioxidant and a
free radical scavenger and serves as an essential cofactor for many
enzymatic reactions through iron-, copper- and 2-oxoglutarate-dependent
dioxygenases. Mucosal damage after paraquat ingestion is not only due to
its caustic nature but also paraquat ingestion causes an accumulation of
free radicals which exacerbate inflammation causing extensive mucosal
and tissue damage. Vitamin C neutralizes those free radicals generated
after paraquat ingestion therefore enhancing body’s antioxidant stores
in order to prevent mucosal damage and to maintain healthy oral tissues.25 45 Vitamin C also plays an
important role in immunomodulation, and its deficiency results in
impaired immune responses.46 Ascorbic acid plays an
important part in wound healing; this is mainly attributed to its role
in collagen synthesis and the hydroxylation of lysine and proline.47 48These three major roles;
antioxidant, immunomodulation and wound healing, are significant in the
treatment of mucosal damage induced by paraquat. Two clinical trials
were highlighted. The first trial used 0.2 Vit C that was taken orally
three times a day.18 The second trial inco-operated 5
grams Vit C as one of the ingredients in the formulation of a compounded
paste. 25 Both trials reported positive outcomes in
relation to pain reduction and oral mucositis severity.