IMMUNE-BOOSTING EFFECT OF VITAMIN C IN COMBINATION WITH ZINC AGAINST PEDIATRIC PNEUMONIA: A RANDOMIZED CONTROLLED TRIAL

Main Article Content

Eman Shakeel
Muhammad Imran Hussain
Gull Noor Khan
Hina Mushtaq
Moha Akram Khan
Mishal Tahir
Tasbiha Irfan
Maria Shahid
Jannat Gull Khan
Sobia Ikram Sheikh
Tayyaba Fatima
Ramisha ibtisam
Amama sadia

Keywords

Immunoglobulins, Pediatric Pneumonia, Vitamin C, Zinc.

Abstract

Lower respiratory tract infections are a major cause of illness and hospitalization in children under 5 years old. It is usually caused by bacteria, viruses, or fungi and is spread through contact with an infected person or their respiratory droplets. Symptoms include fever, rapid breathing, chills, cough, wheezing, fast heart rate, poor appetite, and fatigue. This study aims to evaluate the Immune-boosting effect of Vitamin C and Zinc against pediatric pneumonia.  A randomized control trial was done on 40 patients between 2 years and 5 years of age with a diagnosis of pneumonia who were enrolled at Raiwind RHC (rural health center). The control, group being studied included 20 children who had pneumonia and were receiving medication for it. The experimental group contains 20 children on medications and given Vitamin C (125mg) and Zinc (20mg). Pre-testing of all participants was done and immunoglobulin levels (IgG, IgA, IgM) were studied. Post-testing of all participants was done at the end of these interventions. The results show that vitamin C and zinc have significant (<0.05) effects against IgG, IgA, and IgM in pediatric pneumonia. Both combined have health-beneficial effects against immunity in pneumonia.

Abstract 156 | PDF Downloads 58

References

1. Ebeledike, C., Ahmad, T., & Martin, S. D. (2021). Pediatric Pneumonia (Nursing).
2. Dean, P., & Florin, T. A. (2018). Factors associated with pneumonia severity in children: a systematic review. Journal of the Pediatric Infectious Diseases Society, 7(4), 323-334..
3. Carr, A. C., & Rowe, S. (2020). The emerging role of vitamin C in the prevention and treatment of COVID-19. Nutrients, 12(11), 3286.
4. Wintergerst, E. S., Maggini, S., & Hornig, D. H. (2006). Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Annals of Nutrition and Metabolism, 50(2), 85-94.
5. Das, J. K., Siddiqui, F., Padhani, Z. A., Khan, M. H., Jabeen, S., Mirani, M., ... & Bhutta, Z. A. (2023). Health behaviors and care seeking practices for childhood diarrhea and pneumonia in a rural district of Pakistan: A qualitative study. Plos one, 18(5), e0285868.
6. Asmaa, Y., Kakalia, S., Irtza, M., Malik, R., & Malik III, R. (2024). The Diagnostic Association of Radiological and Clinicopathological Parameters in Community-Acquired Pneumonia in Children: A Cross-Sectional Study. Cureus, 16(2).
7. Jafari, D., Esmaeilzadeh, A., Mohammadi-Kordkhayli, M., & Rezaei, N. (2019). Vitamin C and the immune system. Nutrition and immunity, 81-102.
8. Li, R., Guo, C., Li, Y., Liang, X., Yang, L., & Huang, W. (2020). Therapeutic target and molecular mechanism of vitamin C-treated pneumonia: a systematic study of network pharmacology. Food & function, 11(5), 4765-4772.
9. Padhani, Z. A., Moazzam, Z., Ashraf, A., Bilal, H., Salam, R. A., Das, J. K., & Bhutta, Z. A. (2020). Vitamin C supplementation for prevention and treatment of pneumonia. Cochrane Database of Systematic Reviews, (4).
10. Mahmoodpoor, A., Shadvar, K., Sanaie, S., Hadipoor, M. R., Pourmoghaddam, M. A., & Saghaleini, S. H. (2021). Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: a preliminary study. BMC Infectious Diseases, 21, 1-7.
11. Kim, W. Y., Jo, E. J., Eom, J. S., Mok, J., Kim, M. H., Kim, K. U., ... & Lee, K. (2018). Combined vitamin C, hydrocortisone, and thiamine therapy for patients with severe pneumonia who were admitted to the intensive care unit: Propensity score-based analysis of a before-after cohort study. Journal of critical care, 47, 211-218.
12. Solomons, N. W. (1998). Mild human zinc deficiency produces an imbalance between cell-mediated and humoral immunity. Nutrition Reviews, 56(1), 27-28.
13. Carr, A. C., & Maggini, S. (2017). Vitamin C and immune function. Nutrients, 9(11), 1211.
14. Ishida, S. T. (2020). Zinc (Ⅱ) Immune Virucidal Activities for 2019-nCoV Prevention and COVID-19 Respiratory Ailment and Pneumonia. IJMRHS, 5, 21-33.
15. Brazel, E. B., Tan, A., Neville, S. L., Iverson, A. R., Udagedara, S. R., Cunningham, B. A., ... & McDevitt, C. A. (2022). Dysregulation of Streptococcus pneumoniae zinc homeostasis breaks ampicillin resistance in a pneumonia infection model. Cell reports, 38(2).
16. Fatima, A., Khan, M. U. A., Najeeb, M., Khan, M. Y. A., & Haq, F. U. (2021). Role of high dose IV vitamin C and zinc in coronavirus. Geriatric Care, 7(1).
17. Maywald, M., & Rink, L. (2022). Zinc in human health and infectious diseases. Biomolecules, 12(12), 1748.
18. Chambial, S., Dwivedi, S., Shukla, K. K., John, P. J., & Sharma, P. (2013). Vitamin C in disease prevention and cure: an overview. Indian journal of clinical biochemistry, 28, 314-328.
19. Zierle-Ghosh, A., & Jan, A. (2018). Physiology, body mass index.
20. World Health Organization. (2024). Body mass index-for-age (BMI-for-age). Retrieved March 29, 2024.
21. Loh, R. K., Vale, S., & McLean-Tooke, A. (2013). Quantitative serum immunoglobulin tests. Australian family physician, 42(4), 195-198.
22. Hussain, M. I., Ahmed, W., Nasir, M., Mushtaq, M. H., Sheikh, A. A., Shaheen, A. Y., & Mahmood, A. (2019). Immune boosting role of vitamin E against pulmonary tuberculosis. Pakistan Journal of Pharmaceutical Sciences, 32.
23. Hussain, M. I., Ahmed, W., Nasir, M., Mushtaq, M. H., Sheikh, A. A., Shaheen, A. Y., ... & Iqbal, S. (2019). Immune modulatory and anti-oxidative effect of selenium against pulmonary tuberculosis. Pakistan Journal of Pharmaceutical Sciences, 32.
24. Khan, I. M., Shabbier, A., Naeemullah, S., Siddiqui, F. R., Rabia, M., Khan, S. N., & Chaudhary, M. T. (2014). Efficacy of vitamin C in reducing duration of severe pneumonia in children. Journal of Rawalpindi Medical College, 18(1).
25. Prinz, W., Bortz, R., Bregin, B., & Hersch, M. (1977). The effect of ascorbic acid supplementation on some parameters of the human immunological defence system. International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin-und Ernahrungsforschung. Journal international de vitaminologie et de nutrition, 47(3), 248-257.
26. Yaqub, A., RIAZ, N., GHANI, Z., & GUL, S. (2015). ROLE OF VITAMIN C IN CHILDREN HAVING PNEUMONIA. ISRA Medical Journal, 7(4).
27. Qasemzadeh, M. J., Fathi, M., Tashvighi, M., Gharehbeglou, M., Yadollah-Damavandi, S., Parsa, Y., & Rahimi, E. (2014). The effect of adjuvant zinc therapy on recovery from pneumonia in hospitalized children: a double-blind randomized controlled trial. Scientifica, 2014.
28. Acevedo-Murillo, J. A., García León, M. L., Firo-Reyes, V., Santiago-Cordova, J. L., Gonzalez-Rodriguez, A. P., & Wong-Chew, R. M. (2019). Zinc supplementation promotes a Th1 response and improves clinical symptoms in fewer hours in children with pneumonia younger than 5 years old. A randomized controlled clinical trial. Frontiers in pediatrics, 7, 431.
29. Brooks, W. A., Yunus, M., Santosham, M., Wahed, M. A., Nahar, K., Yeasmin, S., & Black, R. E. (2004). Zinc for severe pneumonia in very young children: double-blind placebo-controlled trial. The Lancet, 363(9422), 1683-1688.
30. Kewcharoenwong, C., Sein, M. M., Nithichanon, A., Khongmee, A., Wessells, K. R., Hinnouho, G. M., ... & Lertmemongkolchai, G. (2022). Daily preventive zinc supplementation increases the antibody response against pathogenic Escherichia coli in children with zinc insufficiency: a randomised controlled trial. Scientific reports, 12(1), 16084.

Most read articles by the same author(s)