Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 129577

AbstractMaterial and MethodsResultsDiscussionReferences
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
Knowledge is treasure of a wise man. The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help ones reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journalsNo manuscriptsNo authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2009 | Month : August | Volume : 3 | Issue : 4 | Page : 1627 - 1632 Full Version

The Effect Of VC On Immunoendocrine And Oxidative Stress Responses To Exercise

Published: August 1, 2009 | DOI:

*Cellular Molecular Research Center, Guilan University of Medical Sciences **,***Exercise Physiology Department of Guilan University ,****Ardebil University of Medical Sciences

Correspondence Address :
Dr Parvin Babaei, Dept of Physiology,
Guilan University of Medical Sciences,
8th km of Rasht -Tehran road, Guilan University complex,
Faculty of medicine Email:
Fax:0098 131 6690007 Tel:0098 131 3234196


The depression of the immune system function that is typically observed after strenuous exercise is believed to be possibly mediated by stress hormones, cytokines and oxidative stress. The aim of this study was to measure immunoendocrine and oxidative stress responses after the ingestion of two different doses of Vitamin C (VC) supplementation. Twenty-four healthy untrained males participated in a 30-min exercise at 75%Vo2max. Immediately pre-exercise, the participants received either of the following regimens: placebo, 500 mg and 1000 mg of VC. Blood samples were obtained prior to ingestion, immediately after ingestion, 2hrs after ingestion and also 2hrs and 24hrs after exercise.

Vitamin C used in doses of 500 mg and 1000 mg could significantly increase the plasma VC concentration and antioxidant capacity in both vitamin receiving groups. The increase in total antioxidant capacity (TAC) followed a significant decrease in post-exercise oxidative stress markers like malondialdehyde (MDA) (P<0.05). Markers of inflammation (total leukocytes, neutrophils and IL-6), muscle damage, creatine kinase (CK) and stress hormone (cortisol) were found to significantly increase in response to the exercise (P<0.05), but VC supplementation failed to decrease these factors significantly. The results suggest that acute supplementation with moderate and high doses of VC might prevent exercise-induced lipid peroxidation but not inflammatory markers.


Ascorbate; stress hormone; cytokine; oxidative stress

It has been documented that high intensity exercise not only induces oxidative stress, but also elicits the mobilization and functional augmentation of neutrophils and monocytes. The changes in the immunoendocrine system and also the paracrine secretion of cytokines lead to the suppression of cellular immunity and increased the susceptibility to infections. Cytokines are considered to induce systemic bioactivity following exercise as anti-inflammatory and also proinflammatory substances (1). It has been known that physical exercise is a model of stress increase energy demand to a large extent, and subsequently oxygen uptake (2),(3). Muscle damage subsequent to exercise can cause inflammation and release of superoxides and free radicals, resulting in lipid peroxidation (4),(5),(6). Reactive oxygen species (ROS) "leaking" from the mitochondria during exercise are considered as a main source of oxidative stress (3),(5). Oxidative stress may result from oxidative reactions within the skeletal muscle (7). The majority of free radicals produced in vivo are oxidants which are capable of oxidizing a range of biological molecules including carbohydrates, amino acids and fatty acids. Moreover, exercise induces highly stereotyped changes in leukocyte subpopulations (8). Immune cells are mobilized and activated during exercise in response to muscle damage and also via the actions of stress hormones (catecholamines, growth hormone, cortisol) that are released in response to increasing metabolic demands and core temperature during exercise (9),(10). Immunological studies revealed that a range of antioxidant defenses have evolved in the body. The main nonenzymatic antioxidants include VC and E. The antioxidant defenses of the body are usually adequate to prevent substantial tissue damage, whereas the stress situation in which there is imbalance could lead to deleterious effects (11).Vitamin C is able to protect endogenous lipids from detectable oxidative damage induced by aqueous peroxyl radicals and other reactive oxygen species (12). Previous studies investigating the protective effects of supplementation with VC have been inconclusive: inhibition of lipid peroxidation (13),(14), no effect (15),(16), and even increased lipid peroxidation (17). Since, VC is water-soluble it´s availability may be adequate after a single dose usage, and hypothetically there may be no need for prolonged supplementation. The aim of this study was to measure the immunoendocrine and oxidative stress responses after the ingestion of two different doses of VC, high and moderate dose, before exercise, in untrained men participating in a 30-min run at 75% Vo2max.

Material and Methods

Twenty-four untrained male students volunteered to take part in this study, which had approval from the Guilan University Ethical Advisory Committee. All subjects were informed verbally and in writing about the nature and demands of the study, and subsequently completed a health history questionnaire and informed consent. Participants with smoking habits, vegetarians and those who took vitamin supplements were excluded from the study and were allocated to 3 groups in a single blind design: those on high dose VC (HD), those on moderate dose VC (MD) or those on placebo (P) (Table/Fig 1). They performed two preliminary treadmill-based tests at least 10 days prior to the main trial. Briefly, a Bruce test to determine Vo2max and also an incremental submaximal running test to determine the relationship between running speed and oxygen uptake were taken.

Experimental Design And Procedure
On the day of the test, participants received either of the following regimens: placebo, 500 mg and 1000 mg of VC with a carbohydrate free breakfast. After a 10-min warm-up consisting of running at 50% Vo2max (5-min) and stretching (5-min), participants ran on the treadmill for 30-min at 75% Vo2max. Blood samples were taken immediately after exercise and 2hrs and 24hrs after exercise. Plasma and serum were obtained using standard procedures. Two small aliquots of EDTA-treated blood were removed for the determination of differential leukocytes using a Cell counter (K-1000 Sysmax, Japan). Due to VC analysis, 0.03 ml distilled water and 0.06 ml of 10% metaphosphoric acid were added to 0.03 ml of plasma (Merck, Germany) and was vortexed in a 1.5-ml centrifuged tube for ~ 10s. The suspension was placed over ice for at least 10 min and was sheltered from strong light. Then, the mixture was centrifuged at 23000 g for 10 min at 4ْ C and was infused to an HPLC column (Jasco, Japan) in 0.05 volume using a Hamilton syringe (18).

In order to analyze MDA, an aliquoted portion of 0.05 ml serum was added to 0.25 ml of 0.1 M Trichloroacetic acid (TCA) and 0.7 ml distilled water and the samples were centrifuged at 4500 g for 5 min and were used for HPLC analysis (19). Serum Creatine kinase (CK) was determined using commercially available methods (autoanalizer, Roche Hittachi-911, Germany and Japan) and IL-6 was analyzed using ELISA (Dynex, USA). Serum cortisol was measured by electrochemiliuminescence (Roche Hittachi, Germany and Japan).

Statistical Analysis
Results are expressed as means ± SEM, and p<0.05 was considered to be statistically significant. An independent two-way analysis of variance with repeated measures and the Tukey Honest post test were used to compare results between treatments and over time. When there were only single comparisons, the student's t-test with Bonferroni correction for correlated data was used to determine whether any differences between treatments existed.


The baseline resting plasma VC concentration was not different between groups (Table/Fig 2). Two hours after supplementation, plasma VC was found to be significantly elevated in the HD and MD groups (p<0.05) and decreased over the course of exercise, but was still significant immediately and 2hrs after exercise in both groups (p<0.05). Then, it returned to baseline levels twenty-four hours after exercise. Baseline serum TAC was not different between groups (Table/Fig 3). The total antioxidant capacity increased immediately after exercise in the placebo group (p>0.05) and decreased 2hrs and 24hrs after exercise even on comparison with the baseline values (p<0.05). In the MD and HD groups, TAC increased after supplementation and continued immediately after exercise and 2hrs later, returning to baseline values after 24hrs. There were no significant differences between the three treatment groups (p>0.05).

Markers Of Lipid Peroxidation And Muscle Damage
Blood MDA is shown in (Table/Fig 4). MDA increased 2hrs after exercise only in the placebo group (p<0.05). There were no significant differences between the treatment groups for MDA over the course of exercise (p<0.05).

The blood CK concentration is shown in (Table/Fig 5). CK increased above baseline values after exercise in all groups. The increase of CK was significant immediately and 2hrs after exercise in all groups as well as 24hrs after exercise only in the placebo group (p< 0.05). There were no differences among the groups for CK over the course of the experiment (p>0.05).

Serum cortisol is shown in (Table/Fig 6). Cortisol concentrations increased immediately after exercise in both the groups (p<0.05). Then, serum cortisol concentrations declined to almost pre-exercise levels, 2hrs and 24hrs after exercise (p>0.05). There were no significant differences between the cortisol concentrations in the placebo and the VC groups (p>0.05).

Serum IL-6 is shown in (Table/Fig 7). IL-6 concentrations were elevated after exercise (p<0.05) and declined to almost pre-exercise levels at 24 hrs after exercise in both groups. There were no detectable differences between the placebo and the VC groups (p>0.05).

The effect of 30 min of exercise at 75% Vo2max on circulating total leukocyte, neutrophil and lymphocyte counts are shown in (Table/Fig 8). There were no significant differences in lymphocyte counts in both groups after the exercise was compared to pre-exercise (p>0.05). Also, there was no significant difference between the groups for total leukocyte, neutrophil and lymphocyte counts over the course of the experiment (p>0.05).


The main purpose of this study was to investigate whether acute supplementation with high and moderate doses of VC would have an effect on the inflammation and lipid peroxidation factors induced by physical stress. Acute supplementation of VC with both doses of 500 mg and 1000 mg could increase plasma VC levels 2hrs after supplementation. Total antioxidant capacity decreased significantly 24hrs after exercise as compared to pre-exercise in the placebo group, proving the effect of VC supplementation as a putative antioxidant. It has been known that exercise by itself could increase plasma VC. This increase relates to the elevation of cortisol during exercise, which promotes the efflux of ascorbic acid from the adrenal gland (20),(21) or the mobilization of ascorbic acid from other tissues such as leukocytes and erythrocytes (20). Contrary to some studies (16),(22), plasma VC concentration was not elevated in the placebo group after exercise. This result is most likely, because of lack of considerable change in serum cortisol. One of the peroxidation factors, MDA, was significantly blunted after exercise in both VC supplemented groups (MD an HD), whereas in the placebo group, MDA increased significantly 2hrs after exercise. The result of our study is in agreement with Ashton et al., but not with Thompson et al. and Davidson et al. The effect of VC on MDA possibly depends on the fitness level or training status of the participants (25). It is assumed that responses to antioxidant supplementation in untrained individuals are much more than in endurance-trained athletes. Some studies (Miyazaki et al., and Fatouros et al.), in contrary to others (Tiidus et al. and Tonkonogi et al.), reported that endurance training could improve the endogenous antioxidant defenses. Moreover, differences in the modes, duration, and intensity of exercise, as well as variation in the methodologies used to assess lipid peroxidation, could be the possible reasons of inconsistencies. The marker of muscle damage (CK) increased immediately after exercise and continued two hours later and returned to pre-exercise values after 24 hours in both groups. The efflux of this enzyme was not different between the VC and the placebo groups. It seems that acute supplementation with VC had no effect on CK as a muscle damage marker. According to Feasson et al., the increase in CK may be due to disruption of the muscle fiber structures, and consequently due to leakage of this protein into the circulation. This efflux relates to increase in the ROS- induced membrane permeability of the muscle cells (31), (32), (33). Peake et al. and Kobayashi et al., have reported that after exercise, CK reaches its peak in 24 or 48hrs, whereas in our study, after the similar time course, CK returned to baseline levels in VC supplemented groups. The reduction in CK relates most likely to blunting MDA by VC pretreatment. However, the low duration and intensity of the exercise used in our study is the reason for insignificant changes. In our study, IL-6 was enhanced only two times in both groups. The insignificant change in IL6 is in agreement with Davidson et al, Davison and Gleeson, but not Thompson et al. According to Paczek et al., the change in IL-6 mainly depends on energy expenditure, calorie intake, glycogen demand and the duration and intensity of exercise. In the present study, VC could not affect IL-6, probably because of the short time of muscles involvement in performance, which was not sufficient to provide the optimum uptake of VC into cytokine producing tissues and to induce molecular cascades of IL6 production (22). On the other hand, another humeral factor such as blood glucose levels can regulate changes in IL-6 and cortisol during exercise (36). The lack of significant effects in WBC counts, could probably relate to insignificant changes in IL6 and cortisol too. It has been known that muscle-derived IL6 has a role in exercise induced leukocyte trafficking directly and indirectly by cortisol elevation.

In summary, acute supplementation with both doses of VC, 2hrs before exercise increased plasma concentrations of this vitamin and consequently could alleviate lipid peroxidation and muscle damage induced by physical stress. Therefore, VC supplementation prevented oxidative damage but had no apparent effect on inflammation, indicating different cascades of oxidative damage and inflammation. It can be conclude that intake of a moderate dose of VC, as an useful antioxidant could protect body from oxidant stress and is of benefit to physical activity. Future studies could be designed to measure the complete profile of inflammation and ROS induced by exercise in different time intervals after VC intake.


Suzuki K, Nakaji S, Yamada M, Totsuka M, Sato K, Sugawara K. Systemic inflammatory response to exhaustive exercise. Cytokine kinetics. Exerc Immunol Rev. 2002; 8: 6-48.
Astrand P, Rodahl K. Textbook of work physiology: physiological basis of exercise. McGraw–Hill Book.1986, New York.
Halliwell B, Gutteridge J. Free radicals in biology and medicine. Oxford Univ. Press.1999, New York;
Alessio H, Hagerman A, Fulkerson B, Ambrose J, Rice R, and Wiley R. Generation of reactive oxygen species after exhaustive aerobic and isometric exercise. Med. Sci. Sports Exerc. 2000; 32: 1576–81.
Hessel E, Haberland A, Muller M, Lerche D, Schimke I. Oxygen radical generation of neutrophils: a reason for oxidative stress during marathon running? Clin. Chim. Acta. 2000; 298: 145–56.
Mastaloudis A, Marrow J, Hopkins D,DevarajS,TraberM.Antioxidantsupplementation prevents exercise-induced lipid peroxidation, but not inflammation in ultramarathon runners. Free Radical Biology & Medicine. 2004;36: 1329-41.
Konig D, Wagner KH. Elmadfa I, Berg A. Exercise and oxidative stress significance of antioxidants with reference to inflammatory, muscular and systemic stress. Exerc Immunol Rev 2001; 7: 108–33.
Pedersen BK, and Hoffman GL. Exercise and the immune system regulation, integration, and adaptation. Physiol Rev 2000; 80: 1055–81.
Rhind SG, Gannon GA, Shek PN, Brenner IK, Severs Y & Zamecnik J et al. Contribution of exertional hyperthermia to sympathoadrenal-mediated lymphocyte subset redistribution. J Appl Physiol.1999; 87: 1178–85.
Nieman DC, Henson DA, Smith LL, Utter AC, Vinci DM & Davis JM. et al. Cytokine changes after a marathon race, J Appl Physiol. 2001; 91: 109–14.
Cooper CE, Vollaard NB, Choueini T, and Wilson MT. Exercise, free radicals and oxidative stress. Biochemical society transactions. 2002; 30: 280-85.
Frei B, Stocker R. , Ames BN. Vit C redox reactions in blood of normal and malaria infected. Proc. Natl. Acad. Sci. USA,1985, 9748–52.
Alessio H, Goldfarb A, Cao, G. Exercise-induced oxidative stress before and after VC supplementation. Int. J. Sport Nutr. 1997; 7: 1–9.
Ashton T, Young I, Peters J,Jones E, Jackson S. Davies B, Rowlands C. Electron spin resonance spectroscopy, exercise and oxidative stress: an ascorbic acid intervention study. J. Appl. Physiol. 1999; 87: 2032–36.
Nieman D, Henson D, McAnulty S, McAnulty L, Swick N, Utter A, Vinci D, Opiela S, Morrow J. Influence of VC supplementation on oxidative and immune changes after an ultramarathon. J. Appl. Physiol. 2002; 92: 1970–77.
Thompson D, Williams C, Kingsley M, Nicholas C, Lakomy H, McArdle F, Jackson M. Muscle soreness and damage parameters after prolonged intermittent shuttle-running following acute VC supplementation. Int J Sports Med 2001; 22: 68–75.
Childs A, Jacobs C, Kaminski T, Halliwell B, Leeuwenburgh C. Supplementation with VC and N-acetyl-cysteine increases oxidative stress in humans after an acute muscle injury induced by eccentric exercise. Free Rad. Biol. Med. 2001; 31: 745–53.
Chung W, Chung J, Szeto Y, Tomlinson B, Benzie .I Plasma ascorbic acid: measurement, stability and clinical utility revisited. Clinic Biochem. 2001; 34: 623-27.
Karatas F, Karatepe M, Baysar A, Determination of free malodialdehyde in human serum by high-performance liquid chromatography. Analytical biochemistry. 2002; 311: 76-79.
Mastaloudis A, Marrow J, Hopkins D, Devaraj S, Traber M, Antioxidant supplementation prevents exercise-induced lipid peroxidation, but not inflammation, in ultramarathon runners, Free Radical Biology and Medicine 2004; 36: 1329-41.
Padayatty SJ, Doppman JL, Chang R, Wang, Y, Gill J, Papanicolaou DA, Levine M, Human adrenal glands secrete VC in response to adrenocorticotrophic hormone American Journal of Clinical Nutrition 2007; July 86( 1): 145-49.
Thompson D, Baily M, Hill J, Hurst T, Powell J. R ,Williams C. Prolonged VC supplementation and recovery from eccentric exercise. European Journal of Applied Physiology 2004; 92: 133-38.
Davison G, Gleeson M, Influence of acute VC and/or carbohydrate ingestion on hormonal, cytokine, and immune responses to prolonged exercise. Int J Sport Nutr Exerc Metab. 2005; 15: 465–79.
Davison G, Gleeson M, The effect of 2 weeks VC supplementation on immunoendocrine responses to 2.5 h cycling exercise in man. Eur J Appl Physiol 2006; 97: 454–61.
Hagobian TA, Jacobs KA, Subudhi A.W, Fattor JA, Rock PB, Muza SR, Cytokine responses at high altitude: effects of exercise and antioxidants at 4300 m, Med Sci Sports Exerc 2006; 38: 276–85.
Miyazaki H, Oh-ishi S, Ookawara T, Kizaki T, Toshinai K, Ha S, Strenuous endurance training in humans reduces oxidative stress following exhausting exercise, Eur J Appl Physiol 2001; 84: 1–6.
Fatouros I.G, Jamurtas AZ, Villiotou V, Pouliopoulou S, Fotinakis P, Taxildaris K, Oxidative stress responses in older men during endurance training and detraining, Med Sci Sports Exerc 2004; 36: 2065–72.
Tiidus P.M, Pushkarenko J, Houston M.E, Lack of antioxidant adaptation to short-term aerobic training in human muscle, Am J Physiol 1996; 271: 832–36.
Tonkonogi I, Tonkonogi M, Walsh B, Svensson M, Sahlin K, Mitochondrial function ad antioxidative defence in human muscle: effects of endurance training and oxidative stress, J Physiol 2000; 528: 379–88.
Feasson L, Stockholm D, Freyssenet D, et al. Molecular adaptations of neuromuscular disease-associated proteins in response to eccentric exercise in human skeletal muscle. J.Physiol 2002; 543: 297-306.
Armstrong R, Warren G, Warren J, Mechanisms of exercise-induced muscle fiber injury, Sports Med 1991; 12: 184–207.
Jackson M. Oxygen radical production and muscle damage during running exercise. In: Marconnet P, Saltin B, Komi P, Poortmans J, (eds). Human Muscular Function during Dynamic Exercise. Med Sci Sport. 1996; Basel: Karger, pp. 121-33.
Cannon J, Orencole S, Fielding R, et al. Acute phase response in exercise: interaction of age and vitamin E on neutrophils and muscle enzyme release. Am.J.Physiol 1990; 259: R1214-R19.
Peake JM, Suzuki K, Wilson J, Hordern M, Nosaka K, Mackinnon L, Coombes JS, Exercise-induced muscle damage, plasma cytokines, and markers of neutrophil activation. Med.Sci.Sports.Exerc2005; 37(5):737-45
Kobayashi Y, Takeuchi T, Hosoi T, Yoshizaki H, Loeppky JA, Effect of a marathon run on serum lipoproteins, creatin kinase, and lactatedehydrogenase in recreational runners, Res. Q. Exerc. Sport 2005; 76(4): 450-5.
Davison G, Gleeson M, The effects of acute VC supplementation on cortisol, interleukin-6, and neutrophil responses to prolonged cycling exercise Published in: European Journal of Sport Science March 2007; ( 7): 15 - 25
Paczek B, Bartlomiejczyk I, Gabrys T, Przybylski J, Nowak M, Paczek L, Lack of relationship between interlukin-6 and CRP levels in healthy male athletes, Immunology letters 2005; 99: 136-40.
Nieman DC, Davis J.M, Henson DA., Gross S, Dumke CL, Utter AC, et al. Muscle cytokine mRNA changes after 2.5 h of cycling: influence of carbohydrate, Med Sci Sports Exerc 2006; 37: 1283–90.

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)