Effect of Vitamin C to The Plasma Level of Interleukin-6, Plasma MDA and Length of Hospitalization of COPD Exacerbation Patient

Fadlia Yulistiana, Suradi Suradi, Reviono Reviono


Background: Exacerbation is an acute condition characterized by worsening of symptoms that require a change in therapy. Increased inflammation of the airways and lungs during exacerbations causes an increase in plasma IL-6 and MDA levels and causes most patients needed treatment at the hospital. Vitamin C is an antioxidant vitamin that has anti-inflammatory and antioxidant effects so that it can be added to COPD exacerbations therapy. This study aims to determine the effect of vitamin C on plasma IL-6, plasma MDA levels and length of hospitalization of acute exacerbation of COPD patients.
Methods: This research is an experimental study with pre-test and post-test design. Subjects consisted of 33 patients with exacerbation of COPD were treated at the Soehadi Pridjonegoro Hospital Sragen in October-November 2015 which were selected by purposive sampling. Subjects were divided into two groups, the treatment group (n=16) received vitamin C therapy 1x1000 mg/day and the control group (n=17) received 5 mL of NaCl 0.9%. Levels of IL-6 plasma and plasma MDA was measured on admission and at discharge criteria are met. Length of hospitalization is calculated based on the number of days’ patients in hospital.
Results: There was no statistically significant difference to decreased of IL-6 plasma level (P=0.379), MDA plasma level (P=0.27) and length of hospitalization (P=0.24) between treatment and control group.
Conclucions: The addition of vitamin C 1x1000 mg/day during hospitalization is not helpful to decreased in levels of plasma IL-6, plasma MDA and length of hospitalization in this study. (J Respir Indo 2018; 38(1): 24-32)


vitamin C, acute exacerbation of COPD, plasma IL-6, plasma MDA, length of hospitalization

Full Text:



Global initiative for chronic obstructive lung disease. 2014. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease update 2015.. [Cited 2016 January 5th]. Available from: http://www.goldcopd.org/uploads/users/files/GOLD_Report_2015.pdf

Evensen AE. Management of COPD Exacerbations. [Cited 2016 februari 10th]. Available from: ww w.aafp.org/afp.

Suradi. Peran kadal IL-1β, IL-12, IFN-γ dan IL-10 terhadap kadar elastase MMP-9 pada emfisema paru. [Disertasi] Surabaya: Universitas Airlangga, 2004.

Mackay AJ, Donaldson GC, Patel ARC, Jones PW, Hurst JR. Usefulness of chronic obstructive pulmonary disease assessment test to evaluate severity of COPD exacerbation. Am J Crit Care Med. 2012;185:1218-24.

Cavalcante AG, Brain PF. The role of oxidative stress in COPD: current concepts and perspectives. J Bras Pneumol. 2009;35:1227-37.

Tanaka T, Narazaki M, Kishimoto T. IL-6 in inflammation, immunity, and disease. Cold Spring Harb Perspect Biol. 2014;6:a016295.

Kubera J, Hammerman K, Williams CMM, Hubeau C. Interleukin-6 neutralization alleviates acute exacerbation-like disease in a model of cigarette smoke-induced pulmonary inflammation. J Inflamm (Lond). 2013;10:P33.

Roca M, Verduri A, Corbetta L, Clini B, Fabbri LM, Beghe B. Mechanism of acute exacerbations of respiratory symptoms in chronic obstructive pulmonary disease. Eur J Clin Invest. 2013;43:510-21.

Antuz B, Harnasi G, Drozdovszky O, Barta I. Monitoring oxidative stress during chronic obstructive pulmonary disease exacerbations using malondialdehyde. Respirology. 2013;19:74-9.

Barnes PJ. New anti-inflammatory targets for chronic obstructive pulmonary disease. Nat Rev Drug Discov. 2013;12:543-59.

Desai U, Gothi D, Joshi JM. COPD exacerbation: clinical management options. Indian Journal of Clinical Medicine. 2012;3:1-15.

Adikwu E, Deo O. Hepatoprotective effect of vitamin C (ascorbic acid). Pharmacology & Pharmacy. 2013;4:84-92.

Anitra CC, Margreet C M. Synthetic or food derived vitamin C are they equally bioavailable? Nutrients. 2013;5:4284-304.

Carcamo JM, Pedraza A, Ojeda OB, Zhang B, Sanchez R, Golde DW. Vitamin C is kinase inhibitor: dehydroascorbic acid anhibits IKβα kinase β. Mol Cell Biol. 2004;8:6645-52.

Vijayan VK. Chronic obstructive pulmonary disease. Indian Journal of Medical Research. 2013;137:251-69.

Curtis JL, Freeman CM, Hogg JC. The immunopathogenesis of chronic obstructive pulmonary disease. Am Thorac Soc. 2007;4:512-21.

Rincon M, Irvin CG. Role of IL-6 in asthma and other inflammatory pulmonary diseases. Int J Biol Sci. 2012;8:1281-90.

Hurst JR, Donaldson GC, Perera WR, Wilkinson TMA, Bllello JA, Hagan GW, et al. Use plasma biomarkers at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2006;174:867-74.

Wedzicha JA, Brill SE, Allinson JP, Donaldson GC. Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease. BMC Med. 2013;11:1-10.

Mikirova N, Rogera A, Casciari J, Taylor P. Effect of high dose intravenous ascorbic acid on the level of inflammation in patients with rheumatoid arthritis. Modern Research in Inflammation. 2012;1:26-32.

Moraes MR, Costa AC, Correx KS, Kipnis APJ, Rabahi MF. Interleukin-6 and interleukin-8 blood level’s poor association with the severity and clinical profile of ex-smokers with COPD. Int J Chron Obstruct Pulmon Dis. 2014;4:735-43.

Ge M, O’Reilly A, Baillie N, Twentyman G, Sturt J, Fitzpatrick M, et al. Vitamin C: evidence, application and commentary. New Zeal Fam Physician. 2008;35:312-8.

DOI: https://doi.org/10.36497/jri.v38i1.136


  • There are currently no refbacks.

Copyright (c) 2018 Jurnal Respirologi Indonesia


SINTA Garuda Indonesian Scientific Journal Database (ISJD) Indonesia One Search (IOS) Crossref

ROAD-ISSN Dimensions Google Scholar 


Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845
Email: editor@jurnalrespirologi.org

An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License