Vitamin C (ascorbic acid) is best known for its role as an antioxidant in humans. However, from a clinical perspective vitamin C has an equally important function in the stabilisation of connective tissue. Most mammals can synthesise adequate vitamin C from glucose, but humans have a genetic deficiency of the enzyme gulonolactone oxidase required for this metabolic pathway. Therefore vitamin C is required in the diet of humans, and without it connective tissue deteriorates and the deficiency disease scurvy develops. Symptoms of scurvy include bleeding gums, ruptured blood vessels, skin discolouration, haemorrhage, easy bruising and slow wound healing. Intakes of vitamin C below 10 mg per day result in the development of scurvy, which is fatal in a short period if not reversed in the early stages with adequate vitamin C in the diet. Related to its role in the stabilisation of connective tissue, some evidence supports a role for vitamin in the prevention of cardiovascular disease. The mechanism by which this could occur was discussed in a paper written by Linus Pauling and Matthias Rath1.
In their paper, Rath and Pauling describe how ascorbate depletion leads to a breakdown in connective tissue, which manifests itself first in the high-pressure areas of the circulatory system. Increased permeability and loosening of the vascular wall results in perivascular bleeding and eventual death. The authors suggests that the multitude of pathomechanisms that lead to the clinical manifestation of cardiovascular disease are in fact a protective mechanism which has evolved to protect the body from haemorrhagic blood loss through the scorbutic vascular wall. This they suggest occurs through the deposition of various athrogenic substances, most frequently lipoprotein a [Lp (a)], which result in stabilisation of the vascular endothelium and a thus have a preventative effect on perivascular bleeding. This ensures the short-term survival of the organism until after reproductive age, at the expense of premature death from cardiovascular disease. These ideas have been almost completely ignored by the mainstream scientific community, which if past experience is anything to go by, suggests that Pauling and Rath were onto something significant.
