Sodium ascorbate rapidly reverses sepsis-induced brain injury

Researchers at the Florey Institute of Neuroscience and Mental Health (The Florey) have shown that a megadose of sodium ascorbate can turn around sepsis-induced low oxygen levels, low blood flow and high temperature within the brain’s frontal cortex. Their work has been published in British Journal of Anaesthesia.

Sepsis is a caused by the body’s excessive inflammatory response to infection that frequently causes damage to vital organs. There are currently no treatments, and the condition can be fatal.

The researchers found that sepsis causes large falls in the blood flow and level of oxygen in the brain, and raises brain temperature; these changes may contribute to coma and delirium during sepsis and cognitive impairment in sepsis survivors. A formulation of sodium ascorbate developed at The Florey was found to reverse these insults to the brain that can lead to brain injuries, as demonstrated in a large animal model of sepsis.

“Before administering the sodium ascorbate, the test subjects were lethargic, unresponsive, lying down and not eating or drinking,” said study co-leader Professor Clive May, who has been studying sepsis for over two decades.

“Within one hour of receiving the intravenous formulation they were more alert, and after four hours they had completely recovered their normal behavioural state. They stood up, responded to external stimuli and started eating and drinking. All of these changes suggest a beneficial effect of the treatment on the brain.

“I have never seen such a dramatic response to treatment.”

Study co-leader Professor Yugeesh Lankadeva said the results were important given the lack of current treatments for brain injury in sepsis. He said measurements in the test subjects’ brains showed that the megadose of sodium ascorbate restored microcirculatory blood flow, oxygen levels and temperature in the frontal cortex.

“Septic patients commonly suffer a range of brain-related complications from delirium to coma, and this can lead to ongoing cognitive impairment and disability in survivors,” Lankadeva said.

“Our work indicates sodium ascorbate may reverse these detrimental symptoms before any persisting damage is done to the brain.”

The team has already completed a Phase Ia clinical trial of the treatment and is moving to a larger nationwide trial of its efficacy in septic patients in intensive care units across Australia, with participants selected by treating clinicians.

“We’ve previously shown that sodium ascorbate has beneficial effects on the kidneys and cardiovascular system in septic patients,” Lankadeva said. “This latest study shows it is also beneficial to the brain.”

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