Vitamin C alleviates hyperglycemic stress in retinal pigment epithelial cells

Mol Biol Rep. 2024 May 10;51(1):637. doi: 10.1007/s11033-024-09595-2.


Background: Retinal pigment epithelial cells (RPECs) are a type of retinal cells that structurally and physiologically support photoreceptors. However, hyperglycemia has been shown to play a critical role in the progression of diabetic retinopathy (DR), which is one of the leading causes of vision impairment. In the diabetic eye, the high glucose environment damages RPECs via the induction of oxidative stress, leading to the release of excess reactive oxygen species (ROS) and triggering apoptosis. In this study, we aim to investigate the antioxidant mechanism of Vitamin C in reducing hyperglycemia-induced stress and whether this mechanism can preserve the function of RPECs.

Methods and results: ARPE-19 cells were treated with high glucose in the presence or absence of Vitamin C. Cell viability was measured by MTT assay. Cleaved poly ADP-ribose polymerase (PARP) was used to identify apoptosis in the cells. ROS were detected by the DCFH-DA reaction. The accumulation of sorbitol in the aldose reductase (AR) polyol pathway was determined using the sorbitol detection assay. Primary mouse RPECs were isolated from adult mice and identified by Rpe65 expression. The mitochondrial damage was measured by mitochondrial membrane depolarization. Our results showed that high glucose conditions reduce cell viability in RPECs while Vitamin C can restore cell viability, compared to the vehicle treatment. We also demonstrated that Vitamin C reduces hyperglycemia-induced ROS production and prevents cell apoptosis in RPECs in an AR-independent pathway.

Conclusions: These results suggest that Vitamin C is not only a nutritional necessity but also an adjuvant that can be combined with AR inhibitors for alleviating hyperglycemic stress in RPECs.

Keywords: Apoptosis; Hyperglycemia; ROS; Retinal pigment epithelial cell; Vitamin C.

MeSH terms

  • Animals
  • Antioxidants / metabolism
  • Antioxidants / pharmacology
  • Apoptosis* / drug effects
  • Ascorbic Acid* / metabolism
  • Ascorbic Acid* / pharmacology
  • Cell Line
  • Cell Survival* / drug effects
  • Diabetic Retinopathy / drug therapy
  • Diabetic Retinopathy / metabolism
  • Epithelial Cells / drug effects
  • Epithelial Cells / metabolism
  • Glucose* / metabolism
  • Humans
  • Hyperglycemia* / complications
  • Hyperglycemia* / drug therapy
  • Hyperglycemia* / metabolism
  • Mice
  • Mitochondria / drug effects
  • Mitochondria / metabolism
  • Oxidative Stress* / drug effects
  • Reactive Oxygen Species* / metabolism
  • Retinal Pigment Epithelium* / drug effects
  • Retinal Pigment Epithelium* / metabolism


  • Ascorbic Acid
  • Reactive Oxygen Species
  • Glucose
  • Antioxidants