JMIR Publications

ABSTRACT

Background:

With a 5-year survival rate of less than 10% in the most regions worldwide, ductal adenocarcinoma of the pancreas (PDAC) has been considered one of the deadliest tumor diseases for many years. In addition, the incidence of both, acute and chronic pancreatitis is also increasing worldwide. Both diseases are characterized by pronounced stromal changes such as the activation of pancreatic stellate cells, fibrosis, immune cell recruitment, and the creation of a proinflammatory microenvironment, which can influence not only the course of the disease but also malignant progression. Ascorbic acid is increasingly coming into focus as a modulatory factor, as it has the potential to act both as an antioxidant and anti-inflammatory agent on pancreatitis tissue and as a cytotoxic and modulatory agent on tumor-relevant signaling pathways in PDAC. While the influence of vitamin C on tumor cells has been extensively studied and systematically classified, there is currently a lack of consideration in the context of stromal and epithelial cells in PDAC and benign/inflammatory pancreatic diseases.

Objective:

This review aims to map the currently scattered literature and thus detect possible gaps in research. The research question posed for this purpose is: “Which data are available on the influence of ascorbic acid on pancreatic stromal cells and pancreatic cells in benign/inflammatory and malignant diseases of the pancreas?”

Methods:

The scoping review will be conducted using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and the recommendations of the Joanna Briggs Institute (JBI). We will conduct the main systematic search using the PubMed/MEDLINE and Web of Science databases. In addition, gray literature will be identified using the Bielefeld Academic Search Engine (BASE). Two independent reviewers will then administer a title/abstract screening followed by a full-text screening. Relevant data will be extracted using a standardized Excel spreadsheet (version 16.104.1). Data analysis will be descriptive and supplemented by thematic groupings and possible tabular or graphical representations. In accordance with the PRISMA-ScR recommendations, we will not perform a formal risk of bias assessment.

Results:

The following data should be extracted from the final included studies: title, author, year of publication, study design, model, cell lines used, vitamin C isoform, treatment periods with vitamin C, control, primary outcomes regarding pancreatic cells, primary outcomes regarding stromal cells, methods, key findings, limitations, conflicts of interest, external funding. In order to comply with the purpose of a scoping review and not to exclude any relevant information, we reserve the right to expand this list during the screening process.

Conclusions:

The expectations for this review are to provide a comprehensive overview of the current state of knowledge in this field of research, to structure it, and thus to highlight possible gaps in the current state of knowledge. This could serve as a basis for further studies.