Abstract
Dietary micronutrients such as vitamins and trace minerals are known modulators of host immune responses against common pathogens. In this respect, vitamin A and zinc have recently received increased attention. Severalin vivo andin vitro studies suggest that vitamin A may be a critical player in the mucosal immune responses in the respiratory and gastrointestinal tracts, particularly in undernourished children. The effect may be mediated primarily by stabilization of the membrane of mucosal epithelial cells, as well as enhanced leukocyte functions. The beneficial effect of vitamin A therapy in reducing measles-associated morbidity and mortality suggests its crucial role in defenses against viral pathogens. Zinc is also known affect leukocyte functions such as phagocytosis and T-lymphocyte-mediated immune responses. However, unlike vitamin A, zinc has been investigated primarily for its effects on bacterial infections. Dietary supplementation or therapeutic treatment with vitamin A and zinc may be a cheap yet effective means of preventing or treating infections in highly susceptible populations. Additional studies, however, are required to better define the types of pathogens and the specific human populations that may benefit from such therapy.
Similar content being viewed by others
References
Ross AC, Hammerling UG. Retinoids and the immune system. In: Sporn MB, Roberts AB, Goodman DS, eds.The Retinoids: Biology, Chemistry and Medicine. New York: Raven Press, 1994: 521–543.
Ellison JB. Intensive vitamin therapy in measles.Br Med J 1992, 2: 708–711.
Barclay AJG, Foster A, Sommer A. Vitamin A supplements and mortality related to measles: a randomized clinical trial.Br Med J 1987; 294: 294–296.
Hussey GD, Klein M. A randomized controlled trial of vitamin A in children with severe measles.N Eng J Med 1990; 323: 160–164.
Rahmathullah Li Underwood BA, Thulasinaj RDet al. Reduced mortality among children in Southern India receiving a small weekly dose of vitamin A.N Engl J Med 1990; 323: 929–935.
West KP Jr, Pokhrel RP, Katz Jet al. Efficiency of vitamin A in reducing child mortality: a randomized double-masked community trial in Nepal.Lancet 1991; 338: 67–71.
Daulaire NMP, Starbuck ES, Houston RMet al. Childhood mortality after a high dose of vitamin A in a high risk population.BMJ 1992; 304: 207–210.
World Health Organization. Expanded programme on immunization: programme for the prevention of blindness nutrition. Joint WHO/UNICEF statement. Vitamin A for measles.Wkly Epidemoil Rec 1987; 62: 133–134.
Sommer A, Tarwotjo I, Djunaedi Eet al. Impact of vitamin A supplementation on childhood mortality: a randomized, controlled community trial.Lancet 1986; 119–1173.
Muhilal, Permeisih D, Idjiradinata Yet al. Vitamin A-fortified monodiu glutamate and health, growth and survival of children.Am J Clin Nutr 1988; 48: 1271–1276.
Rahmathullah L, Underwood BA, Thulasiraj RDet al. Reduced mortality among children in Southern India receiving a small weekly dose of vitamin A.N Engl J Med 1990; 323: 929–935.
Vijayaraghavan K, Radhaiah G, Prakasam BSet al. Effect of massive dose of vitamin A on morbidity and mortality in Indian children.Lancet 1990; 336: 1342–1345.
West KP Jr, Pokhrel RP, Katz Jet al. Efficacy of vitamin A in reducing preschool child mortality: a randomized, double-masked community trial in Nepal.Lancet 1991; 338: 67–71.
Daulaire NMP, Starbuck ES, Houston RMet al. Childhood mortality after a high dose of vitamin A in a high risk population.BMJ 1992; 304: 207–210.
Kirkwood AP, Ross Det al. Impact of vitamin A supplementation on childhood mortality in Northern Ghana.Lancet 1992; 340: 267–271.
Herrera MG, Nestel P, El Amin Aet al. Vitamin A supplementation and child survival.Lancet 1992; 340: 267–271.
Abdeljaber MH, Monto AS, Tilden RLet al. The impact of vitamin A supplementation on morbidity: a randomized community intervention trial.Am J Public Health 1991; 81: 1654–1656.
Rahmathullah L, Underwood BA, Thulasirajet al. Diarrhea, respiratory infections, and growth are not affected by a weekly dose low-dose vitamin A supplement: a masked, controlled field trial in children in southern India.Am J Clin Nutr 1991; 342: 578–582.
Stansfield SK, Peirre-Louis M, Lerebours Get al. Vitamin A supplementation and increased prevalence of childhood diarrhoea and acute respiratory infections.Lancet 1993; 342: 578–582.
Sheni JP, Kennedy KA, Chutil Fet al. Clinical trial of vitamin A supplementation in infants susceptible to bronchopulmonary dysplasia.J Pediatr 1987; 111: 269–277.
Shenai JP, Chytil F, Parkeret al. Vitamin A status and airway infection in mechanically ventilated very low birth weight neonates.Ped Pulmon 1995; 19: 256–261.
Neuzil KM, Gruber WC, Chytil Fet al. Serum vitamin A levels in respiratory syncytial virus infection.J Pediatr 124: 433–436.
Pinnock CB, Douglas RM, Martin AJet al. Vitamin A status of children with a history of respiratory syncytial virus infection in infants.Aust Paediatr J 1988; 24: 286–289.
Semba RD, Miotti PG, Chiphangwi JDet al. Maternal vitamin A deficiency and mother-to-child transmission of HIV-1.Lancet 1994; 343: 1593–1597.
Dushimimana A, Graham NMH, Humphrey JHet al. Maternal vitamin A levels and HIV-related birth outcome in Rwanda. VII Int Conf on AIDS, Amsterdam, July 1992 Abst.
Beisel, WR Pedarek, RS. Acute stress and trace element metabolism.Int. Rev. Neurobiol. 1972; 1: 53–82.
Beisel, WR, Pekarek RS, Wannemacher, RW. The impact of infectious disease on trace element metabolism of the host. In: Hoekstra WG, Suttie JW, Ganther, Heet al. eds.Trace Element Metabolism in Animals-2. Baltimore: University Park Press, 1974; 217–240.
Heese HDV, Ryder CS, Beatty DWet al. Serum zinc and copper levels in children with meningococcal disease.Eur J Pediatr 1985; 144: 152–156.
Sugarman B. Zinc and infection.Rev of Infect Dis 1983; 5(1): 137–147.
Licastro F, Chricolo M, Mocchegiani Eet al. Oral zinc supplementation in down syndrome subjects decreased infections and normalized some humoral and cellular immune parameters.J Intel disab Res 1994; 28: 149–162.
Snyder SL, Walker RI. Inhibition of lethality in endotoxin-challenged mice treated with zinc chloride.Infect Immun 1976; 13: 998–1000.
Brody I. Treatment of recurrent furunculosis with oral zinc (letter).Lancet 1977; 2: 1358.
Fabris N, Mocchegiani E, Galli Met al. AIDS, zinc deficiency and thymic hormone failure.JAMA 1988; 259: 839–845.
Falutz J, Tsoukas C, Cardno Tet al. Serum zinc in homosexual men.Clin Chem 1989; 35: 704–705.
Graham NMH, Sorensen D, Odaka Net al. Relationship of serum copper and zinc levels to HIV-1 seropositivity and progression to AIDS.J Acq Imm Def Syndr 1991; 4: 976–80.
Sohnle PG, Collins-Lech C, Wiessner JH. The zinc-reversible antimicrobial activity of neutrophil lysates and abscess fluid supernatants.J Infect Dis 1991; 164: 137–142.
Bamberger D, Herndon B, Suvarna P. The effect of zinc on microbial growth and bacterial killing by cefazolin in astaphylococcus aureus abscess milieu.J Infect Dis 1993; 168: 893–896.