Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T08:58:45.713Z Has data issue: false hasContentIssue false

The effect of vitamin A on epithelial integrity

Published online by Cambridge University Press:  28 February 2007

F. S. W. McCullough*
Affiliation:
Northern Ireland Centre for Diet and Health (NICHE), University of Ulster, Coleraine BT52 1SA, UK
C. A. Northrop-Clewes
Affiliation:
Northern Ireland Centre for Diet and Health (NICHE), University of Ulster, Coleraine BT52 1SA, UK
D. I. Thurnham
Affiliation:
Northern Ireland Centre for Diet and Health (NICHE), University of Ulster, Coleraine BT52 1SA, UK
*
*Corresponding author: Fiona McCullough, fax +44 (0)1265 324965, email f.mccullough@ulst.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Vitamin A is the generic term for a variety of fat-soluble substances including retinol, retinyl palmitate and the provitamin A carotenoids such as all-trans-β-carotene. Vitamin A is commonly known as the anti-infective vitamin and has an essential role in vision and cellular differentiation, the latter providing a unique core mechanism helping to explain the influence of vitamin A on epithelial barriers. Alterations in the epithelial lining of vital organs occur early in deficiency, suggesting a potentially important role for the barrier function. Vitamin A deficiency (VAD) is most commonly recognized in the eye. The conjunctival-impression cytology test detects the presence of larger irregular keratinized cells and the absence of mucous-secreting goblet cells, indicative of VAD. The method is simple, quick and sensitive in populations where VAD is present. In the respiratory tract, observational studies all show an association with VAD, although vitamin A supplementation studies appear to have little effect on respiratory disease. Organ-specific targeting may improve success rates. The dual-sugar intestinal-permeability test allows the effect of vitamin A supplementation to be monitored on the gastrointestinal tract. Two vitamin A supplementation studies were carried out recently in Orissa State, India. Healthy infants of weaning age were administered orally eight weekly doses of 5.0 mg retinol equivalents and hospitalized infants received one large oral dose 60 mg retinol equivalents in the form of retinyl palmitate. Improvements in gut integrity and haematological status were observed in both studies. In summary, the response of the eye to vitamin A supplementation is well established; the present review highlights some of the more recent observations examining the effects of vitamin A.

Type
Postgraduate Symposium
Copyright
Copyright © The Nutrition Society 1999

References

Ahmed, F, Jones, DB & Jackson, AA (1990) The interaction of vitamin A deficiency and rotavirus in the mouse. British Journal of Nutrition 63, 363373.CrossRefGoogle ScholarPubMed
Alvarez, JO, Salazar-Lindo, E, Kohatsu, J, Miranda, P & Stephenson, CB (1995) Urinary excretion of retinol in children with acute diarrhoea. American Journal of Clinical Nutrition 61, 12731276.CrossRefGoogle Scholar
Amedee-Manesme, O, Luzeau, R, Wittpenn, JR, Hanck, A & Sommer, A (1988) Impression cytology test detects subclinical vitamin A deficiency. American Journal of Clinical Nutrition 50, 814817.Google Scholar
Bates, CJ (1995) Vitamin A. Lancet 345, 3135.CrossRefGoogle ScholarPubMed
Biesalski, HK (1996) Efficient vitamin A supply through inhalation. Report of the XVII IVACG Meeting, Guatamala City, Guatamala, p. 100. Washington, DC: IVACG Secretariat.Google Scholar
Brewster, DR, Manary, MJ, Menzies, IS, O'Loughlin, EV & Henry, RL (1997) Intestinal permeability in kwashiorkor. Archives of Disease in Childhood 76, 236241.CrossRefGoogle ScholarPubMed
Coutsoudis, A, Adhikari, M & Coovadia, HM (1993) Serum vitamin A concentrations and association with respiratory disease in premature infants. Journal of Tropical Pediatrics 41, 230233.CrossRefGoogle Scholar
Coutsoudis, A & Way, R (1996) An evaluation of the association between external eye diseases and vitamin A status in black South African children. South African Medical Journal 86, 871879.Google Scholar
Das, BS, Thurnham, DI & Das, DB (1996) Plasma tocopherol, retinol and carotenoids in children with falciparium malaria. American Journal of Clinical Nutrition 64, 94100.CrossRefGoogle Scholar
Egbert, PR, Lauber, S & Maurice, DM (1977) A simple conjunctival biopsy. American Journal of Opthalmology 84, 798801.CrossRefGoogle ScholarPubMed
Elia, M, Behrens, R, Northrop, C, Wraight, P & Neale, G (1987) Evaluation of mannitol, lactulose and 51-Cr-labelled ethylenediamine tetra acetate as markers of intestinal permeability in man. Clinical Science 73, 197204.CrossRefGoogle Scholar
Fleming, SC, Duncan, A, Russell, RI & Laker, MF (1996) Measurement of sugar probes in serum: an alternative to urine measurement in intestinal permeability testing. Clinical Chemistry 42, 445448.CrossRefGoogle ScholarPubMed
Gadomski, AM, Kjolhede, CL, Wittpenn, J, Bulux, J, Rosas, AR & Forman, MR (1989) Conjunctival impression cytology (CIC) to detect sub-clinical vitamin A deficiency: comparison of CIC with biochemical assessments. American Journal of Clinical Nutrition 49, 495500.CrossRefGoogle Scholar
Herrera, MG, Fawzi, WW, Nestel, P, El Amin, A & Mohamed, KA (1996) Effect of vitamin A on the incidence of cough, diarrhoea and fever. Report of the XVII IVACG Meeting, Guatamala City, Guatemala, p. 95. Washington, DC: IVACG Secretariat.Google Scholar
Hubble, D & Littlejohn, S (1963) D-Xylose excretion test in coeliac disease in childhood. Archives of Disease in Childhood 38, 476480.CrossRefGoogle ScholarPubMed
Kessing, V (1968) Mucous gland system of the conjunctiva. Acta Ophthalmologica 95, 119133.Google Scholar
Lamabadusuriya, SP, Packer, S & Harries, JT (1975) Limitations of the xylose tolerance test as a screening procedure in childhood coeliac disease. Archives of Disease in Childhood 50, 3439.CrossRefGoogle ScholarPubMed
Lunn, PG, Northrop, CA & Northrop, AJ (1989) Automated enzymatic assays for the determination of intestinal permeability probes in urine. 2. Mannitol. Clinica Chimica Acta 183, 163170.CrossRefGoogle ScholarPubMed
McCollum, EV & Davis, M (1915) The essential factors in the diet during growth. Journal of Biological Chemistry 15, 23.Google Scholar
Meneghetti, L, Ceriani, T, Maccabelli, G, Ferraris, P, Gori, S & Ventura, U (1989) Potential difference and mucus content in the stomach of vitamin A deficient rats. European Journal of Physiology 415, 30 Abstr.Google Scholar
Menzies, IS, Laker, MF & Pounder, RE (1979) Abnormal intestinal permeability to sugars in villous atrophy. Lancet ii, 11071109.CrossRefGoogle Scholar
Miller, KW, Stoltzfus, RJ, Hakimi, M & Rasmussen, KM (1993) Conjunctival impression cytology as an indicator of vitamin A status in lactating Indonesian women. American Journal of Clinical Nutrition 58, 167173.Google Scholar
Natadiastra, G, Wittpenn, JR, Muhilal, M, West, KP Jr., Mele, L & Sommer, A (1988) Impression cytology a practical index of vitamin A status. American Journal of Clinical Nutrition 48, 695701.CrossRefGoogle Scholar
Nelson, JA, Wiley, CA, Reynolds-Kohler, C, Reese, CE, Mergaretten, W & Levey, JA (1988) Human immunodeficiency virus was detected in bowel epithelium from patients with gastrointestinal symptoms. Lancet i, 259262.CrossRefGoogle Scholar
Northrop, CA, Lunn, PG & Behrens, RH (1990) Automated enzymatic assays for the determination of intestinal permeability probes in urine. 1. Lactulose and lactose. Clinica Chimica Acta 187, 163170.CrossRefGoogle ScholarPubMed
Northrop-Clewes, CA, Lunn, PG & Downes, RM (1997) Lactose maldigestion in Gambian infants. Journal of Paediatric Gastroenterology and Nutrition 24, 257263.Google ScholarPubMed
Reddy, V, Rao, V, Arunjyothi, & Reddy, M (1989) Conjunctival impression cytology for assessment of vitamin A status. American Journal of Clinical Nutrition 50, 814817.CrossRefGoogle ScholarPubMed
Ross, AC (1992) Vitamin A status: relationship to immunity and the antibody response. Proceedings of the Society of Experimental and Biological Medicine 200, 303320.CrossRefGoogle ScholarPubMed
Shenai, JP, Kennedy, KA, Chytil, F & Stahlman, MT (1987) Clinical trial of vitamin A supplementation in infants susceptible to bronchopulmonary dysplasia. Journal of Pediatrics 111, 269277.CrossRefGoogle ScholarPubMed
Sommer, A, Green, WR & Kenyon, KR (1982) Bitot's spots responsive and non-responsive to vitamin A. Clinicopathologic correlations. Archives of Ophthalmology 99, 20142027.CrossRefGoogle Scholar
Tanumihardjo, SA & Olsen, JA (1991) The reproducibility of the modified relative dose response (MRDR) assay in healthy individuals over time and its comparison with conjunctival impression cytology (CIC). European Journal of Clinical Nutrition 45, 407411.Google ScholarPubMed
Vijayaraghavan, K, Radhalah, G, Prakasam, BS, Sarma, KVR & Reddy, V (1990) Effect of massive dose of vitamin A on morbidity and mortality of Indian children. Lancet ii, 13421345.CrossRefGoogle Scholar
World Health Organization (1995) Division of Diarrhoeal and Acute Respiratory Disease Control, Vitamin A Supplementation and Childhood Pneumonia. Geneva: WHO.Google Scholar
Wittpenn, JR, Tseng, SCG & Sommer, A (1986) Detection of early xerophthalmia by impression cytology. Archives of Ophthalmology 104, 237239.CrossRefGoogle ScholarPubMed
Wolbach, SB & Howe, PR (1925) Tissue changes following deprivation of fat-soluble A vitamin. Journal of Experimental Medicine 42, 753777.CrossRefGoogle ScholarPubMed
Wolf, G (1978) A historical note on the mode of administration of vitamin A for the cure of night-blindness. American Journal of Clinical Nutrition 31, 290292.CrossRefGoogle ScholarPubMed
Zile, MH, Bunge, EC & DeLuca, HF (1981) DNA labelling of rat epithelial tissues in vitamin A deficiency. Journal of Nutrition 111, 777788.CrossRefGoogle ScholarPubMed