Decreased vitamin A levels in common variable immunodeficiency:: vitamin A supplementation in vivo enhances immunoglobulin production and downregulates inflammatory responses
Decreased vitamin A levels in common variable immunodeficiency:: vitamin A supplementation in vivo enhances immunoglobulin production and downregulates inflammatory responses
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DOI：
10.1046/j.1365-2362.2000.00619.x
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发表时间：
2000-03-01
影响因子：
5.5
通讯作者：
Froland, SS
中科院分区：
文献类型：
--
作者：
Aukrust, P;Müller, F;Froland, SS
背景维生素 A 具有广泛的免疫作用，维生素 A 缺乏与复发性感染有关。常见变异型免疫缺陷病（CVI）是一组以抗体产生受损和反复细菌感染为主要表现的B细胞缺陷综合征，但免疫功能障碍也可能包括T细胞和巨噬细胞。在本研究中，预先检查了维生素 A 缺乏在 CVI 中的可能作用。 患者和方法 我们分析了 20 名 CVI 患者和 16 名对照者的血浆维生素 A 水平，并检查了维生素 A 与 CVI 中临床、免疫学和代谢参数之间的关系。在维生素 A 水平最低的 6 名 CVI 患者中，我们还研究了补充维生素 A 的体内效果以及这些患者的几种免疫功能。 结果 (i) 横断面和纵向测试均发现，与健康对照相比，大多数 CVI 患者的维生素 A 水平降低。 (ii) 维生素 A 水平低与慢性细菌感染和脾肿大以及新蝶呤水平高有关。没有观察到载体蛋白水平下降和吸收不良，(iii)维生素A水平较低的患者补充维生素A导致白细胞介素10 (IL-10)水平增加和肿瘤坏死因子-α (TNF α)水平下降，正如在血浆和单核细胞上清液中发现的那样，可能有利于抗炎净效应。 (iv) 体内补充维生素 A 还增强了抗 CD40 刺激的 IgG 产生、血清 IgA 水平和植物血凝素 (PHA) 刺激的外周血单核细胞 (PBMC) 增殖。 结论 CVI 患者中相当一部分亚组的特点是维生素 A 水平低。我们的研究结果支持补充维生素 A 在 CVI 中可能发挥的作用，可能会增强免疫球蛋白合成并下调炎症反应。
Background Vitamin A has a broad range of immunological effects, and vitamin A deficiency is associated with recurrent: infections. Common variable immunodeficiency (CVI) is a group of B-cell deficiency syndromes with impaired antibody production and recurrent bacterial infections as the major manifestations, but the immunological dysfunctions may also include T cells and macrophages. In the present study pre examined the possible role of vitamin A deficiency in CVI.Patients and methods We analysed plasma vitamin A levels in 20 CVI patients and 16 controls, and examined the relationships between vitamin A and clinical, immunological and metabolic parameters in CVI. In the six CVI patients with the lowest vitamin A levels we also studied the effect of vitamin A supplementation in vivo an several immunological functions in these patients.Results (i) The majority of CVI patients had decreased vitamin A levels compared with healthy controls, as found in both cross-sectional and longitudinal testing. (ii) Low vitamin A levels were associated with the occurrence of chronic bacterial infections and splenomegaly as well as high neopterin levels. Decreased levels of carrier protein and malabsorption were not observed, (iii) Vitamin A supplementation in patients with lour vitamin A levels resulted in increased interleukin-10 (IL-10) and decreased tumour necrosis factar-alpha (TNF alpha) levels, as found in both plasma and monocyte supernatants, possibly favouring anti-inflammatory net effects. (iv) Vitamin A supplementation in vivo also enhanced anti-CD40-stimulated IgG production, serum IgA levels and phytohaemagglutinin (PHA)-stimulated peripheral blood mononuclear cell (PBMC) proliferation.Conclusion A considerable subgroup of CVI patients appears to be characterized by low vitamin A levels. Our findings support a possible role for vitamin A supplementation in CVI, perhaps resulting in enhanced immunoglobulin synthesis and downregulated inflammatory responses.