The role of vitamin A and related retinoids in immune function
The role of vitamin A and related retinoids in immune function
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DOI：
10.1111/j.1753-4887.1998.tb01643.x
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发表时间：
1998-01-01
影响因子：
6.1
通讯作者：
Semba, RD
中科院分区：
文献类型：
--
作者：
Semba, RD
维生素A及其相关的类维生素A在调节免疫功能中起着重要作用。缺乏维生素A会损害免疫力，导致严重的发病率和死亡率。临床维生素A缺乏（夜盲症和干眼症）与传染病发病率和死亡率之间的联系已为人所知数百年。20世纪二三十年代的实验观察和临床试验使维生素A获得了“抗感染”维生素的声誉（Green and Mellanby 1928）。到20世纪60年代，人们注意到，在微量营养素中，“没有一种营养缺乏症比维生素A缺乏症更能始终如一地与传染病产生协同作用”（Scrimshaw等人，1968年）。最近以社区和医院为基础的临床试验表明，补充维生素A可使儿童死亡率降低20-30%（Beaton et al. 1993）。分发维生素A胶囊被认为是改善健康的最具成本效益的干预措施之一（世界银行，1993年），作为一项公共卫生措施，其重要性与疫苗接种和口服体液补充疗法并列。补充维生素A以降低传染病发病率和死亡率的根本依据是它在增强免疫力方面的作用。维生素A和相关的类维生素A具有作为免疫调节剂的治疗潜力，其中一些用途也开始在皮肤病学和肿瘤学领域得到实现。在过去的几十年里，在阐明维生素A和相关类维生素A在免疫功能中的作用方面取得了重大进展。维甲酸受体的发现极大地促进了我们对维生素A如何在遗传水平上影响免疫功能的理解。分析方法的改进导致了维生素A和维甲酸新的天然代谢物的发现，这表明在类维甲酸生物反应的调节中存在巨大的复杂性。本综述的目的是概述维生素A和相关类维生素A在免疫功能中的不同作用，重点介绍近十年来的进展（表1）。在以前的评论中可以找到对早期文献的全面覆盖（Nauss 1986, Ross 1992, Semba 1994a）。
Vitamin A and related retinoids play an important role in the regulation of immune function. Vitamin A deficiency compromises immunity, resulting in major morbidity and mortality. The link between clinical vitamin A deficiency (nightblindness and xerophthalmia) and infectious disease morbidity and mortality has been known for hundreds of years. Experimental observations and clinical trials in the 1920s and 30s led to the reputation of vitamin A as the “anti-infective’’vitamin (Green and Mellanby 1928). By the 196Os, it was noted that among the micronutrients,“no nutritional deficiency is more consistently synergistic with infectious disease than that of vitamin A”(Scrimshaw et al. 1968). More recent community-and hospital-based clinical trials show that vitamin A supplementation reduces child mortality by 20-30%(Beaton et al. 1993). Vitamin A capsule distribution is recognized as one of the most cost-effective interventions to improve health (World Bank 1993) and ranks among vaccination and oral rehydration therapy in importance as a public health measure.The underlying basis for the use of vitamin A supplementation to reduce infectious disease morbidity and mortality is its role in enhancing immunity. Vitamin A and related retinoids have therapeutic potential as immune modulators, and some of these uses are also beginning to be realized in the fields of dermatology and oncology. Over the last several decades, major progress has been made in elucidating the role of vitamin A and related retinoids in immune function. The discovery of retinoic acid receptors has greatly facilitated our understanding of how vitamin A may influence immune function at the genetic level. Improvements in analytical methods have led to the discovery of new natural metabolites of vitamin A and retinoic acid, which suggests immense complexity in the regulation of biologic responses by retinoids. The purpose of this review is to provide an overview of the different effects that vitamin A and related retinoids play in immune function, with an emphasis on developments in the last decade ITable 1). Comprehensive coverage of the earlier literature can be found in previous reviews (Nauss 1986, Ross 1992, Semba 1994a).