VITAMIN-A STATUS IN HIV-INFECTION

被引:26
作者
WARD, BJ
HUMPHREY, JH
CLEMENT, L
CHAISSON, RE
机构
[1] JOHNS HOPKINS UNIV, SCH MED, DEPT MED, BALTIMORE, MD 21205 USA
[2] JOHNS HOPKINS UNIV, SCH MED, DANA CTR PREVENT OPHTHALMOL, BALTIMORE, MD 21205 USA
关键词
VITAMIN-A; HIV; IL-2; INTERFERON-GAMMA;
D O I
10.1016/S0271-5317(05)80437-3
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
HIV+ individuals may be at particular risk for deficiency of vitamin A, a critical micronutrient in the maintenance of epithelial barriers and normal immune function. We studied 25 HIV+ outpatients with CD4+ T cell counts less than 800 : 5 had AIDS, 2 had diarrhea and weight loss and 18 were asymptomatic. Vitamin A status was assessed with a battery of tests; conjunctival impression cytology (CIC), relative dose responses (RDR) and serum retinol and retinol binding protein (RBP) levels. We also measured mitogen-induced lymphoproliferation and in vitro cytokine production (soluble IL-2 receptor (sIL-2R) and interferon-gamma (IFN-gamma)) with and without supplemental retinol. Eight subjects (32%) had one or more tests suggestive of vitamin A deficiency: serum retinol levels < 1.05 muM/L (4), abnormal CIC (6), abnormal RDR (1), RBP < 7 (1). Correspondence between the various measures of vitamin status was limited but subjects with abnormal CIC tended to have lower serum retinol levels than those with normal CIC (1.54 +/- 0.30 vs 2.20 +/- 0.21 muM/L; P=.15). 60% of subjects with AIDS had abnormal CIC (vs 17% in non-AIDS subjects; P<.04). Retinol levels in subjects with CD4+ counts less-than-or-equal-to 300 tended to be lower than in those with CD4+ counts > 300 (1.80 +/- 0.24 vs 2.20 +/- 0.24 muM/L; P=.15). Subjects taking a daily multivitamin containing modest amounts of vitamin A had higher serum retinol levels than those taking no supplements (2.50 +/- 0.24 vs 1.47 +/- 0.21 muM/L; P<.009), an association which remained after stratification by CD4+ cell counts. In vitro proliferation and cytokine production were not correlated with measures of vitamin A status. Retinol supplementation in cultures with the lowest baseline cytokine levels increased production of sIL-2R (>27-fold; P<.03) and IFN-gamma (>3.1-fold; P<.02) regardless of apparent vitamin A status. These preliminary observations suggest that vitamin A status may deteriorate with advancing HIV and that even modest doses of vitamin A can have significant impact on serum retinol levels. Increased cytokine production with supplemental retinol in vitro demonstrates that lymphocytes can be retinoid responsive despite apparently normal vitamin A status.
引用
收藏
页码:157 / 166
页数:10
相关论文
共 47 条
[1]  
ABB J, 1980, EXP CELL BIOL, V48, P169
[2]   BETA-CAROTENE STIMULATES HUMAN-LEUKOCYTES TO SECRETE A NOVEL CYTOKINE [J].
ABRIL, ER ;
RYBSKI, JA ;
SCUDERI, P ;
WATSON, RR .
JOURNAL OF LEUKOCYTE BIOLOGY, 1989, 45 (03) :255-261
[3]   IMPRESSION CYTOLOGY DETECTS SUBCLINICAL VITAMIN-A-DEFICIENCY [J].
AMEDEEMANESME, O ;
LUZEAU, R ;
WITTEPEN, JR ;
HANCK, A ;
SOMMER, A .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1988, 47 (05) :875-878
[4]   MORE EXACT QUANTIFICATION OF INTERLEUKIN-2 PRODUCTION BY ADDITION OF ANTI-TAC MONOCLONAL-ANTIBODY TO CULTURES OF STIMULATED LYMPHOCYTES [J].
BAROJA, ML ;
CEUPPENS, JL .
JOURNAL OF IMMUNOLOGICAL METHODS, 1987, 98 (02) :267-270
[5]  
BEACH RS, 1989, INT C AIDS, V5, P218
[6]   SIMULTANEOUS DETERMINATION OF ALPHA-TOCOPHEROL AND RETINOL IN PLASMA OR RED-CELLS BY HIGH-PRESSURE LIQUID-CHROMATOGRAPHY [J].
BIERI, JG ;
TOLLIVER, TJ ;
CATIGNANI, GL .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1979, 32 (10) :2143-2149
[7]   MICRONUTRIENT STATUS AND HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) INFECTION [J].
BOGDEN, JD ;
BAKER, H ;
FRANK, O ;
PEREZ, G ;
KEMP, F ;
BRUENING, K ;
LOURIA, D .
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1990, 587 :189-195
[8]  
CALLE PF, 1991, 7TH P INT C AIDS FLO
[9]  
CARMAN JA, 1991, J IMMUNOL, V147, P1247
[10]  
CHAISSON RE, 1990, PRINCIPLES PRACTICE, P1059