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Special Issue "Vitamin A, Infectious Diseases and the Immune Function"

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (1 January 2019)

Special Issue Editors

Guest Editor
Dr. Frank Wieringa

UMR-204 Nutripass, Institut de Recherche pour le Développement, Montpellier, France
Website | E-Mail
Interests: micronutrient deficiency; infectious diseases; acute malnutrition; growth faltering; gut flora; cognitive development
Guest Editor
Prof. Christine Stabell Benn

Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut and OPEN, University of Southern Denmark/Odense University Hospital, Copenhagen, Denmark
Website | E-Mail
Interests: vitamin A; vaccines; immune function; child mortality

Special Issue Information

Dear Colleagues,

Vitamin A was known, almost 100 years ago, as the ‘anti-infection vitamin’. The important role of vitamin A in the immune system, and how vitamin A can contribute towards better health remained obscure for many decades. In the last decade of 20th century, high dose vitamin A supplementation for children living was introduced in many developing countries as a strategy to reduce child mortality, even though underlying mechanism were not completely understood. Recent research has revealed that the effect of vitamin A on the immune system is complex, and outcomes in terms of health benefits depend on many other factors.

To summarize recent developments in vitamin A, infectious diseases and the immune system, a Special Issue of the journal Nutrients is currently inviting papers covering these topics.

Dr. Frank Wieringa
Prof. Christine Stabell Benn
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vitamin A
  • Immune System
  • Infection
  • Mortality

Published Papers (8 papers)

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Research

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Open AccessArticle Assessment of Vitamin Status in Patients with Nontuberculous Mycobacterial Pulmonary Disease: Potential Role of Vitamin A as a Risk Factor
Nutrients 2019, 11(2), 343; https://doi.org/10.3390/nu11020343
Received: 12 December 2018 / Revised: 31 January 2019 / Accepted: 1 February 2019 / Published: 5 February 2019
Cited by 2 | PDF Full-text (820 KB) | HTML Full-text | XML Full-text
Abstract
As microbiological diagnostic techniques improve and the frequency of nontuberculous mycobacterial pulmonary disease (NTM-PD) infection increases worldwide, NTM-PD is becoming increasingly important to clinicians and researchers. Vitamin activity has been associated with the host immune response in tuberculosis; however, such information is very [...] Read more.
As microbiological diagnostic techniques improve and the frequency of nontuberculous mycobacterial pulmonary disease (NTM-PD) infection increases worldwide, NTM-PD is becoming increasingly important to clinicians and researchers. Vitamin activity has been associated with the host immune response in tuberculosis; however, such information is very limited in NTM-PD. We performed a case-control study in 150 patients with NTM-PD and 150 healthy controls to investigate serum vitamin status. We measured concentrations of vitamins A, D, and E along with homocysteine and methylmalonic acid (MMA) as indicators of vitamin B12 deficiency, using high-performance liquid chromatography (HPLC) or HPLC-tandem mass spectrometry. The serum concentrations of vitamins A and E were significantly lower in patients with NTM-PD than in healthy controls (1.5 vs. 2.1 µmol/L, p < 0.01 for vitamin A; and 27.3 vs. 33.1 µmol/L, p < 0.01 for vitamin E). In contrast, the serum concentrations of vitamin D and homocysteine were not significantly different between the two groups. Vitamin A deficiency (< 1.05 µmol/L) was significantly more prevalent in patients with NTM-PD than in healthy controls (p < 0.01) and was associated with an 11-fold increase in risk of NTM-PD. Multiple vitamin deficiencies were only observed in patients with NTM-PD (7.3% of all NTM-PD patients). Positive correlations were observed among vitamins (vitamins A and D; r = 0.200, p < 0.05; vitamins D and E, r = 0.238, p < 0.05; vitamins A and E, r = 0.352, p < 0.05). Serum vitamin status, demographic variables, and biochemical indicators were not associated with treatment outcomes. Vitamin A deficiency was strongly associated with patients with NTM-PD. Our study suggests that altered vitamin status is associated with mycobacterial disease. Future well-designed prospective studies with large patient cohorts addressing these issues are needed to clarify the significance of vitamins in NTM-PD. Full article
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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Open AccessArticle Effects of Inflammation on Biomarkers of Vitamin A Status among a Cohort of Bolivian Infants
Nutrients 2018, 10(9), 1240; https://doi.org/10.3390/nu10091240
Received: 2 August 2018 / Revised: 24 August 2018 / Accepted: 31 August 2018 / Published: 5 September 2018
Cited by 1 | PDF Full-text (1086 KB) | HTML Full-text | XML Full-text
Abstract
Globally, vitamin A deficiency (VAD) affects nearly 200 million children with negative health consequences. VAD can be measured by a retinol-binding protein (RBP) and serum retinol concentrations. Their concentrations are not always present in a 1:1 molar ratio and are affected by inflammation. [...] Read more.
Globally, vitamin A deficiency (VAD) affects nearly 200 million children with negative health consequences. VAD can be measured by a retinol-binding protein (RBP) and serum retinol concentrations. Their concentrations are not always present in a 1:1 molar ratio and are affected by inflammation. This study sought to quantify VAD and its impact on infant mortality and infectious morbidity during the first 18 months of life in a cohort of mother-infant dyads in El Alto, Bolivia, while accounting for the previously mentioned measurement issues. Healthy mother-infant dyads (n = 461) were enrolled from two hospitals and followed for 12 to 18 months. Three serum samples were collected (at one to two, six to eight, and 12 to 18 months of infant age) and analyzed for RBP, and a random 10% subsample was analyzed for retinol. Linear regression of RBP on retinol was used to generate RBP cut-offs equivalent to retinol <0.7 µmol/L. All measures of RBP and retinol were adjusted for inflammation, which was measured by a C-reactive protein and alpha (1)-acid glycoprotein serum concentrations using linear regression. Infant mortality and morbidity rates were calculated and compared by early VAD status at two months of age. Retinol and RBP were weakly affected by inflammation. This association varied with infant age. Estimated VAD (RBP < 0.7 µmol/L) decreased from 71.0% to 14.8% to 7.7% at two, six to eight, and 12 to 18 months of age. VAD was almost nonexistent in mothers. Early VAD was not significantly associated with infant mortality or morbidity rates. This study confirmed a relationship between inflammation and vitamin A biomarkers for some subsets of the population and suggested that the vitamin A status in early infancy improves with age and may not have significantly affected morbidity in this population of healthy infants. Full article
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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Open AccessArticle Approaches to Assess Vitamin A Status in Settings of Inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project
Nutrients 2018, 10(8), 1100; https://doi.org/10.3390/nu10081100
Received: 23 July 2018 / Revised: 8 August 2018 / Accepted: 13 August 2018 / Published: 16 August 2018
Cited by 2 | PDF Full-text (889 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The accurate estimation of vitamin A deficiency (VAD) is critical to informing programmatic and policy decisions that could have important public health implications. However, serum retinol and retinol binding protein (RBP) concentrations, two biomarkers often used to estimate VAD, are temporarily altered during [...] Read more.
The accurate estimation of vitamin A deficiency (VAD) is critical to informing programmatic and policy decisions that could have important public health implications. However, serum retinol and retinol binding protein (RBP) concentrations, two biomarkers often used to estimate VAD, are temporarily altered during the acute phase response, potentially overestimating the prevalence of VAD in populations with high levels of inflammation. In 22 nationally-representative surveys, we examined (1) the association between C-reactive protein (CRP) or α1-acid glycoprotein (AGP) and retinol or RBP, and (2) how different adjustment approaches for correcting for inflammation compare with one another. In preschool age children (PSC) and school age children (SAC), the association between inflammation and retinol and RBP was largely statistically significant; using the regression approach, adjustments for inflammation decreased the estimated prevalence of VAD compared to unadjusted VAD (range: −22.1 to −6.0 percentage points). In non-pregnant women of reproductive age (WRA), the association between inflammation and vitamin A biomarkers was inconsistent, precluding adjustments for inflammation. The burden of VAD can be overestimated if inflammation is not accounted for, and the regression approach provides a method for adjusting retinol and RBP for inflammation across the full range of concentrations in PSC and SAC. Full article
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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Review

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Open AccessReview Lessons Learned from the Testing of Neonatal Vitamin A Supplementation
Nutrients 2019, 11(2), 449; https://doi.org/10.3390/nu11020449
Received: 4 January 2019 / Revised: 18 February 2019 / Accepted: 18 February 2019 / Published: 21 February 2019
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Abstract
A total of 12 trials have tested the effect of neonatal vitamin A supplementation (NVAS) on mortality. Overall, NVAS had no effect on mortality, but results were heterogeneous. Two competing hypotheses have been put forward to explain the divergent effects: A) NVAS works [...] Read more.
A total of 12 trials have tested the effect of neonatal vitamin A supplementation (NVAS) on mortality. Overall, NVAS had no effect on mortality, but results were heterogeneous. Two competing hypotheses have been put forward to explain the divergent effects: A) NVAS works by preventing vitamin A deficiency (VAD) and not all countries have VAD; B) NVAS interacts negatively with subsequent diphtheria-tetanus-pertussis (DTP) vaccine, increasing mortality in females; in countries with low DTP coverage NVAS may have a beneficial effect. Only hypothesis A was tested in a recent meta-analysis; there is no strong empirical support for hypothesis A and it would not explain observed negative effects in some settings. Hypothesis B accounts for most observations. However, so far it has only been tested properly in a few trials. If hypothesis B is correct, it has major consequences for the understanding of the effects of vitamin A, and for the VAS policy in older children. As a WHO priority, the DTP coverage is bound to increase, and therefore hypothesis B urgently needs to be tested. Full article
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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Open AccessReview Modulation of Intestinal Immune and Barrier Functions by Vitamin A: Implications for Current Understanding of Malnutrition and Enteric Infections in Children
Nutrients 2018, 10(9), 1128; https://doi.org/10.3390/nu10091128
Received: 12 July 2018 / Revised: 11 August 2018 / Accepted: 17 August 2018 / Published: 21 August 2018
Cited by 1 | PDF Full-text (770 KB) | HTML Full-text | XML Full-text
Abstract
The micronutrient vitamin A refers to a group of compounds with pleiotropic effects on human health. These molecules can modulate biological functions, including development, vision, and regulation of the intestinal barrier. The consequences of vitamin A deficiency and supplementation in children from developing [...] Read more.
The micronutrient vitamin A refers to a group of compounds with pleiotropic effects on human health. These molecules can modulate biological functions, including development, vision, and regulation of the intestinal barrier. The consequences of vitamin A deficiency and supplementation in children from developing countries have been explored for several years. These children live in an environment that is highly contaminated by enteropathogens, which can, in turn, influence vitamin A status. Vitamin A has been described to modulate gene expression, differentiation and function of diverse immune cells; however, the underlying mechanisms are not fully elucidated. This review aims to summarize the most updated advances on elucidating the vitamin A effects targeting intestinal immune and barrier functions, which may help in further understanding the burdens of malnutrition and enteric infections in children. Specifically, by covering both clinical and in vivo/in vitro data, we describe the effects of vitamin A related to gut immune tolerance/homeostasis, intestinal barrier integrity, and responses to enteropathogens in the context of the environmental enteric dysfunction. Some of the gaps in the literature that require further research are also highlighted. Full article
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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Open AccessReview Retinoic Acid, Leaky Gut, and Autoimmune Diseases
Nutrients 2018, 10(8), 1016; https://doi.org/10.3390/nu10081016
Received: 12 June 2018 / Revised: 25 July 2018 / Accepted: 27 July 2018 / Published: 3 August 2018
Cited by 1 | PDF Full-text (1195 KB) | HTML Full-text | XML Full-text
Abstract
A leaky gut has been observed in a number of autoimmune diseases including type 1 diabetes, multiple sclerosis, inflammatory bowel disease, and systemic lupus erythematosus. Previous studies from our laboratory have shown that lupus mice also bear a leaky gut and that the [...] Read more.
A leaky gut has been observed in a number of autoimmune diseases including type 1 diabetes, multiple sclerosis, inflammatory bowel disease, and systemic lupus erythematosus. Previous studies from our laboratory have shown that lupus mice also bear a leaky gut and that the intestinal barrier function can be enhanced by gut colonization of probiotics such as Lactobacillus spp. Retinoic acid (RA) can increase the relative abundance of Lactobacillus spp. in the gut. Interestingly, RA has also been shown to strengthen the barrier function of epithelial cells in vitro and in the absence of probiotic bacteria. These reports bring up an interesting question of whether RA exerts protective effects on the intestinal barrier directly or through regulating the microbiota colonization. In this review, we will discuss the roles of RA in immunomodulation, recent literature on the involvement of a leaky gut in different autoimmune diseases, and how RA shapes the outcomes of these diseases. Full article
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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Other

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Open AccessReply Reply: “Letter to the Editor Re: Oh J., et al. Nutrients 2019, 11, 343”
Nutrients 2019, 11(3), 668; https://doi.org/10.3390/nu11030668
Received: 18 March 2019 / Accepted: 18 March 2019 / Published: 20 March 2019
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Abstract
We appreciate Hernández-Garduño’s interest in our recent research article [...] Full article
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
Open AccessLetter Letter to the Editor Re: Oh J., et al. Nutrients 2019, 11, 343
Nutrients 2019, 11(3), 667; https://doi.org/10.3390/nu11030667
Received: 25 February 2019 / Accepted: 18 March 2019 / Published: 20 March 2019
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Abstract
To the editor, [...] Full article
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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