title: Depressed immune response to tetanus in children with vitamin A deficiency.
abstract: A randomized, double-masked, placebo-controlled clinical trial was conducted with 236 preschool children, age 3-6 y, in Indonesia to assess immune status in mild vitamin A deficiency. The immune response to tetanus immunization was used as a measure of immune competence. Clinically normal children (n = 118) and children with mild xerophthalmia (n = 118) were randomly assigned to receive oral vitamin A (60,000 micrograms retinol equivalent) or placebo treatment for a total of four study groups. Two weeks after treatment, children were immunized with diphtheria-pertussis-tetanus vaccine. The immunoglobulin G (IgG) responses to tetanus at baseline and 3 wk following immunization were measured by ELISA. After adjusting for previous tetanus immunization, clinically normal and xerophthalmic children receiving vitamin A had a significantly greater IgG response to tetanus than clinically normal and xerophthalmic children receiving placebo (P less than 0.05). These results suggest that children with mild vitamin A deficiency have a relative immune depression compared with children who have been supplemented to normal vitamin A levels.
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Institute, Baltimore, MD 21205.
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.lastname: Muhilal
authors.forename: A L
authors.initials: AL
authors.lastname: Scott
authors.forename: G
authors.initials: G
authors.lastname: Natadisastra
authors.forename: S
authors.initials: S
authors.lastname: Wirasasmita
authors.forename: L
authors.initials: L
authors.lastname: Mele
authors.forename: E
authors.initials: E
authors.lastname: Ridwan
authors.forename: K P
authors.initials: KP
authors.lastname: West
authors.forename: A
authors.initials: A
authors.lastname: Sommer
mesh_terms: D000917:Antibody Formation; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D013745:Tetanus Toxoid / Q000276:immunology*; D014801:Vitamin A / Q000097:blood / Q000627:therapeutic use; D014802:Vitamin A Deficiency / Q000276:immunology*; D014985:Xerophthalmia / Q000178:diet therapy
chemical_list: D013745:Tetanus Toxoid; D014801:Vitamin A