Vitamin a deficiency in patients with common variable immunodeficiency.
Vitamin A, a naturally occuring antioxidant micronutrient, has immunomodulating effect in patients with immunodeficiency, including an influence on cytokine production and lymphocyte growth and functions. Vitamin A deficiency is associated with a shift from type 2 cytokines to predominantly type 1 cytokines. The aims of this study were to determine Vitamin A status in Common variable immunodeficiency (CVID) patients and the relationship between Vitamin A status and cytokines production. Serum Vitamin A, neopterin, TNF-alpha, IL-2, IL-4, and IL-10 levels were determined in 19 CVID patients and 15 healthy children. Effects of 9-cis retinal, Vitamin A derivative, on cytokines (TNF-alpha, IL-2, IL-4 and IL-10) production in lymphocytes were tested in vitro condition using lymphocyte cultures obtained from CVID patients and healthy children.Serum Vitamin A level in CVDI patients was, 21.1+/- 1.5 microg/dL, significantly (p < 0.001) lower than the value, 35.7+/- 1.8 microg/dL, observed in healthy children. Serum neopterin level in the patients was, 9.8+/- 2.9 nmol/L, higher (p < 0.05) than the value, 3.9+/- 0.7 nmol/L, observed in control group. Common variable immunodeficiency patients, serum IL-4 level was significantly (p < 0.05) lower than the value observed for healthy children. Serum TNF-alpha, IL-2 and IL-10 levels were similar in the patients and healthy children. Vitamin A derivative, 9-cis retinal, increased TNF-alpha and IL-4 production in cultured mononuclear cells obtained from control and CVID patients. Vitamin A derivative, also, increased IL-2 and Il-4 production in cultured mononuclear cells obtained from CVID patients. These results show that CVID patients have low serum Vitamin A levels and high serum neopterin levels. A supplementation with Vitamin A may have role in downregulation of inflammatory responses in CVID patients.
Department of Pediatric Immunology, Uludag University School of Medicine, Bursa, Turkey. sebnemkl@uludag.edu.tr
Sara Sebnem
SS
Kilic
Esra Yapici
EY
Kezer
Yesim Ozarda
YO
Ilcol
Tahsin
T
Yakut
Sami
S
Aydin
Ismail Hakki
IH
Ulus
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D017074:Common Variable Immunodeficiency / Q000150:complications*; D016207:Cytokines / Q000096:biosynthesis / Q000097:blood; D004224:Diterpenes; D015536:Down-Regulation / Q000187:drug effects; D005260:Female; D006801:Humans; D015847:Interleukin-4 / Q000032:analysis; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D008297:Male; D012172:Retinaldehyde / Q000494:pharmacology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014801:Vitamin A / Q000097:blood / Q000494:pharmacology; D014802:Vitamin A Deficiency / Q000209:etiology*
D016207:Cytokines; D004224:Diterpenes; D014409:Tumor Necrosis Factor-alpha; D014801:Vitamin A; D015847:Interleukin-4; C031390:9-cis-retinal; D012172:Retinaldehyde