Enhancement of vitamin A combined vitamin D supplementation on immune response to Bacille Calmette-Guérin vaccine revaccinated in Chinese infants.
OBJECTIVE
To investigate whether there is an association between diameter of bacille Calmette-Guérin (BCG) scars and effect of purified protein derivative (PPD) reaction and to determine whether vitamin A (VA) combined vitamin D (VD) supplementation influences the immune response to BCG revaccinated in Chinese infants.


METHODS
A cross-section and 3-month community-randomised trial was conducted. A total of 5 629 infants at 3, 6 and 12 months of age in Junan County of China were examined for BCG scar formation. Then, 597 revaccinated infants were randomly assigned to supplementation (n=307) and control (n=290) groups. The supplementation group were daily assigned to 1 500 IU VA and 500 IU VD for 3 months. Then all infants were subjected to skin test with PPD.


RESULTS
The diameter of BCG scars was positively correlated with diameter of skin indurations of PPD (r=0.17, P<0.05) in the 5 629 infants. The rate of positive response to PPD was higher in the supplementation group than in the control group (96.1% versus 89.7%, P<0.05, prevalence ratio 1.07, 95% CI 1.02-1.12). The prevalence ratio of PPD response for the supplementation group compared with that for the control group was 1.07 (95% CI 1.01-1.13) for the males and 1.08 (95% CI 1.00-1.17) for the females. For the supplementation group, the males got larger tuberculin induration than the females [(0.73±0.21) cm versus (0.67±0.20) cm, P<0.05) after intervention.


CONCLUSIONS
The diameter of BCG scars was effectively correlated with PPD response, which indicates BCG scar formation may be an useful tool to evaluate the effect of tuberculosis prevention. VA combined VD supplementation may play an immuno-regulatory role in BCG revaccination. This may contribute to the prevention of childhood tuberculosis.
Institute of Human Nutrition, Medical College of Qingdao University, Qingdao 266021, PR China.
Ying
Y
Zheng
Institute of Human Nutrition, Medical College of Qingdao University, Qingdao 266021, PR China.
Xue-Gang
XG
Li
Institute of Human Nutrition, Medical College of Qingdao University, Qingdao 266021, PR China.
Qiu-Zhen
QZ
Wang
Institute of Human Nutrition, Medical College of Qingdao University, Qingdao 266021, PR China. Electronic address: jasminemaki@126.com.
Ai-Guo
AG
Ma
Department of International Health, University of Copenhagen, DK-1014 Copenhagen, Denmark.
Ib Christian
IC
Bygbjerg
Institute of Human Nutrition, Medical College of Qingdao University, Qingdao 266021, PR China.
Yong-Ye
YY
Sun
Institute of Human Nutrition, Medical College of Qingdao University, Qingdao 266021, PR China.
Yong
Y
Li
Department of Pediatrics, Guilin Medical College Affiliated Hospital, Guilin 541001, PR China.
Ming-Ci
MC
Zheng
Department of Orthopaedic Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, PR China.
Xi
X
Wang
D000367:Age Factors; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000276:immunology; D002681:China; D002921:Cicatrix / Q000473:pathology; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007117:Immunization, Secondary / Q000379:methods; D007223:Infant; D008297:Male; D015995:Prevalence; D014373:Tuberculin / Q000276:immunology; D014376:Tuberculosis / Q000276:immunology / Q000517:prevention & control; D014801:Vitamin A / Q000008:administration & dosage*; D014807:Vitamin D / Q000008:administration & dosage*
D001500:BCG Vaccine; D014373:Tuberculin; D014801:Vitamin A; D014807:Vitamin D
Bacille Calmette-Guérin; Purified protein derivative; Revaccination; Tuberculosis; Vitamin A; Vitamin D