Newton Sam, Cousens Simon, Owusu-Agyei Seth, Filteau Suzanne, Stanley Carolynne, Linsell Louise, Kirkwood Betty
Kintampo Health Research Centre, Ghana.
J Nutr. 2005 Nov;135(11):2669-73. doi: 10.1093/jn/135.11.2669.
It has been suggested that administering vitamin A with the measles vaccine may reduce the vaccine's immunogenicity. This trial examined the effect of supplementing vitamin A during the early months of life on infants' immune responses to tetanus and polio vaccines. Young infants (n = 1085) were enrolled and individually randomized into 1 of 4 groups in a factorial, double-blind, placebo-controlled trial. Three vitamin A supplementation strategies were investigated: 1) supplementation of breast-feeding mothers with 60 mg retinol equivalent (RE) vitamin A within 4 wk of delivery; 2) Expanded Program on Immunization (EPI)-linked supplementation of infants with 7.5 mg RE vitamin A at 6, 10, and 14 wk; and 3) combined mother and child supplementations. A 4th group in which mother and child were given placebos served as controls. Blood samples were collected from each child at 6 wk and 6 mo of age to measure antipolio antibody titer, antitetanus toxoid antibodies, and avidity of antibodies to tetanus. Of the infants randomized into the 4 arms of the study, 767 (71%) completed follow-up at 6 mo of age. Follow-up rates were similar in all 4 arms (69-72%, P = 0.8). Antibody titers were relatively high in all 4 groups at both 6 wk and 6 mo of age, with no differences among the groups. We found no evidence that vitamin A supplementation affects infants' antibody responses to tetanus toxoid or oral polio vaccine delivered at EPI contacts.
有人提出,在接种麻疹疫苗时同时给予维生素A可能会降低疫苗的免疫原性。本试验研究了在婴儿生命早期补充维生素A对其针对破伤风和脊髓灰质炎疫苗的免疫反应的影响。在一项析因、双盲、安慰剂对照试验中,招募了年幼婴儿(n = 1085),并将其个体随机分为4组中的1组。研究了三种维生素A补充策略:1)在分娩后4周内给母乳喂养的母亲补充60毫克视黄醇当量(RE)的维生素A;2)在6周、10周和14周时,与扩大免疫规划(EPI)相关,给婴儿补充7.5毫克RE的维生素A;3)母亲和儿童联合补充。第4组中母亲和儿童均给予安慰剂作为对照。在每个儿童6周和6月龄时采集血样,以测量抗脊髓灰质炎抗体滴度、抗破伤风类毒素抗体以及破伤风抗体的亲和力。在随机分组进入研究4个组的婴儿中,767名(71%)在6月龄时完成了随访。所有4组的随访率相似(69 - 72%,P = 0.8)。在6周和6月龄时,所有4组的抗体滴度都相对较高,组间无差异。我们没有发现证据表明补充维生素A会影响婴儿对EPI接种时给予的破伤风类毒素或口服脊髓灰质炎疫苗的抗体反应。