Rumore M M
Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, NY 11201.
Clin Pharm. 1993 Jul;12(7):506-14.
Findings on the benefits and mechanism of action of vitamin A in measles and other infectious diseases and immunocompromised states are discussed. Vitamin A deficiency is one of the world's major malnutrition problems and is most commonly found in children under the age of five years. An association between vitamin A status and immune function has been suggested by community studies and animal experiments. Mortality and susceptibility to infection and diarrhea are higher in children with vitamin A deficiency. The association between increased mortality and morbidity and vitamin A deficiency is strongest in children with measles. Vitamin A supplementation reduces mortality and complications resulting from measles. Measles may increase the body's utilization of vitamin A, possibly because of the rapid destruction of epithelial surfaces. Vitamin A may boost immune responses in the elderly, persons with high exposure to ultraviolet light, patients who have undergone surgery, and persons with parasitic infection, but more studies are needed. The immune defect caused by vitamin A deficiency may be due to alterations in the glycoproteins of the lymphocyte membrane, an adverse effect on helper T-cell function, the effect on epithelial tissue, or some other mechanism. Vitamin A therapy is relatively safe, and its effectiveness in children with measles and possibly other groups appears to justify public health campaigns to eliminate vitamin A deficiency. Vitamin A apparently has important immunomodulating properties, notably in patients with measles.
本文讨论了维生素A在麻疹及其他传染病和免疫功能低下状态中的益处及作用机制。维生素A缺乏是全球主要的营养不良问题之一，最常见于五岁以下儿童。社区研究和动物实验表明维生素A状态与免疫功能之间存在关联。维生素A缺乏的儿童死亡率更高，更容易感染和腹泻。维生素A缺乏与死亡率和发病率增加之间的关联在麻疹患儿中最为明显。补充维生素A可降低麻疹导致的死亡率和并发症。麻疹可能会增加人体对维生素A的利用，这可能是由于上皮表面的快速破坏。维生素A可能会增强老年人、高紫外线暴露人群、接受过手术的患者以及寄生虫感染患者的免疫反应，但还需要更多研究。维生素A缺乏引起的免疫缺陷可能是由于淋巴细胞膜糖蛋白的改变、对辅助性T细胞功能的不利影响、对上皮组织的影响或其他一些机制。维生素A疗法相对安全，其对麻疹患儿及可能的其他群体的有效性似乎证明了开展消除维生素A缺乏的公共卫生运动是合理的。维生素A显然具有重要的免疫调节特性，尤其是在麻疹患者中。
