Smith F R, Goodman D S
N Engl J Med. 1976 Apr 8;294(15):805-8. doi: 10.1056/NEJM197604082941503.
The plasma retinol transport system was studied in three patients with chronic hypervitaminosis A. The toxic state in each was associated with increased plasma concentrations of total vitamin A, and particularly of retinyl esters. The concentrations of plasma retinol-binding protein and prealbumin were, in contrast, non to retinol-binding protein. These limited clinical data support conclusions from detailed studies with hypervitaminotic rats, which suggest that vitamin A toxicity occurs when excessive amounts of vitamin A are presented to cell membranes in association with plasma lipoproteins, rather than specifically bound to retinol-binding protein. Retinol-binding protein may not only regulate the supply of retinol to tissues but also protect tissues from the surface-active properties of the vitamin.
对三名患有慢性维生素A过多症的患者的血浆视黄醇转运系统进行了研究。每名患者的中毒状态都与血浆中总维生素A浓度升高有关,尤其是视黄酯浓度升高。相比之下,血浆视黄醇结合蛋白和前白蛋白的浓度与视黄醇结合蛋白无关。这些有限的临床数据支持了对维生素A过多症大鼠进行详细研究得出的结论,即当过量的维生素A与血浆脂蛋白结合而非特异性结合到视黄醇结合蛋白上呈现给细胞膜时,就会发生维生素A毒性。视黄醇结合蛋白不仅可能调节视黄醇向组织的供应,还可能保护组织免受维生素的表面活性特性的影响。