retinol-palmitate and Pneumonia

To assess vitamin A status in children with pneumonia.. Thirty-four hospitalised patients with pneumonia were randomly allocated into two groups: the study group, besides the routine treatment, received a high dose of aqueous retinyl palmitate oral solution; the control group received only the routine treatment.. The concentrations of plasma vitamin A and carotenoids were determined by colorimetric method. Retinol binding protein (RBP) was determined by the radial immunodiffusion technique.. After 1 week of treatment there was a statistically significant (P < 0.05) increase in the levels (mean +/- s.e.) of vitamin A (study group: 14.1 +/- 1.6 to 26.5 +/- 5.8 micrograms/dl; control group: 16.1 +/- 3.3 to 24.1 +/- 2.3 micrograms/dl) and RBP (study group: 0.8 +/- 0.2 to 2.2 +/- 0.6 mg/dl; control group: 0.6 +/- 0.2 to 3.0 +/- 0.5 mg/dl) in both groups as compared to the baseline. On day 7 of treatment when the average levels of vitamin A (26.5 +/- 5.8 and 24.1 +/- 2.3 micrograms/dl) were compared, there was no statistically significant difference between the groups.. This study suggests that low levels of circulating plasma vitamin A in child with pneumonia may be a consequence of acute phase of infectious disease.

Topics: Acute-Phase Reaction; Administration, Oral; Carotenoids; Child; Child, Preschool; Diterpenes; Dose-Response Relationship, Drug; Female; Humans; Infant; Male; Nutritional Status; Pneumonia; Retinol-Binding Proteins; Retinol-Binding Proteins, Plasma; Retinyl Esters; Vitamin A; Vitamin A Deficiency

Measles kills about 2 million children annually, and there is no specific therapy for the disease. It has been suggested that vitamin A may be of benefit in the treatment of measles.. We conducted a randomized, double-blind trial involving 189 children who were hospitalized at a regional center in South Africa because of measles complicated by pneumonia, diarrhea, or croup. The children (median age, 10 months) were assigned to receive either vitamin A (total dose, 400,000 IU of retinyl palmitate, given orally; n = 92) or placebo (n = 97), beginning within five days of the onset of the rash. At base line, the characteristics of the two groups were similar.. Although clinically apparent vitamin A deficiency is rare in this population, the children's serum retinol levels were markedly depressed (mean [+/- SEM], 0.405 +/- 0.021 mumols per liter [11.6 +/- 0.6 micrograms per deciliter]), and 92 percent of them had hyporetinemia (serum retinol level less than 0.7 mumols per liter [20 micrograms per deciliter]). Serum concentrations of retinol-binding protein (mean, 30.1 +/- 2.0 mg per liter) and albumin (mean, 33.4 +/- 0.5 g per liter) were also low. As compared with the placebo group, the children who received vitamin A recovered more rapidly from pneumonia (mean, 6.3 vs. 12.4 days, respectively; P less than 0.001) and diarrhea (mean, 5.6 vs. 8.5 days; P less than 0.001), had less croup (13 vs. 27 cases; P = 0.03), and spent fewer days in the hospital (mean, 10.6 vs. 14.8 days; P = 0.01). Of the 12 children who died, 10 were among those given placebo (P = 0.05). For the group treated with vitamin A, the risk of death or a major complication during the hospital stay was half that of the control group (relative risk, 0.51; 95 percent confidence interval, 0.35 to 0.74).. Treatment with vitamin A reduces morbidity and mortality in measles, and all children with severe measles should be given vitamin A supplements, whether or not they are thought to have a nutritional deficiency.

Topics: Administration, Oral; Child, Preschool; Croup; Diarrhea; Diterpenes; Double-Blind Method; Female; Humans; Infant; Male; Measles; Pneumonia; Randomized Controlled Trials as Topic; Retinol-Binding Proteins; Retinyl Esters; Serum Albumin; Vitamin A

The present study was conducted to better understand the immure response to Toxocara canis pneumonia in mice with preweaning nutritional deprivation. Breast-fed Swiss mice, undernourished due to large litter size (up to 15 pups) and paired controls with only 5-8 pups were used. At 21 days old, both groups were infected with T. canis larvae. Liver retinol, retinyl palmitate, and inflammatory infiltrate in lungs were compared in both groups. Significantly lower levels of retinol and retinyl palmitate in liver tissue confirmed the hypovitaminosis A (P < 0.0001 for both comparisons) in the nutritionally deprived animals. Histological analysis showed similar eosinophilic infiltration in both groups at day 3 but was significantly more severe in undernourished mice at day 20 post-infection (P = 0.01). The present findings indicate that preweaning undernourishment is associated with a more severe inflammation in response to T. canis pneumonia. It suggests that vitamin A deficiency that persists after nutritional rehabilitation, may contribute to the severity of T. canis infection. The authors suggest that nutritional status should be carefully investigated in patients with more severe clinical findings.

Topics: Animals; Chromatography, High Pressure Liquid; Diterpenes; Liver; Lung; Lung Diseases, Parasitic; Malnutrition; Mice; Pneumonia; Retinyl Esters; Toxocara canis; Toxocariasis; Vitamin A