Vitamin A status, inflammation adjustment, and immunologic response in the context of acute febrile illness : A pilot cohort study among pediatric patients
Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved..
BACKGROUND: Vitamin A is necessary for an adequate immune response to infections. Infection also alters vitamin A biomarkers, which interferes with assessment of vitamin A deficiency and thus impairs clinical management. Here we apply multiple strategies to adjust vitamin A biomarkers for inflammation during acute infection and evaluate associations between adjusted vitamin A status and immunologic response markers.
METHODS: We measured biomarkers in pediatric patients presenting with acute febrile illness in Guayaquil, Ecuador at paired acute and convalescent visits. Four adjustment strategies were applied to retinol-binding protein (RBP) concentrations: Thurnham correction factor (TCF), BRINDA regression correction (BRC), CRP-only adjustment factor (CRP), and proof-of-concept for a proposed interleukin 6 regression model (IL-6 RM). Adjusted RBP concentrations were compared between visits using the paired Wilcoxon signed-rank test. Multivariate regression analysis was used to assess associations between adjusted vitamin A status and immunologic response markers.
RESULTS: A sample of 57 participants completed the acute visit 1, and 18 of these individuals completed the convalescent visit 2. The IL-6 RM was the only strategy resulting in adjusted RBP concentrations that were not significantly different between paired visits (p = 0.20). Following RBP adjustment, 0.0% of participants were classified as vitamin A deficient (RBP ≤ 0.70 μmol/L) and 14.0% were classified as vitamin A insufficient (RBP ≤ 1.05 μmol/L). Adjusted vitamin A insufficiency was associated with an increase in macrophage inflammatory protein 1-alpha (MIP-1α, p = 0.03) and a pro-inflammatory immune response profile (p = 0.03) during the acute visit.
CONCLUSIONS: We introduce a strategy for adjusting vitamin A in the context of clinical illness based on IL-6 concentrations that will need to be validated in larger studies. Assessment of vitamin A during infection allows for further understanding of how vitamin A status modulates immunopathology and enables targeted strategies for vitamin A supplementation in the context of infection among children in settings with high burdens of undernutrition and infectious diseases.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
|---|---|
| Enthalten in: |
Clinical nutrition (Edinburgh, Scotland) - 40(2021), 5 vom: 15. Mai, Seite 2837-2844 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Colt, Susannah [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
11103-57-4 |
|---|
| Anmerkungen: |
Date Completed 02.09.2021 Date Revised 03.05.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.clnu.2021.03.023 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM324868642 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM324868642 | ||
| 003 | DE-627 | ||
| 005 | 20231225191228.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.clnu.2021.03.023 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1082.xml |
| 035 | |a (DE-627)NLM324868642 | ||
| 035 | |a (NLM)33933750 | ||
| 035 | |a (PII)S0261-5614(21)00170-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Colt, Susannah |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Vitamin A status, inflammation adjustment, and immunologic response in the context of acute febrile illness |b A pilot cohort study among pediatric patients |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 02.09.2021 | ||
| 500 | |a Date Revised 03.05.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved. | ||
| 520 | |a BACKGROUND: Vitamin A is necessary for an adequate immune response to infections. Infection also alters vitamin A biomarkers, which interferes with assessment of vitamin A deficiency and thus impairs clinical management. Here we apply multiple strategies to adjust vitamin A biomarkers for inflammation during acute infection and evaluate associations between adjusted vitamin A status and immunologic response markers | ||
| 520 | |a METHODS: We measured biomarkers in pediatric patients presenting with acute febrile illness in Guayaquil, Ecuador at paired acute and convalescent visits. Four adjustment strategies were applied to retinol-binding protein (RBP) concentrations: Thurnham correction factor (TCF), BRINDA regression correction (BRC), CRP-only adjustment factor (CRP), and proof-of-concept for a proposed interleukin 6 regression model (IL-6 RM). Adjusted RBP concentrations were compared between visits using the paired Wilcoxon signed-rank test. Multivariate regression analysis was used to assess associations between adjusted vitamin A status and immunologic response markers | ||
| 520 | |a RESULTS: A sample of 57 participants completed the acute visit 1, and 18 of these individuals completed the convalescent visit 2. The IL-6 RM was the only strategy resulting in adjusted RBP concentrations that were not significantly different between paired visits (p = 0.20). Following RBP adjustment, 0.0% of participants were classified as vitamin A deficient (RBP ≤ 0.70 μmol/L) and 14.0% were classified as vitamin A insufficient (RBP ≤ 1.05 μmol/L). Adjusted vitamin A insufficiency was associated with an increase in macrophage inflammatory protein 1-alpha (MIP-1α, p = 0.03) and a pro-inflammatory immune response profile (p = 0.03) during the acute visit | ||
| 520 | |a CONCLUSIONS: We introduce a strategy for adjusting vitamin A in the context of clinical illness based on IL-6 concentrations that will need to be validated in larger studies. Assessment of vitamin A during infection allows for further understanding of how vitamin A status modulates immunopathology and enables targeted strategies for vitamin A supplementation in the context of infection among children in settings with high burdens of undernutrition and infectious diseases | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Acute febrile illness | |
| 650 | 4 | |a Children | |
| 650 | 4 | |a Cytokines | |
| 650 | 4 | |a Vitamin A | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a Cytokines |2 NLM | |
| 650 | 7 | |a Vitamin A |2 NLM | |
| 650 | 7 | |a 11103-57-4 |2 NLM | |
| 650 | 7 | |a C-Reactive Protein |2 NLM | |
| 650 | 7 | |a 9007-41-4 |2 NLM | |
| 700 | 1 | |a Gannon, Bryan M |e verfasserin |4 aut | |
| 700 | 1 | |a Finkelstein, Julia L |e verfasserin |4 aut | |
| 700 | 1 | |a Zambrano, Mildred P |e verfasserin |4 aut | |
| 700 | 1 | |a Andrade, Joyce K |e verfasserin |4 aut | |
| 700 | 1 | |a Centeno-Tablante, Elizabeth |e verfasserin |4 aut | |
| 700 | 1 | |a August, Avery |e verfasserin |4 aut | |
| 700 | 1 | |a Erickson, David |e verfasserin |4 aut | |
| 700 | 1 | |a Cárdenas, Washington B |e verfasserin |4 aut | |
| 700 | 1 | |a Mehta, Saurabh |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical nutrition (Edinburgh, Scotland) |d 1982 |g 40(2021), 5 vom: 15. Mai, Seite 2837-2844 |w (DE-627)NLM08284366X |x 1532-1983 |7 nnns |
| 773 | 1 | 8 | |g volume:40 |g year:2021 |g number:5 |g day:15 |g month:05 |g pages:2837-2844 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.clnu.2021.03.023 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 40 |j 2021 |e 5 |b 15 |c 05 |h 2837-2844 | ||